Hunfeld K P, Allwinn R, Peters S, Kraiczy P, Brade V
Institute of Medical Microbiology, University of Frankfurt, Frankfurt/Main, Federal Republic of Germany.
Wien Klin Wochenschr. 1998 Dec 23;110(24):901-8.
The seroprevalence of antibodies against the human granulocytic ehrlichiosis agent (HGE) and Babesia microti was retrospectively determined in 76 Lyme borreliosis patients and in 44 asymptomatic individuals with a positive borreliosis serology, in comparison to 100 healthy blood donors from the Rhein-Main area. Additionally, seroreactivity for tick-borne encephalitis virus (TBEV) was investigated. For antibody detection, commercially available immunofluorescence assays (MRL Diagnostics, USA) and a TBEV-ELISA (Immuno, Germany) were used. In the control group, the positivity rate for anti-Borrelia burgdorferi (IgG/IgM) and anti-Babesia microti-antibodies in the population of the Rhein-Main area (Midwestern Germany) may be estimated at 15% and 8%, respectively. Examination for both HGE and TBEV demonstrated seroreactivity (IgG) in 1% of tested individuals. Specific anti-HGE IgG and/or IgM antibodies were more often discovered in cases of early Borrelia infection (stage I: 13.6%, stage II: 18.4%) than in patients with stage III disease (0%) or in seropositive but asymptomatic patients (6.8%). Investigation for TBEV revealed seroreactivity for IgG in 13% of these cases. No TBEV-IgM was found. Interestingly, the prevalence of anti-HGE and anti-TBEV antibodies among Lyme borreliosis patients and seropositive patients without active Lyme disease symptoms was significantly higher than that in the control group of healthy blood donors (p < 0.05). Likewise, antibody titers reflecting a recent infection with Babesia microti could be demonstrated more often in patients with Lyme borreliosis stage I or II (p < 0.05). Analysis of 50 samples from patients with florid or recent syphilis infection revealed no crossreactivity between Babesia microti, HGE and Treponema pallidum. Our findings suggest that concomitant or serial infection due to TOBB may be common in tick exposed patients from the Rhein-Main area and in European countries in general. Hence, in addition to TBEV, human babesiosis and HGE should always be considered by European physicians in the differential diagnosis of acute febrile illness following a tick bite.
回顾性测定了76例莱姆病患者和44例血清学检测莱姆病呈阳性的无症状个体中抗人粒细胞埃立克体病病原体（HGE）和微小巴贝斯虫抗体的血清阳性率，并与来自莱茵 - 美因地区的100名健康献血者进行比较。此外，还研究了蜱传脑炎病毒（TBEV）的血清反应性。采用市售免疫荧光检测法（美国MRL诊断公司）和TBEV酶联免疫吸附测定法（德国Immuno公司）进行抗体检测。在对照组中，莱茵 - 美因地区（德国中西部）人群中抗伯氏疏螺旋体（IgG/IgM）和抗微小巴贝斯虫抗体的阳性率估计分别为15%和8%。对HGE和TBEV的检测显示，1%的受测个体有血清反应性（IgG）。在早期伯氏疏螺旋体感染病例（I期：13.6%，II期：18.4%）中，比III期疾病患者（0%）或血清学阳性但无症状的患者（6.8%）更常发现特异性抗HGE IgG和/或IgM抗体。对TBEV的检测显示，这些病例中有13%的患者IgG呈血清反应性。未发现TBEV - IgM。有趣的是，莱姆病患者和无活动性莱姆病症状的血清学阳性患者中抗HGE和抗TBEV抗体的患病率显著高于健康献血者对照组（p < 0.05）。同样，在莱姆病I期或II期患者中，更常检测到反映近期感染微小巴贝斯虫的抗体滴度（p < 0.05）。对50例活动性或近期梅毒感染患者的样本分析显示，微小巴贝斯虫、HGE和梅毒螺旋体之间无交叉反应。我们的研究结果表明，在来自莱茵 - 美因地区以及一般欧洲国家的蜱叮咬患者中，蜱传病原体（TOBB）的合并或相继感染可能很常见。因此，除了TBEV外，欧洲医生在蜱叮咬后急性发热性疾病的鉴别诊断中，应始终考虑人巴贝斯虫病和HGE。
