Phylogenetic Analysis of the 56 kDa Protein Genes of Orientia tsutsugamushi in Southwest Area of Korea

Lee, Yu‐Mi; Kim, Dong-Min; Lee, Seung–Hyun; Jang, Mi-Sun; Neupane, Ganesh Prasad

doi:10.4269/ajtmh.2011.09-0601

Cited by 36 publications

(33 citation statements)

References 32 publications

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“…4,9 In addition, Kato, Neimeng-65, and Kawasaki genotypes have been identified in South Korea. 10 Although a prior study reported that the Boryong genotype rather than the Karp genotype predominated on Jeju Island, 7 we found that the Taguchi type was also common on Jeju Island. Previously, reports indicated that the Taguchi genotype is uncommon in endemic areas and does not show clinical manifestation.…”

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confidence: 66%

Unusual Genotypic Distribution of Orientia tsutsugamushi Strains Causing Human Infections on Jeju Island

Yoo¹,

Heo²,

Koh³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. We investigated the clinical characteristics and serologic types of tsutsugamushi disease on the largest island of South Korea. There were 141 patients with tsutsugamushi disease at Jeju National University Hospital and Seogwipo Medical Center between November of 2003 and December of 2012. Median age of patients was 61 years, and 59% were women. The major clinical manifestations were fever (80.5%) and skin rash (55.7%), with eschars evident in 75

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confidence: 66%

Unusual Genotypic Distribution of Orientia tsutsugamushi Strains Causing Human Infections on Jeju Island

Yoo¹,

Heo²,

Koh³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…These 3 disease entities represent major infectious diseases that occur between September and December, and pose challenges related to differential diagnosis during the autumn season. The genotypic distribution in the southern district of Korea included Boryong (88.4z), Kato (2.9z), Kawasaki (5.8z), Jecheon (1.4z), and Neimeng-65 (1.4z) (18). Another report on the genotypic distribution of O. tsutsugamushi strains that cause human infections in South Korea listed Boryong (68.6z), Taguchi (19.6z), Kanda/Kawasaki (9.2z), Jecheon (1.3z), and UAP7 (1.3z) (19).…”

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confidence: 99%

Dynamics of Clinical Symptoms in Patients with Scrub Typhus

Lee

Chung

et al. 2013

Jpn J Infect Dis

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SUMMARY:The clinical manifestations and complications of scrub typhus are variable. Few studies have examined the timeline of clinical symptoms after the appropriate antimicrobial agents have been administered. The most prevalent clinical manifestations are fever and cough, followed by headache, myalgia, eschar, skin rash, and nausea. Systemic symptoms are most severe during the early stages of illness (i.e., the first 5 days), but resolve slowly within 2 weeks. The associated skin rash is most severe during the first 8 days of infection, but it resolves slowly within 21 days.Scrub typhus is a potentially fatal infectious disease caused by the organism Orientia tsutsugamushi (1). Typical signs include eschar formation and acute febrile illness with symptoms that include abrupt fever, chills, rash, lymphadenopathy, abdominal pain, and myalgia (2,3). The clinical manifestations and complications of scrub typhus vary; most symptoms are mild but severe complications have been reported, including acute respiratory distress syndrome, encephalitis, interstitial pneumonia, myocarditis and pericarditis, acute renal failure, and acute hepatic failure (4-10). Very few reports describe the clinical course beyond the occurrence of fever after the appropriate antimicrobial agents have been administered (11). An established timeline of the clinical symptoms may help physicians manage patients with scrub typhus more effectively.This study was conducted in 5 university medical centers in Korea between October and December 2010. In the current study, we used several diagnostic criteria for scrub typhus. First, a diagnosis of scrub typhus was made according to the World Health Organization criteria in 4 out of 5 hospitals when specific IgM antibody titers were equal to or greater than 1:10, or IgG titers were either equal to or greater than 1:256, or a 4-fold increase in titer was demonstrated using paired serum samples in an indirect immunofluorescence antibody (IFA) test (11,12). The O. tsutsugamushi strains used in the IFA test included Gilliam, Karp, Kato, and Boryong. Second, in the remaining hospital, O. tsutsugamushi was detected in passive hemagglutination assay (PHA) against O. tsutsugamushi with an antibody titer of 1:80 or greater in a single serum sample or 4-fold increase or greater during follow-up (13,14). The PHA was conducted using the Genedia Tsutsu PHA II test kit (Green Cross Corp., Yongin, Korea), which provides qualitative and quantitative detection of serum antibodies against O. tsutsugamushi. Sheep erythrocytes for the PHA were sensitized with the Karp and Gilliam strains, including the Boryong strain found in Korea (11,12).Respiratory symptoms included cough and dyspnea. Systemic symptoms included subjective fever, chills, headache, weight loss, and myalgia. Gastrointestinal symptoms included nausea, vomiting, diarrhea, and abdominal pain (15). Neurologic symptoms included mental confusion and delirium. Moreover, a skin rash was also observed. Symptom severity was scored using a 4-point scale: no symptoms...

