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McMillan IA, Norris MH, Golon SJ, Franckowiak GA, Grinolds JM, Goldstein SM, Phelps DM, Bodenchuk MJ, Leland BR, Bowen RA, Brown VR, Borlee BR. Serosurveillance of Coxiella burnetii in feral swine populations of Hawai'i and Texas identifies overlap with human Q fever incidence. J Clin Microbiol 2024:e0078024. [PMID: 39189735 DOI: 10.1128/jcm.00780-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024] Open
Abstract
Feral swine are invasive in the United States and a reservoir for infectious diseases. The increase in feral swine population and the geographic range are a concern for the spread of zoonotic diseases to humans and livestock. Feral swine could contribute to the spread of Coxiella burnetii, the causative agent of human Q fever. In this study, we characterized the seroprevalence of C. burnetii in feral swine populations of Hawai'i and Texas, which have low and high rates of human Q fever, respectively. Seropositivity rates were as high as 0.19% and 6.03% in Hawai'i and Texas, respectively, indicating that feral swine cannot be ruled out as a potential reservoir for disease transmission and spread. In Texas, we identified the overlap between seropositivity of feral swine and human Q fever incidence. These results indicate that there is a potentially low but detectable risk of C. burnetii exposure associated with feral swine populations in Hawai'i and Texas.
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Affiliation(s)
- Ian A McMillan
- School of Life Sciences, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Michael H Norris
- Pathogen Analysis and Translational Health Group, School of Life Sciences, University of Hawai'i at Mānoa, Honolulu, Hawai'i, USA
| | - Samuel J Golon
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
| | - Gregory A Franckowiak
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Feral Swine Damage Management Program, Fort Collins, Colorado, USA
| | - James M Grinolds
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Feral Swine Damage Management Program, Fort Collins, Colorado, USA
| | - Samuel M Goldstein
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, Honolulu, Hawai'i, USA
| | - Darrin M Phelps
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, Honolulu, Hawai'i, USA
| | - Michael J Bodenchuk
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, San Antonio, Texas, USA
| | - Bruce R Leland
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, San Antonio, Texas, USA
| | - Richard A Bowen
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Vienna R Brown
- US Department of Agriculture, Animal and Plant Health Inspection Service, Wildlife Services, National Feral Swine Damage Management Program, Fort Collins, Colorado, USA
| | - Bradley R Borlee
- Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA
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Rodrigo C, Walker G, Sevendal ATK, Nguyen C, Stelzer-Braid S, Rawlinson W, Graves S, Gidding HF, Stenos J, Lloyd AR. Acute Q fever in patients with an influenza-like illness in regional New South Wales, Australia. PLoS Negl Trop Dis 2024; 18:e0012385. [PMID: 39102433 PMCID: PMC11326637 DOI: 10.1371/journal.pntd.0012385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 08/15/2024] [Accepted: 07/18/2024] [Indexed: 08/07/2024] Open
Abstract
INTRODUCTION Query (Q) fever is a zoonosis caused by the bacterium Coxiella burnetii typically presenting as an influenza-like illness (ILI) with or without hepatitis. The infection may be missed by clinicians in settings of low endemicity, as the presentation is clinically not specific, and there are many more common differential diagnoses for ILI including SARS-CoV-2 infection. METHODS Residual serum samples were retrospectively tested for Phase 1 and 2 Q fever-specific IgM, IgG, IgA antibodies by indirect immunofluorescence and C. burnetii DNA by polymerase chain reaction. They had not been previously tested for Q fever, originating from undiagnosed patients with probable ILI, aged 10-70 years and living in regional New South Wales, Australia. The results were compared with contemperaneous data on acute Q fever diagnostic tests which had been performed based on clinicians requests from a geographically similar population. RESULTS Only one (0.2%) instance of missed acute Q fever was identified after testing samples from 542 eligible patients who had probable ILI between 2016-2023. Laboratory data showed that during the same period, 731 samples were tested for acute Q fever for clinician-initiated requests and of those 70 (9.6%) were positive. Probability of being diagnosed with Q fever after a clinician initiated request was similar regardless of the patients sex, age and the calendar year of sampling. CONCLUSION In this sample, Q fever was most likely to be diagnosed via clinician requested testing rather than by testing of undiagnosed patients with an influenza like illness.
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Affiliation(s)
- Chaturaka Rodrigo
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Gregory Walker
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Andrea T K Sevendal
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Chelsea Nguyen
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Sacha Stelzer-Braid
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - William Rawlinson
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- NSW Health Pathology, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Stephen Graves
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Heather F Gidding
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - John Stenos
- Australian Rickettsial Reference Laboratory, Geelong, Victoria, Australia
| | - Andrew R Lloyd
- Kirby Institute, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Delahaye A, Eldin C, Bleibtreu A, Djossou F, Marrie TJ, Ghanem-Zoubi N, Roeden S, Epelboin L. Treatment of persistent focalized Q fever: time has come for an international randomized controlled trial. J Antimicrob Chemother 2024; 79:1725-1747. [PMID: 38888195 DOI: 10.1093/jac/dkae145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/15/2024] [Indexed: 06/20/2024] Open
Abstract
Q fever is a worldwide zoonosis due to Coxiella burnetii, responsible for endocarditis and endovascular infections. Since the 1990s, the combination hydroxychloroquine + doxycycline has constituted the curative and prophylactic treatment in persistent focalized Q fever. This combination appears to have significantly reduced the treatment's duration (from 60 to 26 months), yet substantial evidence of effectiveness remains lacking. Data are mostly based on in vitro and observational studies. We conducted a literature review to assess the effectiveness of this therapy, along with potential alternatives. The proposed in vitro mechanism of action describes the inhibition of Coxiella replication by doxycycline through the restoration of its bactericidal activity (inhibited in acidic environment) by alkalinization of phagolysosome-like vacuoles with hydroxychloroquine. So far, the rarity and heterogeneous presentation of cases have made it challenging to design prospective studies with statistical power. The main studies supporting this treatment are retrospective cohorts, dating back to the 1990s-2000s. Retrospective studies from the large Dutch outbreak of Q fever (>4000 cases between 2007 and 2010) did not corroborate a clear benefit of this combination, notably in comparison with other regimens. Thus, there is still no consensus among the medical community on this issue. However insufficient the evidence, today the doxycycline + hydroxychloroquine combination remains the regimen with the largest clinical experience in the treatment of 'chronic' Q fever. Reinforcing the guidelines' level of evidence is critical. We herein propose the creation of an extensive international registry, followed by a prospective cohort or ideally a randomized controlled trial.
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Affiliation(s)
- Audrey Delahaye
- Department of Infectious and Tropical Diseases, Andrée Rosemon Hospital, Cayenne, French Guiana
| | - Carole Eldin
- UMR UVE, Aix Marseille University, IRD 190 Inserm, 1207 EFS-IRBA, Marseille, France
| | - Alexandre Bleibtreu
- Department of Infectious and Tropical Diseases, University Hospitals Pitié Salpêtrière-Charles Foix, AP-HP, Paris, France
| | - Félix Djossou
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel
| | - Thomas J Marrie
- Faculty of Medicine, Dalhousie University, 1459 Oxford Street, Halifax, NS B3H 4R2, Canada
| | - Nesrin Ghanem-Zoubi
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Sonja Roeden
- Internal Medicine and Dermatology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Loïc Epelboin
- Department of Infectious and Tropical Diseases, Andrée Rosemon Hospital, Cayenne, French Guiana
- Clinical Investigation Center Antilles Guyane, Inserm 1424, Centre Hospitalier de Cayenne Andrée Rosemon, Cayenne, French Guiana
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Tan T, Heller J, Firestone S, Stevenson M, Wiethoelter A. A systematic review of global Q fever outbreaks. One Health 2024; 18:100667. [PMID: 39010957 PMCID: PMC11247264 DOI: 10.1016/j.onehlt.2023.100667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 07/17/2024] Open
Abstract
Q fever is an important zoonotic disease with a worldwide distribution. Outbreaks of Q fever are unpredictable and can affect many people, resulting in a significant burden on public health. The epidemiology of the disease is complex and substantial efforts are required to understand and control Q fever outbreaks. The purpose of this study was to systematically review previous investigations of outbreaks and summarise important epidemiological features. This will improve knowledge of the factors driving the occurrence of Q fever outbreaks and assist decision makers in implementing mitigation strategies. A search of four electronic databases identified 94 eligible articles published in English between 1990 and 2022 that related to 81 unique human Q fever outbreaks. Outbreaks were reported across 27 countries and mostly in industrialised nations. Documented Q fever outbreaks varied in size (2 to 4107 cases) and duration (4 to 1722 days). Most outbreaks (43/81) occurred in communities outside of traditional at-risk occupational settings and were frequently associated with living in proximity to livestock holdings (21/43). Indirect transmission via environmental contamination, windborne spread or fomites was the most common route of infection, particularly for large community outbreaks. Exposure to ruminants and/or their products were confirmed as the principal risk factors for infection, with sheep (28/81) as the most common source followed by goats (12/81) and cattle (7/81). Cooperation and data sharing between human and animal health authorities is valuable for outbreak investigation and control using public health and veterinary measures, but this multisectoral approach was seldom applied (14/81). Increased awareness of Q fever among health professionals and the public may facilitate the early detection of emerging outbreaks that are due to non-occupational, environmental exposures in the community.
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Affiliation(s)
- Tabita Tan
- Gulbali Institute, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Jane Heller
- Gulbali Institute, School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia
| | - Simon Firestone
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Mark Stevenson
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Anke Wiethoelter
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, VIC 3010, Australia
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Huber N, Gundling N, Thurow M, Ligges U, Hoedemaker M. Which Factors Influence the Consumption of Antibiotics in Q-Fever-Positive Dairy Farms in Northern Germany? Animals (Basel) 2024; 14:1375. [PMID: 38731379 PMCID: PMC11083311 DOI: 10.3390/ani14091375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
It was the aim of this study to examine whether the usage of the vaccine COXEVAC® (Ceva Santé Animale) could reduce the consumption of antibiotics in Q-fever-positive dairy farms. Additionally, the effects of other herd-level factors on the consumption of antibiotics were investigated. A total of 36 farms with vaccination and 13 farms without vaccination participated in this longitudinal cohort study. In all herds, Coxiella burnetii had been directly or indirectly diagnosed. To compare the treatment frequency of antibiotics between the vaccinated group and the non-vaccinated group, the consumption of antibiotics for each farm was collected using the veterinary documents about the application and delivery of antibiotics. To gather detailed information about herd data, nutrition, milking management, housing, and animal health, the farmers were interviewed with the help of a questionnaire. The results thereof suggest that there might be an association between the vaccination against Q fever and a reduced consumption of antibiotics. Neither herd size nor milk yield level influenced the consumption of antibiotics in the study herds. Type of flooring and udder-cluster disinfection while milking were associated with a lower and higher therapy frequency, respectively. Further studies are necessary to elucidate the cause-effect relationship between vaccination and the consumption of antibiotics.
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Affiliation(s)
- Niclas Huber
- Clinic for Cattle, University of Veterinary Medicine Hanover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany
| | - Natascha Gundling
- Clinic for Cattle, University of Veterinary Medicine Hanover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany
| | - Maria Thurow
- Department of Statistics, TU Dortmund University, 44221 Dortmund, Germany (U.L.)
