1
|
Ghazanabad AE, Esfandiari N, Najafi M, Mehrabi S, Sarani S, Khademi P, Maurin M. Molecular detection of Coxiella burnetii in tick and blood samples from small ruminants in northwest of Iran. EXPERIMENTAL & APPLIED ACAROLOGY 2024; 92:529-546. [PMID: 38407754 DOI: 10.1007/s10493-023-00888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024]
Abstract
This survey sought to molecularly detect Coxiella burnetii in Argasidae and Ixodidae ticks attached to small ruminants in the region of West Azerbaijan (Northwest of Iran) and blood samples collected from the same animals. 451 tick samples and 927 blood samples were obtained from sheep (n = 536) and goats (n = 391) and tested by nested PCR for detection of C. burnetii insertion sequence IS1111 or icd gene sequence. The collected ticks were morphologically classified as Rhipicephalus sanguineus, Rhipicephalus turanicus, Hyalomma asiaticum, Hyalomma anatolicum, or Argas reflexus. 14% of ticks (65 in total 43 for IS1111 and 22 for icd gene) tested positive for C. burnetii, none of which were from the Argas genus. Among the 927 blood samples, 218 (23.5%) tested positive for C. burnetii. The positive result from analysis targeting the genes IS1111 and icd were 131 and 87 respectively. As Q fever is a tickborne zoonosis and endemic to Iran, such information is critical for creating effective, coordinated, and strategic tick and pathogen control programs to prevent disease outbreak in domestic animals and humans.
Collapse
Affiliation(s)
| | - Negin Esfandiari
- Department of Food Hygiene and Quality Control, Division of Epidemiology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Mohammadreza Najafi
- Department of Pathobiology, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Shahryar Mehrabi
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | - Saeedeh Sarani
- Department of Pathology, Faculty of Veterinary Medicine, Zabol University, Zabol, Iran
| | - Peyman Khademi
- Department of pathology, Faculty of Veterinary Medicine, Lorestan University, Khoram Abad, Iran
| | - Max Maurin
- Department of Clinical Microbiology, CHU Grenoble Alpes, University Grenoble Alpes, CNRS, TIMC, 38000, Grenoble, France
| |
Collapse
|
2
|
Ohlopkova OV, Yakovlev SA, Emmanuel K, Kabanov AA, Odnoshevsky DA, Kartashov MY, Moshkin AD, Tuchkov IV, Nosov NY, Kritsky AA, Agalakova MA, Davidyuk YN, Khaiboullina SF, Morzunov SP, N'Fally M, Bumbali S, Camara MF, Boiro MY, Agafonov AP, Gavrilova EV, Maksyutov RA. Epidemiology of Zoonotic Coxiella burnetii in The Republic of Guinea. Microorganisms 2023; 11:1433. [PMID: 37374935 DOI: 10.3390/microorganisms11061433] [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: 04/28/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Q fever is a zoonotic infectious disease characterized by fever, malaise, chills, significant weakness, and muscle pain. In some cases, the disease can become chronic and affect the inner membranes of the heart, such as the valves, leading to endocarditis and a high risk of death. Coxiella burnetii (C. burnetii) is the primary causative agent of Q fever in humans. This study aims to monitor the presence of C. burnetii in ticks collected from small mammals and cattle in the Republic of Guinea (RG). METHODS Rodents were trapped in the Kindia region of RG during 2019-2020, and ticks were collected from cattle in six regions of RG. Total DNA was extracted using a commercial kit (RIBO-prep, InterLabService, Russia) following the manufacturer's instructions. Real-time PCR amplification was conducted using the kit (AmpliSens Coxiella burnetii-FL, InterLabService, Russia) to detect C. burnetii DNA. RESULTS AND CONCLUSIONS Bacterial DNA was detected in 11 out of 750 (1.4%) small mammals and 695 out of 9620 (7.2%) tick samples. The high number of infected ticks (7.2%) suggests that they are the main transmitters of C. burnetii in RG. The DNA was detected in the liver and spleen of a Guinea multimammate mouse, Mastomys erythroleucus. These findings demonstrate that C. burnetii is zoonotic in RG, and measures should be taken to monitor the bacteria's dynamics and tick prevalence in the rodent population.
