Human infection with a novel tick-borne Anaplasma species in China: a surveillance study
Human infection with a novel tick-borne Anaplasma species in China: a surveillance study
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中国人类感染一种新型蜱传无形体：一项监测研究。
DOI：
10.1016/s1473-3099(15)70051-4
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发表时间：
2015-06-01
影响因子：
56.3
通讯作者：
Cao, Wu-Chun
中科院分区：
文献类型：
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作者：
Li, Hao;Zheng, Yuan-Chun;Cao, Wu-Chun
背景嗜吞噬细胞无形体和绵羊无形体引起人类感染。方法收集2014年5月1日至6月10日在黑龙江省牡丹江市林业中心医院就诊的有蜱叮咬史的患者的血液标本，采用PCR方法检测新发现的山羊无形体，并进行病原学鉴定。我们将阳性样本接种到细胞培养物中。我们通过形态学和系统发育分析鉴定了分离的病原体。结果477例患者中有28例（6%）经PCR和测序证实感染了新型无形体。我们从三个病人的体外分离出病原体。rrs，gltA，groEL，msp2和msp4的系统发育分析表明，该病原体是从所有已知的无形体属物种不同。我们暂时命名它为“山羊无形体”。24例有数据的患者中有22例（92%）发生血清转化或抗体滴度增加4倍。所有28例患者均出现非特异性发热表现，包括23例（82%）发热，14例（50%）头痛，13例（46%）不适，9例（32%）头晕，4例（14%）肌痛和4例（14%）寒战。此外，28例患者中有10例（36%）出现皮疹或焦痂，8例（29%）出现淋巴结病，8例（29%）出现胃肠道症状，3例（11%）出现落枕。5名患者因病情严重入院治疗。六（35%）的17例患者的数据有很高的肝转氨酶concentration.Interpretation“山羊”作为人类疾病的原因的出现表明，个人生活在或前往流行地区在北方中国应采取预防措施，以减少他们的风险，暴露于这种新的蜱传病原体。
Background Anaplasma phagocytophilum and Anaplasma ovis cause human infections. We investigated the potential for human pathogenicity of a newly discovered Anaplasma species infecting goats in China.Methods We collected blood samples from patients with a history of tick bite in the preceding 2 months at Mudanjiang Forestry Central Hospital of Heilongjiang Province from May 1, to June 10, 2014, to detect the novel Anaplasma species by PCR. We inoculated positive samples into cell cultures. We characterised the isolated pathogen by morphological and phylogenetic analyses. We tested serum antibodies by indirect immunofluorescence assay.Findings 28 (6%) of 477 patients assessed were infected with the novel Anaplasma species according to PCR and sequencing. We isolated the pathogen in vitro from three patients. Phylogenetic analyses of rrs, gltA, groEL, msp2, and msp4 showed that the pathogen was distinct from all known Anaplasma species. We provisionally nominate it "Anaplasma capra". 22 (92%) of 24 patients with data available had seroconversion or a four-fold increase in antibody titres. All 28 patients developed non-specific febrile manifestations, including fever in 23 (82%), headache in 14 (50%), malaise in 13 (46%), dizziness in nine (32%), myalgia in four (14%), and chills in four (14%). Additionally, ten (36%) of 28 patients had rash or eschar, eight (29%) had lymphadenopathy, eight (29%) had gastrointestinal symptoms, and three (11%) had stiff neck. Five patients were admitted to hospital because of severe disease. Six (35%) of 17 patients with data available had high hepatic aminotransferase concentrations.Interpretation The emergence of "A capra" as a cause of human disease suggests that individuals living in or travelling to endemic regions in northern China should take precautions to reduce their risk of exposure to this novel tick-borne pathogen.