151
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Mehraj V, Textoris J, Capo C, Raoult D, Leone M, Mege JL. Overexpression of the Per2 gene in male patients with acute Q fever. J Infect Dis 2012; 206:1768-70. [PMID: 22984121 DOI: 10.1093/infdis/jis600] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prevalence of Q fever is higher in men than in women. Because the expression of circadian clock genes differs in male and female mice infected with Coxiella burnetii, we hypothesized that circadian genes are differently modulated in men and women with Q fever. The expression of the Per2 gene was significantly (P = .01) increased in males with acute Q fever compared with healthy volunteers. No significant difference was observed in females. We showed for the first time that gender altered the expression of a circadian gene, Per2, in an infectious disease.
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Affiliation(s)
- Vikram Mehraj
- Unité de Recherche sur les Maladies Infectieuses Tropicales et Emergentes, Aix-Marseille Université, Marseille, France
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152
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Paul S, Agger JF, Markussen B, Christoffersen AB, Agerholm JS. Factors associated with Coxiella burnetii antibody positivity in Danish dairy cows. Prev Vet Med 2012; 107:57-64. [PMID: 22748360 DOI: 10.1016/j.prevetmed.2012.05.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Revised: 05/25/2012] [Accepted: 05/28/2012] [Indexed: 10/28/2022]
Abstract
The aim of the study was to identify associations between the level of Coxiella burnetii (C. burnetii) antibodies in individual milk samples and cow and herd level factors in Danish dairy cows. The study, designed as a prospective cross sectional study with follow up, included 24 herds identified by a stratified random sampling procedure according to the level of C. burnetii antibodies in one bulk tank milk (BTM) sample at the beginning of the study. Ten herds were BTM positive, ten herds were BTM negative and four herds had an intermediate level. The samples were tested with an ELISA and results determined as S/P (sample to positive control) values. Three cross sectional studies of all lactating cows within each herd were then conducted during an 11 months follow up period with collection of a total of 5829 milk samples from 3116 cows. Each sample was tested with the same ELISA as used for BTM testing, and cows were considered test positive for S/P values ≥ 40, and otherwise negative. Individual cow information was extracted from the Danish Cattle Database and herd information was obtained from a telephone interview with each farmer. From multivariable logistic regression analysis accounting for hierarchical structures in the data it was concluded that odds for seropositivity increased with Danish Holstein breed, increasing number of parity and high milk protein contents, but decreased with increasing milk yield and high milk fat contents. Cows were at a higher risk during summer than other seasons. Among the herd level factors, herd size, tie stall housing system, quarantine of newly purchased animals and good hygienic precautions taken by the veterinarian before entering into the stable were also significantly associated with reduced odds of C. burnetii antibody positivity. The prevalence of test positive cows was almost constant during the study period in herds which were initially BTM positive and BTM intermediate, whilst the prevalence of positive cows in a few of the initial BTM negative herds changed from almost zero to higher than 60%. This indicates that herd infections last quite long and that test negative herds may convert to positive due to a few latently infected cows or due to transmissions from other herds.
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Affiliation(s)
- Suman Paul
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Groennegaardsvej 8, DK-1870 Frederiksberg C, Denmark.
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153
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Palmela C, Badura R, Valadas E. Acute Q fever in Portugal. Epidemiological and clinical features of 32 hospitalized patients. Germs 2012; 2:43-59. [PMID: 24432263 DOI: 10.11599/germs.2012.1013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/22/2012] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Q fever is a worldwide zoonosis caused by Coxiella burnetii. The main characteristic of acute Q fever is its clinical polymorphism, usually presenting as a febrile illness with varying degrees of hepatitis and/or pneumonia. Q fever is endemic in Portugal, and it is an obligatory notifiable disease since 1999. However, its epidemiological and clinical characteristics are still incompletely described. METHODS We performed a retrospective study of 32 cases admitted in the Infectious Diseases Department, Santa Maria's University Hospital, from January 2001 to December 2010, in whom acute Q fever was diagnosed by the presence of antibodies to phase II Coxiella burnetii antigens associated with a compatible clinical syndrome. RESULTS Out of the 32 cases recorded, 29 (91%) were male, with a male:female ratio of 9.7:1. Individuals at productive age were mainly affected (88%, n=28, with ages between 25 and 64 years). Clinically, the most common manifestation of acute Q fever was hepatic involvement (84%, n=27), which occurred isolated in 53% (n=17) of the cases. Hepatitis was more severe, presenting with higher values of liver function tests, in patients presenting both pulmonary and hepatic involvement. Additionally, we report one case of myocarditis and another one with neurological involvement. Empiric but appropriate antibiotic therapy was given in 66% (n=21) of the cases. There was a complete recovery in 94% (n=30) of the patients, and one death. We confirmed the sub-notification of this disease in Portugal, with only 47% (n=15) of the cases notified. CONCLUSION In Portugal further studies are needed to confirm our results. From the 32 cases studied, acute Q fever presented more frequently as a febrile disease with hepatic involvement affecting mainly young male individuals. Furthermore, acute Q fever is clearly underdiagnosed and underreported in Portugal, which suggests that an increased awareness of the disease is needed, together with a broader use of serological testing.
