Infectious diseases & clinical microbiology · 2026
Analysis of Bacteremic Brucellosis Caused by Brucella melitensis Biovar 3 vs. Non-Bacteremic Cases in an Endemic Region of Türkiye.
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Kapmaz Mahir, Şahin İbrahim Halil, Dede-Yılmaz Gülay, Dumlu Rıdvan, Şahin Meyha
Аннотация
OBJECTIVE: This study aimed to compare bacteremic brucellosis caused by Brucella melitensis biovar 3 with non-bacteremic cases in Bitlis, Türkiye, an endemic region, and to emphasize the importance of bacteremia in patients with suspected brucellosis.
MATERIALS AND METHODS: Patients aged ≥18 years who were diagnosed with brucellosis at a hospital in Bitlis between February 24, 2012, and August 12, 2013, were retrospectively included. Clinical, laboratory, and epidemiological data were analyzed. Only patients who had blood cultures obtained at their initial outpatient visit were included. Brucella species identification and biotyping were performed using conventional and molecular microbiological methods.
RESULTS: A total of 110 patients with brucellosis who had blood cultures obtained at initial presentation were included. Of these, 69% 76/110 were culture-positive, and all isolates were identified as B. melitensis biovar 3. In univariate analysis, culture-positive patients were younger (p=0.012) and were more likely to present with fever (odds ratio [OR] 2.75; 95% confidence interval [CI] 1.01-7.48), hepatomegaly (OR 4.29; 95% CI 1.05-17.55), splenomegaly (OR 4.12; 95% CI 1.20-14.09), chills (OR 2.89; 95% CI 1.10-7.55), dry cough (OR 15.0; 95% CI 1.82-123.44), and a lymphocyte ratio >40% within 10 days (OR 8.54; 95% CI 2.33-31.36). Notably, 53.3% (24/45) of afebrile patients at presentation were culture-positive, underscoring the diagnostic value of blood cultures regardless of fever status. Multivariate analysis identified fever (OR 2.75; 95% CI 1.00-7.50), hepatomegaly (OR 4.29; 95% CI 1.00-17.51), and a lymphocyte ratio >40% (OR 8.54; 95% CI 2.23-32.80) as independent predictors of bacteremia. Environmental disposal of animal miscarriages by patients or their neighbors was reported in 67 cases (61%).
CONCLUSION: Brucella melitensis biovar 3 was the only strain identified, with a high rate of blood culture positivity even among afebrile patients at the initial presentation in Bitlis, Türkiye. Fever, hepatomegaly, and a lymphocyte percentage >40% were key predictors of B. melitensis biovar 3 bacteremia. The frequent environmental disposal of animal miscarriage materials highlights the need for sustained public education and strengthened zoonotic disease control efforts to interrupt transmission.
MATERIALS AND METHODS: Patients aged ≥18 years who were diagnosed with brucellosis at a hospital in Bitlis between February 24, 2012, and August 12, 2013, were retrospectively included. Clinical, laboratory, and epidemiological data were analyzed. Only patients who had blood cultures obtained at their initial outpatient visit were included. Brucella species identification and biotyping were performed using conventional and molecular microbiological methods.
RESULTS: A total of 110 patients with brucellosis who had blood cultures obtained at initial presentation were included. Of these, 69% 76/110 were culture-positive, and all isolates were identified as B. melitensis biovar 3. In univariate analysis, culture-positive patients were younger (p=0.012) and were more likely to present with fever (odds ratio [OR] 2.75; 95% confidence interval [CI] 1.01-7.48), hepatomegaly (OR 4.29; 95% CI 1.05-17.55), splenomegaly (OR 4.12; 95% CI 1.20-14.09), chills (OR 2.89; 95% CI 1.10-7.55), dry cough (OR 15.0; 95% CI 1.82-123.44), and a lymphocyte ratio >40% within 10 days (OR 8.54; 95% CI 2.33-31.36). Notably, 53.3% (24/45) of afebrile patients at presentation were culture-positive, underscoring the diagnostic value of blood cultures regardless of fever status. Multivariate analysis identified fever (OR 2.75; 95% CI 1.00-7.50), hepatomegaly (OR 4.29; 95% CI 1.00-17.51), and a lymphocyte ratio >40% (OR 8.54; 95% CI 2.23-32.80) as independent predictors of bacteremia. Environmental disposal of animal miscarriages by patients or their neighbors was reported in 67 cases (61%).
CONCLUSION: Brucella melitensis biovar 3 was the only strain identified, with a high rate of blood culture positivity even among afebrile patients at the initial presentation in Bitlis, Türkiye. Fever, hepatomegaly, and a lymphocyte percentage >40% were key predictors of B. melitensis biovar 3 bacteremia. The frequent environmental disposal of animal miscarriage materials highlights the need for sustained public education and strengthened zoonotic disease control efforts to interrupt transmission.