免疫正常和免疫功能低下个体中巴贝斯虫病的血清流行率。

Seroprevalence of babesiosis in immunocompetent and immunocompromised individuals.

机构信息

National Medical University, Kharkiv, Ukraine.

Mechnikov Institute of Microbiology and Immunology, Kharkiv, Ukraine.

出版信息

Pol Merkur Lekarski. 2021 Jun 16;49(291):193-197.

PMID:34218237

Abstract

UNLABELLED

Interest in Babesia species is gaining an increasing attention as an emerging tick-borne pathogen. Infection is primarily transmitted through Ixodes ticks, and alternatively by blood transfusions from asymptomatic donors.

AIM

The aim of the study was detection of Babesia seroprevalence in different groups of population with the usage of experimental B. divergens whole-cell slide antigen and commercial B. microti immunofluorescence assay substrate slide.

MATERIALS AND METHODS

Indirect immunofluorescence assay trial was performed by testing of 145 blood samples of different origins: healthy individuals (60 - blood donors), risk groups (30 - HIV-infected individuals, 30 - Lyme disease patients) and false-positive IFA controls (10 - seropositive rheumatoid arthritis patients, 15 - patients with toxoplasmosis).

RESULTS

The study revealed Babesia antibodies to B. divergens (6.9%) and B. microti (3.4%) that were detected with higher (p <0.05) frequency in HIV-infected individuals (26.7%) and in Lyme disease patients (16.7%) than at blood donors (1.7%). Diagnostically significant IgG titres were detected at 23.3% HIV-infected individuals, 13.3% Lyme disease patients and by 1.7% of blood donors and patients with seropositive latent toxoplasmosis. Specific IgM were detected at 20.0% HIV-infected individuals and 13.3% Lyme disease patients. 57.1% of diagnostically significant titres in HIV-infected and Lyme disease patients were represented by IgG and IgM.

CONCLUSIONS

Immunofluorescence assay has a limited use in babesiosis: in acute form with negative microscopy or PCR; in chronic, asymptomatic and subclinical form with low level of parasitemia; and in retrospective and epidemiological studies of the population immune structure. Clinicians need to have increased awareness of babesiosis, and further studies are needed to clarify the optimal management of this infection in risk groups (including HIV-infected patients and blood donors).

摘要

未加标签

随着作为新兴蜱传病原体的伯氏疏螺旋体（Babesia）种类受到越来越多的关注，人们对其产生了浓厚的兴趣。感染主要通过硬蜱传播，也可通过无症状供体的输血传播。

目的

本研究旨在使用实验性伯氏疏螺旋体全细胞载玻片抗原和商业微小巴贝斯虫免疫荧光分析底物载玻片检测不同人群的巴贝斯虫血清流行率。

材料和方法

通过检测来自不同来源的 145 份血样进行间接免疫荧光分析试验：健康个体（60 例-献血者）、高危人群（30 例-感染 HIV 的个体、30 例-莱姆病患者）和假阳性免疫荧光分析对照（10 例-血清阳性类风湿关节炎患者、15 例-弓形体病患者）。

结果

本研究发现了针对伯氏疏螺旋体（6.9%）和微小巴贝斯虫（3.4%）的抗体，在感染 HIV 的个体（26.7%）和莱姆病患者（16.7%）中检测到的频率更高（p<0.05），而在献血者（1.7%）中则较低。在 23.3%的 HIV 感染个体、13.3%的莱姆病患者和 1.7%的献血者和血清阳性潜伏弓形体病患者中检测到具有诊断意义的 IgG 滴度。在 20.0%的 HIV 感染个体和 13.3%的莱姆病患者中检测到特异性 IgM。在 HIV 感染和莱姆病患者中，具有诊断意义的滴度的 57.1%为 IgG 和 IgM。

结论

免疫荧光分析在巴贝斯虫病中的应用具有一定的局限性：在显微镜或 PCR 检查呈阴性的急性感染期；在低水平寄生虫血症的慢性、无症状和亚临床感染期；以及在人群免疫结构的回顾性和流行病学研究中。临床医生需要提高对巴贝斯虫病的认识，还需要进一步研究来明确在高危人群（包括感染 HIV 的患者和献血者）中对此感染的最佳管理。