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Affiliation(s)
| | - Robert Badura
- MD, Infectious and Parasitic Diseases University Clinic, Faculty of Medicine, Santa Maria's University Hospital, Lisbon, Portugal
| | - Emília Valadas
- PhD, Infectious and Parasitic Diseases University Clinic, Faculty of Medicine, Santa Maria's University Hospital, Lisbon, Portugal
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154
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Quijada S, Terán B, Murias P, Anitua A, Cermeño J, Frías A. Q fever and spontaneous abortion. Clin Microbiol Infect 2012; 18:533-8. [DOI: 10.1111/j.1469-0691.2011.03562.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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155
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Zoonotic Infections in Native Communities of James Bay, Canada. Vector Borne Zoonotic Dis 2012; 12:473-81. [DOI: 10.1089/vbz.2011.0739] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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156
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Carrascosa MF, Pascual Velasco F, Gómez Izquierdo R, Salcines-Caviedes JR, Gómez Amigo V, Canga-Villegas AM. Acute Q fever myocarditis: Thinking about a life-threatening but potentially curable condition. Int J Cardiol 2012; 158:e17-9. [DOI: 10.1016/j.ijcard.2011.10.042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 10/18/2011] [Indexed: 01/17/2023]
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157
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Bernard H, Brockmann SO, Kleinkauf N, Klinc C, Wagner-Wiening C, Stark K, Jansen A. High seroprevalence of Coxiella burnetii antibodies in veterinarians associated with cattle obstetrics, Bavaria, 2009. Vector Borne Zoonotic Dis 2012; 12:552-7. [PMID: 22607080 DOI: 10.1089/vbz.2011.0879] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Q fever is a zoonosis caused by Coxiella burnetii. Infection can result in severe disease. However, little is known about the risk of infection in veterinarians. In a cross-sectional study among German veterinarians, participants provided sera and completed an exposure questionnaire. We investigated predictors for seropositivity using multivariable logistic regression modelling. The 424 participants' median age was 40 (18-74) years, and 276 (65%) were female. Sera of 162 (38%) were positive for Coxiella burnetii phase II IgG antibodies (by ELISA and IFAT). Predictors for seropositivity were occupational exposure to cattle (aOR 2.83, 95% CI 1.64-4.87), occupational exposure to sheep (2.09, 1.22-3.58), male sex (1.9, 1.15-3.13), and increasing age (30-39 years: 4.91, 2.00-12.04; 40-49 years: 5.32, 2.12-13.33; >50 years: 6.70, 2.60-17.25; compared with <30 years). When investigating occupational exposure to cattle and sheep in detail in a separate model, the seroprevalence increased with increasing numbers of cattle obstetrics procedures performed per month, and with increasing numbers of individual cattle treated per week. The high antibody prevalence implies a high lifetime-risk of Q fever in veterinarians. Cattle veterinarians, especially those frequently performing obstetrics, should be counseled early in their career on the clinical picture of Q fever, and on specific risks.
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Affiliation(s)
- Helen Bernard
- Robert Koch Institute, Department for Infectious Disease Epidemiology, Berlin, Germany.
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158
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Chronic Q fever: expert opinion versus literature analysis and consensus. J Infect 2012; 65:102-8. [PMID: 22537659 DOI: 10.1016/j.jinf.2012.04.006] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 04/10/2012] [Indexed: 12/20/2022]
Abstract
Q fever has long been considered a rare disease. The extensive outbreak in the Netherlands generated a body of literature based solely on the consensus in the Netherlands. As a long-standing expert on Q fever, I offer my experience and recommendations to the E-CDC and the Dutch Q fever Consensus Group. My (biased) opinion is that experts deeply involved in the field continue to be useful in the management of outbreaks and can avoid decisions that produce an unfavorable progression in patients. Here, I propose that the definition of "chronic Q fever" be avoided and suggest a new score-based diagnosis for Q fever endocarditis and vascular infection.
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159
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Kampschreur LM, Dekker S, Hagenaars JCJP, Lestrade PJ, Renders NHM, de Jager-Leclercq MGL, Hermans MHA, Groot CAR, Groenwold RHH, Hoepelman AIM, Wever PC, Oosterheert JJ. Identification of risk factors for chronic Q fever, the Netherlands. Emerg Infect Dis 2012; 18:563-70. [PMID: 22469535 PMCID: PMC3309671 DOI: 10.3201/eid1804.111478] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Since 2007, the Netherlands has experienced a large Q fever outbreak. To identify and quantify risk factors for development of chronic Q fever after Coxiella burnetii infection, we performed a case-control study. Comorbidity, cardiovascular risk factors, medications, and demographic characteristics from 105 patients with proven (n = 44), probable (n = 28), or possible (n = 33) chronic Q fever were compared with 201 patients who had acute Q fever in 2009 but in whom chronic Q fever did not develop (controls). Independent risk factors for development of proven chronic Q fever were valvular surgery, vascular prosthesis, aneurysm, renal insufficiency, and older age.
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160
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A Case of Acute Q Fever Hepatitis Diagnosed by F-18 FDG PET/CT. Nucl Med Mol Imaging 2012; 46:125-8. [PMID: 24900046 DOI: 10.1007/s13139-012-0130-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 02/10/2012] [Indexed: 10/28/2022] Open
Abstract
A 53-year-old man with fever of unknown origin underwent F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) as a workup for a fever of unknown origin. On presentation, he complained of fever, chills, and myalgia. The F-18 FDG PET/CT scan showed diffusely increased uptake of the liver with mild hepatomegaly. A liver biopsy then revealed fibrin-ring granulomas typically seen in Q fever. The patient was later serologically diagnosed as having acute Q fever as the titers for C. burnetii IgM and IgG were 64:1 and 16:1, respectively. He recovered completely following administration of doxycycline. This indicates that F-18 FDG PET/CT may be helpful for identifying hepatic involvement in Q fever as a cause of fever of unknown origin.
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161
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Microbiological challenges in the diagnosis of chronic Q fever. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:787-90. [PMID: 22441385 DOI: 10.1128/cvi.05724-11] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Diagnosis of chronic Q fever is difficult. PCR and culture lack sensitivity; hence, diagnosis relies mainly on serologic tests using an immunofluorescence assay (IFA). Optimal phase I IgG cutoff titers are debated but are estimated to be between 1:800 and 1:1,600. In patients with proven, probable, or possible chronic Q fever, we studied phase I IgG antibody titers at the time of positive blood PCR, at diagnosis, and at peak levels during chronic Q fever. We evaluated 200 patients, of whom 93 (46.5%) had proven, 51 (25.5%) had probable, and 56 (28.0%) had possible chronic Q fever. Sixty-five percent of proven cases had positive Coxiella burnetii PCR results for blood, which was associated with high phase I IgG. Median phase I IgG titers at diagnosis and peak titers in patients with proven chronic Q fever were significantly higher than those for patients with probable and possible chronic Q fever. The positive predictive values for proven chronic Q fever, compared to possible chronic Q fever, at titers 1:1,024, 1:2,048, 1:4,096, and ≥1:8,192 were 62.2%, 66.7%, 76.5%, and ≥86.2%, respectively. However, sensitivity dropped to <60% when cutoff titers of ≥1:8,192 were used. Although our study demonstrated a strong association between high phase I IgG titers and proven chronic Q fever, increasing the current diagnostic phase I IgG cutoff to >1:1,024 is not recommended due to increased false-negative findings (sensitivity < 60%) and the high morbidity and mortality of untreated chronic Q fever. Our study emphasizes that serologic results are not diagnostic on their own but should always be interpreted in combination with clinical parameters.