- UA Ruhr, Research Center Trustworthy Data Science and Security, 44227 Dortmund, Germany
| | - Uwe Ligges
- Department of Statistics, TU Dortmund University, 44221 Dortmund, Germany (U.L.)
| | - Martina Hoedemaker
- Clinic for Cattle, University of Veterinary Medicine Hanover, Foundation, Bischofsholer Damm 15, 30173 Hannover, Germany
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Diseko LJ, Tsotetsi-Khambule AM, Onyiche TE, Ramatla T, Thekisoe O, Gcebe N. Coxiella burnetii infections from animals and ticks in South Africa: a systematic review. Vet Res Commun 2024; 48:19-28. [PMID: 37642820 PMCID: PMC10811037 DOI: 10.1007/s11259-023-10204-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
Coxiella burnetii is a zoonotic intracellular bacterium that is widely distributed and affects domestic animals, wildlife, humans and non-mammalian species. This systematic review was aimed at synthesizing research findings on C. burnetii in both domestic and wild animals of South Africa. The systematic review protocol was registered with Open Society Foundations of systematic reviews ( https://doi.org/10.17605/OSF.IO/8WS ). PRISMA guidelines were followed to collect and evaluate relevant scientific articles published on C. burnetii infecting domestic and wild animals in South Africa. Published articles were sourced from five electronic databases, namely, Google Scholar, PubMed and ScienceDirect, EBSCO and Scopus. Results showed 11 eligible studies involving four domestic animals, three wild animals and one ectoparasite species from seven provinces across South Africa. The occurrence of C. burnetii infection was high in Ceratotherium simum (white rhinoceros) (53.9%), medium in sheep (29.0%) and low in pigs (0.9%). Limpopo province (26%) had the most recorded infections followed by KwaZulu-Natal (19%) and Free State (3%) had the least reported occurrence of C. burnetii. The current study discovered that there is scarcity of published research on prevalence and distribution of C. burnetii infecting domestic and wild animals in South Africa, and this is of concern as this bacterium is an important zoonotic pathogen of "One Health" importance.
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Affiliation(s)
- Letlhogonolo J Diseko
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Ana M Tsotetsi-Khambule
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida, 1709, South Africa
| | - ThankGod E Onyiche
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
- Department of Veterinary Parasitology and Entomology, University of Maiduguri, P.M.B. 1069, Maiduguri, Nigeria
| | - Tsepo Ramatla
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa.
| | - Oriel Thekisoe
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, 2520, South Africa
| | - Nomakorinte Gcebe
- Agricultural Research Council-Bacteriology and Zoonotic Diseases Diagnostic Laboratory, Onderstepoort Veterinary Research, Onderstepoort, Pretoria, 0110, South Africa
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7
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Price C, Smith S, Stewart J, Palesy T, Corbitt M, Galappaththy C, Hanson J. Increased recognition of Q fever aortitis as a chronic manifestation of Q fever in tropical North Queensland, Australia. Eur J Clin Microbiol Infect Dis 2023; 42:1537-1541. [PMID: 37882919 PMCID: PMC10651697 DOI: 10.1007/s10096-023-04687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Aortitis is a life-threatening, manifestation of chronic Q fever. We report a series of 5 patients with Q fever aortitis who have presented to our hospital in tropical Australia since 2019. All diagnoses were confirmed with polymerase chain reaction (PCR) testing of aortic tissue. Only one had a previous diagnosis of acute Q fever, and none had classical high-risk exposures that might increase clinical suspicion for the infection. All patients underwent surgery: one died and 3 had significant complications. Q fever aortitis may be underdiagnosed; clinicians should consider testing for Coxiella burnetii in people with aortic pathology in endemic areas.
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Affiliation(s)
- Cody Price
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - James Stewart
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Tom Palesy
- Department of Surgery, Cairns Hospital, Cairns, Queensland, Australia
| | - Matthew Corbitt
- Department of Surgery, Cairns Hospital, Cairns, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | | | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia.
- Kirby Institute, University of New South Wales, Sydney, Level 6, Wallace Wurth Building High Street, Kensington, New South Wales, 2052, Australia.
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8
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Dolcé P, de Beaumont-Dupont A, Jutras P, Mailhot-Léonard F, Alexandra Rosca M, Aubé-Maurice J. The lower Saint Lawrence River region of Quebec, a hot spot for sheepfold-associated Q fever in Canada: Review of 258 cases. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2023; 8:201-213. [PMID: 38058500 PMCID: PMC10697106 DOI: 10.3138/jammi-2023-0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/18/2023] [Indexed: 12/08/2023]
Abstract
Background The lower Saint Lawrence river region (LSLRR), in Quebec, has a 10-fold higher incidence of Q fever compared to the provincial rate. This study aimed to review clinical cases and the Q fever risk exposure in this region. Methods Data were retrieved from microbiology laboratory, medical records from Rimouski Regional Hospital and Public Health reports between 1991 and 2018. They were analyzed with Epi Info 7.2.2.6. Patients with confirmed acute, probable acute, and chronic Q fever were classified using standard case definitions and mapped according to the postal code, to assess the correlation between cases and sheep distribution. Results Out of 295 cases, 258 were included (241 confirmed acute, seven probable acute, 10 chronic). Median age was 49 years, 76% were male. For acute cases, the prominent symptoms were fever (99%), headache (83%), chills (80%), sweating (72%), myalgia (69%), and fatigue (67%). Clinical presentation was mostly febrile syndrome with mild hepatitis (84%). A seasonal peak was observed from May to July (56% of acute cases). Most cases (56%) occurred within the two counties where sheep production was highest. Exposure to sheep was prominent 93%, including 64% direct contact (15% shepherds, 49% sheepfold visitors), 14% indirect contact, and 15% sheepfold neighbors. Conclusions To our knowledge, this is one of the largest retrospective studies of Q fever cases reported in Canada. Q fever in Quebec LSLRR is associated mainly with sheep exposure. Fever and hepatitis were the most common manifestations. Preventive measures should be considered in this region to protect sheepfold workers, visitors, and their neighbors.
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Affiliation(s)
- Patrick Dolcé
- Department of Medical Microbiology and Infectious Diseases, Centre hospitalier régional de Rimouski, Rimouski, Quebec, Canada
| | - Annie de Beaumont-Dupont
- Department of Medical Microbiology and Infectious Diseases, Centre hospitalier régional de Rimouski, Rimouski, Quebec, Canada
- Department of Biology, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Philippe Jutras
- Department of Medical Microbiology and Infectious Diseases, Centre hospitalier régional de Rimouski, Rimouski, Quebec, Canada
| | - Florence Mailhot-Léonard
- Department of Medical Microbiology and Infectious Diseases, Centre hospitalier régional de Rimouski, Rimouski, Quebec, Canada
| | - Maria Alexandra Rosca
- Department of Medical Microbiology and Infectious Diseases, Centre hospitalier régional de Rimouski, Rimouski, Quebec, Canada
- Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Joanne Aubé-Maurice
- Department of Public Health, CISSS du Bas-St-Laurent, Kamouraska, Quebec, Canada
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Bauer BU, Schwecht KM, Jahnke R, Matthiesen S, Ganter M, Knittler MR. Humoral and cellular immune responses in sheep following administration of different doses of an inactivated phase I vaccine against Coxiella burnetii. Vaccine 2023:S0264-410X(23)00746-6. [PMID: 37357077 DOI: 10.1016/j.vaccine.2023.06.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
An inactivated Coxiella burnetii Phase I (PhI) vaccine (Coxevac®) is licensed in several European countries for goats and cattle to prevent coxiellosis. The vaccine is also applied to sheep, although detailed information about the ovine immune response and vaccine dose is missing. Eighteen gimmers from a C. burnetii unsuspected flock were randomly divided into three groups of six. Group 1 (Cox1) and 2 (Cox2) were vaccinated twice with 1 ml and 2 ml Coxevac®, respectively, three weeks apart (primary vaccination). The same procedure was applied with Cox3 (2 ml sodium chloride, control group). A third injection (booster) was performed after nine months. Potential side effects were determined by measuring the rectal body temperature and skin thickness at the injection site. Blood samples were collected to detect phase-specific IgM and IgG antibodies and interferon-ɣ (IFN-ɣ) release by immunofluorescence assay and ELISAs, respectively. Moreover, a cell infection neutralization assay determined the appearance of neutralizing sera. Body temperatures increased for one day post vaccination, and the skin swelled only slightly. Regardless of the vaccine volume, immunized sheep reacted first with an IgM and IgG PhII response. Ten weeks after the primary vaccination, IgG PhI antibodies predominated. Boosting eight months after primary vaccination resulted in a robust IgG PhI increase and strong IFN-ɣ response. In the vaccinated animals, the neutralizing effect is more widespread after the administration of 1 ml than after the treatment with 2 ml. In summary, differences between 1 and 2 ml Coxevac® are minor, and a vaccine volume of 1 ml seems to be sufficient. A booster after the primary vaccination is apparently necessary to stimulate the cell-mediated immune response in naïve sheep.
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Affiliation(s)
- Benjamin U Bauer
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, 30173 Hannover, Germany.
| | - Kay M Schwecht
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, 30173 Hannover, Germany.
| | - Rico Jahnke
- Institute of Immunology, Friedrich-Loeffler-Institut, 17493 Greifswald - Isle of Riems, Germany.
| | - Svea Matthiesen
- Institute of Immunology, Friedrich-Loeffler-Institut, 17493 Greifswald - Isle of Riems, Germany.
| | - Martin Ganter
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, 30173 Hannover, Germany.
| | - Michael R Knittler
- Institute of Immunology, Friedrich-Loeffler-Institut, 17493 Greifswald - Isle of Riems, Germany.
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Prolonged Fever in a Child With Congenital Heart Disease and a Prosthetic Valve. Pediatr Infect Dis J 2023; 42:350-352. [PMID: 36893123 DOI: 10.1097/inf.0000000000003728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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11
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Christodoulou M, Malli F, Tsaras K, Billinis C, Papagiannis D. A Narrative Review of Q Fever in Europe. Cureus 2023; 15:e38031. [PMID: 37228530 PMCID: PMC10207987 DOI: 10.7759/cureus.38031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Coxiella burnetii, the causative agent of Q fever, causes abortions in animals. Its effects on humans and the management of Q fever in certain conditions like pregnancy are undetermined. The World Health Organization has estimated that zoonotic diseases cause around one billion cases of infections and millions of deaths globally each year. It is worth noting that many emerging infectious diseases currently being reported worldwide are zoonoses. We reviewed studies reporting on Q fever prevalence and incidence in Europe. Articles from 1937 to 2023 with the following terms "Coxiella burnetii and Europe and Q fever, and seroprevalence studies" were identified in the PubMed database and reports by organizations such as the European Centre for Disease Prevention and Control (ECDC). We included randomized and observational studies, seroprevalence studies, case series, and case reports. According to the ECDC in 2019, 23 countries reported 1069 cases, the majority of which were classified as confirmed cases. The number of reports per 100,000 inhabitants in the EU/EEA was 0.2 for 2019, the same as the previous four years. The highest report rate (0.7 cases per 100,000 population) was observed in Spain, followed by Romania (0.6), Bulgaria (0.5), and Hungary. Considering the typically asymptomatic nature of Q fever infection, it is imperative to strengthen the existing systems to promote the rapid identification and reporting of Q fever outbreaks in animals, particularly in cases of abortion. It is also essential to consider the facilitation of early information exchange between veterinarians and public health counterparts to ensure the timely detection and prevention of potential zoonotic events, including Q fever.
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Affiliation(s)
| | - Foteini Malli
- Department of Nursing, University of Thessaly, Larissa, GRC
| | | | - Charalambos Billinis
- Department of Microbiology and Parasitology, Faculty of Veterinary Science, University of Thessaly, Karditsa, GRC
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Voss L, Huaman J, Pacioni C, Tolpinrud A, Helbig K, Carvalho TG, Firestone SM. Seroprevalence of Coxiella burnetii antibodies in wild deer populations in eastern Australia. Aust Vet J 2023; 101:106-114. [PMID: 36544232 DOI: 10.1111/avj.13223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022]
Abstract
Coxiella burnetii causes significant reproduction losses in livestock and the disease Q fever in humans. Transmission of C. burnetii is facilitated by the stability of the bacterium in the environment and the susceptibility of a variety of host species to infection. Consequently, inter-species transmission occurs frequently through either direct or indirect contact. Wildlife may represent reservoirs of C. burnetii and could therefore be a source of infection for domestic animals. Understanding the prevalence of C. burnetii infections at the wildlife-livestock interface is important for disease control. This study aimed to investigate the extent of C. burnetii exposure in wild deer in eastern Australia. Serum samples were obtained from 413 wild deer from seven regions in four eastern Australian states from 2017 to 2020. Antibodies were detected using a commercial Q fever antibody kit validated for ruminants. Seroprevalence of C. burnetii antibodies in deer was determined and true prevalence estimated, for each region. The overall seroprevalence of C. burnetii antibodies in wild deer was 3.4% (14 seropositive of 413 deer sampled) with true prevalence estimated to be 4.3% (95% credible interval: 0.6%, 10.9%). Seropositive deer were identified only in Queensland (7/108 seropositive) and northern New South Wales (7/120 seropositive). This geospatial distribution is consistent with seropositivity in other animal species and indicative of the level of C. burnetii in the environment. The low seroprevalence suggests that wild deer are unlikely to be a major reservoir species for C. burnetii in eastern Australia but may still be implicated in inter-species transmission cycles.