Collapse
Affiliation(s)
- Olesia V Ohlopkova
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Sergey A Yakovlev
- Russian Research Anti-Plague Institute «Microbe» of Rospotrebnadzor, Saratov 410005, Russia
| | - Kabwe Emmanuel
- OpenLab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan 420008, Russia
| | - Alexey A Kabanov
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Dmitry A Odnoshevsky
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Mikhail Yu Kartashov
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Alexey D Moshkin
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Igor V Tuchkov
- Russian Research Anti-Plague Institute «Microbe» of Rospotrebnadzor, Saratov 410005, Russia
| | - Nikita Yu Nosov
- Russian Research Anti-Plague Institute «Microbe» of Rospotrebnadzor, Saratov 410005, Russia
- State Research Center of Dermatovenerology and Cosmetology of Russian Ministry of Health, Moscow 107076, Russia
| | - Andrey A Kritsky
- Russian Research Anti-Plague Institute «Microbe» of Rospotrebnadzor, Saratov 410005, Russia
- Limited Liability Company, «Biotech Campus», Moscow 117437, Russia
| | - Milana A Agalakova
- Faculty of Preventive Medicine, Ural State Medical University, Yekaterinburg 620014, Russia
- Limited Liability Company, «Quality Med», Yekaterinburg 105318, Russia
| | - Yuriy N Davidyuk
- OpenLab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan 420008, Russia
| | - Svetlana F Khaiboullina
- OpenLab "Gene and Cell Technologies", Institute of Fundamental Medicine and Biology, Kazan (Volga Region) Federal University, Kazan 420008, Russia
| | | | - Magasuba N'Fally
- Faculty of Medicine, Pharmacy and Dentistry, University Gamal Abdel Nasser, Conakry 001, Guinea
| | - Sanaba Bumbali
- Research Institute of Applied Biology of Guinea, Kindia 100, Guinea
| | | | | | - Alexander P Agafonov
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Elena V Gavrilova
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| | - Rinat A Maksyutov
- State Research Center of Virology and Biotechnology «Vector» of Rospotrebnadzor, Koltsovo 630559, Russia
| |
Collapse
|
3
|
Muema J, Nyamai M, Wheelhouse N, Njuguna J, Jost C, Oyugi J, Bukania Z, Oboge H, Ogoti B, Makori A, Fernandez MDP, Omulo S, Thumbi S. Endemicity of Coxiella burnetii infection among people and their livestock in pastoral communities in northern Kenya. Heliyon 2022; 8:e11133. [PMID: 36303929 PMCID: PMC9593183 DOI: 10.1016/j.heliyon.2022.e11133] [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: 01/26/2022] [Revised: 07/26/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background Coxiella burnetti can be transmitted to humans primarily through inhaling contaminated droplets released from infected animals or consumption of contaminated dairy products. Despite its zoonotic nature and the close association pastoralist communities have with their livestock, studies reporting simultaneous assessment of C. burnetti exposure and risk-factors among people and their livestock are scarce. Objective This study therefore estimated the seroprevalence of Q-fever and associated risk factors of exposure in people and their livestock. Materials and methods We conducted a cross-sectional study in pastoralist communities in Marsabit County in northern Kenya. A total of 1,074 women and 225 children were enrolled and provided blood samples for Q-fever testing. Additionally, 1,876 goats, 322 sheep and 189 camels from the same households were sampled. A structured questionnaire was administered to collect individual- and household/herd-level data. Indirect IgG ELISA kits were used to test the samples. Results Household-level seropositivity was 13.2% [95% CI: 11.2–15.3]; differences in seropositivity levels among women and children were statistically insignificant (p = 0.8531). Lactating women had higher odds of exposure, odds ratio (OR) = 2.4 [1.3–5.3], while the odds of exposure among children increased with age OR = 1.1 [1.0–1.1]. Herd-level seroprevalence was 83.7% [81.7–85.6]. Seropositivity among goats was 74.7% [72.7–76.7], while that among sheep and camels was 56.8% [51.2–62.3] and 38.6% [31.6–45.9], respectively. Goats and sheep had a higher risk of exposure OR = 5.4 [3.7–7.3] and 2.6 [1.8–3.4], respectively relative to camels. There was no statistically significant association between Q-fever seropositivity and nutrition status in women, p = 0.900 and children, p = 1.000. We found no significant association between exposure in people and their livestock at household level (p = 0.724) despite high animal exposure levels, suggesting that Q-fever exposure in humans may be occurring at a scale larger than households. Conclusion The one health approach used in this study revealed that Q-fever is endemic in this setting. Longitudinal studies of Q-fever burden and risk factors simultaneously assessed in human and animal populations as well as the socioeconomic impacts of the disease and further explore the role of environmental factors in Q-fever epidemiology are required. Such evidence may form the basis for designing Q-fever prevention and control strategies.
Collapse
Affiliation(s)
- Josphat Muema
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Corresponding author.
| | - Mutono Nyamai
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | | | - Joseph Njuguna
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Christine Jost
- United States Agency for International Development's Bureau for Humanitarian Assistance (USAID/BHA), Washington, DC, USA,Global Health Support Initiative III, Social Solutions International, Washington DC, USA
| | - Julius Oyugi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Zipporah Bukania
- Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Harriet Oboge
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA
| | - Brian Ogoti
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | - Anita Makori
- Washington State University Global Health Program – Kenya, Nairobi, Kenya,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya
| | | | - Sylvia Omulo
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Paul G. Allen School for Global Health, Washington State University, Pullman, USA
| | - S.M. Thumbi
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya,Feed the Future Innovation Lab for Animal Health, Washington State University, USA,Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya,Paul G. Allen School for Global Health, Washington State University, Pullman, USA,South African Center for Epidemiological Modelling Analysis, South Africa,Institute of Immunology and Infection Research, University of Edinburgh, UK
| |
Collapse
|
4
|
Vidal MS, Lintao RCV, Severino MEL, Tantengco OAG, Menon R. Spontaneous preterm birth: Involvement of multiple feto-maternal tissues and organ systems, differing mechanisms, and pathways. Front Endocrinol (Lausanne) 2022; 13:1015622. [PMID: 36313741 PMCID: PMC9606232 DOI: 10.3389/fendo.2022.1015622] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022] Open
Abstract
Survivors of preterm birth struggle with multitudes of disabilities due to improper in utero programming of various tissues and organ systems contributing to adult-onset diseases at a very early stage of their lives. Therefore, the persistent rates of low birth weight (birth weight < 2,500 grams), as well as rates of neonatal and maternal morbidities and mortalities, need to be addressed. Active research throughout the years has provided us with multiple theories regarding the risk factors, initiators, biomarkers, and clinical manifestations of spontaneous preterm birth. Fetal organs, like the placenta and fetal membranes, and maternal tissues and organs, like the decidua, myometrium, and cervix, have all been shown to uniquely respond to specific exogenous or endogenous risk factors. These uniquely contribute to dynamic changes at the molecular and cellular levels to effect preterm labor pathways leading to delivery. Multiple intervention targets in these different tissues and organs have been successfully tested in preclinical trials to reduce the individual impacts on promoting preterm birth. However, these preclinical trial data have not been effectively translated into developing biomarkers of high-risk individuals for an early diagnosis of the disease. This becomes more evident when examining the current global rate of preterm birth, which remains staggeringly high despite years of research. We postulate that studying each tissue and organ in silos, as how the majority of research has been conducted in the past years, is unlikely to address the network interaction between various systems leading to a synchronized activity during either term or preterm labor and delivery. To address current limitations, this review proposes an integrated approach to studying various tissues and organs involved in the maintenance of normal pregnancy, promotion of normal parturition, and more importantly, contributions towards preterm birth. We also stress the need for biological models that allows for concomitant observation and analysis of interactions, rather than focusing on these tissues and organ in silos.