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162
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Chronic Q fever: Review of the literature and a proposal of new diagnostic criteria. J Infect 2012; 64:247-59. [DOI: 10.1016/j.jinf.2011.12.014] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 12/20/2011] [Accepted: 12/20/2011] [Indexed: 12/19/2022]
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163
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Lee M, Jang JJ, Kim YS, Lee SO, Choi SH, Kim SH, Yu E. Clinicopathologic features of q Fever patients with acute hepatitis. KOREAN JOURNAL OF PATHOLOGY 2012; 46:10-4. [PMID: 23109972 PMCID: PMC3479695 DOI: 10.4132/koreanjpathol.2012.46.1.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 10/04/2011] [Accepted: 11/22/2011] [Indexed: 11/17/2022]
Abstract
Background Q fever caused by Coxiella burnetii presents with diverse clinical and pathological features including subclinical or cholestatic hepatitis. However, the pathological features of liver biopsies from patients with Q fever have not been well described. Methods Clinical features and pathological findings of liver biopsies were reviewed in seven cases of Q fever that were confirmed by serological, microbiological, or molecular tests. Results All cases presented with fever. Liver enzymes were mildly elevated except one case with marked hyperbilirubinemia. Characteristic fibrin ring granulomas were present in three cases, epithelioid granulomas with eosinophilic infiltration in two cases, extensive extravasated fibrins without ring configuration mimicking necrotizing granuloma in one case, and acute cholangitis without granuloma in one case. All cases were treated with antibiotics for 20 days. Six cases were completely cured, but one suffered from multiorgan failure. Conclusions C. burnetii infection is uncommon, but should always be considered in patients with acute hepatitis and fever. Because variable-sized circumferential or radiating fibrin deposition was a consistent feature of the present cases, Q fever can be strongly suggested by pathological features and confirmed by serological and/or molecular tests.
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Affiliation(s)
- Miji Lee
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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164
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Merhej V, Tattevin P, Revest M, Le Touvet B, Raoult D. Q fever osteomyelitis: a case report and literature review. Comp Immunol Microbiol Infect Dis 2012; 35:169-72. [PMID: 22285690 DOI: 10.1016/j.cimid.2011.12.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 12/14/2011] [Accepted: 12/19/2011] [Indexed: 11/28/2022]
Abstract
Q fever is a worldwide zoonosis caused by Coxiella burnetii. The clinical manifestations of Q fever include endocarditis, pneumonitis and hepatitis. Disease awareness and evolving diagnostic tests have enabled the recognition of unusual manifestations of Q fever. We report a case of Q fever osteomyelitis. A 51-year-old patient was admitted to hospital because of fever, leg weakness, and asthenia. His past medical history included surgery and a bone graft for the treatment of a giant cell tumor on the distal part of the femur. Blood and bone biopsy cultures were negative. Bone histological examination was consistent with a sub-acute or chronic inflammatory reaction that involved foci of epithelioid and gigantocellular infiltrates and necrosis. Serology testing revealed high antibody titers to C. burnetii antigens (phase I: IgG 3200; IgA 200; phase II: IgG 6400; IgA 400), which is indicative of chronic Q fever. The specific Polymerase Chain Reaction (PCR) of the abscess sample from the femoral region was positive for C. burnetii. The patient was treated for chronic Q fever with doxycycline and hydroxychloroquine for 18 months and recovered gradually without recurrence of pain or functional impairment. Q fever osteomyelitis is a rare and most likely underestimated disease. Epithelioid and gigantocellular granulomatous osteomyelitis in the context of culture-negative bone specimens should raise suspicion of Q fever. Serological tests, specific PCR and cell culture can provide evidence of a C. burnetii infection. Although bone diffusion may be a concern, the currently recommended treatment for Q fever was effective in this case.
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Affiliation(s)
- Vicky Merhej
- University of the Mediterranean, Marseille, France
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165
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Epidemic Q fever in humans in the Netherlands. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 984:329-64. [PMID: 22711640 DOI: 10.1007/978-94-007-4315-1_17] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In 2005, Q fever was diagnosed on two dairy goat farms and 2 years later it emerged in the human population in the south of the Netherlands. From 2007 to 2010, more than 4,000 human cases were notified with an annual seasonal peak. The outbreaks in humans were mainly restricted to the south of the country in an area with intensive dairy goat farming. In the most affected areas, up to 15% of the population may have been infected. The epidemic resulted in a serious burden of disease, with a hospitalisation rate of 20% of notified cases and is expected to result in more cases of chronic Q fever among risk groups in the coming years. The most important risk factor for human Q fever is living close (<5 km) to an infected dairy goat farm. Occupational exposure plays a much smaller role. In 2009 several veterinary control measures were implemented including mandatory vaccination of dairy goats and dairy sheep, improved hygiene measures, and culling of pregnant animals on infected farms. The introduction of these drastic veterinary measures has probably ended the Q fever outbreak, for which the Netherlands was ill-prepared.
