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1. Brucellosis in pregnancy: results of multicenter ID-IRI study

Author

Seval Bilgic-Atli, Hakan Erdem, Ayşe Erbay, Nicholas J. Beeching, Ergin Ayaslioglu, Recep Tekin, Mile Bosilkovski, S. Sahin, Mehmet Ulug, Tuna Demirdal, Serap Ural, Alper Şener, Tansu Yamazhan, Asuman Inan, Emsal Aydin, Selma Tosun, Asli Haykir-Solay, Serda Gulsun, Selçuk Kaya, Nazif Elaldi, Pınar Ergen, Abdullah Umut Pekok, Elif Sahin-Horasan, Murat Muhcu, Mustafa Kasim Karahocagil, Mahmut Sunnetcioglu, Ayten Kadanali, Yakup Cag, Ali Avci, Şafak Kaya, Kırıkkale Üniversitesi, and [Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Erdem, Hakan] Gulhane Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Gulsun, Serda -- Kaya, Safak -- Bilgic-Atli, Seval] Diyarbakir Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Karahocagil, Mustafa K.] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Pekok, Abdullah U.] Pendik Med Pk Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Ulug, Mehmet] Private Umut Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Tekin, Recep] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey -- [Bosilkovski, Mile] Skopje Med Fac, Dept Infect Dis & Febrile Condit, Skopje, Macedonia -- [Haykir-Solay, Asli] Diskapi Yildirim Beyazit Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Demirdal, Tuna -- Ural, Serap] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Kaya, Selcuk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Sener, Alper] Onsekiz Mart Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Canakkale, Turkey -- [Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Aydin, Emsal] Kafkas Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kars, Turkey -- [Yamazhan, Tansu] Ege Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Muhcu, Murat] GATA Haydarpasa Training Hosp, Dept Obstet & Gynecol, Istanbul, Turkey -- [Ayaslioglu, Ergin] Kirikkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kirikkale, Turkey -- [Erbay, Ayse] Bozok Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Yozgat, Turkey -- [Ergen, Pinar] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kadanali, Ayten] Umraniye Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Sahin, Suzan] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Avci, Ali] Katip Celebi Univ, Ataturk Training & Res Hosp, Dept Urol, Izmir, Turkey -- [Cag, Yakup] Turkish Hlth Sci Univ, Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Beeching, Nicholas J.] Univ Liverpool Liverpool Sch Trop Med, Clin Sci, Liverpool, Merseyside, England

Subjects
Adult, 0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Adolescent, Fever, Turkey, 030106 microbiology, Bacteremia, Oligohydramnios, Abortion, Brucellosis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Abortus, Epidemiology, medicine, Humans, 030212 general & internal medicine, Pregnancy Complications, Infectious, Retrospective Studies, Intrauterine fetal demise, Obstetrics, business.industry, Infant, Newborn, General Medicine, Middle Aged, medicine.disease, Brucella, Abortion, Spontaneous, Low birth weight, Cross-Sectional Studies, Infectious Diseases, Risk factors, Splenomegaly, Cohort, Vomiting, Female, medicine.symptom, business
Abstract

WOS: 000471726700008, PubMed ID: 30989418, Brucellosis in pregnant women is reported to be associated with obstetric complications (OCs), and adequate data for human brucellosis during pregnancy are largely lacking. We performed this multicenter retrospective cross-sectional study to evaluate the epidemiology, clinical course, treatment responses, and outcomes of brucellosis among pregnant women. The study period comprised a 14-year period from January 2002 to December 2015. All consecutive pregnant women diagnosed with brucellosis in 23 participating hospitals were included. Epidemiological, clinical, laboratory, therapeutic, and outcome data along with the assessment data of the neonate were collected using a standardized questionnaire. Data of 242 patients were analyzed. The OC rate was 14.0% (34/242) in the cohort. Of the 242 women, 219 (90.5%) delivered at term, 3 (1.2%) had preterm delivery, 15 (6.2%) aborted, and 5 (2.1%) had intrauterine fetal demise. Seventeen (7.0%) of the newborns were considered as low birth weight. Spontaneous abortion (6.1%) was the commonest complication. There were no maternal or neonatal deaths and pertinent sequelae or complications were not detected in the newborns. Splenomegaly (p=0.019), nausea and/or vomiting (p41IU/L; p=0.025), oligohydramnios on ultrasonography (p=0.0002), history of taking medication other than Brucella treatment during pregnancy (p=0.027), and Brucella bacteremia (p=0.029) were the significant factors associated with OCs. We recommend that pregnant women with OC or with fever should be investigated for brucellosis if they live in or have traveled to an endemic area.