Collapse
Affiliation(s)
- Manuel S. Vidal
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ryan C. V. Lintao
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Mary Elise L. Severino
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ourlad Alzeus G. Tantengco
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines, Manila, Philippines
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Ramkumar Menon
- Division of Basic Science and Translational Research, Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| |
Collapse
|
5
|
From Coxiella burnetii Infection to Pregnancy Complications: Key Role of the Immune Response of Placental Cells. Pathogens 2021; 10:pathogens10050627. [PMID: 34069587 PMCID: PMC8160966 DOI: 10.3390/pathogens10050627] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/17/2023] Open
Abstract
The infection of pregnant animals and women by Coxiella burnetii, an intracellular bacterium, compromises both maternal health and foetal development. The placenta is targeted by C. burnetii, as demonstrated by bacteriological and histological evidence. It now appears that placental strains of C. burnetii are highly virulent compared to reference strains and that placental injury involves different types of placental cells. Trophoblasts, the major placental cells, are largely infected by C. burnetii and may represent a replicating niche for the bacteria. The placenta also contains numerous immune cells, including macrophages, dendritic cells, and mast cells. Placental macrophages are infected and activated by C. burnetii in an unusual way of M1 polarisation associated with bacterial elimination. Placental mast cells eliminate bacteria through a mechanism including the release of extracellular actin filaments and antimicrobial peptides. In contrast, C. burnetii impairs the maturation of decidual dendritic cells, favouring bacterial pathogenicity. Our aim is to review C. burnetii infections of human placentas, paying special attention to both the action and function of the different cell types, immune cells, and trophoblasts targeted by C. burnetii in relation to foetal injury.
Collapse
|
6
|
Jaubert J, Atiana L, Larrieu S, De Vos P, Somon-Payet C, Porcherat S, Mboussou Y, Naze F, Picot S, Boukerrou M, Robillard PY, Gérardin P. Q fever seroprevalence in parturient women: the EQRUN cross-sectional study on Reunion Island. BMC Infect Dis 2020; 20:261. [PMID: 32245372 PMCID: PMC7118902 DOI: 10.1186/s12879-020-04969-w] [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: 03/18/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
Background Q fever (Coxiella burnetii infection) has been associated with adverse perinatal outcomes. After investigating the obstetrical importance of Q fever on Reunion island and demonstrating an association between incident Q fever and miscarriage, we conducted a cross-sectional serosurvey to assess the prevalence of Coxiella burnetii infection among parturient women. Methods Between January 9 and July 24, 2014, within the level-4 maternity of Saint Pierre hospital and the level-1 maternity of Le Tampon, we proposed to screen all parturient women for Coxiella burnetii serology. Seropositivity was defined using indirect immunofluorescence for a dilution of phase 2 IgG titre ≥1:64. Further dilutions were chosen to discriminate recent or active infections from past or prevalent infections (< 1:128) and classify these as either possible (1:128), or probable (≥1:256). Recurrent miscarriage, stillbirth, preterm birth, small-for-gestational as well as a composite outcome of these adverse pregnancy outcomes were compared according to seropositivity using bivariate analysis or propensity score matching of seropositive and seronegative women on confounding factors. Results Among 1112 parturient women screened for Q fever over this 7-month period, 203 (18.3%) were seropositive. Overall weighted seroprevalence was of 20.1% (95%CI, 17.7–22.5%). Weighted seroprevalence of probable infections was 4.7% (95%CI 3.4–5.9%), while > 90% of positive serologies corresponded to past infections or false positives. Seropositivity was associated with none of the abovementioned adverse perinatal outcomes, whether in unpaired or matched analyses on propensity score. Conclusion The magnitude and the pattern of seroprevalence suggest that Q fever is endemic on Reunion island. In this context, we found no significant contribution of prevalent Coxiella burnetii infection to adverse pregnancy outcomes. Although reassuring, these data put in our endemic context, with a previously demonstrated increased risk of incident Q fever associated miscarriage, encourage us to protect pregnant women against the risk of new infection, periconceptional or early in pregnancy.
