Characteristics of <i>Rickettsia typhi</i> Infections Detected with Next-Generation Sequencing of Microbial Cell-Free Deoxyribonucleic Acid in a Tertiary Care Hospital

Centeno, Fernando H; Lasco, Todd M.; Ahmed, Asim A.; Mohajer, Mayar Al

doi:10.1093/ofid/ofab147

Cited by 7 publications

(11 citation statements)

References 9 publications

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“…The most common infections seen were extrapulmonary and latent tuberculosis (n 5 169), NCC (n 5 78), * Regions were defined with the United Nations geoscheme, with sub-regional divisions used for the Americas. 17 † The sum exceeds the total number of patients because some patients had more than one type of health-care coverage. strongyloidiasis (n 5 28), Chagas disease (n 5 25), and schistosomiasis (n 5 12) (Supplemental Table 1).…”

Section: Resultsmentioning

confidence: 99%

“… * Regions were defined with the United Nations geoscheme, with sub-regional divisions used for the Americas. 17 † The sum exceeds the total number of patients because some patients had more than one type of health-care coverage. …”

Section: Resultsmentioning

confidence: 99%

“… * Regions were defined with the United Nations geoscheme, with sub-regional divisions used for the Americas. 17 …”

Section: Resultsmentioning

confidence: 99%

“…16 We categorized countries of origin into six regions based on the United Nations M49 standard for world regions. 17 For simplicity, within this classification system, we refer to the "Latin America and the Caribbean region" as "Latin America." Eosinophilia was defined as an absolute value greater than 500 cells/mL.…”

Section: Methodsmentioning

confidence: 99%

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Reviewing a Decade of Outpatient Tropical Medicine in Houston, Texas

Kaplan

Centeno

Hayon

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Tropical diseases cause significant morbidity among the world’s poorest populations. Although more common in low- and middle-income countries, tropical diseases are also found among underserved populations living in high-income countries such as the United States. The National School of Tropical Medicine at Baylor College of Medicine and the Harris Health System founded a tropical medicine clinic—the Harris Health Tropical Medicine Clinic (HHTMC)—in Houston in 2011 in response to tropical disease-related morbidity in Texas. We conducted a retrospective chart review of a sample of patients older than 18 years of age who were referred to the HHTMC between October 2011 and January 2020. Of the 523 patients reviewed, 185 (35.4%) had mycobacterial infections, 184 (35.2%) had parasitic infections, 38 (7.3%) had fungal infections, 16 (3.1%) had eosinophilia without a confirmed clinical diagnosis, 28 (5.4%) had bacterial infections, and 13 (2.5%) had viral infections. The most common infections overall were extrapulmonary and latent tuberculosis (n = 169), neurocysticercosis (n = 78), strongyloidiasis (n = 28), Chagas disease (n = 25), and schistosomiasis (n = 12). The epidemiology of tropical diseases in the United States is understudied at national and regional levels. This 10-year retrospective study contributes to bridging this knowledge gap by detailing the frequencies of tropical disease diagnoses made at the HHTMC in Houston, TX. These data highlight areas for advancement in the field of tropical medicine within the United States, such as improving front-line health-care provider education; establishing tropical medicine clinics in areas of high prevalence such as the Gulf Coast, Appalachia, and urban areas; and developing comprehensive, systematic national tropical disease screening programs and patient registries.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… * Regions were defined with the United Nations geoscheme, with sub-regional divisions used for the Americas. 17 …”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Reviewing a Decade of Outpatient Tropical Medicine in Houston, Texas

Kaplan

Centeno

Hayon

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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“…sibirica . A cohort of 10 patients with murine typhus infection underwent NGS of microbial cell-free deoxyribonucleic acid (mcfDNA) to identify R. typhi [ 75 ]. Sequencing of R. typhi mcfDNA was more rapid and specific than serology and was able to change clinical management in half of the cases.…”

Section: Genomic Approaches In the Diagnosis Of Rickettsia Species Infectionmentioning

confidence: 99%

An Update on the Laboratory Diagnosis of Rickettsia spp. Infection

Stewart

2021

Pathogens

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Rickettsia species causing human illness are present globally and can cause significant disease. Diagnosis and identification of this intracellular bacteria are challenging with many available diagnostic modalities suffering from several shortcomings. Detection of antibodies directed against Rickettsia spp. via serological methods remains widely used with a broad range of sensitivity and specificity values reported depending on the assay. Molecular methods, including polymerase chain reaction (PCR) testing, enables species-specific identification with a fast turnaround time; however, due to resource requirements, use in some endemic settings is limited. Reports on the use of next-generation sequencing (NGS) and metagenomics to diagnose Rickettsia spp. infection have been increasing. Despite offering several potential advantages in the diagnosis and surveillance of disease, genomic approaches are currently only limited to reference and research laboratories. Continued development of Rickettsia spp. diagnostics is required to improve disease detection and epidemiological surveillance, and to better understand transmission dynamics.

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Clinical usefulness of metagenomic next-generation sequencing for Rickettsia and Coxiella burnetii diagnosis

Zhang

Chen

Han

et al. 2023

Eur J Clin Microbiol Infect Dis

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Rickettsia and Coxiella burnetii are zoonotic tick-borne pathogens that cause febrile illnesses in humans. Metagenomic next-generation sequencing (mNGS) is a new technology used to diagnose infectious diseases. However, clinical experience with applying the test to rickettsioses and Q fever is relatively limited. Therefore, this study aimed to explore the diagnostic performance of mNGS in detecting Rickettsia and C. burnetii. We retrospectively studied patients with rickettsioses or Q fever between August 2021 and July 2022. Peripheral blood mNGS and polymerase chain reaction (PCR) were performed for all patients. Clinical data were retrieved for analysis. Thirteen patients were included in this study (eleven confirmed cases and two suspected cases). Signs and symptoms included fever (13, 100%), rash (7, 53.8%), muscle soreness (5, 38.5%), headache (4, 30.8%), skin eschar (3, 23.1%), and disturbance of consciousness (2, 15.4%). In addition, eight patients (61.6%) had thrombocytopenia, ten (76.9%) had liver function impairment, and two (15.4%) had renal function impairment. The results of mNGS revealed seven patients with R. japonica (53.8%), five with C. burneti (38.5%), two with R. heilongjiangensis (15.4%), and one with R. honei (7.7%). PCR results were positive in 11 patients (84.6%). After receiving doxycycline-based treatment, 12 (92.3%) patients returned to a normal temperature within 72 h. All patients were discharged in better health. Therefore, mNGS can help diagnose Rickettsia and C. burnetii and shorten the diagnosis time, especially for patients with atypical clinical manifestations and unclear epidemiologic evidence of a tick bite or exposure.

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Characteristics of Rickettsia typhi Infections Detected with Next-Generation Sequencing of Microbial Cell-Free Deoxyribonucleic Acid in a Tertiary Care Hospital

Cited by 7 publications

References 9 publications

Reviewing a Decade of Outpatient Tropical Medicine in Houston, Texas

Reviewing a Decade of Outpatient Tropical Medicine in Houston, Texas

An Update on the Laboratory Diagnosis of Rickettsia spp. Infection

Clinical usefulness of metagenomic next-generation sequencing for Rickettsia and Coxiella burnetii diagnosis

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