Co-infections with Borrelia species, Anaplasma phagocytophilum and Babesia spp. in patients with tick-borne encephalitis

Abstract

The purpose of this study was evaluation of the prevalence of co-infection with Borrelia species, A. phagocytophilum and Babesia spp. in patients with tick-borne encephalitis (TBE). At total of 110 patients with TBE were included in the study. Serological tests for tick-borne encephalitis virus (TBEV), PCR for Borrelia species, Anaplasma phagocytophilum and Babesia spp., blood smears for A. phagocytophilum and Babesia spp. and BLAST analysis for Babesia spp. were performed. Results showed a significant majority of patients co-infected with Borrelia species (30/110; 27 %), much less with A. phagocytophilum (12/110; 10.9 %) and with Babesia spp. (1/110; 0.9 %). The BLAST analysis of the 18S rDNA sequence obtained with the Babesia spp. specific primers indicated that the patient was infected with Babesia microti. Triple co-infections (TBEV-Borrelia species- A. phagocytophilum) were observed in three (3/110; 2.7 %) patients. Conclusions were such that differential diagnosis in patients after the tick bite, presenting with acute symptoms, should include not only TBE and Lyme disease, but also other diseases transmitted by ticks. In patients with low parasitemia in suspicion of Babesia spp. infection PCR seems to be a more sensitive method than blood smear. Co-infection with various tick-borne pathogens must be always considered, especially in endemic regions.

Infection withBabesia microtiin humans with non-specific symptoms in North East Poland

“…Analyses have been conducted following manufacturer's instructions: before June 2012 as a conventional PCR and after June 2012 in the nested type of PCR as previous described. [24] A positive control standard for A. phagocytophilum was included in the PCR Anaplasma diagnostic kit. [24] Presence of the 16S rRNA gene fragments in PCR-OUT (932 bp) and in PCR-IN (546 bp) attest to A. phagocytophilum infection.…”

“…[24] A positive control standard for A. phagocytophilum was included in the PCR Anaplasma diagnostic kit. [24] Presence of the 16S rRNA gene fragments in PCR-OUT (932 bp) and in PCR-IN (546 bp) attest to A. phagocytophilum infection. Lack of 932 bp long fragments in PCR-OUT did not exclude a positive result of test.…”

“…A positive control standard for B. burgdorferi was included in the PCR Borrelia burgdorferi kit. [24] In all PCR courses an appropriate PCR reaction mixture without template DNA was used as a negative control. Matrix DNA was replaced with ultra-pure water free from RNase and DNase for molecular diagnostic.…”

Tick-borne diseases in Poland: Prevalence and difficulties in diagnostics

“…Do zarażenia dochodzi najczęściej wskutek ukłucia przez zakażonego kleszcza, ale też drogą krwiopochodną. Opisane, wykryte na terenie Polski, przypadki zostały zawleczone z krajów tropikalnych i stwierdzono je u pacjentów ze współistniejącymi innymi TBD lub odkryto w ramach badań naukowych [59]. Tymczasem, jak wykazały zespoły badawcze Chmielewskiej-Badory i wsp.…”

Impact of Co-Infections in Lyme Disease

“…In 2007, Grab et al found that the infection of A. phagocytophilum may be responsible of a more severe form of LD with enhanced dissemination and possible long-term complications because co-infection causes reduction in transendothelial electric resistance and increased production of metalloproteinases, cytokines and chemokines [20,21].…”