Collapse
Affiliation(s)
- Julien Jaubert
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Laura Atiana
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sophie Larrieu
- CIRE Océan Indien, Santé Publique France, French National Public Health Agency, Saint Denis, Reunion, France
| | | | - Claudine Somon-Payet
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France
| | - Sylvaine Porcherat
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France
| | - Yoan Mboussou
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Florence Naze
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Sandrine Picot
- Laboratoire de Bactériologie, Virologie et Parasitologie, Centre Hospitalier Universitaire (CHU) de la Réunion, Saint Pierre, Reunion, France
| | - Malik Boukerrou
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Pierre-Yves Robillard
- Maternité, Pôle Femme Mère Enfant, CHU de la Réunion, St Pierre, Reunion, France.,CEPOI-EA7388, Pôle Femme Mère Enfant, CHU de la Réunion, Saint Pierre, Reunion, France
| | - Patrick Gérardin
- INSERM CIC 1410 Epidémiologie Clinique, Centre Hospitalier Universitaire, Groupe Hospitalier Sud Réunion, CHU Réunion, BP 350, 97448, Saint Pierre, Cedex-Reunion, France. .,UM 134 PIMIT Processus Infectieux en Milieu Insulaire Tropical, Université de La Réunion, INSERM 1187, CNRS 9192, IRD 249, CYROI, Sainte Clotilde, Reunion, France.
| |
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Q Fever in the First Trimester: A Case Report from Northern Rural New South Wales. Trop Med Infect Dis 2019; 4:tropicalmed4020090. [PMID: 31181651 PMCID: PMC6630656 DOI: 10.3390/tropicalmed4020090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 11/17/2022] Open
Abstract
Pregnant women are significantly more likely to have an asymptomatic acute infection with C. burnetii which, untreated, has been associated with poor obstetric outcomes including miscarriage, stillbirth, intrauterine growth restriction, and premature delivery. As such, Q fever is a potentially under-recognised and treatable cause of adverse pregnancy outcomes in rural Northern New South Wales, with testing of Q fever polymerase chain reaction (PCR)—whether on maternal sera or placental tissue—not currently recommended by the Perinatal Society of Australia and New Zealand for Stillbirth.
Collapse
|
9
|
Abstract
Mast cells (MCs) are found in tissues that are in close contact with external environment, such as skin, lungs, or intestinal mucosa but also in the placenta during pregnancy. If their role in mediating allergic conditions is established, several studies now highlight their importance during infection with extracellular pathogens. This study showed a new and effective antimicrobial mechanism of MCs against Coxiella burnetii, an intracellular bacterium whose infection during pregnancy is associated with abortion, preterm labor, and stillbirth. The data reveal that in response to C. burnetii, MCs release extracellular actin filaments that contain antimicrobial agents and are capable to trap and kill bacteria. We show that this mechanism is dependent on the cooperation of two membrane receptors, CD36 and Toll-like receptor 4, and may occur in the placenta during pregnancy by using ex vivo placental MCs. Overall, this study reports an unexpected role for MCs during infection with intracellular bacteria and suggests that MC response to C. burnetii infection is a protective defense mechanism during pregnancy. Mast cells (MCs) are critical mediators of inflammation; however, their microbicidal activity against invading pathogens remains largely unknown. Here, we describe a nonpreviously reported antibacterial mechanism used by MCs against Coxiella burnetii, the agent of Q fever. We show that C. burnetii interaction with MCs does not result in bacterial uptake but rather induces the formation of extracellular actin filaments named cytonemes. MC cytonemes express cathelicidin and neutrophil elastase and mediate the capture and destruction of entrapped bacteria. We provide evidence that MC cytoneme formation and microbicidal activity are dependent on the cooperation of the scavenger receptor CD36 and Toll-like receptor 4. Taken together, our results suggest that MCs use an extracellular sophisticated mechanism of defense to eliminate intracellular pathogens, such as C. burnetii, before their entry into host cells.
Collapse
|
10
|
Kledmanee K, Liabsuetrakul T, Sretrirutchai S. Risk of adverse pregnancy outcomes and seroprevalence for brucellosis in pregnant women exposed to goats or raw goat products in southern Thailand: a prospective cohort study. BMC Pregnancy Childbirth 2019; 19:118. [PMID: 30953474 PMCID: PMC6451268 DOI: 10.1186/s12884-019-2267-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 03/27/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Pregnant women infected with brucellosis have been shown to have higher odds of having been exposed to goats and raw goat products and adverse pregnancy outcomes. However, information on these associations in asymptomatic pregnant women is limited, particularly in the brucellosis-endemic areas. This study aimed to assess the association of a history of exposure to goats and/or raw goat products and the serological status of anti-Brucella abortus immunoglobulin G (IgG) with adverse pregnancy outcomes among pregnant women, and explore factors associated with having exposure to goats and/or raw goat products. METHODS A prospective cohort study was conducted among pregnant women from July 2015 to July 2016 at Songkhla province in southern Thailand. All pregnant women who came for antenatal care (ANC) visits were approached. Blood samples from the women who agreed to participate were randomly tested for anti-Brucella abortus IgG. The women were then followed for adverse pregnancy outcomes. RESULTS Of 666 pregnant women, the majority (74.4%) were aged 20-34 years and Muslim (89.2%), 30.6% indicated exposure to goats or raw goat products, and 17.3% had adverse pregnancy outcomes. Women rearing goats at home or having neighbors rearing goats were more likely to be exposed to goats or raw goat products by cutaneous contact. Of 465 women having a blood test, 3.7% had seropositive results for anti-Brucella abortus IgG. No association with adverse pregnancy outcomes was found in the women reporting any exposure to goat and raw goat products. Having the first ANC visit at the first trimester and history of preterm birth or low birth weight newborn were independent risk factors of adverse pregnancy outcomes. Women who had positive serological results were more likely to have a history of drinking raw goat milk than those who had negative results significantly. CONCLUSIONS Although no association between past exposure with goats and raw goat products and adverse pregnancy outcomes was found, women with past exposure showed positive anti-Brucella abortus IgG. Counseling on avoiding consumption of raw goat milk would be beneficial to prevent goat-related infection in pregnant women in this area.