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Affiliation(s)
- L Voss
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, Victoria, Australia
| | - J Huaman
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, Victoria, Australia
| | - C Pacioni
- Department of Environment, Land, Water and Planning, Arthur Rylah Institute for Environmental Research, Heidelberg, Victoria, Australia.,Environmental and Conservation Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - A Tolpinrud
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, Victoria, Australia
| | - K Helbig
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, Victoria, Australia
| | - T G Carvalho
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Melbourne, Victoria, Australia
| | - S M Firestone
- Melbourne Veterinary School, Faculty of Science, The University of Melbourne, Parkville, Victoria, Australia
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13
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Pikoulas A, Arapi S, Kosta G, Lampropoulos C, Papaioannou I. Q Fever Severe Pericarditis With Cardiac Tamponade: A Case Report. Cureus 2023; 15:e34980. [PMID: 36938255 PMCID: PMC10019786 DOI: 10.7759/cureus.34980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/16/2023] Open
Abstract
Q fever can present in acute or chronic form with a wide range of clinical symptoms and presentations. Here we report severe pericarditis with cardiac tamponade due to a chronic Coxiella burnetii (C. burnetii) infection. Our report emphasizes and justifies the importance of serological testing for chronic Q fever in patients with unexplained pericarditis, particularly in areas where C. burnetii is endemic.
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Affiliation(s)
- Antonios Pikoulas
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, GRC
- Department of Medicine, University of Crete and Foundation for Research and Technology, Heraklion, GRC
| | - Sofia Arapi
- Cardiology, G. Gennimatas General Hospital, Athens, GRC
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14
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Tokarevich NK, Blinova OV, Stoyanova NA, Baimova RR, Siuziumova EA, Lomonosova VI, Tronin AA, Buzinov RV, Sokolova OV, Gnativ BR, Buts LV, Bubnova LA, Safonova OS, Stankevich AI, Kalinina EL, Vikse R, Andreassen AK. Seroprevalence of tick-borne diseases in the Northwest Federal District of the Russian Federation. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2022. [DOI: 10.15789/2220-7619-sot-1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction. Knowledge about tick-borne disease (TBD) distribution is necessary to improve prevention, whereas detection of human serum IgG antibodies against relevant pathogens is a method for monitoring TBD prevalence in local population. The study objective was to estimate seroprevalence of IgG antibodies against tick-borne encephalitis virus (TBEV), Borrelia burgdorferi sensu lato, Coxiella burnetii, Anaplasma phagocytophilum, and Ehrlichia chaffeensis/E. muris in healthy residents from the five territories of the Northwestern Federal District of the Russian Federation (Arkhangelsk Oblast, Leningrad Oblast, Pskov Oblast, the Republic of Komi and the Republic of Karelia). Materials and methods. In 20172019, a total of 1244 serum samples from healthy residents, not vaccinated against TBDs or other flavivirus-caused infections was studied by ELISA. Results. 21.7% of the sera samples contained IgG antibodies against a single TBD pathogen, whereas 2.1% showed signs of coinfection with two or more pathogens. The most common were IgG antibodies against TBEV (5 territories, 12.2%), followed by Borrelia burgdorferi sensu lato (5 territories, 3.5%), C. burnetii (4 territories, 2.9%), Anaplasma phagoсytophilum (3 territories, 1.6%), E. chaffeensis/E. muris (5 territories, 1.5%). The IgG antibodies were more common in men (55.2%) than in women (44.8%), being found virtually evenly in age-independent manner (from juniors under 18 to seniors over 60). Conclusion. The results of this first comprehensive serosurveillance study in the Northwestern Federal District of the Russian Federation assessing serum IgG antibodies against tick-borne diseases indicate a wide distribution of such pathogens. Moreover, infections caused by C. burnetii, Anaplasma phagocytophilum, and Ehrlichia chaffeensis/E. muris might be highly underdiagnosed.
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15
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El-Mokhtar MA, Sayed IM, Kamel AM, Mesalam AA, Elgohary EA, Khalaf KAB, Adel S, Elfadl AA, Khalifa WA, Ramadan HKA. The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt. Microorganisms 2022; 10:2168. [PMID: 36363760 PMCID: PMC9693106 DOI: 10.3390/microorganisms10112168] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 01/13/2024] Open
Abstract
The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals.
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Affiliation(s)
- Mohamed A. El-Mokhtar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Ibrahim M. Sayed
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Ayat M. Kamel
- Microbiology and Immunology Department, Faculty of Pharmacy, Assiut University, Assiut 71515, Egypt
| | - Ahmed Atef Mesalam
- Department of Therapeutic Chemistry, Pharmaceutical and Drug Industries Research Institute, National Research Centre (NRC), Cairo 12622, Egypt
| | - Elsayed A. Elgohary
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Khaled Abo bakr Khalaf
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Sara Adel
- Clinical Pathology Department, Faculty of Medicine Al-Azhar University-Assiut Branch, Assiut 71515, Egypt
| | - Azza Abo Elfadl
- Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Walaa A. Khalifa
- Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
| | - Haidi Karam-Allah Ramadan
- Department of Tropical Medicine and Gastroenterology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
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16
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Grostieta E, Zazueta-Islas HM, Cruz-Valdez T, Ballados-González GG, Álvarez-Castillo L, García-Esparza SM, Cruz-Romero A, Romero-Salas D, Aguilar-Domínguez M, Becker I, Sánchez-Montes S. Molecular detection of Coxiella-like endosymbionts and absence of Coxiella burnetii in Amblyomma mixtum from Veracruz, Mexico. EXPERIMENTAL & APPLIED ACAROLOGY 2022; 88:113-125. [PMID: 36244047 DOI: 10.1007/s10493-022-00748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Ticks are obligate ectoparasites associated with a wide range of vertebrate hosts, including domestic animals. Moreover, ticks are capable of transmitting many pathogens such as Coxiella. To date, Coxiella burnetii, the etiological agent of coxiellosis or Q fever, is the only valid species of the genera. Nevertheless, a wide range of agents denominated Coxiella-like have been detected in recent studies, mainly associated with ticks. The pathogenicity of these Coxiella-like agents is controversial as some of them can infect both birds and humans. In Mexico, knowledge about Q fever is scarce and limited to historical serological records, and there is an overall lack of molecular proof of any agent of the genus Coxiella circulating in the country. Therefore, the aim of this study was to detect the presence of Coxiella in ticks associated with cattle in all 10 regions of Veracruz, Mexico. To accomplish this objective, first, we identified ticks collected from cattle and horses in Veracruz. Then, for Coxiella detection, DNA extraction from ticks and PCR amplification of the 16S-rDNA of Coxiella was performed. Finally, we performed a phylogenetic reconstruction to determine the Coxiella lineages detected. From the 10 regions sampled we collected 888 ticks grouped in 180 pools, and only five Amblyomma mixtum from the locality of Castán, and one from Los Angeles from Tuxpan were found positive, which represents a frequency of 20% for each locality. This study represents the first attempt at molecular detection of Coxiella in ticks associated with cattle in the state of Veracruz, the major livestock producer in the country. The findings of the present study are relevant as they establish a precedent regarding the circulation of Coxiella-like agents, as well as the absence in three municipalities of the state of Veracruz of C. burnetii, an abortive agent of livestock importance.
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Affiliation(s)
- Estefanía Grostieta
- Centro de Medicina Tropical, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México, Dr. Balmis 148, Ciudad de Mexico, C.P. 06726, México
| | - Héctor M Zazueta-Islas
- Centro de Medicina Tropical, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México, Dr. Balmis 148, Ciudad de Mexico, C.P. 06726, México
| | - Timoteo Cruz-Valdez
- Facultad de Ciencias Biológicas y Agropecuarias Región Tuxpan, Universidad Veracruzana, Veracruz, México
| | - Gerardo G Ballados-González
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Veracruzana, Circunvalación s/n, Veracruz, 91710, México
| | - Lucía Álvarez-Castillo
- Posgrado en Ciencias del Mar y Limnología, Universidad Nacional Autónoma de México, Ciudad de Mexico, México
| | - Sandra M García-Esparza
- Centro de Medicina Tropical, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México, Dr. Balmis 148, Ciudad de Mexico, C.P. 06726, México
| | - Anabel Cruz-Romero
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Veracruzana, Circunvalación s/n, Veracruz, 91710, México
| | - Dora Romero-Salas
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Veracruzana, Circunvalación s/n, Veracruz, 91710, México
| | - Mariel Aguilar-Domínguez
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Veracruzana, Circunvalación s/n, Veracruz, 91710, México.
| | - Ingeborg Becker
- Centro de Medicina Tropical, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México, Dr. Balmis 148, Ciudad de Mexico, C.P. 06726, México.
| | - Sokani Sánchez-Montes
- Centro de Medicina Tropical, Facultad de Medicina, Unidad de Investigación en Medicina Experimental, Universidad Nacional Autónoma de México, Dr. Balmis 148, Ciudad de Mexico, C.P. 06726, México
- Facultad de Ciencias Biológicas y Agropecuarias Región Tuxpan, Universidad Veracruzana, Veracruz, México
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17
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ALKAN S. … İlindeki Q ateşi olgularının retrospektif olarak değerlendirilmesi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1052874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Amaç: Q ateşi, özellikle risk grubundaki bireylerde akut ve kronik formda görülebilen, özgül olmayan semptomları nedeniyle tanısı atlanabilen, zoonotik bir hastalıktır. Önceleri sıklıkla yanlış tanı alan bu hastalık olguları, ülkemizden de son yıllarda bildirilmeye başlamıştır. Bu çalışmada Q ateşi olgularının klinik ve laboratuvar parametrelerini retrospektif olarak değerlendirmeyi ve Q ateşi farkındalığını arttırmayı amaçladık.
Gereç ve Yöntem: Retrospektif gözlemsel çalışmamızda, 1 Ocak 2018–1 Mart 2021 tarihleri arasında hastanemizde takip ve tedavi edilen, 18 yaş üstü, kesin tanı almış, Q ateşi olguları değerlendirildi. Hastalara ait yaş, cinsiyet, meslek, ikamet edilen yer gibi demografik veriler, kene teması öyküleri, hastalığın geliştiği zaman dilimi (yıl, mevsim, ay), eşlik eden komorbiditeler, semptomlar, fizik muayene ve laboratuvar bulguları, tedaviler, hastaların iyileşme ve mortalite durumları irdelendi.
Bulgular: Çalışmaya yaş ortalaması 49,23±12,07 yıl, 7’si (%57) erkek olan 14 olgu dahil edildi. Olguların sadece 5’i (%35,7) çiftçi, dördü (%28,57) hayvancılık yapıyordu. Kırsal alanda yaşama 9 (%64,28) olguda mevcuttu. En sık semptomlar ateş yüksekliği (%100), öksürük (%71,42) ve miyalji (%57,14) idi. Olguların tamamı akut Q ateşi olgusu olup, endokardit hiçbir olguda saptanmadı.
Sonuç: Ülkemizin Q ateşi hastalığı için olası endemik bölgelerden olması nedeniyle, özellikle kırsal kesimde yaşayan, hayvancılıkla uğraşma, pastörize edilmemiş süt/süt ürünü tüketme gibi risk faktörleri olan hastalarda pnömoni başta olmak üzere birçok hastalığın ayırıcı tanısında düşünülmesi gerektiğini vurgulamak istedik.