Published
2019

2. Cranial imaging findings in neurobrucellosis: results of Istanbul-3 study

Author

Ayşe Seza Inal, Kaan Meric, Filiz Pehlivanoglu, Meltem Avci, Oğuz Reşat Sipahi, Asuman Inan, Derya Ozturk-Engin, Hanefi Cem Gul, Selçuk Kaya, Esmeray Mutlu-Yilmaz, Selma Tosun, Ayten Kadanali, Sibel Bolukcu, Tumer Guven, Elif Sahin-Horasan, Emel Yilmaz, Abdullah Umut Pekok, Fatma Sirmatel, Canan Agalar, Celal Ayaz, Mustafa Kasim Karahocagil, Ayse Batirel, Hasan Karsen, Secil Deniz, Hakan Erdem, Asli Haykir-Solay, Nefise Oztoprak, Asim Ulcay, Gonul Sengoz, Mahmut Sunnetcioglu, Ayhan Akbulut, Nazif Elaldi, Selma Ates-Guler, Mehmet Ulug, Recep Tekin, Affan Denk, Yasemin Cag, Mustafa Namiduru, Emine Parlak, Sukran Kose, Rodrigo Hasbun, Mustafa Kemal Çelen, Tuna Demirdal, Seniha Senbayrak, Huseyin Turgut, Kadriye Kart Yaşar, Ali İrfan Baran, Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı., Yılmaz, Emel, Çukurova Üniversitesi, [Erdem, Hakan] Gulhane Mil Med Acad, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Senbayrak, Seniha -- Deniz, Secil -- Ozturk-Engin, Derya -- Inan, Asuman] Haydarpasa Numune Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Meric, Kaan] Haydarpasa Numune Training & Res Hosp, Dept Radiol, Istanbul, Turkey -- [Batirel, Ayse] Dr Lutfi Kirdar Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Karahocagil, Mustafa Kasim -- Baran, Ali Irfan -- Sunnetcioglu, Mahmut] Yuzuncu Yil Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Van, Turkey -- [Hasbun, Rodrigo] Univ Texas Hlth Sci Ctr Houston, Sch Med, Dept Infect Dis, Houston, TX 77030 USA -- [Sengoz, Gonul -- Pehlivanoglu, Filiz] Haseki Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Karsen, Hasan] Harran Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sanliurfa, Turkey -- [Kaya, Seluk] Karadeniz Tech Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Trabzon, Turkey -- [Inal, Ayse Seza] Cukurova Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Adana, Turkey -- [Pekok, Abdullah Umut] Private Erzurum Sifa Hosp, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Celen, Mustafa Kemal -- Tekin, Recep -- Ayaz, Celal] Dicle Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Diyarbakir, Turkey -- [Ulug, Mehmet] Private Umit Hosp, Dept Infect Dis & Clin Microbiol, Eskisehir, Turkey -- [Demirdal, Tuna] Katip Celebi Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Namiduru, Mustafa] Gaziantep Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Gaziantep, Turkey -- [Guven, Tumer] Ankara Atatrk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Ankara, Turkey -- [Parlak, Emine] Ataturk Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Erzurum, Turkey -- [Bolukcu, Sibel -- Sipahi, Oguz Resat] Bezmi Alem Vakif Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Avci, Meltem -- Tosun, Selma] Izmir Bozyaka Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Yasar, Kadriye] Bakirkoy Dr Sadi Konuk Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Yilmaz, Emel] Uludag Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bursa, Turkey -- [Ates-Guler, Selma] Sutcu Imam Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Kahramanmaras, Turkey -- [Mutlu-Yilmaz, Esmeray] Samsun Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Samsun, Turkey -- [Sirmatel, Fatma] Abant Izzet Baysal Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Bolu, Turkey -- [Sahin-Horasan, Elif] Mersin Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Mersin, Turkey -- [Akbulut, Ayhan -- Denk, Affan] Firat Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Elazig, Turkey -- [Oztoprak, Nefise] Antalya Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Antalya, Turkey -- [Cag, Yasemin] Medeniyet Univ, Goztepe Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Kadanali, Ayten] Umraniye Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Turgut, Huseyin] Pamukkale Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Denizli, Turkey -- [Gul, Hanefi Cem -- Ulcay, Asim] GATA Haydarpasa Training Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Haykir-Solay, Asli] Igdir State Hosp, Dept Infect Dis & Clin Microbiol, Igdir, Turkey -- [Kose, Sukran] Tepecik Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Izmir, Turkey -- [Agalar, Canan] Fatih Sultan Mehmet Training & Res Hosp, Dept Infect Dis & Clin Microbiol, Istanbul, Turkey -- [Elaldi, Nazif] Cumhuriyet Univ, Sch Med, Dept Infect Dis & Clin Microbiol, Sivas, Turkey, Inal, Ayse Seza -- 0000-0002-1182-7164, ayaz, celal -- 0000-0002-9060-1090, and Kart Yasar, Kadriye -- 0000-0003-2963-4894