Collapse
Affiliation(s)
- Kan Kledmanee
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Tippawan Liabsuetrakul
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
| | - Somporn Sretrirutchai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| |
Collapse
|
11
|
Ghaoui H, Bitam I, Ait-Oudhia K, Achour N, Saad-Djaballah A, Saadnia FZ, Kedjour S, Fournier PE, Raoult D. Coxiella burnetii infection with women's febrile spontaneous abortion reported in Algiers. New Microbes New Infect 2018; 26:8-14. [PMID: 30245827 PMCID: PMC6141670 DOI: 10.1016/j.nmni.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 07/21/2018] [Accepted: 08/03/2018] [Indexed: 11/25/2022] Open
Abstract
We investigated Q fever infection in Febrile Spontaneous Abortions in women by using a serologic method (Immuno-Fluorescence Assay, IFA) and a molecular method (real-time quantitative PCR, qPCR) in Obstetric-Gynaecology (OB-GYN) services in two hospitals in Algiers. We included in the case group 380 women who experienced Febrile Spontaneous Abortion; the control group comprised 345 women who gave birth without any other infections or complications. Among the 725 women included, antibodies against Coxiella burnetii were detected by IFA in three (03) cases patients; all control group samples were IFA negative. In other hand, only four (04) placental samples among the case group came back with q PCR positive for IS1111 and IS30a too. A relationship between C. burnetii infection and febrile spontaneous abortion exists in OB-GYN services in Algiers.
Collapse
Affiliation(s)
- H Ghaoui
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.,École Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Alger, Algérie
| | - I Bitam
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.,École Supérieure En sciences de l'Aliment et des industries Agroalimentaire d'Alger, Algérie
| | - K Ait-Oudhia
- École Nationale Supérieure Vétérinaire d'Alger, RABIE BOUCHAMA, Alger, Algérie
| | - N Achour
- EHS des maladies infectieuses, ELHADI FLICI, Alger, Algérie
| | | | | | - S Kedjour
- EPH HASSEN BADI Ex BELFORT, El-Harrache, Alger, Algérie
| | - P-E Fournier
- IRD, VITROME, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France
| | - D Raoult
- IRD, MEPHI, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France
| |
Collapse
|
12
|
Plummer PJ, McClure JT, Menzies P, Morley PS, Van den Brom R, Van Metre DC. Management of Coxiella burnetii infection in livestock populations and the associated zoonotic risk: A consensus statement. J Vet Intern Med 2018; 32:1481-1494. [PMID: 30084178 PMCID: PMC6189356 DOI: 10.1111/jvim.15229] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 01/02/2023] Open
Abstract
Infections caused by Coxiella burnetii, commonly referred to as coxiellosis when occurring in animals and Query fever when occurring in humans, are an important cause of abortions, decreased reproductive efficiency, and subclinical infections in ruminants. The organism also represents an important zoonotic concern associated with its ability to aerosolize easily and its low infectious dose. Available diagnostic tests have limited sensitivity, which combined with the absence of treatment options in animals and limited approaches to prevention, result in difficulty managing this agent for optimal animal health and zoonotic disease outcomes. The purpose of this consensus statement is to provide veterinarians and public health officials with a summary of the available information regarding management of C. burnetii infection in livestock populations. A discussion of currently available testing options and their interpretation is provided, along with recommendations on management practices that can be implemented on‐farm in the face of an outbreak to mitigate losses. Emphasis is placed on biosecurity measures that can be considered for minimizing the zoonotic transmission risk in both field and veterinary facilities.
