University of Queensland, UQ Centre for Clinical Research, Brisbane, QLD, Australia; Department of Microbiology, NSW Health Pathology-Pathology North, Newcastle, NSW, Australia; Department of Immunology and Infectious Diseases, John Hunter Hospital, Newcastle, NSW, Australia.
Townsville Public Health Unit, Queensland Health, Townsville, Queensland, Australia.
Microbes Infect. 2016 Jun;18(6):406-411. doi: 10.1016/j.micinf.2016.03.006. Epub 2016 Mar 19.
Scrub typhus is caused by the obligate intracellular bacterium Orientia tsutsugamushi and is endemic to many countries in the Asia-Pacific region, including tropical Australia. We describe a recent large outbreak amongst military personnel in north Queensland. A total of 45 clinical cases were identified (36% of all potentially exposed individuals). This occurred despite existing military protocols stipulating the provision of doxycycline prophylaxis. Doxycycline resistance in O. tsutsugamushi has been described in South-East Asia, but not Australia. In one case, O. tsutsugamushi was cultured from eschar tissue and blood. Using quantitative real-time PCR to determine susceptibility to doxycycline for the outbreak strain, a minimum inhibitory concentration (MIC) of ≤0.04 μg/mL was found, indicating susceptibility to this agent. It seems most probable that failure to adhere to adequate prophylaxis over the duration of the military exercise accounted for the large number of cases encountered rather than doxycycline resistance.
恙虫病是由专性细胞内细菌恙虫东方体引起的，流行于亚太地区的许多国家，包括热带澳大利亚。我们描述了北昆士兰州最近一次军人中发生的大规模暴发。共发现 45 例临床病例（所有潜在暴露者的 36%）。尽管存在规定提供强力霉素预防的现有军事协议，但仍发生了这种情况。恙虫东方体的强力霉素耐药性已在东南亚得到描述，但在澳大利亚尚未描述。在一个病例中，从焦痂组织和血液中培养出恙虫东方体。使用定量实时 PCR 确定暴发菌株对强力霉素的敏感性，发现最小抑菌浓度（MIC）≤0.04μg/mL，表明对该药物敏感。最有可能的是，在军事演习期间未能坚持足够的预防措施导致了大量病例的发生，而不是强力霉素耐药性。
