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Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020

Ticks carry numerous pathogens that, if transmitted, can cause disease in susceptible humans and animals. The present study describes our approach on how to investigate clinical presentations following tick bites in humans. To this aim, the occurrence of major tick-borne pathogens (TBPs) in human bl...

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Autores principales: Banović, Pavle, Díaz-Sánchez, Adrian A., Simin, Verica, Foucault-Simonin, Angélique, Galon, Clemence, Wu-Chuang, Alejandra, Mijatović, Dragana, Obregón, Dasiel, Moutailler, Sara, Cabezas-Cruz, Alejandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825779/
https://www.ncbi.nlm.nih.gov/pubmed/35154030
http://dx.doi.org/10.3389/fmicb.2021.797399
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author Banović, Pavle
Díaz-Sánchez, Adrian A.
Simin, Verica
Foucault-Simonin, Angélique
Galon, Clemence
Wu-Chuang, Alejandra
Mijatović, Dragana
Obregón, Dasiel
Moutailler, Sara
Cabezas-Cruz, Alejandro
author_facet Banović, Pavle
Díaz-Sánchez, Adrian A.
Simin, Verica
Foucault-Simonin, Angélique
Galon, Clemence
Wu-Chuang, Alejandra
Mijatović, Dragana
Obregón, Dasiel
Moutailler, Sara
Cabezas-Cruz, Alejandro
author_sort Banović, Pavle
collection PubMed
description Ticks carry numerous pathogens that, if transmitted, can cause disease in susceptible humans and animals. The present study describes our approach on how to investigate clinical presentations following tick bites in humans. To this aim, the occurrence of major tick-borne pathogens (TBPs) in human blood samples (n = 85) and the ticks collected (n = 93) from the same individuals were tested using an unbiased high-throughput pathogen detection microfluidic system. The clinical symptoms were characterized in enrolled patients. In patients with suspected TBP infection, serological assays were conducted to test for the presence of antibodies against specific TBPs. A field study based on One Health tenets was further designed to identify components of a potential chain of infection resulting in Rickettsia felis infection in one of the patients. Ticks species infesting humans were identified as Ixodes ricinus, Rhipicephalus sanguineus sensu lato (s.l.), Dermacentor reticulatus, and Haemaphysalis punctata. Five patients developed local skin lesions at the site of the tick bite including erythema migrans, local non-specific reactions, and cutaneous hypersensitivity reaction. Although Borrelia burgdorferi s.l., Babesia microti, Anaplasma phagocytophilum, and Candidatus Cryptoplasma sp. DNAs were detected in tick samples, different Rickettsia species were the most common TBPs identified in the ticks. The presence of TBPs such as Rickettsia helvetica, Rickettsia monacensis, Borrelia lusitaniae, Borrelia burgdorferi, Borrelia afzelii, A. phagocytophilum, and B. microti in ticks was further confirmed by DNA sequencing. Two of the patients with local skin lesions had IgG reactive against spotted fever group rickettsiae, while IgM specific to B. afzelii, Borrelia garinii, and Borrelia spielmanii were detected in the patient with erythema migrans. Although R. felis infection was detected in one human blood sample, none of the components of the potential chain of infection considered in this study tested positive to this pathogen either using direct pathogen detection in domestic dogs or xenodiagnosis in ticks collected from domestic cats. The combination of high-throughput screening of TBPs and One Health approaches might help characterize chains of infection leading to human infection by TBPs, as well as prevalence of emerging rickettsial pathogens in the Balkan region.
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spelling pubmed-88257792022-02-10 Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020 Banović, Pavle Díaz-Sánchez, Adrian A. Simin, Verica Foucault-Simonin, Angélique Galon, Clemence Wu-Chuang, Alejandra Mijatović, Dragana Obregón, Dasiel Moutailler, Sara Cabezas-Cruz, Alejandro Front Microbiol Microbiology Ticks carry numerous pathogens that, if transmitted, can cause disease in susceptible humans and animals. The present study describes our approach on how to investigate clinical presentations following tick bites in humans. To this aim, the occurrence of major tick-borne pathogens (TBPs) in human blood samples (n = 85) and the ticks collected (n = 93) from the same individuals were tested using an unbiased high-throughput pathogen detection microfluidic system. The clinical symptoms were characterized in enrolled patients. In patients with suspected TBP infection, serological assays were conducted to test for the presence of antibodies against specific TBPs. A field study based on One Health tenets was further designed to identify components of a potential chain of infection resulting in Rickettsia felis infection in one of the patients. Ticks species infesting humans were identified as Ixodes ricinus, Rhipicephalus sanguineus sensu lato (s.l.), Dermacentor reticulatus, and Haemaphysalis punctata. Five patients developed local skin lesions at the site of the tick bite including erythema migrans, local non-specific reactions, and cutaneous hypersensitivity reaction. Although Borrelia burgdorferi s.l., Babesia microti, Anaplasma phagocytophilum, and Candidatus Cryptoplasma sp. DNAs were detected in tick samples, different Rickettsia species were the most common TBPs identified in the ticks. The presence of TBPs such as Rickettsia helvetica, Rickettsia monacensis, Borrelia lusitaniae, Borrelia burgdorferi, Borrelia afzelii, A. phagocytophilum, and B. microti in ticks was further confirmed by DNA sequencing. Two of the patients with local skin lesions had IgG reactive against spotted fever group rickettsiae, while IgM specific to B. afzelii, Borrelia garinii, and Borrelia spielmanii were detected in the patient with erythema migrans. Although R. felis infection was detected in one human blood sample, none of the components of the potential chain of infection considered in this study tested positive to this pathogen either using direct pathogen detection in domestic dogs or xenodiagnosis in ticks collected from domestic cats. The combination of high-throughput screening of TBPs and One Health approaches might help characterize chains of infection leading to human infection by TBPs, as well as prevalence of emerging rickettsial pathogens in the Balkan region. Frontiers Media S.A. 2022-01-26 /pmc/articles/PMC8825779/ /pubmed/35154030 http://dx.doi.org/10.3389/fmicb.2021.797399 Text en Copyright © 2022 Banović, Díaz-Sánchez, Simin, Foucault-Simonin, Galon, Wu-Chuang, Mijatović, Obregón, Moutailler and Cabezas-Cruz. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Banović, Pavle
Díaz-Sánchez, Adrian A.
Simin, Verica
Foucault-Simonin, Angélique
Galon, Clemence
Wu-Chuang, Alejandra
Mijatović, Dragana
Obregón, Dasiel
Moutailler, Sara
Cabezas-Cruz, Alejandro
Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title_full Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title_fullStr Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title_full_unstemmed Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title_short Clinical Aspects and Detection of Emerging Rickettsial Pathogens: A “One Health” Approach Study in Serbia, 2020
title_sort clinical aspects and detection of emerging rickettsial pathogens: a “one health” approach study in serbia, 2020
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8825779/
https://www.ncbi.nlm.nih.gov/pubmed/35154030
http://dx.doi.org/10.3389/fmicb.2021.797399
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