Bazovska Sylvia, Durovska Judita, Derdakova Marketa, Taragelova Veronika, Pancak Jaroslav, Zaborska Magdalena, Traubner Pavel
Institute of Epidemiology, Comenius University, Bratislava, Slovakia.
Neuro Endocrinol Lett. 2011;32(4):491-5.
Lyme borreliosis (LB) is the most disseminated tick-borne disease in the Northern hemisphere, and infestation with ticks is one of the essential factors influencing transmission of the disease to humans. This work intends to compare the occurrence of borrelia circulating in indigenous ticks and in patients suffering from neurological diseases.
MATERIALS & METHODS: The total of 660 nymphs and 567 adult ticks from the Bratislava and Košice areas was examined over the years 2001-2004, and the cerebrospinal fluid (CSF) of 82 neurological patients suffering from suspected Lyme borreliosis infection was investigated in the 2007-2009 period, using the polymerase chain reaction method (PCR).
PCR investigation proved presence of borrelia in 23.3% of the total 1227 ticks; of these, co-infection was found in 2.7% of all ticks. Borrelia garinii (9.9%) and B. valaisaina (9.2%) were the prevalent types. PCR investigation of the CSF samples of 32 patients with clinically diagnosed Lyme borreliosis showed the presence of B. burgdorferi s.l. in 17 cases. Positive results were found also in patients with unclear or different diagnoses. In cases where the genospecies could be identified, B. garinii was most frequently found (8x), followed with B. burgdorferi s.s. (4×) and B. afzelii (3×).
The high infestation level of ticks with borrelia, mainly with B. garinii which is the most-often documented borrelia species identified in neurological patients, is indicative of a high risk of this contamination in Slovakia. B. garinii were found also in our neuroborreliosis patients, whereas their proof in the CSF of patients with suspected neuroborreliosis or with a different clinical diagnosis pointed upon their persistence after an infectious experience. However, knowledge of not only the genospecies but also of the genotypes capable of eliciting an invasive disorder would be necessary for better clarification of the relationship between borrelia and their peccant capacity. Identification of the invasive borrelia types circulating in nature, and clarification of the vector vs. human infection incidence relationship is of importance from the aspect of detailed knowledge of the epidemiology of this disease.
莱姆病(LB)是北半球传播最广的蜱传疾病,蜱虫叮咬是影响该病传播给人类的重要因素之一。本研究旨在比较本地蜱虫和神经疾病患者体内伯氏疏螺旋体的感染情况。
在2001年至2004年期间,对来自布拉迪斯拉发和科希策地区的660只若蜱和567只成蜱进行了检测,并在2007年至2009年期间,采用聚合酶链反应法(PCR)对82例疑似莱姆病感染的神经疾病患者的脑脊液(CSF)进行了检测。
PCR检测证实,在1227只蜱虫中,23.3%检测到伯氏疏螺旋体;其中,2.7%的蜱虫存在共感染。加氏疏螺旋体(9.9%)和瓦氏疏螺旋体(9.2%)为主要流行类型。对32例临床诊断为莱姆病的患者的脑脊液样本进行PCR检测,结果显示17例患者存在狭义伯氏疏螺旋体。在诊断不明确或诊断不同的患者中也发现了阳性结果。在能够鉴定基因种的病例中,最常发现的是加氏疏螺旋体(8例),其次是狭义伯氏疏螺旋体(4例)和阿氏疏螺旋体(3例)。
蜱虫中伯氏疏螺旋体的高感染率,主要是加氏疏螺旋体,这是神经疾病患者中最常记录到的伯氏疏螺旋体种类,表明斯洛伐克存在这种污染的高风险。在我们的神经莱姆病患者中也发现了加氏疏螺旋体,而在疑似神经莱姆病或临床诊断不同的患者的脑脊液中检测到该菌,表明其在感染后仍持续存在。然而,为了更好地阐明伯氏疏螺旋体与其致病能力之间的关系,不仅需要了解基因种,还需要了解能够引发侵袭性疾病的基因型。从详细了解该疾病的流行病学角度来看,确定自然界中传播的侵袭性伯氏疏螺旋体类型,并阐明媒介与人类感染发生率之间的关系非常重要。