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Affiliation(s)
- Sevil ALKAN
- Çanakkale On sekiz Mart Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı, Çanakkale
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18
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Thanamayooran A, Tennankore K, Geldenhuys L, Murphy E, More K. Q-uestioning the Diagnosis: An Educational Case Report. Can J Kidney Health Dis 2022; 9:20543581221097749. [PMID: 35528726 PMCID: PMC9069601 DOI: 10.1177/20543581221097749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Rationale: Q fever is a zoonotic infection that may lead to acute or long-term renal injury. Given its rare incidence, Q fever is not often considered on the initial differential diagnosis for glomerular disease which can lead to delays in treatment. This case highlights the importance of avoiding early diagnostic closure and revisiting the differential diagnosis in the setting of an atypical clinical presentation or response to treatment. Presenting Concerns: A 52-year-old female was referred for assessment of possible glomerulonephritis. She described a 3-month history of bilateral lower extremity rash, intermittent knee pain with swelling, and a 2-year history of subjective fevers. Urinalysis showed persistent microscopic hematuria, and her creatinine was elevated at 94 umol/L (baseline 59 umol/L). Her initial investigations included an elevated C-reactive protein (CRP) and rheumatoid factor with a weakly positive anti nuclear antibody (ANA). Diagnoses: Kidney biopsy was consistent with an immune complex mesangial proliferative glomerulonephritis. Light microscopy showed diffuse global mesangial hypercellularity. Immunofluorescence was positive for trace mesangial IgG and kappa, 1+ IgM, lambda and C1q, and 2+ C3. Electron microscopy showed mesangial electron dense deposits. These findings were felt to be most in keeping with mesangial proliferative lupus nephritis; however, it was acknowledged that clinical and laboratory findings supporting this diagnosis were lacking. Interventions: Following treatment with oral prednisone her symptoms resolved, and renal function improved. However, she was unable to taper off prednisone completely without her symptoms returning. Additional immunosuppressive therapies were trialed, but she remained steroid dependent with disease flares related to prednisone tapers. Her atypical response to treatment led to consideration of alternative diagnoses, and further investigation revealed positive Q fever serology (phase-I IgG 1:1892, phase II IgG 1:8192, phase-I and -II IgM < 1:16). She was diagnosed with long-term Q fever and was treated with doxycycline and hydroxychloroquine. Outcomes: She remained on treatment for 2 years. During this time, her symptoms resolved, hematuria disappeared, and her creatinine returned to baseline. Following cessation of therapy, her Q fever IgM titres rose, and she was restarted on doxycycline and hydroxychloroquine indefinitely. Teaching Points: (1) Keeping a broad differential diagnosis in the setting of atypical clinical features or unexpected response to therapy is important for ensuring accurate diagnosis and appropriate treatment. (2) Clinical improvement in relation to immunosuppressive therapy does not preclude an infectious cause of glomerular disease.
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Affiliation(s)
| | - Karthik Tennankore
- Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Laurette Geldenhuys
- Division of Anatomical Pathology, Department of Pathology, Dalhousie University, Halifax, NS, Canada
| | - Elana Murphy
- Division of Rheumatology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Keigan More
- Division of Nephrology, Department of Medicine, Dalhousie University, Halifax, NS, Canada
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19
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Oberbach A, Schlichting N, Hagl C, Lehmann S, Kullnick Y, Friedrich M, Köhl U, Horn F, Kumbhari V, Löffler B, Schmidt F, Joskowiak D, Born F, Saha S, Bagaev E. Four decades of experience of prosthetic valve endocarditis reflect a high variety of diverse pathogens. Cardiovasc Res 2022; 119:410-428. [PMID: 35420122 DOI: 10.1093/cvr/cvac055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/04/2022] [Accepted: 03/23/2022] [Indexed: 01/18/2023] Open
Abstract
Prosthetic valve endocarditis (PVE) remains a serious condition with a high mortality rate. Precise identification of the PVE-associated pathogen/s and their virulence is essential for successful therapy, and patient survival. The commonly described PVE-associated pathogens are staphylococci, streptococci and enterococci, with Staphylococcus aureus being the most frequently diagnosed species. Furthermore, multi-drug resistance pathogens are increasing in prevalence, and continue to pose new challenges mandating a personalized approach. Blood cultures in combination with echocardiography are the most common methods to diagnose PVE, often being the only indication, it exists. In many cases, the diagnostic strategy recommended in the clinical guidelines does not identify the precise microbial agent and to frequently, false negative blood cultures are reported. Despite the fact that blood culture findings are not always a good indicator of the actual PVE agent in the valve tissue, only a minority of re-operated prostheses are subjected to microbiological diagnostic evaluation. In this review, we focus on the diversity and the complete spectrum of PVE-associated bacterial, fungal and viral pathogens in blood, and prosthetic heart valve, their possible virulence potential, and their challenges in making a microbial diagnosis. We are curious to understand if the unacceptable high mortality of PVE is associated with the high number of negative microbial findings in connection with a possible PVE. Herein, we discuss the possibilities and limits of the diagnostic methods conventionally used and make recommendations for enhanced pathogen identification. We also show possible virulence factors of the most common PVE-associated pathogens and their clinical effects. Based on blood culture, molecular biological diagnostics, and specific valve examination, better derivations for the antibiotic therapy as well as possible preventive intervention can be established in the future.
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Affiliation(s)
- Andreas Oberbach
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.,Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany
| | - Nadine Schlichting
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Christian Hagl
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany.,Munich Heart Alliance, Partner Site German Centre for Cardiovascular Disease (DZHK), Munich, Germany
| | - Stefanie Lehmann
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Yvonne Kullnick
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Maik Friedrich
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Ulrike Köhl
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Friedemann Horn
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Diagnostics, Leipzig, Germany.,Institute of Clinical Immunology, University of Leipzig, Leipzig, Germany
| | - Vivek Kumbhari
- Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Florida, USA
| | - Bettina Löffler
- Institute of Medical Microbiology, Jena University Hospital, Jena, Germany
| | - Frank Schmidt
- Proteomics Core, Weill Cornell Medical Centre Qatar, Doha, Qatar
| | - Dominik Joskowiak
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany
| | - Frank Born
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany
| | - Shekhar Saha
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany
| | - Erik Bagaev
- Department of Cardiac Surgery, Ludwig Maximilian University, Munich, Germany
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20
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Serological Prevalence of and Risk Factors for Coxiella burnetti Infection in Women of Punjab Province, Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084576. [PMID: 35457443 PMCID: PMC9027314 DOI: 10.3390/ijerph19084576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/01/2022] [Accepted: 04/07/2022] [Indexed: 01/09/2023]
Abstract
Background: Coxiella burnetii, the etiological agent of Q (query) fever, provokes abortions in ruminants and is suspected to cause adverse pregnancy outcomes in women. Infection of pregnant women is linked with high mortality and morbidity of the fetus and the mother is at high risk to acquire chronic Q fever. This research was conducted to evaluate the prevalence of Q fever in women and to detect associated risk factors in four districts of Punjab Province, Pakistan. Methods: A total of 297 blood samples were obtained from 147 pregnant and 150 non-pregnant women of the districts Okara, Jhang, Chiniot and Faisalabad of Punjab, Pakistan. Data related to risk factors and demographic parameters were collected using a questionnaire. Serum samples were screened for phase I and phase II specific IgG antibodies for antigens of phase I and phase II using ELISA tests. Univariate and binary regression were used to analyze important risk factors of Q fever. Results: Twenty-five serum samples (8.4%) were found seropositive for Q fever. Seventeen women were positive for Phase-I and twenty-one were positive for phase-II antibodies. Highest and statistically significant (p < 0.05) seroprevalence of 17.1% was observed in Faisalabad. Age, urbanicity, living status, pregnancy status, abortion history, occupation, and consumption of tap water were positively correlated (p < 0.05) with Q fever, while being aged, urbanity, low income, contact with animals and consumption of tap water was identified as potential risk factors. Conclusions: Q fever is prevalent in women of Pakistan. There is a need for an awareness program about the importance of C. burnetii infections and prevention strategies in women during pregnancy to minimize adverse pregnancy outcomes.
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21
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Huang HHH, Power RI, Mathews KO, Ma GC, Bosward KL, Šlapeta J. Cat fleas ( Ctenocephalides felis clade 'Sydney') are dominant fleas on dogs and cats in New South Wales, Australia: Presence of flea-borne Rickettsia felis, Bartonella spp. but absence of Coxiella burnetii DNA. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 1:100045. [PMID: 35284882 PMCID: PMC8906117 DOI: 10.1016/j.crpvbd.2021.100045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 01/04/2023]
Abstract
The cat flea (Ctenocephalides felis) is the most common flea species parasitising both domestic cats and dogs globally. Fleas are known vectors of zoonotic pathogens such as vector-borne Rickettsia spp. and Bartonella spp. and could theoretically transmit Coxiella burnetii, the causative agent of Q fever. A total of 107 fleas were collected from 21 cats and 14 dogs in veterinary clinics, a feline rescue organisation and a grooming salon in New South Wales, Australia, to undergo PCR detection of Bartonella spp., Rickettsia spp. and C. burnetii DNA. Morphological identification confirmed that the cat flea (C. felis) is the most common flea in New South Wales, Australia, with only a single stick fast flea, Echidnophaga gallinacea recorded. The examined fleas (n = 35) at the cox1 locus revealed five closely related C. felis haplotypes (inter-haplotype distance < 0.5%). Multiplex TaqMan qPCR targeting the gltA (Rickettsia spp.) and ssrA (Bartonella spp.) genes was positive in 22.9% (95% CI: 11.8–39.3%) and 11.4% (95% CI: 3.9–26.6%) of samples, respectively. None of the DNA isolated from fleas was positive on TaqMan qPCRs targeting the C. burnetii IS1111, Com1 and htpAB genes. Co-infection of C. felis with Bartonella henselae and Bartonella clarridgeiae was demonstrated using gltA and ssrA Illumina next-generation amplicon sequencing. These findings reinforce the importance of flea control on domestic dogs and cats to effectively control the transmission of Rickettsia felis and Bartonella spp. The flea, however, is unlikely to be a vector of C. burnetii between companion animals and humans. The cat flea (Ctenocephalides felis) is the flea species on cats and dogs in New South Wales Australia. Absence of Coxiella burnetii DNA in flea extract, but presence of Rickettsia felis. Detection of Bartonella DNA using gltA and ssrA Illumina next-generation amplicon sequencing.
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Q Fever Masquerading as Legionnaires Disease in an Endovascular Stent Infection. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Shepard Z, Skorupa T, Espinoza L, Erlandson K, Damioli L. Coxiella burnetii Infection Associated With Thromboangiitis Obliterans-like Phenomena With Digital Autoamputation: A Case Report and Review of Q Fever-Associated Autoimmunity. Open Forum Infect Dis 2022; 9:ofab637. [PMID: 35028337 PMCID: PMC8753030 DOI: 10.1093/ofid/ofab637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
We present a case of a patient with chronic Q fever who presented with digital necrosis, autoamputations, and positive anticentromere antibody, mimicking a scleroderma vasculopathy or thromboangiitis obliterans. Coxiella burnetii infection has long been associated with the presence of autoantibodies and autoimmune phenomena including vasculitis. Clinicians should consider Q fever testing in patients with new-onset autoimmune diseases or autoantibodies and appropriate exposure histories.
