Close geographic association of human neoehrlichiosis and tick populations carrying "Candidatus Neoehrlichia mikurensis" in eastern Switzerland
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Close geographic association of human neoehrlichiosis and tick populations carrying "Candidatus Neoehrlichia mikurensis" in eastern Switzerland. / Maurer, Florian P.
In: J CLIN MICROBIOL, Vol. 51, No. 1, 01.2013, p. 169-76.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Close geographic association of human neoehrlichiosis and tick populations carrying "Candidatus Neoehrlichia mikurensis" in eastern Switzerland
AU - Maurer, Florian P
PY - 2013/1
Y1 - 2013/1
N2 - Neoehrlichiosis caused by "Candidatus Neoehrlichia mikurensis" is an emerging zoonotic disease. In total, six patients have been described in Europe, with the first case detected in 2007. In addition, seven patients from China were described in a report published in October 2012. In 2009, we diagnosed the first human case of "Ca. Neoehrlichia mikurensis" infection in the Zurich area (Switzerland). Here, we report two additional human cases from the same region, which were identified by broad-range 16S rRNA gene PCR. Both patients were immunocompromised and presented with similar clinical syndromes, including fever, malaise, and weight loss. A diagnostic multiplex real-time PCR was developed for specific detection of "Ca. Neoehrlichia mikurensis" infections. The assay is based on the signature sequence of a 280-bp fragment of the "Ca. Neoehrlichia mikurensis" 16S rRNA gene and incorporates a "Ca. Neoehrlichia mikurensis" species, a "Ca. Neoehrlichia" genus, and an Anaplasmataceae family probe for simultaneous screening. The analytical sensitivity was determined to be below five copies of the "Ca. Neoehrlichia mikurensis" 16S rRNA gene. Our results show that the assay is suitable for the direct detection of "Ca. Neoehrlichia mikurensis" DNA in clinical samples from, for example, blood and bone marrow. In addition, it allows for monitoring treatment response during antibiotic therapy. Using the same assay, DNA extracts from 1,916 ticks collected in four forests in close proximity to the patients' residences (<3 km) were screened. At all sampling sites, the minimal prevalence of "Ca. Neoehrlichia mikurensis" was between 3.5 to 8% in pools of either nymphs, males, or females, showing a strong geographic association between the three patients and the assumed vector.
AB - Neoehrlichiosis caused by "Candidatus Neoehrlichia mikurensis" is an emerging zoonotic disease. In total, six patients have been described in Europe, with the first case detected in 2007. In addition, seven patients from China were described in a report published in October 2012. In 2009, we diagnosed the first human case of "Ca. Neoehrlichia mikurensis" infection in the Zurich area (Switzerland). Here, we report two additional human cases from the same region, which were identified by broad-range 16S rRNA gene PCR. Both patients were immunocompromised and presented with similar clinical syndromes, including fever, malaise, and weight loss. A diagnostic multiplex real-time PCR was developed for specific detection of "Ca. Neoehrlichia mikurensis" infections. The assay is based on the signature sequence of a 280-bp fragment of the "Ca. Neoehrlichia mikurensis" 16S rRNA gene and incorporates a "Ca. Neoehrlichia mikurensis" species, a "Ca. Neoehrlichia" genus, and an Anaplasmataceae family probe for simultaneous screening. The analytical sensitivity was determined to be below five copies of the "Ca. Neoehrlichia mikurensis" 16S rRNA gene. Our results show that the assay is suitable for the direct detection of "Ca. Neoehrlichia mikurensis" DNA in clinical samples from, for example, blood and bone marrow. In addition, it allows for monitoring treatment response during antibiotic therapy. Using the same assay, DNA extracts from 1,916 ticks collected in four forests in close proximity to the patients' residences (<3 km) were screened. At all sampling sites, the minimal prevalence of "Ca. Neoehrlichia mikurensis" was between 3.5 to 8% in pools of either nymphs, males, or females, showing a strong geographic association between the three patients and the assumed vector.
KW - Aged
KW - Anaplasmataceae
KW - Anaplasmataceae Infections
KW - Animals
KW - Base Sequence
KW - China
KW - Europe
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Molecular Sequence Data
KW - Polymerase Chain Reaction
KW - Prevalence
KW - RNA, Ribosomal, 16S
KW - Sequence Alignment
KW - Ticks
KW - Topography, Medical
KW - Case Reports
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1128/JCM.01955-12
DO - 10.1128/JCM.01955-12
M3 - SCORING: Journal article
C2 - 23115262
VL - 51
SP - 169
EP - 176
JO - J CLIN MICROBIOL
JF - J CLIN MICROBIOL
SN - 0095-1137
IS - 1
ER -