Mitchell P D, Reed K D, Hofkes J M
Microbiology Section, Marshfield Laboratories, WI 54449, USA.
J Clin Microbiol. 1996 Mar;34(3):724-7. doi: 10.1128/jcm.34.3.724-727.1996.
In Wisconsin and Minnesota, Ixodes scapularis (Ixodes dammini) ticks are the vector of three microorganisms that may cause significant disease in humans and lower mammals. These diseases include Lyme borreliosis, which is caused by Borrelia burgdorferi, babesiosis, which is caused by Babesia microti, and human granulocytic ehrlichiosis (HGE), which is caused by an apparently new species in the genus Ehrlichia. Immunoserologic testing was performed on sera from patients with a diagnosis of one of these diseases to determine if there was evidence of coinfection with one or more of the other agents. Of 96 patients with Lyme borreliosis, 9 (9.4%) demonstrated immunoserologic evidence of coinfection: 5 (5.2%) with the agent of HGE, 2 (2.1%) with B. microti, and 2 (2.1%) with both microorganisms. Of 19 patients diagnosed with HGE, 3 (15.8%) showed immunoserologic evidence of coinfection: 1 (5.3%) with B. burgdorferi, 1 (5.3%) with B. microti, and 1 (5.3%) with both microorganisms. One patient diagnosed with babesiosis was also seropositive for ehrlichiosis. These results provide evidence for coinfection, perhaps explaining the variable manifestations and clinical responses noted in some patients with tick-transmitted diseases. In certain clinical settings, laboratory testing for coinfection is indicated to ensure that appropriate antimicrobial treatment is given.
在威斯康星州和明尼苏达州，肩突硬蜱（达氏硬蜱）是三种可导致人类和低等哺乳动物严重疾病的微生物的传播媒介。这些疾病包括由伯氏疏螺旋体引起的莱姆病、由微小巴贝斯虫引起的巴贝斯虫病以及由埃立克体属中一个明显的新物种引起的人类粒细胞埃立克体病（HGE）。对诊断患有这些疾病之一的患者血清进行了免疫血清学检测，以确定是否存在与一种或多种其他病原体合并感染的证据。在96例莱姆病患者中，9例（9.4%）显示有合并感染的免疫血清学证据：5例（5.2%）感染HGE病原体，2例（2.1%）感染微小巴贝斯虫，2例（2.1%）同时感染这两种微生物。在19例诊断为HGE的患者中，3例（15.8%）显示有合并感染的免疫血清学证据：1例（5.3%）感染伯氏疏螺旋体，1例（5.3%）感染微小巴贝斯虫，1例（5.3%）同时感染这两种微生物。1例诊断为巴贝斯虫病的患者埃立克体病血清学检查也呈阳性。这些结果为合并感染提供了证据，这或许可以解释一些蜱传疾病患者出现的症状和临床反应的差异。在某些临床情况下，需要进行合并感染的实验室检测，以确保给予适当的抗菌治疗。