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Affiliation(s)
- Zachary Shepard
- Division of Infectious Diseases, University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado, USA
| | - Tara Skorupa
- Division of Rheumatology, University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado, USA
| | - Leigh Espinoza
- Division of Infectious Diseases, University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado, USA
| | - Kristine Erlandson
- Division of Infectious Diseases, University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado, USA
| | - Laura Damioli
- Division of Infectious Diseases, University of Colorado Denver, Anschutz Medical Campus, Denver, Colorado, USA
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24
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Miailhes P, Conrad A, Sobas C, Laurent F, Lustig S, Ferry T, Ferry T, Valour F, Perpoint T, Ader F, Roux S, Becker A, Triffault-Fillit C, Conrad A, Pouderoux C, Chauvelot P, Chabert P, Lippman J, Braun E, Lustig S, Servien E, Batailler C, Gunst S, Schmidt A, Sappey-Marinier E, Ode Q, Fessy MH, Viste A, Besse JL, Chaudier P, Louboutin L, Van Haecke A, Mercier M, Belgaid V, Gazarian A, Walch A, Bertani A, Rongieras F, Martres S, Trouillet F, Barrey C, Mojallal A, Brosset S, Hanriat C, Person H, Céruse P, Fuchsmann C, Gleizal A, Aubrun F, Dziadzko M, Macabéo C, Patrascu D, Laurent F, Beraud L, Roussel-Gaillard T, Dupieux C, Kolenda C, Josse J, Craighero F, Boussel L, Pialat JB, Morelec I, Tod M, Gagnieu MC, Goutelle S, Mabrut E. Coxiella burnetti prosthetic joint infection in an immunocompromised woman: iterative surgeries, prolonged ofloxacin-rifampin treatment and complex reconstruction were needed for the cure. ARTHROPLASTY 2021; 3:43. [PMID: 35610714 PMCID: PMC8796341 DOI: 10.1186/s42836-021-00097-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/16/2021] [Indexed: 12/04/2022] Open
Abstract
Background Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii, a strictly intracellular pathogen that can cause acute and chronic infection. Chronic Q fever can occur in immunocompetent as well as in immuno-compromised hosts, as a persistent localized infection. The main localizations are endocardial, vascular and, less frequently, osteoarticular. The most frequent osteoarticular form is spondyliscitis. Recommended treatment is combined doxycycline and hydroxychloroquine for 18 months, with cotrimoxazole as another option. Coxiella burnetti infection has been implicated in rare cases of prosthetic joint infection (PJI), and the medical and surgical management and outcome in such cases have been little reported. Case presentation We report an unusual case of chronic Q fever involving a hip arthroplasty in an immunocompromised woman treated with tumor necrosis factor (TNF)-α blockers for rheumatoid arthritis. Numerous surgical procedures (explantation, “second look”, femoral resection and revision by megaprosthesis), modification of the immunosuppressant therapy and switch from doxycycline-hydroxychloroquine to prolonged ofloxacin-rifampin combination therapy were needed to achieve reconstruction and treat the PJI, with a follow-up of 7 years. Conclusions Coxiella burnetti PJI is a complex infection that requires dedicated management in an experienced reference center. Combined use of ofloxacin-rifampin can be effective.
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25
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Cherry CC, Nichols Heitman K, Bestul NC, Kersh GJ. Acute and chronic Q fever national surveillance - United States, 2008-2017. Zoonoses Public Health 2021; 69:73-82. [PMID: 34626097 DOI: 10.1111/zph.12896] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 09/21/2021] [Accepted: 09/24/2021] [Indexed: 11/30/2022]
Abstract
Q fever is a zoonotic disease caused by the bacterium Coxiella burnetii and can manifest in an acute or chronic form. Many persons with acute Q fever are asymptomatic, but some develop a febrile illness, pneumonia or hepatitis. Chronic infections are rare and occur in less than 5% of persons exposed. Forms of chronic Q fever include endocarditis, infection of vascular grafts or aneurysms, osteomyelitis and osteoarthritis. Acute and chronic Q fever are nationally notifiable diseases, and presented here are the incidence, demographics and distribution of acute and chronic Q fever in the United States during 2008-2017. We summarized passive surveillance data from the Centers for Disease Control and Prevention's (CDC) National Notifiable Diseases Surveillance System (NNDSS) and supplemental case report forms (CRFs). Health departments reported 1,109 cases of acute Q fever and 272 chronic Q fever cases to NNDSS during this period. The 10-year average annual incidence for acute Q fever was 0.36 cases per million persons, and the average annual incidence for chronic Q fever was 0.09. Males accounted for nearly 75% of both acute and chronic Q fever cases. Average annual incidence was highest among persons aged 60-69 years for both acute and chronic Q fever (0.70 cases per million persons and 0.25, respectively). As reported through CRFs, many Q fever cases did not have a known exposure to C. burnetii; 60% (n = 380) of acute Q fever cases did not report exposure to animals in the 2 months before symptom onset. Almost 90% (n = 558) did not report exposure to unpasteurized milk. Only 40% (n = 247) of persons with reported Q fever were employed in high-risk occupations. Even though Q fever is a rare disease in the United States, incidence doubled from 2008 to 2017.
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Affiliation(s)
- Cara C Cherry
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kristen Nichols Heitman
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nicolette C Bestul
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee, USA
| | - Gilbert J Kersh
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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26
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Uribe Pulido N, Escorcia García C, Cabrera Orrego R, Gutiérrez LA, Agudelo CA. Acute Q Fever With Dermatologic Manifestations, Molecular Diagnosis, and No Seroconversion. Open Forum Infect Dis 2021; 8:ofab458. [PMID: 34692888 PMCID: PMC8530256 DOI: 10.1093/ofid/ofab458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/06/2021] [Indexed: 11/14/2022] Open
Abstract
We herein described a case of acute infection by Coxiella burnetii (acute Q fever) that started with a short incubation period and showed prominent dermatological manifestations and unusual serological behavior. The infection was confirmed by molecular detection through real-time polymerase chain reaction using genomic DNA collected from peripheral blood.
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Affiliation(s)
| | | | - Ruth Cabrera Orrego
- Grupo Biología de Sistemas, Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Lina Andrea Gutiérrez
- Grupo Biología de Sistemas, Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Carlos Andrés Agudelo
- Clínica Universitaria Bolivariana, Medellín, Colombia
- Escuela de Ciencias de la Salud, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellín, Colombia
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27
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Rabaza A, Giannitti F, Fraga M, Macías-Rioseco M, Corbellini LG, Riet-Correa F, Hirigoyen D, Turner KME, Eisler MC. Serological Evidence of Human Infection with Coxiella burnetii after Occupational Exposure to Aborting Cattle. Vet Sci 2021; 8:196. [PMID: 34564590 PMCID: PMC8473284 DOI: 10.3390/vetsci8090196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/30/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022] Open
Abstract
Cattle are broadly deemed a source of Coxiella burnetii; however, evidence reinforcing their role in human infection is scarce. Most published human Q fever outbreaks relate to exposure to small ruminants, notably goats. Anti-phase II C. burnetii IgG and IgM were measured by indirect fluorescent antibody tests in 27 farm and veterinary diagnostic laboratory workers to ascertain whether occupational exposure to cattle aborting due to C. burnetii was the probable source of exposure. Four serological profiles were identified on the basis of anti-phase II IgG and IgM titres. Profile 1, characterised by high IgM levels and concurrent, lower IgG titres (3/27; 11.1%); Profile 2, with both isotypes with IgG titres higher than IgM (2/27; 7.4%); Profile 3 with only IgG phase II (5/27; 18.5%); and Profile 4, in which neither IgM nor IgG were detected (17/27; 63.0%). Profiles 1 and 2 are suggestive of recent C. burnetii exposure, most likely 2.5-4.5 months before testing and, hence, during the window of exposure to the bovine abortions. Profile 3 suggested C. burnetii exposure that most likely predated the window of exposure to aborting cattle, while Profile 4 represented seronegative individuals and, hence, likely uninfected. This study formally linked human Q fever to exposure to C. burnetii infected cattle as a specific occupational hazard for farm and laboratory workers handling bovine aborted material.
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Affiliation(s)
- Ana Rabaza
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
| | - Federico Giannitti
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Martín Fraga
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Melissa Macías-Rioseco
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- California Animal Health & Food Safety Laboratory System, University of California-Davis, Tulare, CA 95616, USA
| | - Luis G. Corbellini
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Franklin Riet-Correa
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
- Programa de Pós Graduação em Ciência Animal nos Trópicos, Faculdade de Veterinária, Universidade Federal da Bahia, Ondina, Salvador 40170-290, Brazil
| | - Darío Hirigoyen
- Instituto Nacional de Investigación Agropecuaria, Plataforma de Investigación en Salud Animal, Estación Experimental La Estanzuela, Colonia 70000, Uruguay; (A.R.); (F.G.); (M.F.); (M.M.-R.); (L.G.C.); (F.R.-C.); (D.H.)
| | - Katy M. E. Turner
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
| | - Mark C. Eisler
- Bristol Veterinary School, University of Bristol, Langford House, Langford, Bristol BS40 5DU, UK;
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28
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Cook EAJ, de Glanville WA, Thomas LF, Kiyong'a A, Kivali V, Kariuki S, Bronsvoort BMDC, Fèvre EM. Evidence of exposure to C. burnetii among slaughterhouse workers in western Kenya. One Health 2021; 13:100305. [PMID: 34430697 PMCID: PMC8367830 DOI: 10.1016/j.onehlt.2021.100305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 12/02/2022] Open
Abstract
Q fever, caused by C. burnetii, has been reported in slaughterhouse workers worldwide. The most reported risk factor for seropositivity is the workers' role in the slaughterhouse. This study examined the seroprevalence and risk factors for antibodies to C. burnetii in slaughterhouse workers in western Kenya to fill a data gap relating to this emerging disease in East Africa. Individuals were recruited from all consenting slaughterhouses in the study area between February and November 2012. Information was collected from participating workers regarding demographic data, animals slaughtered and role in the slaughterhouse. Sera samples were screened for antibodies to C. burnetii using a commercial ELISA and risk factors associated with seropositivity were identified using multi-level logistic regression analysis. Slaughterhouse workers (n = 566) were recruited from 84 ruminant slaughterhouses in western Kenya. The seroprevalence of antibodies to C. burnetii was 37.1% (95% Confidence Interval (CI) 33.2–41.2%). The risk factors identified for C. burnetii seropositivity included: male workers compared to female workers, odds ratio (OR) 5.40 (95% CI 1.38–21.22); slaughtering cattle and small ruminants compared to those who only slaughtered cattle, OR 1.52 (95% CI 1.06–2.19). In addition, specific roles in the slaughterhouse were associated with increased odds of being seropositive, including cleaning the slaughterhouse, OR 3.98 (95% CI 1.39–11.43); cleaning the intestines, OR 3.24 (95% CI 1.36–7.73); and flaying the carcass OR 2.63 (95% CI 1.46–4.75) compared to being the slaughterman or foreman. We identified that slaughterhouse workers have a higher seroprevalence of antibodies to C. burnetii compared to published values in the general population from the same area. Slaughterhouse workers therefore represent an occupational risk group in this East African setting. Workers with increased contact with the viscera and fluids are at higher risk for exposure to C. burnetii. Education of workers may reduce transmission, but an alternative approach may be to consider the benefits of vaccination in high-risk groups.