Collapse
Affiliation(s)
- Paul J Plummer
- Department of Veterinary Diagnostic and Production Animal Medicine and the Department of Veterinary Microbiology and Preventative Medicine, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - J Trenton McClure
- Dpeartment of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward, Canada
| | - Paula Menzies
- Department Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Paul S Morley
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Colorado School of Public Health, Fort Collins, Colorado
| | | | - David C Van Metre
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| |
Collapse
|
13
|
Chlamydia trachomatis and chlamydia-like bacteria: new enemies of human pregnancies. Curr Opin Infect Dis 2018; 30:289-296. [PMID: 28306562 DOI: 10.1097/qco.0000000000000369] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW This review provides an update on the roles of Chlamydia trachomatis and the related Waddlia chondrophila and Parachlamydia acanthamoebae in miscarriage, stillbirths and preterm labour in humans. A broad audience, including microbiologist, infectiologists, obstetricians and gynaecologists, should be aware of the potential threat of these Chlamydiales for human reproduction. RECENT FINDINGS Despite increasing laboratory techniques and possibilities to perform diagnostic tests, the cause of miscarriage is only identified in 50% of the cases. Intracellular bacteria, such as C. trachomatis and Chlamydia-related bacteria, are difficult to detect in routine clinical samples and could represent possible agents of miscarriages. C. trachomatis is considered the world largest sexual transmitted bacterial agent and is associated with adverse pregnancy outcome in human. In the last decade Chlamydia-like organisms, such as W. chondrophila and P. acanthamoebae, have also been associated with adverse pregnancy outcomes in human and/or animals. SUMMARY We review here the current evidences for a pathogenic role in humans, the diagnostic approaches and possible treatment options of C. trachomatis, W. chondrophila and P. acanthamoebae.
Collapse
|
14
|
Pechstein J, Schulze-Luehrmann J, Lührmann A. Coxiella burnetii as a useful tool to investigate bacteria-friendly host cell compartments. Int J Med Microbiol 2017; 308:77-83. [PMID: 28935173 DOI: 10.1016/j.ijmm.2017.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/21/2017] [Accepted: 09/11/2017] [Indexed: 10/25/2022] Open
Abstract
Coxiella burnetii is an obligate intracellular and airborne pathogen which can cause the zoonotic disease Q fever. After inhalation of contaminated aerosols alveolar macrophages are taking up C. burnetii into a phagosome. This phagosome matures to a very large vacuole called the C. burnetii-containing vacuole (CCV). Host endogenous and bacterial driven processes lead to the biogenesis of this unusual compartment, which resembles partially a phagolysosome. However, there are several important differences to the classical phagolysosome, which are crucial for the ability of C. burnetii to replicate intracellularly and depend on a functional type IV secretion system (T4SS). The T4SS delivers effector proteins into the host cell cytoplasm to redirect intracellular processes, leading to the establishment of a microenvironment allowing bacterial replication. This article summarizes the current knowledge of the microenvironment permissive for C. burnetii replication.
Collapse
Affiliation(s)
- Julian Pechstein
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054 Erlangen, Germany
| | - Jan Schulze-Luehrmann
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054 Erlangen, Germany
| | - Anja Lührmann
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054 Erlangen, Germany.
| |
Collapse
|
15
|
Stephen S, Ambroise S, Pradeep J, Gunasekaran D, Sangeetha B, Sarangapani K. Unreliability of three commercial Coxiella burnetii phase II IgM ELISA kits for the seroscreening of acute Q fever in human cases. Indian J Med Res 2017; 146:386-391. [PMID: 29355147 PMCID: PMC5793475 DOI: 10.4103/ijmr.ijmr_1815_15] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND & OBJECTIVES Seroprevalence of Q fever (QF) caused by Coxiella burnetii has been reported from different parts of India. Usually serological/molecular tests are employed for detection of infection. The present study was undertaken to verify the validity of three different QF phase II IgM ELISA kits for acute QF diagnosis by comparing with the gold standard indirect fluorescent antibody assay (IFA). METHODS Fifty eight serum samples collected from 42 patients (26 patients provided acute sample only and 16 both acute and convalescent samples) which were examined by all three commercial kits, were cross-checked with QF Phase II IgM IFA for confirmation. RESULTS Eleven patients were positive for C. burnetii antibodies by IFA in acute and/or convalescent serum samples. Taking IFA as a reference, percentages of sensitivity, specificity, positive predictive value and negative predictive value for Virion-Serion/Vircell/NovaTec were 36.36, 61.29, 25.00, 73.08; 81.82, 35.48, 31.03, 84.62 and 100, 25.81, 32.35, 100 per cent, respectively. INTERPRETATION & CONCLUSIONS The three different ELISA kits exhibited poor agreement amongst them and unacceptable level of false positivity. IFA remains to be the only option for diagnosing acute QF. Discrepancy between the clinical findings and IFA/ELISA results needs confirmation by C. burnetii DNA detection in real-time polymerase chain reaction.
