Faculty of Medicine, Sam Ratulangi University, Manado, Indonesia.
Emerging Virus Research Unit, Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
PLoS Negl Trop Dis. 2020 Feb 18;14(2):e0007893. doi: 10.1371/journal.pntd.0007893. eCollection 2020 Feb.
Rickettsia felis has recently emerged worldwide as a cause of human illness. Typically causing mild, undifferentiated fever, it has been implicated in several cases of non-fatal neurological disease in Mexico and Sweden. Its distribution and pathogenicity in Southeast Asia is poorly understood.
METHODOLOGY/PRINCIPAL FINDINGS: We retroactively tested cerebrospinal fluid (CSF) or sera from 64 adult patients admitted to hospital in North Sulawesi, Indonesia with acute neurological disease. Rickettsia felis DNA was identified in the CSF of two fatal cases of meningoencephalitis using multi-locus sequence typing semi-nested PCR followed by Sanger sequencing. DNA from both cases had 100% sequence homologies to the R. felis reference strain URRWXCal2 for the 17-kDa and ompB genes, and 99.91% to gltA.
CONCLUSION/SIGNIFICANCE: The identification of R. felis in the CSF of two fatal cases of meningoencephalitis in Indonesia suggests the distribution and pathogenicity of this emerging vector-borne bacteria might be greater than generally recognized. Typically Rickettsia are susceptible to the tetracyclines and greater knowledge of R. felis endemicity in Indonesia should lead to better management of some acute neurological cases.
猫立克次体最近在全球范围内成为人类疾病的病因。它通常引起轻度、非特异性发热，在墨西哥和瑞典的几例非致命性神经疾病中也有牵连。其在东南亚的分布和致病性知之甚少。
方法/主要发现：我们对印度尼西亚北苏拉威西住院的 64 名急性神经疾病成年患者的脑脊液 (CSF) 或血清进行了回顾性检测。使用多位点序列分型半巢式 PCR 结合 Sanger 测序，在两例致命性脑膜脑炎中 CSF 中鉴定出猫立克次体 DNA。这两个病例的 DNA 在 17-kDa 和 ompB 基因方面与 R. felis 参考株 URRWXCal2 的序列同源性均为 100%，在 gltA 基因方面的序列同源性为 99.91%。
结论/意义：在印度尼西亚两例致命性脑膜脑炎患者的 CSF 中鉴定出猫立克次体表明，这种新兴的媒介传播细菌的分布和致病性可能比普遍认为的更为广泛。通常情况下，立克次体对四环素敏感，对猫立克次体在印度尼西亚的流行情况有更多了解，应该会导致一些急性神经病例得到更好的治疗。
