Severe Fever with Thrombocytopenia Syndrome Complicated by Co-infection with Spotted Fever Group Rickettsiae, China.
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ABSTRACT:
SUBMITTER: Lu QB
PROVIDER: S-EPMC5088031 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Tick species distribution and prevalence of spotted fever group Rickettsiae (SFGR) in ticks were investigated in Zhejiang Province, China in 2010 and 2011. PCR was used to detect SFGR and positive amplicons were sequenced, compared to published sequences and phylogenic analysis was performed using MEGA 4.0. A total of 292 adult ticks of ten species were captured and 7.5 % (22/292) of the ticks were PCR-positive for SFG Rickettsia. The PCR-positive rates were 5.5 % (6/110) for Haemaphysalis longicornis, 3.6 % (1/28) for Amblyomma testudinarium and 16 % (15/94) for Ixodes sinensis, respectively. Phylogenetic analyses of gltA genes detected in ticks indicated that there are two dominating groups of SFGR. Sequences of group one were closely related to Rickettsia monacensis, whereas sequences of group two were closest related to Rickettsia heilongjiangensis and Rickettsia japonica, which are human pathogens. Our findings underline the importance of these ticks in public health surveillance in Zhejiang Province, China.
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Project description:Severe fever with thrombocytopenia syndrome (SFTS) and Japanese spotted fever (JSF; a spotted fever group rickettsiosis) are tick-borne zoonoses that are becoming a significant public health threat in Japan and East Asia. Strategies for treatment and infection control differ between the two; therefore, initial differential diagnosis is important. We aimed to compare the clinical characteristics of SFTS and JSF based on symptomology, physical examination, laboratory data, and radiography findings at admission. This retrospective study included patients with SFTS and JSF treated at five hospitals in Nagasaki Prefecture, western Japan, between 2013 and 2020. Data from 23 patients with SFTS and 38 patients with JSF were examined for differentiating factors and were divided by 7:3 into a training cohort and a validation cohort. Decision tree analysis revealed leukopenia (white blood cell [WBC] < 4000/μL) and altered mental status as the best differentiating factors (AUC 1.000) with 100% sensitivity and 100% specificity. Using only physical examination factors, absence of skin rash and altered mental status resulted in the best differentiating factors with AUC 0.871, 71.4% sensitivity, and 90.0% specificity. When treating patients with suspected tick-borne infection, WBC < 4000/µL, absence of skin rash, and altered mental status are very useful to differentiate SFTS from JSF.
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Project description:BackgroundRickettsia spp. are obligate intracellular bacteria and well known as transmitted by arthropods. These pathogens have a broad geographic distribution and a high degree of biological and clinical diversity. This study was conducted to determine the prevalence and molecular characterization of Rickettsia spp. in ticks collected from Gansu, where Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum were previously reported in ticks and ruminants.MethodsA total of 1,583 questing Haemaphysalis qinghaiensis ticks were collected and tested for the presence of Rickettsia spp. gltA gene by PCR. Samples positive for gltA were examined by specific primers targeted for the ompA gene of SFG rickettsiae. The infections were further validated by sequencing and positive samples were genetically characterized based on the gltA and ompA genes.ResultsIn total, Rickettsia spp. infection was found in 179 (18.5 %) H. qinghaiensis tick pools by using PCR and primers specific for the gltA gene. Of those, 157 (16.3 %) tick pools were positive for SFG rickettsiae by PCR based on ompA gene. Amplification and molecular analysis of the nucleotide sequences of gltA and ompA genes indicated three potential novel spotted fever group rickettsiae in H. qinghaiensis ticks. These three potential novel spotted fever group rickettsiae were clustered together in a subgroup, which represents a sister taxon to and separates from other known four SFG rickettsiae subgroups.ConclusionsThis study revealed a high infection rate of SFG rickettsiae in H. qinghaiensis ticks in northwest China. Three potential novel spotted fever group rickettsiae classified into a novel SFG rickettsiae subgroup were identified and named "Candidatus Rickettsia gannanii" related strains in recognition of the location where it was first detected.
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Project description:Birds are important hosts and dispersers of parasitic arthropods and vector-borne zoonotic pathogens. Particularly migratory species may carry these parasites over long distances in short time periods. Migratory hotspots present ideal conditions to get a snapshot of parasite and pathogen diversity of birds migrating between continents. The aim of this study was to investigate the presence and diversity of Rickettsia spp. in ticks collected from birds at a migratory hot-spot in the Danube Delta, Romania, eastern Europe.DNA was extracted from ticks that were collected from migratory birds in the Danube Delta during migratory seasons in 2011-2012. Two 360 bp fragments of the 16S ribosomal RNA gene and a 381 bp fragment Gene gltA were PCR amplified and analyzed by sequence analysis (performed at Macrogen Europe, Amsterdam, The Netherlands). Nucleotide sequences were compared to reference sequences available in the GenBank database, using Basic Local Alignment Search Tool.Four hundred ticks of four different species were found on 11 bird species. The prevalence of Rickettsia spp. infection was 14 % (56/400, CI: 11.7-29.1), with significantly more nymphs hosting rickettsial infection compared to larvae (48 vs 7; P?<?0.001). Significantly more ticks in nymphal stage were hosting Rickettsia spp. infection in spring, than in autumn. Four different genospecies were found: R. monacensis (29 ticks), R. helvetica (13), R. massiliae (3) and R. slovaca (2). The seasonal distribution of different Rickettsia spp. was heterogeneous; with most of the R. monacensis-infected ticks were found in spring, while more R. helvetica were found in autumn than spring. R. massiliae was found only in autumn and R. slovaca was found only in spring.This study has shown that birds migrating through eastern Europe may carry ticks infected with a high diversity of rickettsial pathogens, with four Rickettsia spp. recorded. Migratory direction was important for pathogen burden, with seasonal differences in the occurrence of individual Rickettsia species. Here we report the first individual records of different Rickettsia spp. in H. concinna (R. monacensis), I. arboricola (R. helvetica, R. massiliae) and I. redikorzevi (R. helvetica) and also the first geographical record of occurrence of R. massiliae in Romania, representing the easternmost observation on the continent.
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