Collapse
Affiliation(s)
- Selvaraj Stephen
- Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
| | - Stanley Ambroise
- Department of General Medicine, Indira Gandhi Government General Hospital & Post Graduate Institute, Puducherry, India
| | - Jothimani Pradeep
- Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
| | - Dhandapany Gunasekaran
- Department of Paediatrics, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
| | - Balakrishnan Sangeetha
- Department of Microbiology, Mahatma Gandhi Medical College & Research Institute, Puducherry, India
| | - Kengamuthu Sarangapani
- Department of Microbiology, Indira Gandhi Government General Hospital & Post Graduate Institute, Puducherry, India
| |
Collapse
|
16
|
Agerholm JS, Jensen TK, Agger JF, Engelsma MY, Roest HIJ. Presence of Coxiella burnetii DNA in inflamed bovine cardiac valves. BMC Vet Res 2017; 13:69. [PMID: 28274243 PMCID: PMC5343293 DOI: 10.1186/s12917-017-0988-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/03/2017] [Indexed: 11/30/2022] Open
Abstract
Background Bacterial endocarditis is a recognised disease in humans and animals. In humans, infection with Coxiella burnetii can cause endocarditis, but this has not been investigated thoroughly in animals. Endocarditis in cattle is a common post-mortem finding in abattoirs and studies have identified Trueperella pyogenes as a major cause. Despite exposure of cattle to C. burnetii, the significance of this particular bacterium for development and progression of endocarditis has not been studied in detail. Cardiac valves of cattle affected with endocarditis (n = 100) were examined by histology, fluorescence in situ hybridization (FISH) and real time quantitative polymerase chain reaction (PCR). Serum was examined for anti-C. burnetii antibodies by enzyme-linked immunosorbent assay (ELISA). Results Serology revealed that 70% of the cattle were positive for antibodies to C. burnetii, while PCR analysis identified 25% of endocarditis valve samples as being positive. C. burnetii was not detected by FISH, probably due to the low infection levels. Most cattle had chronic valvular vegetative endocarditis with lesions being characterised by a core of fibrous tissue covered by significant amounts of fibrin, sometimes with areas of liquefaction, and with a coagulum covering the surface. In a few cases, including the case with the highest infection level, lesions were characterized by extensive fibrosis and calcification. Histologically, bacteria other than C. burnetii were observed in most cases. Conclusions The presence of C. burnetii DNA is relatively common in cattle affected with valvular endocarditis. The role of C. burnetii remains however unknown as lesions did not differ between C. burnetii infected and non-infected cattle and because T. pyogenes–like bacteria were present in the inflamed valves; a bacterium able to induce the observed lesions. Heart valves of normal cattle should be investigated to assess if C. burnetii may be present without preexisting lesions.
Collapse
Affiliation(s)
- Jørgen S Agerholm
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hojbakkegaard Alle 5, DK-2630, Taastrup, Denmark.
| | - Tim K Jensen
- National Veterinary Institute, Technical University of Denmark, Bülowsvej 27, DK-1870, Frederiksberg C, Denmark
| | - Jens F Agger
- Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hojbakkegaard Alle 5, DK-2630, Taastrup, Denmark
| | - Marc Y Engelsma
- Department of Diagnostics and Crisis Organisation, Wageningen Bioveterinary Research, Edelhertweg 15, 8219 PH, Lelystad, The Netherlands
| | - Hendrik I J Roest
- Department of Bacteriology and Epidemiology, Wageningen Bioveterinary Research, Edelhertweg 15, 8219 PH, Lelystad, The Netherlands
| |
Collapse
|
17
|
Eldin C, Mélenotte C, Mediannikov O, Ghigo E, Million M, Edouard S, Mege JL, Maurin M, Raoult D. From Q Fever to Coxiella burnetii Infection: a Paradigm Change. Clin Microbiol Rev 2017; 30:115-190. [PMID: 27856520 PMCID: PMC5217791 DOI: 10.1128/cmr.00045-16] [Citation(s) in RCA: 554] [Impact Index Per Article: 79.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.
Collapse
Affiliation(s)
- Carole Eldin
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Cléa Mélenotte
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Oleg Mediannikov
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Eric Ghigo
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Matthieu Million
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Sophie Edouard
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Jean-Louis Mege
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| | - Max Maurin
- Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France
| | - Didier Raoult
- URMITE, UMR CNRS 7278, IRD 198, INSERM U1095, Faculté de Médecine, Marseille, France
| |
Collapse
|
18
|
KHAYYAT KHAMENEIE M, ASADI J, KHALILI M, ABIRI Z. The First Serological Study of Coxiella burnetii among Pregnant Women in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2016; 45:523-30. [PMID: 27252922 PMCID: PMC4888180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
BACKGROUND Q fever is a zoonotic disease caused by Coxiella burnetii. There is no information about this disease in pregnant women in Iran. The aim of this study was to investigate the seroprevalence of C. burnetii infection among pregnant women in southwestern (Ahvaz) and northern (Parsabad) Iran and further to comparison its prevalence in normal and abnormal pregnancies. METHODS A total of 400 samples were collected randomly from pregnant women who referred to diagnostic laboratories of Ahvaz and Parsabad in 2014. An indirect ELISA kit, designed in Veterinary Faculty, was used to detect the specific antibodies against phase II humanC. burnetii in serum samples. RESULTS The overall prevalence of C. burnetii in sera from pregnant women was 29.3% (95% confidence interval (CI): 25-34%). The prevalence of C. burnetii infection was significantly different in Ahvaz and Parsabad with, respectively, 22 (95% CI: 16-28%) and 36.5% (95% CI: 30-43%). Total prevalence of C. burnetii infection in serum was significantly higher in women with abnormal pregnancy history (39.8%) compared with normal pregnancies (23.8%). Furthermore, maternal age had significant association with seropositivity and the prevalence increased with maternal age. This could be due to higher probability of encountering C. burnetii in older women. CONCLUSION The present study demonstrated ahigh seroprevalence of C. burnetii infection among pregnant women in Iran for the first time. Seropositivity was associated with adverse pregnancy outcomes and maternal age. The pregnant women who experienced abnormal pregnancy had higher seroprevalence of C. burnetii compared to women with normal pregnancy.