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Affiliation(s)
| | - William Anson de Glanville
- International Livestock Research Institute, Old Naivasha Road, PO Box 30709, 00100 Nairobi, Kenya.,Center for One Health, University of Global Health Equity, Rwanda
| | - Lian Francesca Thomas
- International Livestock Research Institute, Old Naivasha Road, PO Box 30709, 00100 Nairobi, Kenya.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK
| | - Alice Kiyong'a
- International Livestock Research Institute, Old Naivasha Road, PO Box 30709, 00100 Nairobi, Kenya
| | - Velma Kivali
- International Livestock Research Institute, Old Naivasha Road, PO Box 30709, 00100 Nairobi, Kenya
| | - Samuel Kariuki
- Kenya Medical Research Institute, PO Box 19464-00200, Nairobi, Kenya
| | - Barend Mark de Clare Bronsvoort
- Roslin Institute, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.,Royal (Dick) School of Veterinary Studies, University of Edinburgh, Roslin, Midlothian EH25 9RG, UK
| | - Eric Maurice Fèvre
- International Livestock Research Institute, Old Naivasha Road, PO Box 30709, 00100 Nairobi, Kenya.,Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK
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29
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Rodríguez-García R, Rodríguez-Esteban MÁ, Fernández-Suárez J, Morilla A, García-Carús E, Telenti M, Morales C, Albaiceta GM, Fernández J. Evaluation of 16S rDNA Heart Tissue PCR as a Complement to Blood Cultures for the Routine Etiological Diagnosis of Infective Endocarditis. Diagnostics (Basel) 2021; 11:1372. [PMID: 34441306 PMCID: PMC8394467 DOI: 10.3390/diagnostics11081372] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/18/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Identification of the causative pathogen is required to optimize the effective therapy in infective endocarditis (IE). The aim of this study was to assess a 16S rDNA PCR to identify bacteria from heart valve tissues and to evaluate its usefulness as a complement to blood and removed valves cultures. A total of 266 patients diagnosed with IE from January 2015 to December 2019 were evaluated. Results between 16S rDNA PCR from heart valve tissues were compared with microbiological cultures. Blood cultures were positive in 83.5% of patients diagnosed with IE, while 39.6% and 71.8% of the evaluated heart valve samples were positive by culture and 16S rDNA PCR, respectively. For 32 (12%) patients, 16S rDNA tissue PCR provided valuable information supporting the results of blood cultures in the case of bacteria characteristic from the skin microbiota. Additionally, a microorganism was identified by using 16S rDNA PCR in 36% of blood culture-negative cases. The present study reveals that molecular diagnosis using 16S rDNA tissue PCR provides complementary information for the diagnosis of IE, and it should be recommended in surgical endocarditis, especially when blood cultures are negative.
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Affiliation(s)
- Raquel Rodríguez-García
- Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.R.-G.); (M.Á.R.-E.); (G.M.A.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- CIBER-Enfermedades Respiratorias, Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - María Ángeles Rodríguez-Esteban
- Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.R.-G.); (M.Á.R.-E.); (G.M.A.)
| | - Jonathan Fernández-Suárez
- Servicio de Microbiología Clínica, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (J.F.-S.); (A.M.); (M.T.)
| | - Ana Morilla
- Servicio de Microbiología Clínica, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (J.F.-S.); (A.M.); (M.T.)
| | - Enrique García-Carús
- Servicio de Medicina Interna, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Mauricio Telenti
- Servicio de Microbiología Clínica, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (J.F.-S.); (A.M.); (M.T.)
| | - Carlos Morales
- Servicio de Cirugía Cardiaca, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain;
| | - Guillermo Muñiz Albaiceta
- Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.R.-G.); (M.Á.R.-E.); (G.M.A.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- CIBER-Enfermedades Respiratorias, Instituto de Salud Carlos III, 28220 Madrid, Spain
- Departamento de Biología Funcional, Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, 33003 Oviedo, Spain
| | - Javier Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Spain
- Servicio de Microbiología Clínica, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (J.F.-S.); (A.M.); (M.T.)
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30
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Sarrell BA, Laurenzano J, Freitas J, Concepcion BP. Q fever presenting with hepatic and splenic lesions in a kidney transplant recipient. Transpl Infect Dis 2021; 23:e13699. [PMID: 34324786 DOI: 10.1111/tid.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Bonnie Ann Sarrell
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - John Laurenzano
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jared Freitas
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Beatrice P Concepcion
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.,Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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31
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Kim YC, Jeong HW, Kim DM, Huh K, Choi SH, Lee HY, Jung Y, Seong YJ, Kim EJ, Choi YH, Heo JY. Epidemiological investigation and physician awareness regarding the diagnosis and management of Q fever in South Korea, 2011 to 2017. PLoS Negl Trop Dis 2021; 15:e0009467. [PMID: 34077423 PMCID: PMC8202952 DOI: 10.1371/journal.pntd.0009467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 06/14/2021] [Accepted: 05/11/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In South Korea, the number of Q fever cases has rapidly increased since 2015. Therefore, this study aimed to characterize the epidemiological and clinical features of Q fever in South Korea between 2011 and 2017. METHODS/PRINCIPAL FINDINGS We analyzed the epidemiological investigations and reviewed the medical records from all hospitals that had reported at least one case of Q fever from 2011 to 2017. We also conducted an online survey to investigate physicians' awareness regarding how to appropriately diagnose and manage Q fever. The nationwide incidence rate of Q fever was annually 0.07 cases per 100,000 persons. However, there has been a sharp increase in its incidence, reaching up to 0.19 cases per 100,000 persons in 2017. Q fever sporadically occurred across the country, with the highest incidences in Chungbuk (0.53 cases per 100,000 persons per year) and Chungnam (0.27 cases per 100,000 persons per year) areas. Patients with acute Q fever primarily presented with mild illnesses such as hepatitis (64.5%) and isolated febrile illness (24.0%), whereas those with chronic Q fever were likely to undergo surgery (41.2%) and had a high mortality rate (23.5%). Follow-up for 6 months after acute Q fever was performed by 24.0% of the physician respondents, and only 22.3% of them reported that clinical and serological evaluations were required after acute Q fever diagnosis. CONCLUSIONS Q fever is becoming an endemic disease in the midwestern area of South Korea. Given the clinical severity and mortality of chronic Q fever, physicians should be made aware of appropriate diagnosis and management strategies for Q fever.
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Affiliation(s)
- Yong Chan Kim
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Dong-Min Kim
- Division of Infectious Diseases, Department of Medicine, Chosun University College of Medicine, Kwangju, Republic of Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee Young Lee
- Center for Preventive Medicine and Public health, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yunjung Jung
- Department of Pulmonology and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yeol Jung Seong
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Eun Jin Kim
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young Hwa Choi
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
- * E-mail:
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Sivabalan P, Visvalingam R, Grey V, Blazak J, Henderson A, Norton R. Utility of positron emission tomography imaging in the diagnosis of chronic Q fever: A Systematic Review. J Med Imaging Radiat Oncol 2021; 65:694-709. [PMID: 34056851 DOI: 10.1111/1754-9485.13244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/29/2021] [Indexed: 11/28/2022]
Abstract
Chronic Q fever is a diagnostic challenge. Diagnosis relies on serology and/or the detection of DNA from blood or tissue samples. PET-CT identifies tissues with increased glucose metabolism, thus identifying foci of inflammation. Our aim was to review the existing literature on the use of PET-CT to help diagnose chronic Q fever. A literature search was conducted in PubMed and Google Scholar to ascertain publications that included the terms 'Positron Emission Tomography' and 'PET CT' in combination with subheadings 'chronic Q fever' and 'Coxiella burnetii' within the search. To broaden our search retrieval, we used the terms 'chronic Q fever' and 'PET-CT'. Published literature up to 16th April 2020 was included. 274 articles were initially identified. Post-exclusion criteria, 46 articles were included. Amongst case reports and series, the most frequent focus of infection was vascular, followed by musculoskeletal then cardiac. 79.5% of patients had a focus detected with 55.3% of these having proven infected prosthetic devices. Amongst the retrospective and prospective studies, a total of 394 positive sites of foci were identified with 186 negative cases. Some had follow-up scans (53), with 75.5% showing improvement or resolution. Average timeframe for documented radiological resolution post-initiating treatment was 8.86 months. PET-CT is a useful tool in the management of chronic Q fever. Knowledge of a precise focus enables for directed surgical management helping reduce microbial burden, preventing future complications. Radiological resolution of infection can give clinicians reassurance on whether antimicrobial therapy can be ceased earlier, potentially limiting side effects.
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Affiliation(s)
- Pirathaban Sivabalan
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Pathology Queensland, Townsville University Hospital, Douglas, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Rozanne Visvalingam
- Department of Radiology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Victoria Grey
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - John Blazak
- Department of Radiology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia
| | - Andrew Henderson
- Department of Infectious Diseases, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Robert Norton
- Pathology Queensland, Townsville University Hospital, Douglas, Queensland, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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Proboste T, Deressa FB, Li Y, Kal DO, Gelalcha BD, Soares Magalhães RJ. Geographical Variation in Coxiella burnetii Seroprevalence in Dairy Farms Located in South-Western Ethiopia: Understanding the Broader Community Risk. Pathogens 2021; 10:pathogens10060646. [PMID: 34071090 PMCID: PMC8224686 DOI: 10.3390/pathogens10060646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 11/18/2022] Open
Abstract
Q fever is a zoonotic disease that is caused by Coxiella burnetii and leads to abortion and infertility in ruminants and debilitating disease in humans. Jimma zone, including Jimma town, located in the Oromia region of Ethiopia, was affected by an outbreak of abortions in ruminants related to Q fever infection between 2013 and 2015. This study aimed to investigate the geo-clustering of C. burnetii seroprevalence in dairy farms of Jimma town and identify the environmental risk factors associated with seroprevalence distribution. A total of 227 cattle were tested for antibodies against C. burnetii in 25 farms. We explored the clustering of C. burnetii seroprevalence using semivariograms. A geostatistical regression-based model was implemented to quantify the risk factors and to predict the geographical variation in C. burnetii seroprevalence at unsampled locations in Jimma town using OpenBugs. Our results demonstrated that the risk of exposure in dairy cattle varied across the landscape of Jimma town and was associated with environmental risk factors. The predictive map of C. burnetii seroprevalence showed that communities in the eastern part of Jimma town had the highest risk of exposure. Our results can inform community-level investigations of human seroprevalence in the high-risk areas to the east of Jimma.
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Affiliation(s)
- Tatiana Proboste
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (Y.L.); (R.J.S.M.)
- Correspondence:
| | - Feyissa Begna Deressa
- School of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Jimma University, Jimma P.O. Box 307, Ethiopia; (F.B.D.); (B.D.G.)
| | - Yanjin Li
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (Y.L.); (R.J.S.M.)
| | - David Onafruo Kal
- College of Veterinary Science, Bahr El Ghazal University, Wau P.O. Box 10739, Sudan;
| | - Benti Deressa Gelalcha
- School of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Jimma University, Jimma P.O. Box 307, Ethiopia; (F.B.D.); (B.D.G.)
| | - Ricardo J. Soares Magalhães
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia; (Y.L.); (R.J.S.M.)
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD 4101, Australia
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Head JR, Bumburidi Y, Mirzabekova G, Rakhimov K, Dzhumankulov M, Salyer SJ, Knust B, Berezovskiy D, Kulatayeva M, Zhetibaev S, Shoemaker T, Nicholson WL, Moffett D. Risk Factors for and Seroprevalence of Tickborne Zoonotic Diseases among Livestock Owners, Kazakhstan. Emerg Infect Dis 2021; 26:70-80. [PMID: 31855140 PMCID: PMC6924887 DOI: 10.3201/eid2601.190220] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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
Crimean-Congo hemorrhagic fever (CCHF), Q fever, and Lyme disease are endemic to southern Kazakhstan, but population-based serosurveys are lacking. We assessed risk factors and seroprevalence of these zoonoses and conducted surveys for CCHF-related knowledge, attitudes, and practices in the Zhambyl region of Kazakhstan. Weighted seroprevalence for CCHF among all participants was 1.2%, increasing to 3.4% in villages with a known history of CCHF circulation. Weighted seroprevalence was 2.4% for Lyme disease and 1.3% for Q fever. We found evidence of CCHF virus circulation in areas not known to harbor the virus. We noted that activities that put persons at high risk for zoonotic or tickborne disease also were risk factors for seropositivity. However, recognition of the role of livestock in disease transmission and use of personal protective equipment when performing high-risk activities were low among participants.
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Mahajan P, Pant K, Majdizadeh S. Q fever: a rare but potentially life-threatening zoonotic disease. BMJ Case Rep 2021; 14:e237155. [PMID: 33602758 PMCID: PMC7896566 DOI: 10.1136/bcr-2020-237155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 11/04/2022] Open
Abstract
Q fever can present as a fever of unknown aetiology and can be challenging to diagnose because of the rare incidence. It can present as an acute illness with manifestations, including influenza-like symptoms, hepatitis, pneumonia or chronic disease involving the cardiovascular system. We present a case of a 39-year-old woman in the USA, who developed acute Q fever with associated sepsis and severe hepatitis. She received treatment with recovery from acute infection but currently has symptoms of post Q fever syndrome.
