Krause Peter J, Carroll Madeleine, Fedorova Natalia, Brancato Janna, Dumouchel Cecilia, Akosa Fredua, Narasimhan Sukanya, Fikrig Erol, Lane Robert S
Department of Epidemiology of Infectious Diseases, Yale School of Public Health, New Haven, CT, United States of America.
Department of Infectious Diseases, Yale School of Medicine, New Haven, CT, United States of America.
PLoS One. 2018 Feb 8;13(2):e0191725. doi: 10.1371/journal.pone.0191725. eCollection 2018.
To determine whether human Borrelia miyamotoi infection occurs in the far-western United States, we tested archived sera from northwestern California residents for antibodies to this emerging relapsing fever spirochete. These residents frequently were exposed to I. pacificus ticks in a region where B. miyamotoi tick infection has been reported. We used a two-step B. miyamotoi rGlpQ assay and a B. miyamotoi whole-cell lysate (WCL) assay to detect B. miyamotoi antibody. We also employed Borrelia hermsii and Borrelia burgdorferi WCL assays to examine if these Borrelia induce cross reacting antibody to B. miyamotoi. Sera were collected from 101 residents in each of two consecutive years. The sera of 12 and 14 residents in years one and two, respectively, were B. miyamotoi rGlpQ seroreactive. Sufficient sera were available to test 15 of the 26 seropositive samples using B. miyamotoi and B. hermsii WCL assays. Two residents in year one and seven residents in year two were seroreactive to both Borrelia antigens. Although discernible differences in seroreactivity were evident between the B. miyamotoi and B. hermsii WCL assays, infection with one or the other could not be determined with certainty. Sera from two Borrelia burgdorferi /B. miyamotoi seropositive subjects reacted strongly against B. miyamotoi and B. hermsii WCL antigens. Ecological, epidemiological, and clinical data implicated B. miyamotoi as the probable cause of infection among those whose sera reacted against both antigens. Our findings suggest that human B. miyamotoi infection occurs in northern California and that B. hermsii and B. burgdorferi infections produce antibodies that cross-react with B. miyamotoi antigens. Health care professionals in the far-western United States should be aware that B. miyamotoi disease may occur throughout the geographic distribution of I. pacificus and that improved relapsing fever group spirochete antibody assays are urgently needed.
为确定美国最西部是否存在人类嗜吞噬细胞无形体感染，我们检测了加利福尼亚州西北部居民的存档血清，以检测针对这种新出现的回归热螺旋体的抗体。这些居民在一个已报告嗜吞噬细胞无形体蜱感染的地区经常接触太平洋硬蜱。我们使用两步法嗜吞噬细胞无形体rGlpQ检测法和嗜吞噬细胞无形体全细胞裂解物（WCL）检测法来检测嗜吞噬细胞无形体抗体。我们还采用了赫氏疏螺旋体和伯氏疏螺旋体WCL检测法，以检查这些疏螺旋体是否会诱导产生与嗜吞噬细胞无形体发生交叉反应的抗体。连续两年每年从101名居民中采集血清。第一年和第二年分别有12名和14名居民的血清对嗜吞噬细胞无形体rGlpQ呈血清反应阳性。有足够的血清可用于使用嗜吞噬细胞无形体和赫氏疏螺旋体WCL检测法对26份血清阳性样本中的15份进行检测。第一年有2名居民，第二年有7名居民对两种疏螺旋体抗原均呈血清反应阳性。尽管嗜吞噬细胞无形体和赫氏疏螺旋体WCL检测法之间的血清反应性存在明显差异，但无法确定感染的是其中哪一种。两名伯氏疏螺旋体/嗜吞噬细胞无形体血清阳性受试者的血清对嗜吞噬细胞无形体和赫氏疏螺旋体WCL抗原反应强烈。生态学、流行病学和临床数据表明，嗜吞噬细胞无形体可能是血清对两种抗原均有反应者感染的原因。我们的研究结果表明人类嗜吞噬细胞无形体感染发生在加利福尼亚州北部，并且赫氏疏螺旋体和伯氏疏螺旋体感染会产生与嗜吞噬细胞无形体抗原发生交叉反应的抗体。美国最西部的医疗保健专业人员应意识到嗜吞噬细胞无形体病可能发生在太平洋硬蜱的整个地理分布区域内，并迫切需要改进回归热群螺旋体抗体检测法。