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“…19 However, serotyping is time-and labor-consuming, and it is limited by the need to include all prototype strains when testing a new strain. Therefore, molecular typing methods, particularly PCR amplification of the 56 kDa protein gene, followed by sequencing have been used extensively for investigations of genotypes of scrub typhus [20][21][22] ; 56 kDa type-specific antigen, which contains both group-and type-specific epitopes, has proven to be more useful for differentiating between O. tsutsugamushi strains. [23][24][25] A previous study by Yu and others 13 showed that sequences from three samples were identical, with a homology of 96% with Kawasaki type, which was the same as the samples analyzed in this study.…”

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confidence: 99%

Laboratory Diagnosis and Genotype Identification of Scrub Typhus from Pinggu District, Beijing, 2008 and 2010

Dou²,

Zhang³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. This study was conducted to determine the diagnosis and genotype of Orientia tsutsugamushi in Pinggu district, Beijing. Indirect immunofluorescence assay (IFA) was performed to detect O. tsutsugamushi-specific immunoglobulin M (IgM) and immunoglobulin G (IgG) antibodies. Nested polymerase chain reaction (PCR) and DNA sequencing analysis targeting the O. tsutsugamushi-specific groEL gene and 56 kDa protein gene were performed on whole-blood samples from scrub typhus patients. We confirmed that 47 patients were infected with scrub typhus in Pinggu district, Beijing. Representative sequences amplified by primers according to the groEL gene (BJ-PG-2008; GenBank accession No. JQ894502) and the 56 kDa protein gene (PG-56kDa; GenBank accession No. JX843795) both clustered with Kawasaki. PG-56kDa had sequence homology of 100% with TADY12-0308, shandong-XDM2, Neimeng-90, and sdu-1 and sequence homology of 96% with Kawasaki, Taguchi, Oishi, and Kanda. We confirmed the genotype of O. tsutsugamushi in Pinggu district, Beijing, as Kawasaki, and the patient in 2008 confirmed in this study was the first patient with confirmed scrub typhus in Beijing. INTRODUCTIONScrub typhus, also known as tsutsugamushi disease, is an acute, febrile illness that is caused by Orientia tsutsugamushi, which is an obligate intracellular bacterium that belongs to the family Rickettsiaceae in the order Rickettsiales. It is a zoonosis transmitted by infected larval trombiculid mites, and it is widespread in the Asia-Pacific region, including Afghanistan, China, Korea, the islands of the southwestern Pacific, and northern Australia.1 The clinical manifestations of this disease range from mild disease with symptoms of fever, rash, eschar, and lymphadenopathy to fatal disease.2 The disease can be treated effectively with doxycycline, azithromycin, or chloramphenicol.

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Phylogenetic Analysis of the 56 kDa Protein Genes of Orientia tsutsugamushi in Southwest Area of Korea

Cited by 36 publications

References 32 publications

Unusual Genotypic Distribution of Orientia tsutsugamushi Strains Causing Human Infections on Jeju Island

Unusual Genotypic Distribution of Orientia tsutsugamushi Strains Causing Human Infections on Jeju Island

Dynamics of Clinical Symptoms in Patients with Scrub Typhus

Laboratory Diagnosis and Genotype Identification of Scrub Typhus from Pinggu District, Beijing, 2008 and 2010

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