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康涅狄格州的微小巴贝斯虫、人巴贝斯虫病和伯氏疏螺旋体

Babesia microti, human babesiosis, and Borrelia burgdorferi in Connecticut.

作者信息

Anderson J F, Mintz E D, Gadbaw J J, Magnarelli L A

机构信息

Department of Entomology, Connecticut Agricultural Experiment Station, New Haven 06504.

出版信息

J Clin Microbiol. 1991 Dec;29(12):2779-83. doi: 10.1128/jcm.29.12.2779-2783.1991.

Abstract

Babesia microti was isolated from a white-footed mouse (Peromyscus leucopus) that was captured in southeastern Connecticut in 1988, when the first human case of babesiosis acquired in Connecticut was recognized. To date, 13 cases of babesiosis have been reported in Connecticut, the largest number of human cases reported on the mainland United States. Two of nine patients quiried remembered a prior tick bite. Since Babesia parasites are known to be vectored only by ticks, we surmise that 12 of these infections were acquired via tick bites; 1 was obtained by blood transfusion (the patient was 46 years of age) from an endemically infected donor. The ages of the patients with tick-acquired babesiosis ranged from 61 to 95 years. Two patients died with active infections, and one patient died from chronic obstructive pulmonary disease soon after treatment with clindamycin and quinine. Indirect fluorescent-antibody titers of blood samples drawn at the time of hospitalization for 11 patients and at the time of active infection for 1 asymptomatic person ranged from 1:1,024 to 1:4,096. Five of eight patients with babesiosis also had significant immunoglobulin G or immunoglobulin M titers (1:640 to 1:5,120) to Borrelia burgdorferi. B. microti was isolated in Syrian hamsters inoculated with blood from 7 of 12 patients tested and was also isolated from mice captured in six towns. The peridomestic nature of the disease was demonstrated by isolating the parasite from white-footed mice captured in or near the yards of eight different patients. Of 59 mice tested, 27 were positive and 25 were coinfected with B. burgdorferi. The isolation of B. microti from a white-footed mouse captured in north-central Connecticut (West Hartford), away from the focus of human infections in southeastern Connecticut, suggests that this pathogen may spread into other areas where Ixodes dammini, the tick vector, becomes established.

摘要

微小巴贝斯虫是从1988年在康涅狄格州东南部捕获的一只白足鼠(白足鼠属)中分离出来的,当时该州确诊了首例本土获得性巴贝斯虫病病例。迄今为止,康涅狄格州已报告了13例巴贝斯虫病病例,是美国本土报告的人类病例数最多的。在接受询问的9名患者中,有2人记得之前被蜱叮咬过。由于已知巴贝斯虫寄生虫仅通过蜱传播,我们推测这些感染中有12例是通过蜱叮咬获得的;1例是通过输血(患者46岁)从一名地方性感染的献血者那里获得的。蜱传播性巴贝斯虫病患者的年龄在6岁至95岁之间。2例患者死于活动性感染,1例患者在接受克林霉素和奎宁治疗后不久死于慢性阻塞性肺疾病。11名患者住院时以及1名无症状感染者处于活动性感染时采集的血样间接荧光抗体效价范围为1:1024至1:4096。8例巴贝斯虫病患者中有5例对伯氏疏螺旋体也有显著的免疫球蛋白G或免疫球蛋白M效价(1:640至1:5120)。微小巴贝斯虫从12名接受检测的患者中的7人的血液接种的叙利亚仓鼠中分离出来,也从六个城镇捕获的小鼠中分离出来。通过从八名不同患者院子里或附近捕获的白足鼠中分离出寄生虫,证明了该病在家庭周边环境中的存在。在接受检测的59只小鼠中,27只为阳性,25只同时感染了伯氏疏螺旋体。在远离康涅狄格州东南部人类感染焦点的中北部康涅狄格州(西哈特福德)捕获的一只白足鼠中分离出微小巴贝斯虫,这表明这种病原体可能传播到其他地区,在那里蜱传播媒介达氏硬蜱已经定殖。

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