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Affiliation(s)
- Pranav Mahajan
- Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
| | - Kailash Pant
- Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA
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36
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Sim BZ, Aaron L, Sim BL, Looke D, Bursle E. Diagnostic challenge of Q fever osteoarticular infection. Intern Med J 2021; 51:142-143. [PMID: 33572020 DOI: 10.1111/imj.15119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/02/2020] [Accepted: 02/11/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Beatrice Z Sim
- Infectious Diseases Department, Brisbane, Queensland, Australia
| | - Luke Aaron
- Physician Training Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Bernice L Sim
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - David Looke
- Infectious Diseases Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Evan Bursle
- Infectious Diseases Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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37
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Ghanem-Zoubi N, Karram T, Kagna O, Merhav G, Keidar Z, Paul M. Q fever vertebral osteomyelitis among adults: a case series and literature review. Infect Dis (Lond) 2021; 53:231-240. [PMID: 33475036 DOI: 10.1080/23744235.2020.1871508] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Q fever osteoarticular infections are a rare complication of the chronic form of Q fever. We aimed to characterize chronic Q fever vertebral osteomyelitis through our experience and a review of the literature. METHODS Four adult patients with Q fever vertebral osteomyelitis diagnosed in a tertiary hospital in northern Israel between 2016 to 2020 are described. In addition, a 30 years' literature review of Q fever vertebral osteomyelitis, characterizing predisposing factors, clinical presentation, course of disease, treatment and outcomes, was performed. RESULTS Thirty-four adult patients with Q fever vertebral osteomyelitis were identified. The vast majority were male (30/34, 88%) with a mean age of 67.2 ± 10 years. Involvement of the adjacent aorta, likely the origin of the infection, was observed in 23/34 (68%) of the patients, usually among patients with aortic graft or aneurysm. Clinical presentation was insidious and fever was frequently absent. Delayed diagnosis for months to years after symptoms onset was frequently reported. Vascular infections were managed with or without extraction of the infected aneurysm/aorta and graft placement. The outcome was variable with limited follow-up data in most cases. Patients were usually treated with prolonged antimicrobial therapy, most commonly doxycycline and hydroxychloroquine combination therapy. CONCLUSION Q fever should be included in the differential diagnosis of vertebral osteomyelitis in endemic settings, in particular when concomitant adjacent vascular infection exists.
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Affiliation(s)
- Nesrin Ghanem-Zoubi
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| | - Tony Karram
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Vascular Surgery, Rambam Medical Center, Haifa, Israel
| | - Olga Kagna
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Goni Merhav
- Department of Radiology, Rambam Health Care Campus, Haifa, Israel
| | - Zohar Keidar
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.,Department of Nuclear Medicine, Rambam Health Care Campus, Haifa, Israel
| | - Mical Paul
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Abstract
We report a case of an 8-year-old Korean girl diagnosed with severe fever with thrombocytopenia syndrome with Q fever coinfection after playing with a dog and being bitten by a tick in a suburb in South Korea. The clinical findings and treatment were summarized. To the best of our knowledge, this case is the youngest patient reported to have been diagnosed with severe fever with thrombocytopenia syndrome and Q fever from South Korea.
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39
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Boisvert A, Gilbert N, Hivon P, Rheaume P. Q fever aortic infection causing an aortoduodenal fistula after endovascular aneurysm repair. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2020; 6:487-489. [PMID: 33134625 PMCID: PMC7588805 DOI: 10.1016/j.jvscit.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Abstract
An aortoduodenal fistula is a rare complication of endovascular aortic aneurysm repair. Q fever infection is known for its vascular tropism, and arterial fistulas have been reported in association with Coxiella burnetii infections. We report the case of a 78-year-old patient who had developed an aortoduodenal fistula secondary to vascular Q fever 5 years after he had been treated with an aortic endograft. Explantation of the endograft, autogenous reconstruction using the neo-aortoiliac system procedure, and duodenal repair were performed as a curative surgical treatment of this serious vascular condition. At the 9-month follow-up examination, the patient showed no signs of recurrent vascular infection and was instructed to complete an 18-month antibiotic regimen.
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Affiliation(s)
- Annie Boisvert
- Division of Vascular Surgery, CHU de Québec, Quebec City, Quebec, Canada
- Correspondence: Annie Boisvert, MD, MSc, Division of Vascular Surgery, CHU de Quebec, 10 rue d’Espinay, Quebec City, Quebec G1L 3L5, Canada
| | - Nathalie Gilbert
- Division of Vascular Surgery, CHU de Québec, Quebec City, Quebec, Canada
| | - Pierre Hivon
- Division of Infectious Diseases and Microbiology, CHU de Québec, Quebec City, Quebec, Canada
| | - Pascal Rheaume
- Division of Vascular Surgery, CHU de Québec, Quebec City, Quebec, Canada
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40
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Atherstone C, Mgode GF, Dhand NK, Alonso S, Grace D, Ward MP, Mor SM. Selected Endemic Zoonoses in Pigs Presenting for Slaughter in Kampala, Uganda. Am J Trop Med Hyg 2020; 103:2552-2560. [PMID: 33069266 PMCID: PMC7695076 DOI: 10.4269/ajtmh.20-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Leptospirosis, brucellosis, and Q fever (coxiellosis) are bacterial zoonoses that cause acute febrile illness in people as well as reproductive losses in pigs. Pig keeping is an increasingly important livelihood to millions of smallholder farmers in Uganda because of exponential increases in demand for pork. The prevalence of leptospirosis and Q fever in pigs is unknown, and the few studies of porcine brucellosis have estimated a range of seroprevalence. Therefore, we undertook a prevalence survey of leptospirosis, brucellosis, and Q fever in pigs using quantitative real-time PCR to determine the potential importance of these zoonoses to the growing pig sector in Uganda. Six hundred forty-nine pigs were sampled in 2015–2016 at an urban pork slaughterhouse. Ten percent of pigs (n = 68) had leptospiral DNA in either their kidney or reproductive tissue. In adjusted analyses, variables predictive of leptospiral status included female sex (odds ratio [OR]: 2.37, P < 0.01) and pigs sampled in March 2016 (OR: 2.23, P = 0.02) and October 2016 (OR: 0.30, P = 0.04). DNA fingerprinting revealed circulation of at least four distinct serovars in these pigs. Brucella spp. and Coxiella burnetii DNA were not detected in any sampled pig. This is the first report of widespread circulation of pathogenic Leptospira spp. in pigs in Uganda, suggesting that leptospirosis likely has a greater impact on the health of pigs than was previously recognized. Pig farmers, pig traders, and slaughterhouse workers may be at greatest occupational risk because of their direct contact with infective leptospires in aborted fetuses, bodily fluids, and other tissues.
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Affiliation(s)
- Christine Atherstone
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
| | - Georgies F Mgode
- Pest Management Centre, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Navneet K Dhand
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
| | - Silvia Alonso
- International Livestock Research Institute, Addis Ababa, Ethiopia
| | - Delia Grace
- Natural Resources Institute, University of Greenwich, Kent, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya
| | - Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
| | - Siobhan M Mor
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,Sydney School of Veterinary Science, The University of Sydney, Camperdown, Australia
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41
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Dabaja-Younis H, Meir M, Ilivizki A, Militianu D, Eidelman M, Kassis I, Shachor-Meyouhas Y. Q Fever Osteoarticular Infection in Children. Emerg Infect Dis 2020; 26. [PMID: 32818415 PMCID: PMC7454116 DOI: 10.3201/eid2609.191360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Studies of this condition, which is underestimated in children, will aid in its diagnosis and treatment. Q fever osteoarticular infection in children is an underestimated disease. We report 3 cases of Q fever osteomyelitis in children and review all cases reported in the literature through March 2018. A high index of suspicion is encouraged in cases of an unusual manifestation, prolonged course, relapsing symptoms, nonresolving or slowly resolving osteomyelitis, culture-negative osteomyelitis, or bone histopathology demonstrating granulomatous changes. Urban residence or lack of direct exposure to animals does not rule out infection. Diagnosis usually requires use of newer diagnostic modalities. Optimal antimicrobial therapy has not been well established; some case-patients may improve spontaneously or during treatment with a β-lactam. The etiology of treatment failure and relapse is not well understood, and tools for follow-up are lacking. Clinicians should be aware of these infections in children to guide optimal treatment, including choice of antimicrobial drugs, duration of therapy, and methods of monitoring response to treatment..
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Reeves PM, Raju Paul S, Baeten L, Korek SE, Yi Y, Hess J, Sobell D, Scholzen A, Garritsen A, De Groot AS, Moise L, Brauns T, Bowen R, Sluder AE, Poznansky MC. Novel multiparameter correlates of Coxiella burnetii infection and vaccination identified by longitudinal deep immune profiling. Sci Rep 2020; 10:13311. [PMID: 32770104 PMCID: PMC7414860 DOI: 10.1038/s41598-020-69327-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/05/2020] [Indexed: 12/12/2022] Open
Abstract
Q-fever is a flu-like illness caused by Coxiella burnetii (Cb), a highly infectious intracellular bacterium. There is an unmet need for a safe and effective vaccine for Q-fever. Correlates of immune protection to Cb infection are limited. We proposed that analysis by longitudinal high dimensional immune (HDI) profiling using mass cytometry combined with other measures of vaccination and protection could be used to identify novel correlates of effective vaccination and control of Cb infection. Using a vaccine-challenge model in HLA-DR transgenic mice, we demonstrated significant alterations in circulating T-cell and innate immune populations that distinguished vaccinated from naïve mice within 10 days, and persisted until at least 35 days post-vaccination. Following challenge, vaccinated mice exhibited reduced bacterial burden and splenomegaly, along with distinct effector T-cell and monocyte profiles. Correlation of HDI data to serological and pathological measurements was performed. Our data indicate a Th1-biased response to Cb, consistent with previous reports, and identify Ly6C, CD73, and T-bet expression in T-cell, NK-cell, and monocytic populations as distinguishing features between vaccinated and naïve mice. This study refines the understanding of the integrated immune response to Cb vaccine and challenge, which can inform the assessment of candidate vaccines for Cb.
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Affiliation(s)
- P M Reeves
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA.
| | - S Raju Paul
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - L Baeten
- Colorado State University, Fort Collins, CO, USA
| | - S E Korek
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - Y Yi
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - J Hess
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - D Sobell
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - A Scholzen
- InnatOss Laboratories B.V, Oss, The Netherlands
| | - A Garritsen
- InnatOss Laboratories B.V, Oss, The Netherlands
| | - A S De Groot
- EpiVax, Inc, Providence, RI, USA.,Center for Vaccines and Immunology, University of Georgia, Athens, GA, USA
| | - L Moise
- EpiVax, Inc, Providence, RI, USA.,Institute for Immunology and Informatics, Department of Cell and Molecular Biology, University of Rhode Island, Providence, RI, USA
| | - T Brauns
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - R Bowen
- Colorado State University, Fort Collins, CO, USA
| | - A E Sluder
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA
| | - M C Poznansky
- Vaccine and Immunotherapy Center, Massachusetts General Hospital, Boston, MA, USA.
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Coxiella Endocarditis as the Cause of Recurrent Fever and Brain Abscess in a Patient with Complex Congenital Heart Disease: A Case Report and Literature Review. Case Rep Infect Dis 2020; 2020:7894574. [PMID: 32670644 PMCID: PMC7333052 DOI: 10.1155/2020/7894574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 03/16/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Blood culture-negative infective endocarditis (BCNIE) can present subtly and is associated with a diagnostic delay leading to increased morbidity and mortality. Case Report. We present the case of an 18-year-old male with a history of complex congenital heart disease and 3-year intermittent episodes of fever of unknown origin, who was referred to our hospital for upper and lower extremity focal seizures. Laboratory blood tests were normal, blood cultures were negative, and brain imaging revealed an abscess. Cardiology consultation was requested, and transthoracic echocardiography revealed an intracardiac vegetation. Empiric antibiotic treatment with sultamicillin, gentamycin, and meropenem was initiated. Serology testing was positive for Coxiella burnetii, and the diagnosis of BCNIE was established. The antibiotic course was changed to oral doxycycline for 36 months and led to resolution of IE, with no vegetation detected on TTE after 15 months. Conclusion BCNIE is a life-threatening disease entity that can lead to severe complications, such as valve regurgitation, emboli, and death. Patients with congenital heart disease are particularly vulnerable to IE. Timely diagnosis and antibiotic management are of paramount importance in order to avoid the potentially fatal sequelae.