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166
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Thuillier F, Chehade H. Endocardite à Coxiella burnetti en l’absence d’exposition évidente. Rev Med Interne 2012; 33:e3-5. [DOI: 10.1016/j.revmed.2011.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 01/03/2011] [Accepted: 01/15/2011] [Indexed: 11/26/2022]
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167
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Delsing CE, Warris A, Bleeker-Rovers CP. Q Fever: Still More Queries than Answers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2012; 719:133-43. [DOI: 10.1007/978-1-4614-0204-6_12] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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168
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Porter SR, Czaplicki G, Mainil J, Guattéo R, Saegerman C. Q Fever: current state of knowledge and perspectives of research of a neglected zoonosis. Int J Microbiol 2011; 2011:248418. [PMID: 22194752 PMCID: PMC3238387 DOI: 10.1155/2011/248418] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Accepted: 08/23/2011] [Indexed: 12/19/2022] Open
Abstract
Q fever is an ubiquitous zoonosis caused by an resistant intracellular bacterium, Coxiella burnetii. In certain areas, Q fever can be a severe public health problem, and awareness of the disease must be promoted worldwide. Nevertheless, knowledge of Coxiella burnetii remains limited to this day. Its resistant (intracellular and environmental) and infectious properties have been poorly investigated. Further understanding of the interactions between the infected host and the bacteria is necessary. Domestic ruminants are considered as the main reservoir of bacteria. Infected animals shed highly infectious organisms in milk, feces, urine, vaginal mucus, and, very importantly, birth products. Inhalation is the main route of infection. Frequently asymptomatic in humans and animals, Q fever can cause acute or chronic infections. Financial consequences of infection can be dramatic at herd level. Vaccination with inactive whole-cell bacteria has been performed and proved effective in humans and animals. However, inactive whole-cell vaccines present several defects. Recombinant vaccines have been developed in experimental conditions and have great potential for the future. Q fever is a challenging disease for scientists as significant further investigations are necessary. Great research opportunities are available to reach a better understanding and thus a better prevention and control of the infection.
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Affiliation(s)
- Sarah Rebecca Porter
- Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR), Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, B42, Boulevard de Colonster 20, 4000 Liège, Belgium
| | - Guy Czaplicki
- Département de Sérologie, Association Régionale de Santé et d'Identification Animales, 4431 Loncin, Belgium
| | - Jacques Mainil
- Laboratory of Bacteriology, Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, Sart-Tilman B43a, 4000 Liège, Belgium
| | - Raphaël Guattéo
- UMR 1300 Bio-Agression, Epidémiologie et Analyse de Risque, INRA, 44307 Nantes, France
| | - Claude Saegerman
- Research Unit in Epidemiology and Risk Analysis Applied to Veterinary Sciences (UREAR), Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, B42, Boulevard de Colonster 20, 4000 Liège, Belgium
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169
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Kloppenburg GT, van de Pavoordt ED, de Vries JPP. Endograft-preserving therapy of a patient with Coxiella burnetii-infected abdominal aortic aneurysm: a case report. J Med Case Rep 2011; 5:565. [PMID: 22145758 PMCID: PMC3250966 DOI: 10.1186/1752-1947-5-565] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 12/06/2011] [Indexed: 11/24/2022] Open
Abstract
Introduction Coxiella burnetii, the causative agent of Q fever, may cause endocarditis and vascular infections that result in severe morbidity and mortality. We report a case of a C. burnetii-infected abdominal aorta and its management in a patient with a previous endovascular aortic aneurysm repair. Case presentation A 62-year-old Caucasian man was admitted to our hospital three months after endovascular aortic aneurysm repair with a bifurcated stent graft. He had increasing abdominal complaints and general malaise. A computed tomography scan of his abdomen revealed several para-aneurysmal abscesses. Surgery was performed via midline laparotomy. The entire abdominal wall of his aneurysmal sac, including the abscesses, was removed. The vascular endoprosthesis showed no macroscopic signs of infection. The decision was made to leave the endograft in place because of the severe cardiopulmonary comorbidities, thereby avoiding suprarenal clamping and explantation of this device with venous reconstruction. The proximal and distal parts of the endograft were secured to the aortic wall and common iliac artery walls, respectively, to avoid future migration. Polymerase chain reaction for C. burnetii was positive in all specimens of aortic tissue. Specific antibiotic therapy was initiated. Our patient was discharged in good clinical condition after six days. Conclusions In our patient, the infection was limited to the abdominal aneurysm wall, which was removed, leaving the endograft in place. Vascular surgeons should be familiar with this bailout procedure in high-risk patients.
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Affiliation(s)
- Geoffrey Tl Kloppenburg
- Department of Cardiothoracic Surgery, St, Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands.
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170
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Bennett MD, Woolford L, Banazis MJ, O'Hara AJ, Warren KS, Nicholls PK, Sims C, Fenwick SG. Coxiella burnetii in western barred bandicoots (Perameles bougainville) from Bernier and Dorre Islands in Western Australia. ECOHEALTH 2011; 8:519-524. [PMID: 22167449 DOI: 10.1007/s10393-011-0729-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2010] [Revised: 10/21/2011] [Accepted: 11/10/2011] [Indexed: 05/31/2023]
Abstract
The aim of this work is to investigate the presence of Coxiella burnetii in Perameles bougainville and their ticks on two islands off Western Australia. Haemaphysalis humerosa, Haemaphysalis ratti, and Haemaphysalis lagostrophi were collected from P. bougainville on Bernier and Dorre Islands from 2005 to 2007; only Amblyomma limbatum was collected from humans over the same interval. One of 13 tick samples and 1 of 12 P. bougainville fecal samples were positive for C. burnetii DNA using quantitative polymerase chain reaction. DNA fragments had >99% similarity to published C. burnetii sequences. Three of 35 P. bougainville sera tested positive for anti-C. burnetii antibodies using enzyme-linked immunosorbent assay. C. burnetii was found in P. bougainville feces and a H. humerosa tick on Dorre Island and Bernier Island, respectively. This is the first reported use of enzyme-linked immunosorbent assay for screening of P. bougainville sera. The risk of zoonotic Q fever infection for human visitors to these islands is considered relatively low, however, appropriate precautions should be taken when handling western barred bandicoots, their feces and their ticks on Bernier and Dorre Islands.
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Affiliation(s)
- Mark D Bennett
- School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA, Australia.
