Surveillance for and Discovery of Borrelia Species in US Patients Suspected of Tickborne Illness

Kingry, Luke C.; Anacker, Melissa; Pritt, Bobbi S.; Bjork, Jenna; Respicio-Kingry, Laurel B.; Liu, Gongping; Sheldon, Sarah W.; Boxrud, David; Strain, Anna K.; Oatman, Stephanie; Berry, Jon; Sloan, Lynne M.; Mead, Paul S.; Neitzel, David F.; Kugeler, Kiersten J.; Petersen, Jeannine M.

doi:10.1093/cid/cix1107

Cited by 63 publications

(45 citation statements)

References 33 publications

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“…This fact is corroborated by largescale studies on post-tick bite febrile illnesses. Indeed, a very small proportion of the tested blood samples were found to be PCR-positive for B. miyamotoi in these previous studies with rates of 0.16% (1/626), 0.84% (97/11,515), 0.33% (7/2150), 0.11% (8/7292) and 0.49% (2/408) [3,4,10,29,30]. In contrast, in Russia, 15.2% (46/302) of the post tick-bite febrile patients [2] were found PCR-positive for B. miyamotoi.…”

Section: Whole Blood Pcrmentioning

confidence: 85%

Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France

et al. 2020

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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.

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Section: Whole Blood Pcrmentioning

confidence: 85%

Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France

et al. 2020

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“…For Anaplasma and Ehrlichia, a real-time PCR assay that uses hybridization probes and targets the groEL gene, followed by melting temperature analysis of PCR products, was utilized (31). For Borrelia, one to eight housekeeping genes, uvrA, rplB, recG, pyrG, pepX, clpX, nifS, and clpA, were amplified, sequenced, and analyzed (15). For Francisella, a real-time Taqman PCR assay were employed for species identification (32,33).…”

Section: Validation Of Taxonomic Predictionsmentioning

confidence: 99%

Targeted Metagenomics for Clinical Detection and Discovery of Bacterial Tick-Borne Pathogens

et al. 2020

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Tickborne diseases, due to a diversity of bacterial pathogens, represent a significant and increasing public health threat throughout the northern hemisphere. A high-throughput 16S V1-V2 rDNA-based metagenomics assay was developed and evaluated using >13,000 residual samples from patients suspected of tickborne illness and >1000 controls. Taxonomic predictions for tickborne bacteria were exceptionally accurate, as independently validated by secondary testing. Overall, 881 specimens were positive for bacterial tickborne agents. Twelve tickborne bacterial species were detected, including two novel pathogens, representing a 100% increase in the number of tickborne bacteria identified compared to what was possible by initial PCR testing. In three blood specimens, two tickborne bacteria were simultaneously detected. Seven bacteria, not known to be tick-transmitted, were also confirmed unique to samples from persons suspected of tickborne illness. These results indicate 16S V1-V2 metagenomics can greatly simplify diagnosis and accelerate discovery of bacterial tickborne pathogens.

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“…It is unknown how many of the >13,000 samples represented true tickborne infections, so further work will be necessary to clarify how well this assay performs in that regard. This author group had previously published the results from using a Borrelia genus-targeting broad PCR in 7,292 (presumably overlapping) specimens with similar findings of different Borrelia species and Candidatus B. johnsonii being detected (9). It is reassuring that targeted metagenomics sequencing of the >13,000 samples that they had found as many or more of each species, but still unknown if any of the Borrelia-specific PCR positive samples were not able to be detected by targeted metagenomics.…”

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confidence: 72%

Targeted Metagenomics Offers Insights into Potential Tick-Borne Pathogens

Thoendel

2020

J Clin Microbiol

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Tickborne disease pathogen identification remains a diagnostic challenge due to the multiple tests necessary for diagnosis. Targeted metagenomic sequencing is an evolving method to detect multiple different pathogens with a single test. In this issue of the Journal of Clinical Microbiology, L. Kingry, S. Sheldon, S. Oatman, B. Pritt, et al. (J Clin Microbiol 58:e00147-20, 2020, https://doi.org/10.1128/JCM.00147-20) explore 16S rRNA gene targeted metagenomics to identify bacterial pathogens in 881 of more than 13,000 specimens submitted for tickborne pathogen testing, giving new insights into suspected tickborne pathogens.

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Surveillance for and Discovery of Borrelia Species in US Patients Suspected of Tickborne Illness

Cited by 63 publications

References 33 publications

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

Targeted Metagenomics for Clinical Detection and Discovery of Bacterial Tick-Borne Pathogens

Targeted Metagenomics Offers Insights into Potential Tick-Borne Pathogens

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