Detection and differentiation of Brucella abortus and Brucella melitensis by multiplex real-time polymerase chain reaction in patients with pyrexia of unknown origin at a tertiary care centre in Northern India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20253959Keywords:
Brucellosis, Multiplex real-time PCR, Brucella abortus, Brucella melitensis, Pyrexia of unknown originAbstract
Background: Brucellosis is a neglected zoonotic disease caused by Brucella spp., posing serious public health and economic challenges, especially in low- and middle-income countries. The disease presents with nonspecific symptoms, and conventional diagnostic methods are often time-consuming and less accurate. Multiplex real-time polymerase chain reaction (m-RT PCR) has emerged as a rapid and reliable diagnostic tool for detecting and differentiating Brucella species. The prevalence, clinical characteristics, and risk factors of human brucellosis among patients with pyrexia of unknown origin (PUO) and to perform molecular characterization of Brucella species using m-RT PCR at King George’s Medical University, Lucknow.
Methods: A total of 315 PUO patients were enrolled between January 2023 and March 2025. Blood samples were collected, sera separated, and DNA extracted using the QIAamp DNA Mini Kit. Multiplex RT-PCR assays targeting the bcsp31 and IS711 genes were performed with species-specific probes to detect Brucella spp., B. abortus, and B. melitensis. Clinical, demographic, and laboratory data were analyzed.
Results: Out of 315 samples, 30 (9.5%) were positive by m-RT PCR-24 (80%) for B. abortus and 6 (20%) for B. melitensis. Most positive cases were adults (70%) and rural residents (73.3%), with housewives (33.3%) and students (26.7%) being the most affected.
Conclusions: Human brucellosis is endemic in Uttar Pradesh, with B. abortus as the predominant species. M-RT-PCR offers a rapid, sensitive, and specific diagnostic method, emphasizing the need for public awareness and a One Health approach for effective control.
Metrics
References
Njeru J, Wareth G, Melzer F, Henning K, Pletz MW, Heller R, et al. Systematic review of brucellosis in Kenya: disease frequency in humans and animals and risk factors for human infection. BMC Public Health. 2016;16(1):853.
Hull NC, Schumaker BA. Comparisons of brucellosis between human and veterinary medicine.
Infect Ecol Epidemiol. 2018;8(1):1500846.
Bosilkovski M, Jurica A, Fariba K. Human brucellosis in pregnancy-an overview. Bosn J Basic Med Sci. 2020;20(4):415-22.
Zhang N, Desheng H, Wei W, Jing L, Feng L, Baosen Z, et al. Animal brucellosis control or eradication programs worldwide: A systematic review of experiences and lessons learned. Prev Vet Med. 2018;160:105-15.
El-Sayed A, Awad W. Brucellosis: Evolution and expected comeback. Int J Vet Sci Med. 2018;6:S31-5.
Koirala KD, François C, Kristien V, Suman R, Marleen B. Persistent febrile illnesses in Nepal: A systematic review. Indian J Med Res. 2018;148(4):385-95.
Yagupsky P, Pilar M, Juan DC. Laboratory diagnosis of human brucellosis. Clin Microbiol Rev. 2019;33(1):e00073-19.
Moosazadeh M, Roja N, Ghasem A, Motahareh K, Saeid S. Epidemiological and Clinical Features of People with Malta Fever in Iran. Osong Public Health Res Perspect. 2016;7(3):157-67.
Dal T, Kara SS, Cikman Al. Comparison of multiplex real-time polymerase chain reaction with serological tests and culture for diagnosing human brucellosis. J Infect Public Health. 2019;12(3):337-42.
Probert WS, Schrader KN, Khuong NY, Bystrom SL, Graves MH. Real-Time Multiplex PCR Assay for Detection of Brucella spp., B. abortus, and B. melitensis. J Clin Microbiol. 2004;42(3):1290-3.
Sanjuan-Jimenez R, Morata P, Bermúdez P, Bravo MJ, Colmenero JD. Comparative Clinical Study of Different Multiplex Real Time PCR Strategies for the Simultaneous Differential Diagnosis between Extrapulmonary Tuberculosis and Focal Complications of Brucellosis. PLoS Negl Trop Dis. 2013;7(12):e2593.