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171
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Gould FK, Denning DW, Elliott TSJ, Foweraker J, Perry JD, Prendergast BD, Sandoe JAT, Spry MJ, Watkin RW, Working Party of the British Society for Antimicrobial Chemotherapy. Guidelines for the diagnosis and antibiotic treatment of endocarditis in adults: a report of the Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 2011; 67:269-89. [PMID: 22086858 DOI: 10.1093/jac/dkr450] [Citation(s) in RCA: 299] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The BSAC guidelines on treatment of infectious endocarditis (IE) were last published in 2004. The guidelines presented here have been updated and extended to reflect developments in diagnostics, new trial data and the availability of new antibiotics. The aim of these guidelines, which cover both native valve and prosthetic valve endocarditis, is to standardize the initial investigation and treatment of IE. An extensive review of the literature using a number of different search criteria has been carried out and cited publications used to support any changes we have made to the existing guidelines. Publications referring to in vitro or animal models have only been cited if appropriate clinical data are not available. Randomized, controlled trials suitable for the development of evidenced-based guidelines in this area are still lacking and therefore a consensus approach has again been adopted for most recommendations; however, we have attempted to grade the evidence, where possible. The guidelines have also been extended by the inclusion of sections on clinical diagnosis, echocardiography and surgery.
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Affiliation(s)
- F Kate Gould
- Department of Microbiology, Freeman Hospital, Newcastle upon Tyne, UK.
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172
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van Wijk MJ, Hogema BM, Maas DW, Bokhorst AG. A Q Fever Outbreak in the Netherlands: Consequences for Tissue Banking. ACTA ACUST UNITED AC 2011; 38:357-364. [PMID: 22403519 DOI: 10.1159/000334599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND: Emerging infectious diseases can compromise the safety of tissues for transplantations. A recent outbreak of Q fever, a zoonosis caused by the bacterium Coxiella burnetii, in the Netherlands compelled the Dutch tissue banks to assess the risk of Q fever transmission through tissue transplantation in order to maintain optimal safety. MATHODS: This article describes the systematic approach that was followed in the Netherlands. This approach included a review of the literature, a qualitative risk assessment, expert opinion gathering and investigations for specific strategies that can help to maintain the balance between tissue safety and availability. RESULTS: This resulted in a specific donor selection policy and in development of further research to fill in gaps in knowledge about Q fever in tissue transplantation. CONCLUSION: The strategy described in this article may be useful for tissue bankers facing similar outbreaks of emerging infections or may be useful for development of future guidelines or assessment strategies for tissue banking.
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173
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van der Hoek W, Versteeg B, Meekelenkamp JCE, Renders NHM, Leenders ACAP, Weers-Pothoff I, Hermans MHA, Zaaijer HL, Wever PC, Schneeberger PM. Follow-up of 686 patients with acute Q fever and detection of chronic infection. Clin Infect Dis 2011; 52:1431-6. [PMID: 21628483 DOI: 10.1093/cid/cir234] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Recent outbreaks in the Netherlands allowed for laboratory follow-up of a large series of patients with acute Q fever and for evaluation of test algorithms to detect chronic Q fever, a condition with considerable morbidity and mortality. METHODS For 686 patients with acute Q fever, IgG antibodies to Coxiella burnetii were determined using an immunofluorescence assay at 3, 6, and 12 months of follow-up. Polymerase chain reaction (PCR) was performed after 12 months and on earlier serum samples with an IgG phase I antibody titer ≥ 1:1024. RESULTS In 43% of patients, the IgG phase II antibody titers remained high (≥ 1:1024) at 3, 6, and 12 months of follow-up. Three months after acute Q fever, 14% of the patients had an IgG phase I titer ≥ 1:1024, which became negative later in 81%. IgG phase I antibody titers were rarely higher than phase II titers. Eleven cases of chronic Q fever were identified on the basis of serological profile, PCR results, and clinical presentation. Six of these patients were known to have clinical risk factors at the time of acute Q fever. In a comparison of various serological algorithms, IgG phase I titer ≥ 1:1024 at 6 months had the most favorable sensitivity and positive predictive value for the detection of chronic Q fever. CONCLUSIONS The wide variation of serological and PCR results during the follow-up of acute Q fever implies that the diagnosis of chronic Q fever, necessitating long-term antibiotic treatment, must be based primarily on clinical grounds. Different serological follow-up strategies are needed for patients with and without known risk factors for chronic Q fever.
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Affiliation(s)
- Wim van der Hoek
- Epidemiology and Surveillance Unit, Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
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174
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Successful management of chronic multifocal Q fever Osteomyelitis with adjuvant interferon-gamma therapy. Pediatr Infect Dis J 2011; 30:810-2. [PMID: 21372749 DOI: 10.1097/inf.0b013e31821487f5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a 3-year-old girl who had chronic recurrent multifocal osteomyelitis caused by Coxiella burnetii despite long-term dual antibiotic therapy. Excellent clinical response was achieved and sustained when immunomodulatory therapy with interferon-γ was initiated. This is the case of a first child who was successfully treated with interferon-γ as adjuvant therapy for chronic multifocal Q fever osteomyelitis.
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175
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Vascular Complications of Q-fever Infections. Eur J Vasc Endovasc Surg 2011; 42:384-92. [DOI: 10.1016/j.ejvs.2011.04.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 04/06/2011] [Indexed: 11/23/2022]
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176
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Abstract
To assess Q fever in France, we analyzed data for 1985–2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous increase. Periodic variations were observed in monthly distribution during January 2000–December 2009; cases peaked during April–September. Q fever was diagnosed more often in patients in southeastern France, where our laboratory is situated, than in other areas. Reevaluation of the current positive predictive value of serologic analysis for endocarditis was performed. We propose a change in the phase I (virulent bacteria) immunoglobulin G cutoff titer to >1,600. Annual incidences of acute Q fever and endocarditis were 2.5/100,000 persons and 0.1/100,000 persons, respectively. Cases and outbreaks of Q fever have increased in France.