Collapse
Affiliation(s)
| | - Javad ASADI
- AJA University of Medical Sciences, Tehran, Iran,Corresponding Author:
| | - Mohammad KHALILI
- Dept. of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Zeinab ABIRI
- Dept. of Pathobiology, School of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| |
Collapse
|
19
|
Q fever and pregnancy: experience from the Limoges Regional University Hospital. Arch Gynecol Obstet 2015; 294:233-8. [PMID: 26559421 DOI: 10.1007/s00404-015-3958-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/03/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Q fever is an ubiquitous zoonosis caused by Coxiella burnetii. Its tropism for the uterus is a potential source of obstetric complications. MATERIALS AND METHODS We describe the obstetric consequences of Q fever diagnosed during pregnancy from a series of cases. When an antenatal diagnosis was made, antibiotic therapy with roxithromycin (Rulid(®)) was started until delivery. RESULTS Between 2007 and 2012, 30 patients were treated for Q fever diagnosed during pregnancy, i.e. 1.9 cases per 1000 people. The most common reasons for performing serology was intrauterine growth retardation, preterm labor and oligoamnios. Q fever was diagnosed as acute and chronic in 26 and 4 cases, respectively. Progression to chronic disease occurred in 8 % of acute forms of the diseases. The prevalence of obstetric complications was 66 %, including 10 % foetal deaths, 31 % preterm delivery and 27 % low birthweight <10th percentile. The obstetric complication rate amongst the 22 patients treated with ante partum macrolides was 60, 30 % of which involved prematurity and 33 % involved low growth. No cases of foetal death were found on treatment and no congenital malformation and placental or neonatal injury was found. No case of disease reactivation was diagnosed in the eight patients who became pregnant again. CONCLUSION Q fever during pregnancy is responsible for severe obstetric complications. It must be diagnosed early and its clinical forms known in order to start appropriate antibiotic therapy.
Collapse
|
20
|
Abstract
Q fever is a zoonosis of worldwide distribution with the exception of New Zealand. It is caused by an intracellular bacterium, Coxiella burnetii. The disease often goes underdiagnosed because the main manifestation of its acute form is a general self-limiting flu-like syndrome. The Dutch epidemics renewed attention to this disease, which was less considered before. This review summarizes the description of C. burnetii (taxonomy, intracellular cycle, and genome) and Q fever disease (description, diagnosis, epidemiology, and pathogenesis). Finally, vaccination in humans and animals is also considered.
Collapse
Affiliation(s)
- Samira Boarbi
- Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique.,Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique
| | - David Fretin
- Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique.,Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique
| | - Marcella Mori
- Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique.,Centre d'étude et de recherches vétérinaires et agrochimiques (CERVA), Direction opérationnelle des maladies bactériennes, Zoonoses bactériennes des animaux de rente, Groeselenberg 99, 1180 Bruxelles, Belgique
| |
Collapse
|
21
|
Million M, Raoult D. Recent advances in the study of Q fever epidemiology, diagnosis and management. J Infect 2015; 71 Suppl 1:S2-9. [DOI: 10.1016/j.jinf.2015.04.024] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2015] [Indexed: 01/26/2023]
|
22
|
de Lange MMA, Hukkelhoven CWPM, Munster JM, Schneeberger PM, van der Hoek W. Nationwide registry-based ecological analysis of Q fever incidence and pregnancy outcome during an outbreak in the Netherlands. BMJ Open 2015; 5:e006821. [PMID: 25862010 PMCID: PMC4401861 DOI: 10.1136/bmjopen-2014-006821] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Whether areas affected by Q fever during a large outbreak (2008-2010) had higher rates of adverse pregnancy outcomes than areas not affected by Q fever. DESIGN Nationwide registry-based ecological study. SETTING Pregnant women in areas affected and not affected by Q fever in the Netherlands, 2003-2004 and 2008-2010. PARTICIPANTS Index group (N=58,737): pregnant women in 307 areas with more than two Q fever notifications. Reference group (N=310,635): pregnant women in 921 areas without Q fever notifications. As a baseline, pregnant women in index and reference areas in the years 2003-2004 were also included in the reference group to estimate the effect of Q fever in 2008-2010, and not the already existing differences before the outbreak. MAIN OUTCOME MEASURES Preterm delivery, small for gestational age, perinatal mortality. RESULTS In 2008-2010, there was no association between residing in a Q fever-affected area and both preterm delivery (adjusted OR 1.01 (95% CI 0.94 to 1.08)), and perinatal mortality (adjusted OR 0.87 (95% CI 0.72 to 1.05)). In contrast, we found a weak significant association between residing in a Q fever-affected area in 2008-2010 and small for gestational age (adjusted OR 1.06 (95% CI 1.01 to 1.12)), with a population-attributable fraction of 0.70% (95% CI 0.07% to 1.34%). We observed no dose-response relation for this outcome with increasing Q fever notifications, and we did not find a stronger association for women who were in their first trimester of pregnancy during the months of high human Q fever incidence. CONCLUSIONS This study found a weak association between residing in a Q fever-affected area and the pregnancy outcome small for gestational age. Early detection of infection would require mass screening of pregnant women; this does not seem to be justified considering these results, and the uncertainties about its efficacy and the adverse effects of antibiotic treatment.
Collapse
Affiliation(s)
- Marit M A de Lange
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Janna M Munster
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Peter M Schneeberger
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch, the Netherlands
| | - Wim van der Hoek
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| |
Collapse
|