Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France
Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France
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DOI：
10.1186/s13071-020-04071-9
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发表时间：
2020-04-17
影响因子：
3.2
通讯作者：
Jaulhac, Benoit
中科院分区：
文献类型：
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作者：
Boyer, Pierre H.;Koetsveld, Joris;Jaulhac, Benoit
宫本疏螺旋体是一种由蓖麻硬蜱复合群传播的回归热疏螺旋体。由B引起的人类疾病。Miyamotoi首先在俄罗斯被描述，后来在美国和日本。此外，5例脑膜脑炎免疫功能低下的患者和1例明显免疫功能正常的患者进行了描述。方法我们调查了B的存在。宫本岛在Alsace（法国），一个蓖麻虫流行区，疑似人粒细胞无形体病的患者。蓖麻蜱和莱姆病，使用直接（PCR）和间接诊断（甘油磷酸二酯-磷酸二酯酶（GlpQ）血清学）。结果在2013年至2016年收集的4354只蜱中发现了2.2%的宫本疏螺旋体。从疑似HGA患者中采集的575份血液样本中没有发现B阳性。miyamotoi通过PCR。这575例患者中有138例获得了急性和晚期血清。检测这些配对血清中抗B的IgM和IgG抗体。miyamotoi GlpQ抗原。138例患者中共有14例至少有一个阳性参数（即抗GlpQ IgG和/或IgM）。1例患者发生IgG血清转化，3例在急性血清中分离出IgM。这三名患者接受了多西环素治疗，这可能会防止血清转化。在审查临床数据和进行的其他生物学试验后，在这些不同病例中，不能排除蜱虫携带的不同微生物之间的共同暴露或血清学交叉反应性。1例患者存在持续性IgG，这强烈提示既往暴露于B。宫本井。结论人体可暴露于B。在阿尔萨斯通过蜱虫叮咬感染宫本。我们提供了可能的B的血清学数据。暴露于宫本蜱或感染蜱叮咬后发热的患者。未来的研究应确定西欧其他地区这种新出现的蜱传疾病的发病率、临床病程和负担。
Background Borrelia miyamotoi is a relapsing fever Borrelia species transmitted by ticks of the Ixodes ricinus complex. Human disease caused by B. miyamotoi was first described in Russia and later in the USA and Japan. Additionally, five cases of meningoencephalitis in immunocompromised patients and one case in an apparently immunocompetent patient were described. Methods We investigated the presence of B. miyamotoi in I. ricinus nymphs and in patients suspected of human granulocytic anaplasmosis, in Alsace (France), an endemic area for I. ricinus ticks and Lyme borreliosis, using direct (PCR) and indirect diagnosis (glycerophosphoryldiester-phosphodiesterase (GlpQ) serology). Results Borrelia miyamotoi was found in 2.2% of 4354 ticks collected between 2013 and 2016. None of the 575 blood samples, collected from the patients suspected of HGA, was found positive for B. miyamotoi by PCR. Acute and late sera from 138 of these 575 patients were available. These paired sera were tested for IgM and IgG antibodies against the B. miyamotoi GlpQ antigen. A total of 14 out of 138 patients had at least one positive parameter (i.e. anti-GlpQ IgG and/or IgM). One patient seroconverted for IgG, and three had isolated IgM in the acute serum. These three patients were treated with doxycycline which could have prevented seroconversion. After reviewing clinical data and other biological tests performed, co-exposure among different microorganisms vectored by ticks or serological cross-reactivity could not be ruled out in these different cases. One patient had persistent IgG, which strongly suggests previous exposure to B. miyamotoi. Conclusions Humans can be exposed to B. miyamotoi through tick bites in Alsace. We present serological data for possible B. miyamotoi exposure or infection of patients with fever after tick bite. Future studies should determine the incidence, clinical course and burden of this emerging tick-borne disease in other parts of Western Europe.