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177
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Harris P, Dixit R, Norton R. Coxiella burnetii causing haemophagocytic syndrome: a rare complication of an unusual pathogen. Infection 2011; 39:579-82. [PMID: 21713429 DOI: 10.1007/s15010-011-0142-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 06/09/2011] [Indexed: 12/25/2022]
Abstract
We describe an unusual presentation of Q fever with associated haemophagocytic syndrome, confirmed by bone marrow aspirate, Q fever polymerase chain reaction (PCR) and serological testing. Clinical recovery was observed after the commencement of doxycycline with normalisation of the patient's full blood count and serum biochemistry. Serial monitoring of the Q fever serology revealed the subsequent development of sustained high phase 1 IgG antibodies, suggestive of chronic Q fever. Although many infectious aetiologies have been associated with haemophagocytosis, Q fever has only rarely been described in this context. The diagnosis of Q fever is often overlooked, especially when the presentation is atypical. We describe how the use of PCR testing significantly shortened the interval to definitive diagnosis and helped elucidate the underlying cause of the patient's haematological disorder.
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Affiliation(s)
- P Harris
- Pathology Queensland, Townsville Hospital, Douglas, QLD 4811, Australia.
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178
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Courcoul A, Monod H, Nielen M, Klinkenberg D, Hogerwerf L, Beaudeau F, Vergu E. Modelling the effect of heterogeneity of shedding on the within herd Coxiella burnetii spread and identification of key parameters by sensitivity analysis. J Theor Biol 2011; 284:130-41. [PMID: 21723294 DOI: 10.1016/j.jtbi.2011.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 04/16/2011] [Accepted: 06/16/2011] [Indexed: 10/18/2022]
Abstract
Coxiella burnetii is the bacterium responsible for Q fever, a worldwide zoonosis. Ruminants, especially cattle, are recognized as the most important source of human infections. Although a great heterogeneity between shedder cows has been described, no previous studies have determined which features such as shedding route and duration or the quantity of bacteria shed have the strongest impact on the environmental contamination and thus on the zoonotic risk. Our objective was to identify key parameters whose variation highly influences C. burnetii spread within a dairy cattle herd, especially those related to the heterogeneity of shedding. To compare the impact of epidemiological parameters on different dynamical aspects of C. burnetii infection, we performed a sensitivity analysis on an original stochastic model describing the bacterium spread and representing the individual variability of the shedding duration, routes and intensity as well as herd demography. This sensitivity analysis consisted of a principal component analysis followed by an ANOVA. Our findings show that the most influential parameters are the probability distribution governing the levels of shedding, especially in vaginal mucus and faeces, the characteristics of the bacterium in the environment (i.e. its survival and the fraction of bacteria shed reaching the environment), and some physiological parameters related to the intermittency of shedding (transition probability from a non-shedding infected state to a shedding state) or to the transition from one type of shedder to another one (transition probability from a seronegative shedding state to a seropositive shedding state). Our study is crucial for the understanding of the dynamics of C. burnetii infection and optimization of control measures. Indeed, as control measures should impact the parameters influencing the bacterium spread most, our model can now be used to assess the effectiveness of different control strategies of Q fever within dairy cattle herds.
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Affiliation(s)
- Aurélie Courcoul
- Institut National de la Recherche Agronomique, UMR1300 Biologie, Epidémiologie et Analyse de Risque, Atlanpôle La Chantrerie, Nantes, France.
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179
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Endocarditis of Bovine Jugular Vein Conduit Due to Q Fever. Ann Thorac Surg 2011; 91:1990-2. [DOI: 10.1016/j.athoracsur.2010.12.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 12/14/2010] [Accepted: 12/20/2010] [Indexed: 11/30/2022]
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180
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Skultety L, Hajduch M, Flores-Ramirez G, Miernyk JA, Ciampor F, Toman R, Sekeyova Z. Proteomic comparison of virulent phase I and avirulent phase II of Coxiella burnetii, the causative agent of Q fever. J Proteomics 2011; 74:1974-84. [PMID: 21616182 DOI: 10.1016/j.jprot.2011.05.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 04/20/2011] [Accepted: 05/09/2011] [Indexed: 01/06/2023]
Abstract
Coxiella burnetii, a category B biological warfare agent, causes multiple outbreaks of the zoonotic disease Q fever world-wide, each year. The virulent phase I and avirulent phase II variants of the Nine Mile RSA 493 and 439 strains of C. burnetii were propagated in embryonated hen eggs and then purified by centrifugation through Renografin gradients. Total protein fractions were isolated from each phase and subjected to analysis by one-dimensional electrophoresis plus tandem mass spectrometry. A total of 235 and 215 non-redundant proteins were unambiguously identified from the phase I and II cells, respectively. Many of these proteins had not been previously reported in proteomic studies of C. burnetii. The newly identified proteins should provide additional insight into the pathogenesis of Q fever. Several of the identified proteins are involved in the biosynthesis and metabolism of components of the extracellular matrix. Forty-four of the proteins have been annotated as having distinct roles in the pathogenesis or survival of C. burnetii within the harsh phagolysosomal environment. We propose that nine enzymes specifically involved with lipopolysaccharide biosynthesis and metabolism, and that are distinctively present in phase I cells, are virulence-associated proteins.
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Affiliation(s)
- Ludovit Skultety
- Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovakia.
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181
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King LA, Goirand L, Tissot-Dupont H, Giunta B, Giraud C, Colardelle C, Duquesne V, Rousset E, Aubert M, Thiéry R, Calatayud L, Daurat G, Hocqueloux L, Cicchelero V, Golliot F, de Valk H. Outbreak of Q fever, Florac, Southern France, Spring 2007. Vector Borne Zoonotic Dis 2011; 11:341-7. [DOI: 10.1089/vbz.2010.0050] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Lisa A. King
- Regional Epidemiology Unit Languedoc-Roussillon, Montpellier, France
- European Program for Intervention Epidemiology Training (Epiet), Stockholm, Sweden
| | - Laurence Goirand
- Regional Epidemiology Unit Languedoc-Roussillon, Montpellier, France
- French Program for Intervention Epidemiology Training (Profet), Saint Maurice, France
| | | | - Bruno Giunta
- Departmental Office of Health and Social Affairs, Lozère, France
| | - Christine Giraud
- Departmental Office of Health and Social Affairs, Lozère, France
| | | | | | | | | | | | | | - Gérald Daurat
- Regional Office of Health and Social Affairs, Montpellier, France
| | | | | | - Franck Golliot
- Regional Epidemiology Unit Languedoc-Roussillon, Montpellier, France
| | - Henriette de Valk
- French Institute for Public Health Surveillance, Saint-Maurice, France
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182
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Abstract
The liver plays an important role in host defense against invasive microorganisms. The effect of microbial pathogens on the liver can vary greatly, presenting with a wide variety of manifestations from asymptomatic increases in aminotransaminases, acute liver failure, hepatic fibrosis, and cirrhosis. In evaluating the liver manifestations of a potential infectious pathogen, diagnosis of some of the less common infectious pathogens is dependent on a high level of suspicion and recognition of some of the key diagnostic clues. Successful diagnosis can only be accomplished through a careful history, including travel and exposures, physical examination, and appropriate microbiologic studies. This article reviews the involvement of the liver during systemic infections with organisms that are not considered to be primarily hepatotropic.