Kumar S, Urmil T, Kumari S, Dhirendra S, Ashok K, Om K. Rapid multiplex PCR assay for simultaneous detection of Brucella genus and species. J Microbiol Biotechnol. 2011;21(1):89-92.
Piran V, Malike S, Mojtaba H, Ali RV, Reza M. Detection and discrimination of Brucella species by multiplex real-time PCR and HRM analysis. Iran J Basic Med Sci. 2015;18(9):909-14.
Sidor IF, Dunn JL, Tsongalis GJ, Carlson J, Frasca Jr S. Multiplex real-time PCR with internal controls for Brucella detection. J Vet Diagn Invest. 2013;25(1):72-81.
Mirzanejad, Reza HD, Reza K, Seied MM, Mehdi K, Ahamadi A. Simultaneous detection and differentiates of Brucella abortus and Brucella melitensis by combinatorial PCR. Asian Pac J Trop Med. 2012;5(1):24-8.
Tutar E, Kübra SA, İsmaİl A. Development and application of a new multiplex real-time PCR assay for simultaneous identification of Brucella melitensis, Cronobacter sakazakii and Listeria monocytogenes in raw milk and cheese. Int J Dairy Tech. 2018;71(3):629-36.
Zamanian M, Jahani E, Mahmoudi H. Multiplex PCR for Brucella detection in blood and serum samples. Open Microbiol J. 2020;14:242.
Batra SA, Krupanidhi S, Tuteja U. A sensitive & specific multiplex PCR assay for simultaneous detection of Bacillus anthracis, Yersinia pestis, Burkholderia pseudomallei & Brucella species. Indian J Med Res. 2013;138(1):111-6.
Piranfar V, Sharif M, Hashemi M, Vahdati AR, Mirnejad R. Detection and discrimination of two Brucella species by multiplex real-time PCR and high-resolution melt analysis curve from human blood and comparison of results using RFLP. Iranian J Basic Med Sci. 2015;18(9):909.
El-Sayed O, Hussein A. Multiplex SYBR green real time PCR for the simultaneous detection and differentiation of four important reproductive infectious pathogens. J Current Veterinary Res. 2019;1(2):69-77.
Thakur S, Bedi JS, Singh R, Gill JP, Arora AK, Kashyap N. Quantitative polymerase chain reaction based quantification of Brucella DNA in serum of pre-and post-therapeutic occupationally exposed infected human population. J Infect Publ Health. 2018;11(4):514-20.
Kuila PR, Dutta DE, Chakrabarty UR, Chatterjee DE, Das SA. Comparison of serological tests and PCR for diagnosis of human brucellosis suffering from fever. Asian J Pharm Clin Res. 2017;10(5):109-1.
Rasheduzzaman M, Hossain MA, Paul SK, Nasreen SA, Haque N, Akter A, et al. Serological and molecular epidemiology of human brucellosis in Mymensingh region Bangladesh. Bang J Med Microbiol. 2020;14(2):19-24.
Sanjuan-Jimenez R, Colmenero JD, Bermúdez P, Alonso A, Morata P. Amplicon DNA melting analysis for the simultaneous detection of Brucella spp and Mycobacterium tuberculosis complex. Potential use in rapid differential diagnosis between extrapulmonary tuberculosis and focal complications of brucellosis. PLoS One. 2013;8(3):e58353.
Piranfar V, Sharif M, Hashemi M, Vahdati AR, Mirnejad R. Detection and discrimination of two Brucella species by multiplex real-time PCR and high-resolution melt analysis curve from human blood and comparison of results using RFLP. Iranian J Basic Med Sci. 2015;18(9):909.
Barua A, Kumar A, Thavaselvam D, Mangalgi S, Prakash A, Tiwari S, et al. Isolation and characterization of Brucella melitensis isolated from patients suspected for human brucellosis in India. Indian J Med Res. 2016;143(5):652-8.