<i><scp>B</scp>abesia microti</i> real‐time polymerase chain reaction testing of <scp>C</scp>onnecticut blood donors: potential implications for screening algorithms

Johnson, Stephanie T.; Tassell, Eric R. Van; Tonnetti, Laura; Cable, Ritchard G.; Berardi, Victor P.; Leiby, David A.

doi:10.1111/trf.12125

Cited by 26 publications

(32 citation statements)

References 18 publications

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“…27 Furthermore, exposure to B. microti through tick bites appears to be relatively frequent in endemic regions of the United States as evidenced by seroprevalence rates ranging from 1% to 2.5%. 14,28 This is consistent with our study results that showed that 90% of EIA repeat-reactive donors in endemic areas and 100% in nonendemic areas were PCR and blood smear negative, indicating that the majority of EIA-reactive donors are not likely to be infectious. Such EIA repeat-reactive donors, many of whom have antibodies to B. microti that can be verified by IFA or immunoblot, likely represent individuals with prior, resolved infections and with lingering but waning antibody as demonstrated in other studies.…”

Section: Discussionsupporting

confidence: 90%

Serologic screening of United States blood donors for Babesia microti using an investigational enzyme immunoassay

Levin

Williamson²,

Bloch

et al. 2016

Transfusion

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BACKGROUND The tick-borne pathogen Babesia microti has become recognized as the leading infectious risk associated with blood transfusion in the United States, yet no Food and Drug Administration–licensed screening tests are currently available to mitigate this risk. The aim of this study was to evaluate the performance of an investigational enzyme immunoassay (EIA) for B. microti as a screening test applied to endemic and nonendemic blood donor populations. STUDY DESIGN AND METHODS The study aimed to test 20,000 blood donors from areas of the United States considered endemic for B. microti and 10,000 donors from a nonendemic area with the investigational B. microti EIA. Repeat-reactive samples were retested by polymerase chain reaction (PCR), blood smear, immunofluorescent assay (IFA), and immunoblot assay. In parallel, serum samples from symptomatic patients with confirmed babesiosis were tested by EIA, IFA, and immunoblot assays. RESULTS A total of 38 of 13,757 (0.28%) of the donors from New York, 7 of 4583 (0.15%) from Minnesota, and 11 of 8363 (0.13%) from New Mexico were found repeat reactive by EIA. Nine of the 56 EIA repeat-reactive donors (eight from New York and one from Minnesota) were positive by PCR. The specificity of the assay in a nonendemic population was 99.93%. Among IFA-positive clinical babesiosis patients, the sensitivity of the assay was 91.1%. CONCLUSION The B. microti EIA detected PCR-positive, potentially infectious blood donors in an endemic population and exhibited high specificity among uninfected and unexposed individuals. The EIA promises to provide an effective tool for blood donor screening for B. microti in a format amenable to high-throughput and cost-effective screening.

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Section: Discussionsupporting

confidence: 90%

Serologic screening of United States blood donors for Babesia microti using an investigational enzyme immunoassay

Levin

Williamson²,

Bloch

et al. 2016

Transfusion

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“…Recent studies using a short-term in vitro culture as well as immunocompromised mice have shown that, of the four drugs used for treatment of human babesiosis, only atovaquone shows efficacy against the parasite in mouse red blood cells both in vitro and in vivo 11. These results, along with the shortcomings of available diagnostic tools to distinguish between past and active infection to prevent transfusion-transmitted babesiosis, have stimulated efforts to improve therapies and diagnostics111213141516171819.…”

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confidence: 99%

Genome-wide diversity and gene expression profiling of Babesia microti isolates identify polymorphic genes that mediate host-pathogen interactions

Silva

Cornillot

McCracken

et al. 2016

Sci Rep

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Babesia microti, a tick-transmitted, intraerythrocytic protozoan parasite circulating mainly among small mammals, is the primary cause of human babesiosis. While most cases are transmitted by Ixodes ticks, the disease may also be transmitted through blood transfusion and perinatally. A comprehensive analysis of genome composition, genetic diversity, and gene expression profiling of seven B. microti isolates revealed that genetic variation in isolates from the Northeast United States is almost exclusively associated with genes encoding the surface proteome and secretome of the parasite. Furthermore, we found that polymorphism is restricted to a small number of genes, which are highly expressed during infection. In order to identify pathogen-encoded factors involved in host-parasite interactions, we screened a proteome array comprised of 174 B. microti proteins, including several predicted members of the parasite secretome. Using this immuno-proteomic approach we identified several novel antigens that trigger strong host immune responses during the onset of infection. The genomic and immunological data presented herein provide the first insights into the determinants of B. microti interaction with its mammalian hosts and their relevance for understanding the selective pressures acting on parasite evolution.

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“…Although the geographic distribution of positive blood donors did not completely overlap with the distribution of the reported clinical cases, a regional screening strategy can be one tool to improve blood safety. Johnson et al [88] identified several NAT-positive, antibody-negative blood donors, which underlines the request for genomic screening systems. Leiby et al [89] reported long-term parasitaemia of T. cruzi in seropositive US blood donors.…”

Section: Discussionmentioning

confidence: 99%

Emerging Pathogens - How Safe is Blood?

Schmidt

Geilenkeuser

Sireis

et al. 2013

Transfus Med Hemother

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During the last few decades, blood safety efforts were mainly focused on preventing viral infections. However, humanity's increased mobility and improved migration pathways necessitate a global perspective regarding other transfusion-transmitted pathogens. This review focuses on the general infection risk of blood components for malaria, dengue virus, Trypanosoma cruzi (Chagas disease) and Babesia spp. Approximately 250 million people become infected by Plasmodium spp. per year. Dengue virus affects more than 50 million people annually in more than 100 countries; clinically, it can cause serious diseases, such as dengue haemorrhagic fever and dengue shock syndrome. Chagas disease, which is caused by Trypanosoma cruzi, mainly occurs in South America and infects approximately 10 million people annually. Babesia spp. is a parasitic infection that infects red blood cells; although many infections are asymptomatic, severe clinical disease has been reported, especially in the elderly. Screening assays are available for all considered pathogens but make screening strategies more complex and more expensive. A general pathogen inactivation for all blood components (whole blood) promises to be a long-term, sustainable solution for both known and unknown pathogens. Transfusion medicine therefore eagerly awaits such a system.

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Babesia microti real‐time polymerase chain reaction testing of Connecticut blood donors: potential implications for screening algorithms

Abstract: We prospectively identified several real-time PCR-positive blood donors, including an IFA-negative real-time PCR-positive donor, in an area highly endemic for B. microti. These results suggest the need to include nucleic acid testing in planned mitigation strategies for B. microti.

Cited by 26 publications

References 18 publications

Serologic screening of United States blood donors for Babesia microti using an investigational enzyme immunoassay

Serologic screening of United States blood donors for Babesia microti using an investigational enzyme immunoassay

Genome-wide diversity and gene expression profiling of Babesia microti isolates identify polymorphic genes that mediate host-pathogen interactions

Emerging Pathogens - How Safe is Blood?

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