Subjects
Nervous-system brucellosis, Male, Pathology, Turkey, Glucose blood level, 0302 clinical medicine, middle aged, nuclear magnetic resonance imaging, granuloma, brain edema, protein cerebrospinal fluid level, neuroimaging, adult, General Medicine, Case Report, Agglutination Tests, Zoonosis, Nuclear magnetic resonance imaging, aged, Protein cerebrospinal fluid level, Diagnostic imaging, brain infection, Human, Microbiology (medical), medicine.medical_specialty, diagnostic imaging, 030106 microbiology, Major clinical study, Microbiology, Article, 03 medical and health sciences, x-ray computed tomography, Humans, human, lymphocyte count, Polyradiculopathy, radiculopathy, Aged, X-ray computed tomography, microbiology, medicine.disease, major clinical study, Brucella, glucose blood level, Glucose, Arachnoiditis, cerebrospinal fluid level, Brain edema, Lymphocyte count, polyneuropathy, 030217 neurology & neurosurgery, 0301 basic medicine, Physiology, Turkey (republic), computer assisted tomography, Cerebrospinal fluid, Diagnosis, Prevalence, glucose, Radiculopathy, brain disease, CSF albumin, cranial nerve, Cranial nerve, Brain Diseases, Granuloma, Cerebrospinal fluid level, medicine.diagnostic_test, White matter, spinal root, Brain infection, Middle Aged, Magnetic Resonance Imaging, brain abscess, Brain abscess, female, Infectious Diseases, brucellosis, young adult, Female, Neurobrucellosis, hydrocephalus, white matter, Polyneuropathy, Hydrocephalus, Adult, Adolescent, Brain Diseases/diagnostic imaging/*pathology, Brucella/physiology, Brucellosis/diagnostic imaging/*epidemiology/microbiology/pathology, Neuroimaging, Tomography, X-Ray Computed, Turkey/epidemiology, Young Adult, Brucellosis, Cerebral edema, Computer assisted tomography, medicine, controlled study, Meningitis, Brain disease, Inflammation, business.industry, Protein, Magnetic resonance imaging, Computerized tomography, arachnoiditis, physiology, DiagnosisInflammation, pathology, Involvement, protein, Spinal root, business, Controlled study
Abstract

WOS: 000388827200008, PubMed ID: 27138335, Objective Neuroimaging abnormalities in central nervous system (CNS) brucellosis are not well documented. The purpose of this study was to evaluate the prevalence of imaging abnormalities in neurobrucellosis and to identify factors associated with leptomeningeal and basal enhancement, which frequently results in unfavorable outcomes. Methods Istanbul-3 study evaluated 263 adult patients with CNS brucellosis from 26 referral centers and reviewed their 242 magnetic resonance imaging (MRI) and 226 computerized tomography (CT) scans of the brain. Results A normal CT or MRI scan was seen in 143 of 263 patients (54.3 %). Abnormal imaging findings were grouped into the following four categories: (a) inflammatory findings: leptomeningeal involvements (44), basal meningeal enhancements (30), cranial nerve involvements (14), spinal nerve roots enhancement (8), brain abscesses (7), granulomas (6), and arachnoiditis (4). (b) White-matter involvement: white-matter involvement (32) with or without demyelinating lesions (7). (c) Vascular involvement: vascular involvement (42) mostly with chronic cerebral ischemic changes (37). (d) Hydrocephalus/cerebral edema: hydrocephalus (20) and brain edema (40). On multivariate logistic regression analysis duration of symptoms since the onset (OR 1.007; 95 % CI 1-28, p = 0.01), polyneuropathy and radiculopathy (OR 5.4; 95 % CI 1.002-1.013, p = 0.044), cerebrospinal fluid (CSF)/serum glucose rate (OR 0.001; 95 % CI 000-0.067, p = 0.001), and CSF protein (OR 2.5; 95 % CI 2.32.7, p = 0.0001) were associated with diffuse inflammation. Conclusions In this study, 45 % of neurobrucellosis patients had abnormal neuroimaging findings. The duration of symptoms, polyneuropathy and radiculopathy, high CSF protein level, and low CSF/serum glucose rate were associated with inflammatory findings on imaging analyses.

Published
2016

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