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Affiliation(s)
- Rohit Talwani
- Assistant Professor of Medicine, Institute of Human Virology, Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
| | - Bruce L. Gilliam
- Associate Professor of Medicine, Institute of Human Virology, Division of Infectious Diseases, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
| | - Charles Howell
- Profesor of Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, University of Maryland School of Medicine, Baltimore MD
- Director of Hepatology Research University of Maryland School of Medicine, Baltimore, MD
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183
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Q fever endocarditis in Spain. Clinical characteristics and outcome. Enferm Infecc Microbiol Clin 2011; 29:109-16. [DOI: 10.1016/j.eimc.2010.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2010] [Revised: 06/12/2010] [Accepted: 07/09/2010] [Indexed: 11/21/2022]
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184
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A case of multifocal chronic Q fever osteomyelitis. Infection 2011; 39:167-9. [DOI: 10.1007/s15010-010-0076-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2010] [Accepted: 12/13/2010] [Indexed: 10/18/2022]
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185
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Distinguishing Tropical Infectious Diseases from Bioterrorism. TROPICAL INFECTIOUS DISEASES: PRINCIPLES, PATHOGENS AND PRACTICE 2011. [PMCID: PMC7150159 DOI: 10.1016/b978-0-7020-3935-5.00125-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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186
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Geri G, Cacoub P. [Hepatic granulomas]. Rev Med Interne 2010; 32:560-6. [PMID: 20832918 DOI: 10.1016/j.revmed.2010.06.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 05/29/2010] [Accepted: 06/24/2010] [Indexed: 10/19/2022]
Abstract
Liver granulomas are histopathologically defined and associated with various liver and non-livers disorders. There are five main causes of liver granulomatosis: primary biliary cirrhosis, tuberculosis, sarcoidosis, B and C viral hepatitis, and drug related. In the other cases, not associated with an underlying systemic granulomatous disease, a systematic diagnostic approach should be used to identify less common etiologies. After a careful diagnostic work-up, a long-term follow-up of patients with undetermined liver granulomatosis is mandatory as it may be a presenting feature of liver lymphoma.
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Affiliation(s)
- G Geri
- Service de Médecine Interne II, Université Pierre-et-Marie-Curie-Paris 6, CNRS, UMR 7087, Hôpital Pitié-Salpêtrière, AP-HP, 47-83, Boulevard de l'Hôpital, 75013 Paris cedex 13, France
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187
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Optic neuritis associated with Q fever: case report and literature review. Int J Infect Dis 2010; 14 Suppl 3:e269-73. [DOI: 10.1016/j.ijid.2009.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 10/09/2009] [Accepted: 11/05/2009] [Indexed: 11/18/2022] Open
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188
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Edouard S, Labussiere AS, Guimard Y, Fournier PE, Raoult D. Q fever: a case with a vascular infection complication. BMJ Case Rep 2010; 2010:2010/aug03_1/bcr0120102690. [PMID: 22767654 DOI: 10.1136/bcr.01.2010.2690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The most common clinical presentation of chronic Q fever is endocarditis with infections of aneurysms or vascular prostheses being the second most common presentation. Here, the authors report a case of vascular chronic Q fever. In this patient, a renal artery aneurysm was discovered by abdominal and pelvic CT during a systematic investigation to identify predisposing factors to chronic Q fever because of high antibody titres in a patient with valve disease.
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Affiliation(s)
- Sophie Edouard
- Universite de la Mediterranee, URMITE - CNRS UMR 6236 - IRD 198, Marseille, France
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189
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Gikas A, Kokkini S, Tsioutis C. Q fever: clinical manifestations and treatment. Expert Rev Anti Infect Ther 2010; 8:529-39. [PMID: 20455682 DOI: 10.1586/eri.10.29] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Public awareness and advances in the diagnostic approach to Q fever have provided important information on epidemiological and clinical aspects of this zoonosis. Coxiella burnetii infection exhibits various acute or chronic clinical forms, and infection during pregnancy may jeopardize the integrity of the fetus. The presentation of infection is often nonspecific and this hinders prompt diagnosis. Therapeutic regimens vary, and treating Q fever during pregnancy and childhood is often challenging. Increasing clinical experience with C. burnetii infections has helped create treatment protocols and follow-up algorithms that have considerably improved management and prognosis. Vaccines are available, although their use is still limited.
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Affiliation(s)
- Achilleas Gikas
- Department of Internal Medicine and Infectious Diseases, University Hospital of Heraklion, Heraklion 71110, Crete, Greece.
