Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study

Velušček, Maša; Blagus, Rok; Kišek, Tjaša Cerar; Ružić‐Sabljić, Eva; Avšič-Županc, Tatjana; Bajrović, Fajko F.; Stupica, Daša

doi:10.3390/jcm8101740

Cited by 8 publications

(6 citation statements)

References 35 publications

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“…In Europe, in addition to Lyme borrelia, I. ricinus ticks can transmit tick-borne encephalitis virus, A. phagocytophilum, species of the bacterial genus Rickettsia, B. miyamotoi, and Babesia protozoans. Tick-borne encephalitis virus is well recognized as a cause of co-infection in patients with Lyme disease in Europe (50). More data are needed on the frequency of coinfections in both the United States and Europe.…”

Section: Lyme Borrelia Co-infectionsmentioning

confidence: 99%

Comparison of Lyme Disease in the United States and Europe

Marques¹,

Strle²,

Wormser³

2021

Emerg. Infect. Dis.

135

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L yme disease, or Lyme borreliosis, is the most common tickborne disease in both the United States and Europe; an estimated ≈476,000 cases are diagnosed and treated per year in the United States and >200,000 cases per year in western Europe (1-3). The principal tick vector in the United States is Ixodes scapularis, followed by I. pacifi cus; in Europe, most cases are transmitted by I. ricinus, followed by I. persulcatus ticks (Table 1). The etiologic agent, Borrelia burgdorferi, was discovered in 1982 in the United States. Later, it became recognized that strains of B. burgdorferi in Europe were more heterogenous than strains in North America. B. burgdorferi sensu lato was then classifi ed into 3 main genospecies. The originally discovered genospecies was named B. burgdorferi sensu stricto.The second genospecies was named Borrelia garinii sp. nov., and the third was named Borrelia afzelii sp. nov. Recently, the taxonomy of the family Borreliaceae (and the genus Borrelia) has been revised into 2 main genera, Borrelia and Borreliella (4). The spirochetes that cause relapsing fever retained the genus name Borrelia, and spirochetes that cause Lyme disease have been renamed Borreliella (hereafter referred to as Lyme borrelia). However, these changes have been challenged (5).Most cases of Lyme disease in the United States occur in the mid-Atlantic, Northeast, and Upper Midwest regions. B. burgdorferi s.s., which also is found in Europe, causes most human infections in the United States (1,2); the newly recognized species B. mayonii (which is not known to exist in Europe) is an infrequent cause of human illness in the Upper Midwest region of the United States (6). The incidence of Lyme disease in Europe is highest in the Scandinavian and Baltic states in northern Europe and in Austria, the Czech Republic, Germany, and Slovenia in central Europe. B. afzelii and B. garinii are the genospecies most frequently detected in I. ricinus and I. persulcatus ticks and cause most cases of Lyme disease in Europe (1,2). Neither genospecies is found in the United States. Transmission of B. burgdorferi s.s. by I. scapularis or by I. pacifi cus ticks is very infrequent during the fi rst 36 hours after tick attachment; in contrast, transmission of B. afzelii by I. ricinus ticks may occur within 24 hours (Table 1) (7). Erythema Migrans and Other Skin ManifestationsAfter Lyme borrelia are deposited in the skin by the bite of an infected Ixodes tick, an infection is typically established at that site, which causes the characteristic skin lesion, erythema migrans (Figure 1). Erythema migrans is the most common clinical manifestation of Lyme disease in the United States and Europe, occurring in >80% of patients in both geographic areas (2). Overall, US patients with erythema migrans caused by B. burgdorferi s.s. are less likely than patients in Europe with erythema migrans caused by B. afzelii or B. garinii to remember a tick bite at the site of the lesion (25% vs. 60% for B. afzelii or 64% for B. garinii) but more likely to have concomitant ...

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Section: Lyme Borrelia Co-infectionsmentioning

confidence: 99%

Comparison of Lyme Disease in the United States and Europe

Marques¹,

Strle²,

Wormser³

2021

Emerg. Infect. Dis.

135

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“…Various investigations confirm the possibility of simultaneous infection with different pathogens transmitted by ticks [24,25]. As reported by Dunaj et al, co-infection with B. burgdorferi s.l.…”

Section: Discussionmentioning

confidence: 63%

Analysis of the concentration of selected serological parameters in patients undergoing antibiotic treatment of Lyme disease and assessment of their potential application in the control of the therapy effectiveness – pilot study

Tokarska-Rodak¹,

Fota-Markowska²,

Pańczuk³

et al. 2021

Ann Agric Environ Med.

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“…It mainly corresponded to an isolated seropositivity for one or the other microorganisms. These patients were mainly included in the study by Velušček et al [ 37 ], which provided 240 TBE patients with a B. burgdorferi s.l. seropositivity.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 109 patients did not receive any etiological treatment. The latter were almost exclusively from a single study on TBE by Velušček et al [ 37 ], in which the diagnosis of active B. burgdorferi s.l. was not retained for all patients.…”

Section: Resultsmentioning

confidence: 99%

Human Co-Infections between Borrelia burgdorferi s.l. and Other Ixodes-Borne Microorganisms: A Systematic Review

et al. 2022

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When it comes to tick-borne diseases, co-infections are often mentioned. This concept includes several entities. On the one hand, tick vectors or vertebrate reservoir host can harbor several microorganisms that can be pathogenic for humans. On the other hand, human co-infections can also be understood in different ways, ranging from seropositivity without clinical symptoms to co-disease, i.e., the simultaneous clinical expression of infections by two tick-borne microorganisms. The latter, although regularly speculated, is not often reported. Hence, we conducted a systematic review on co-infections between B. burgdorferi s.l., the etiological agent of Lyme borreliosis, and other microorganisms potentially transmitted to humans by Ixodes spp. ticks. A total of 68 relevant articles were included, presenting 655 cases of possible co-infections. Most cases of co-infections corresponded to patients with one tick-borne disease and presenting antibody against another tick-borne microorganism. Co-disease was particularly frequent in two situations: patients with clinical symptoms of high fever and erythema migrans (EM), and patients with neurological symptoms linked to the TBEv or a neuroborreliosis. No impact on severity was evidenced. Further studies are needed to better appreciate the frequency and the impact of co-infections between several tick-borne microorganisms.

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Antibiotic Use and Long-Term Outcome in Patients with Tick-Borne Encephalitis and Co-Infection with Borrelia Burgdorferi Sensu Lato in Central Europe. A Retrospective Cohort Study

Cited by 8 publications

References 35 publications

Comparison of Lyme Disease in the United States and Europe

Comparison of Lyme Disease in the United States and Europe

Analysis of the concentration of selected serological parameters in patients undergoing antibiotic treatment of Lyme disease and assessment of their potential application in the control of the therapy effectiveness – pilot study

Human Co-Infections between Borrelia burgdorferi s.l. and Other Ixodes-Borne Microorganisms: A Systematic Review

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