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44
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Coxiella burnetii-infected abdominal endovascular aortic stent graft in a kidney transplant recipient. Enferm Infecc Microbiol Clin 2020; 39:207-208. [PMID: 32660733 DOI: 10.1016/j.eimc.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 11/23/2022]
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45
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Browning S, Lai K, Pickles R, Graves SR. Q fever vertebral osteomyelitis in the absence of cardiovascular involvement: Two cases and a literature review. CLINICAL INFECTION IN PRACTICE 2020. [DOI: 10.1016/j.clinpr.2020.100019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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46
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Vranakis I, Kokkini S, Yachnakis E, Tselentis Y, Chochlakis D, Psaroulaki A. Q fever in Greece: Findings of a 13 years surveillance study. Comp Immunol Microbiol Infect Dis 2020; 69:101340. [PMID: 32014623 DOI: 10.1016/j.cimid.2019.101340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 07/12/2019] [Accepted: 07/26/2019] [Indexed: 10/25/2022]
Abstract
Q fever is an endemic disease in different parts of Greece. The current study aimed to investigate the prevalence of acute Q fever disease in Greece through the operation of the national reference centre for Q fever. A total of 5397 sera were received from febrile patients under the suspicion of Q fever infection during a 13 years period (2001-20013). A questionnaire was filled in by the clinicians containing certain clinical/epidemiological/demographic information. The diagnosis was based both on IFA (IgG and IgM phase II antibodies against Coxiella burnetii) and on molecular means. A total of 685 (12.7 %) samples were initially tested positive for acute Q fever. The mean (±SD) age of patients was 55.3 years (±18.7). Out of the 489 convalescent samples, 134 (27.4 %) samples indicated a minimum of a four-fold seroconversion and were considered as laboratory confirmed cases of acute Q fever. Pneumonia was the most frequently encountered clinical symptom with presence in 6.8 % of all positive samples. Forty six (46) patients were laboratory confirmed as chronic Q fever cases. Climate seemed to influence the distribution of Q fever cases throughout the years. The findings of the current study comply with past studies carried out elsewhere that had demonstrated a clear relation of the disease with temperature, south winds, etc. This study represents the first large scale attempt to gather a long period information on Q fever infection in Greece. The findings of the current study support the fact that Q fever is an important endemic zoonotic disease in Greece and needs increased awareness by clinical physicians and health care system.
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Affiliation(s)
- Iosif Vranakis
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece
| | - Sofia Kokkini
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece
| | - Emmanouil Yachnakis
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece
| | - Yannis Tselentis
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece
| | - Dimosthenis Chochlakis
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece
| | - Anna Psaroulaki
- Laborotary of Clinical Microbiology and Microbial Pathogenesis, Parasitology, Zoonoses and Geographical Medicine, School of Medicine, University of Crete, Heraklion, Crete, 71100, Greece.
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Ghanem-Zoubi N, Paul M. Q fever during pregnancy: a narrative review. Clin Microbiol Infect 2019; 26:864-870. [PMID: 31682987 DOI: 10.1016/j.cmi.2019.10.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Coxiella burnetii, the causative agent of Q fever, causes abortions in animals. Its effects on pregnancy in humans and the management of Q fever in pregnancy are uncertain. OBJECTIVES To summarize data on the effects of Q fever on pregnancy in women, the effects of pregnancy on Q fever complications and the optimal screening and management of Q fever during pregnancy. SOURCES We searched for studies reporting on Q fever during pregnancy in women. We included randomized and observational studies, seroprevalence studies, case series and case reports, including clinical and histopathological studies. CONTENT The accumulating data seems convincing that Q fever increases the risk of abortions in early pregnancy and prematurity or intrauterine fetal demise in late pregnancy. Data are based on sero-epidemiological associations of Q fever and adverse pregnancy outcomes and case reports showing the presence and effects of C. burnetii on the placenta and the fetus. Based on observational studies, acquisition of Q fever during pregnancy also increases the risk for maternal chronic Q fever. Treatment of recently infected women seems to improve these outcomes, based on case series only, but the optimal duration of treatment has not been studied. The efficacy of active surveillance during pregnancy, timing and frequency have not been determined in high-endemicity settings. Obstetricians should be aware of the risk for transmission of the disease during delivery. Currently available data are based mostly on case series and case reports, with some discrepancy between the French experience in chronic endemicity settings and Dutch experience in outbreak settings. IMPLICATIONS Since infection with Q fever is largely asymptomatic, we believe that the accumulating information linking Q fever to adverse pregnancy outcomes justifies screening in the high-endemicity setting and treatment of infected women. High-quality research addressing the questions raised by this review is needed to determine the optimal public health policy.
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Affiliation(s)
- N Ghanem-Zoubi
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel.
| | - M Paul
- Infectious Diseases Institute, Rambam Health Care Campus, Haifa, Israel; The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
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Heo JY, Choi YW, Kim EJ, Lee SH, Lim SK, Hwang SD, Lee JY, Jeong HW. Clinical characteristics of acute Q fever patients in South Korea and time from symptom onset to serologic diagnosis. BMC Infect Dis 2019; 19:903. [PMID: 31660875 PMCID: PMC6819606 DOI: 10.1186/s12879-019-4479-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 09/13/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Acute Q fever usually presents as a nonspecific febrile illness, and its occurrence is rapidly increasing in South Korea. This study investigated the clinical characteristics of acute Q fever patients in South Korea and the time from symptom onset to serologic diagnosis. The clinical courses were examined according to antibiotic treatment. METHODS Data of patients diagnosed with acute Q fever at Chungbuk National University Hospital between January 2015 and February 2018 were retrospectively collected. Demographic and epidemiologic data were reviewed. The time from symptom onset to serologic diagnosis by an immunofluorescence assay (IFA) was analyzed. Clinical courses and the percentage of patients with a high phase I immunoglobulin G titer (≥ 1:1024) were compared between patients administered antibiotics with anti-Coxiella burnetii activity and patients not administered such antibiotics. RESULTS Forty-eight patients (median age: 51.5 years) were included. Most were male (95.8%) and had no history of animal contact (91.7%). The median time from illness onset to serologic diagnosis was 21 days. Thirty-nine patients received antibiotics with anti-C. burnetii activity. The length of hospital stay and fever duration did not significantly differ between patients who received antibiotics with anti-C. burnetii activity (7 and 15 days) and those who did not (5 and 8 days) (P = 0.110 and P = 0.137, respectively). The percentage of patients with a high phase I immunoglobulin G titer (≥ 1:1024) did not significantly differ between patients who received antibiotics with anti-C. burnetii activity and those who did not (P = 0.340). CONCLUSIONS Most acute Q fever patients had a nonspecific febrile illness with mild elevation of transaminases and no history of animal contact or occupational risk. The time from symptom onset to a positive IFA test was longer than the fever duration in most acute Q fever patients. Consequently, it may be difficult for clinicians to serologically diagnose acute Q fever. However, inappropriate antibiotic treatment was not associated with prolongation of symptoms or progression to chronic Q fever.
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Affiliation(s)
- Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young Wha Choi
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Eun Jin Kim
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seung Hun Lee
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Cheongju, Republic of Korea.,Yeosu National Quarantine Office, Korea Centers for Disease Control and Prevention, Yeosu, Republic of Korea
| | - Seung Kwan Lim
- Department of Internal Medicine, Gyeonggi Provincial Medical Center Ansung Hospital, Ansung, Republic of Korea
| | - Seon Do Hwang
- Division of Bacterial Diseases, Center for Laboratory Control of Infectious Diseases, Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Ju Young Lee
- Department of Internal Medicine, Sam Anyang Hospital, Anyang, Republic of Korea
| | - Hye Won Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. .,Department of Internal Medicine, Chungbuk National University College of Medicine, Chungdae-Ro 1, Seowon-Gu, Cheongju, Chungbuk, 28644, Republic of Korea.
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49
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Khademi P, Ownagh A, Mardani K, Khalili M. Prevalence of Coxiella burnetii in milk collected from buffalo (water buffalo) and cattle dairy farms in Northwest of Iran. Comp Immunol Microbiol Infect Dis 2019; 67:101368. [PMID: 31627037 DOI: 10.1016/j.cimid.2019.101368] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/07/2019] [Indexed: 11/19/2022]
Abstract
The present study was conducted to determine the prevalence of C. burnetii in raw milk samples collected from water buffalos and cattle in Northwest of Iran (West Azerbaijan Province). A total number of 840 milk samples were randomly collected from buffalos and cattle belonged to three different geographical regions in west Azerbaijan (the map is necessary). The milk samples were collected seasonally during 2018 and the age of animals were recorded. All the milk samples were subjected to DNA extraction. Nested-PCR was used to detect C. burnetii based on the transposable gene IS1111. The results showed that 16.9% (95% CI: 14.5%-19.6%) of the examined milk samples (19.3% buffalo and 14.6% cattle samples) were positive for C. burnetii. There was a significant difference in C. burnetii shedding in milk between different age groups in cattle but not in buffalos (p value <0.05). The shedding of C. burnetii in milk was highly prevalent in summer (31.1%) (p < 0.05, 95% CI: 26.1%-38.4%). There were significant regional and seasonal variations in the prevalence of C. burnetii in the examined milk samples. It was concluded that buffalo population in west Azerbaijan should be considered as an important factor in the epidemiology of Q fever and consequently in public health.
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Affiliation(s)
- Payman Khademi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran
| | - Abdulghaffar Ownagh
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran.
| | - Karim Mardani
- Department of Food Hygiene and Quality Control, Faculty of Veterinary Medicine, Urmia University, Urmia, West Azerbaijan, Iran
| | - Mohammad Khalili
- Department of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Chenouard R, Hoppé E, Lemarié C, Talha A, Ducellier F, Ferchaud F, Kempf M, Edouard S, Abgueguen P, Rabier V, Pailhoriès H. A rare case of Prosthetic Joint Infection associated with Coxiella burnetii. Int J Infect Dis 2019; 87:166-169. [PMID: 31374343 DOI: 10.1016/j.ijid.2019.07.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/24/2019] [Accepted: 07/24/2019] [Indexed: 01/15/2023] Open
Abstract
We report here the case of a Prosthetic Joint Infection (PJI) associated with Coxiella burnetii in a 62-year-old man with a revised total hip arthroplasty. The diagnosis was performed first by 16S rDNA sequencing on hip fluid aspirate, and confirmed by specific qPCR. Q fever has been reported in few cases of Prosthetic Joint Infections, often associated with chronic evolution and iterative surgeries. This case report alerts about such an unexpected diagnosis in a patient with no known risk factors.
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Affiliation(s)
- Rachel Chenouard
- Laboratoire de Bactériologie, Institut de Biologie en Santé, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Emmanuel Hoppé
- Service de Rhumatologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Carole Lemarié
- Laboratoire de Bactériologie, Institut de Biologie en Santé, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Abdelhafid Talha
- Service de Chirurgie Osseuse, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Florian Ducellier
- Service de Chirurgie Osseuse, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - François Ferchaud
- Service de Chirurgie Osseuse, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Marie Kempf
- Laboratoire de Bactériologie, Institut de Biologie en Santé, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Sophie Edouard
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Pierre Abgueguen
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Valérie Rabier
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Hélène Pailhoriès
- Laboratoire de Bactériologie, Institut de Biologie en Santé, Centre Hospitalier Universitaire d'Angers, Angers, France.
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