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190
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Vos FJ, Bleeker-Rovers CP, Delsing CE, Kullberg BJ, Oyen WJG. Bone-marrow uptake of 18F-FDG during fever. THE LANCET. INFECTIOUS DISEASES 2010; 10:509-10; author reply 510-1. [DOI: 10.1016/s1473-3099(10)70137-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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191
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Extremely elevated erythrocyte sedimentation rates (ESRs) in Legionnaires’ disease. Eur J Clin Microbiol Infect Dis 2010; 29:1567-9. [DOI: 10.1007/s10096-010-1016-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 06/26/2010] [Indexed: 11/26/2022]
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192
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Sakhaee E, Khalili M. The first serologic study of Q fever in sheep in Iran. Trop Anim Health Prod 2010; 42:1561-4. [PMID: 20521106 DOI: 10.1007/s11250-010-9606-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2010] [Indexed: 10/19/2022]
Abstract
Coxiella burnetii is an obligate intracellular microorganism that causes Q fever in humans and animals. In ewes, C. burnetii infections are generally asymptomatic, but they can lead to abortions, stillbirths, and delivery of weak and unviable lambs. Serological assays are suitable for screening herds. Enzyme-linked immunosorbent assays (ELISA) technique has a high sensitivity and a good specificity. The aim of this study was to investigate the presence of anti-C. burnetii antibodies among sheep in southeast Iran. A total of 85 serum samples were collected from ten sheep flocks from April to September 2009. Serum samples were tested for Q fever antibodies using a commercial indirect ELISA kit. Antibodies were detected in 25 sera (29.42%) of 85 samples. Sixteen female (18.82%) and nine male (10.58%) cases had antibodies specific to C. burnetii. There is significant difference in seropositivity between male and female groups (P < 0.05). This first study of C. burnetii seroprevalence in sheep in southeast Iran has indicated that seropositive animals can be found throughout the country. Further work is now required to characterize the epidemiology of the infection more thoroughly.
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Affiliation(s)
- Ehsanollah Sakhaee
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran.
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193
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Samoilis G, Aivaliotis M, Vranakis I, Papadioti A, Tselentis Y, Tsiotis G, Psaroulaki A. Proteomic screening for possible effector molecules secreted by the obligate intracellular pathogen Coxiella burnetii. J Proteome Res 2010; 9:1619-26. [PMID: 20044831 DOI: 10.1021/pr900605q] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Coxiella burnetii is a Gram-negative, gamma-proteobacteria with nearly worldwide distribution, and it is the pathogenic agent of Q-fever in man. It is an obligate intracellular parasite that is highly adapted to reside within the eukaryotic phagolysosome. In fact, it is the only known intracellular bacterium that manages to survive and replicate within a fully formed, acidic phagolysosome. C. burnetti possesses a functional Type 4 Secretion System (T4SS), similar to the Dot/Icm system of Legionella pneumophila. Up to date there have been no reports for the effector molecules secreted by Coxiella's T4SS. These are speculated to have quite different roles than the effectors of other intracellular pathogens, since there is no need for phagosomal arrest or escape in the case of Coxiella. In this study, we have investigated the cytoplasm of Vero cells infected with C. burnetti strain Nine Mile Phase II. We have identified by mass spectrometry (ESI-MS/MS) several C. burnetti proteins that bear typical characteristics of effector molecules. Most of the identified proteins were also very alkaline, something which is supportive for a protective strategy that has evolved in this bizarre pathogen against acidic environments.
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Affiliation(s)
- Georgios Samoilis
- Division of Biochemistry, Department of Chemistry, University of Crete, P.O. Box 2208, GR-71003 Voutes, Greece
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194
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195
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Courcoul A, Vergu E, Denis JB, Beaudeau F. Spread of Q fever within dairy cattle herds: key parameters inferred using a Bayesian approach. Proc Biol Sci 2010; 277:2857-65. [PMID: 20444719 DOI: 10.1098/rspb.2010.0575] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Q fever is a worldwide zoonosis caused by Coxiella burnetii. Although ruminants are recognized as the most important source of human infection, no previous studies have focused on assessing the characteristics of the bacterial spread within a cattle herd and no epidemic model has been proposed in this context. We assess the key epidemiological parameters from field data in a Bayesian framework that takes into account the available knowledge, missing data and the uncertainty of the observation process owing to the imperfection of diagnostic tests. We propose an original individual-based Markovian model in discrete time describing the evolution of the infection for each animal. Markov chain Monte Carlo methodology is used to estimate parameters of interest from data consisting of individual health states of 217 cows of five chronically infected dairy herds sampled every week for a four-week period. Outputs are the posterior distributions of the probabilities of transition between health states and of the environmental bacterial load. Our findings show that some herds are characterized by a very low infection risk while others have a mild infection risk and a non-negligible intermittent shedding probability. Moreover, the antibody status seems to be a key point in the bacterial spread (shedders with antibodies shed for a longer period of time than shedders without antibodies). In addition to the biological insights, these estimates also provide information for calibrating simulation models to assess control strategies for C. burnetii infection.
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196
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Lefebvre M, Grossi O, Agard C, Perret C, Le Pape P, Raoult D, Hamidou MA. Systemic Immune Presentations of Coxiella burnetii Infection (Q Fever). Semin Arthritis Rheum 2010; 39:405-9. [DOI: 10.1016/j.semarthrit.2008.10.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 09/02/2008] [Accepted: 10/01/2008] [Indexed: 11/26/2022]
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197
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Seroprevalence of Q fever in a district located in the west Black Sea region of Turkey. Eur J Clin Microbiol Infect Dis 2010; 29:465-9. [PMID: 20195671 DOI: 10.1007/s10096-010-0885-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 01/30/2010] [Indexed: 10/19/2022]
Abstract
Q fever is a worldwide zoonosis caused by Coxiella burnetii. In Turkey, it has been reported from the late 1940s that Q fever is endemic in humans and animals. Our objective was to evaluate the seroprevalence in Samsun Tekkeköy (north Turkey), where an outbreak of Q fever occurred in 2002. In this cross-sectional study, subjects were selected by the random proportional sampling method. All subjects were healthy with no specific symptoms and tested by the microimmunofluorescent antibody test. In total, we tested 407 subjects; 33 (8.1%) of them were identified as past evidence of infection and 22 (5.4%) were considered as evolutive form of Q fever (17 acute and five chronic forms). The seroprevalence was significantly higher among people over 30 years of age, hunters, and slaughters than the others (p = 0.001, p = 0.034, and p = 0.006, respectively). We found 13.5% seropositivity among healthy subjects, confirming that Q fever is prevalent in our region and is often asymptomatic.
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Angelakis E, Raoult D. Q fever. Vet Microbiol 2010; 140:297-309. [DOI: 10.1016/j.vetmic.2009.07.016] [Citation(s) in RCA: 434] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2008] [Revised: 07/03/2009] [Accepted: 07/30/2009] [Indexed: 01/17/2023]
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