Detection of Spotted Fever Group<i>Rickettsia</i>DNA by Deep Sequencing

Graham, Rikki; Donohue, Steven; McMahon, Jamie; Jennison, Amy V.

doi:10.3201/eid2311.170474

Cited by 13 publications

(12 citation statements)

References 6 publications

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“…Scrub typhus was more common than SFG infections during the study period, but SFG infections had a more severe clinical phenotype, echoing the findings of another series from southern Queensland where 11% had severe disease [34]. Our cohort contains the third-ever reported fatality from SFG infection in Australia [9, 35], while 22% of the SFG cases required ICU care. Renal disease was also relatively common in patients with SFG infection in this series.…”

Section: Discussionsupporting

confidence: 72%

The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management

et al. 2019

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Background Rickettsial infections are a common cause of hospitalization in tropical settings, although early diagnosis is challenging in the rural locations where these infections are usually seen. Methods This retrospective, clinical audit of microbiologically-confirmed cases of scrub typhus or spotted fever group (SFG) rickettsial infection between 1997 and 2016 was performed a tertiary referral hospital in tropical Australia. Clinical, laboratory and radiological findings at presentation were correlated with the patients’ subsequent clinical course. Results There were 135 locally-acquired cases (95 scrub typhus, 37 SFG, 3 undifferentiated). There were nine hospitalizations during the first 5 years of the study period and 81 in the last 5 years (p for trend = 0.003). Eighteen (13%) of the 135 cases required ICU admission, all of whom were adults. A greater proportion of patients with SFG infection required ICU support (8/37 (22%) compared with 10/95 (11%) scrub typhus cases), although this difference did not reach statistical significance (p = 0.10). Three (8%) of the 37 patients with SFG infection had severe disease (1 died, 2 developed permanent disability) versus 0/95 scrub typhus patients (p = 0.02). Adults with a high admission qSOFA score (≥2) had an odds ratio (OR) of 19 (95% CI:4.8–74.5) for subsequent ICU admission (p<0.001); adults with a high NEWS2 score (≥7) had an OR of 14.3 (95% CI:4.5–45.32) for ICU admission (p<0.001). A patient’s respiratory rate at presentation had strong prognostic utility: if an adult had an admission respiratory rate <22 breaths/minute, the negative predictive value for subsequent ICU admission was 95% (95% CI 88–99). Conclusions In the well-resourced Australian health system outcomes are excellent, but the local burden of rickettsial disease appears to be increasing and the clinical phenotype of SFG infections may be more severe than previously believed. Simple, clinical assessment on admission has prognostic utility and may be used to guide management.

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Section: Discussionsupporting

confidence: 72%

The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management

et al. 2019

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“…Nevertheless, TBDs are dangerously expanding and they constitute underestimated causes of human illness worldwide [ 5 ]. The implementation of NGS platforms aimed to diagnosis is being developed, although reports about the contribution of this technique to the clinical diagnostic of TBDs are sporadic [ 25 ]. Herein, the bacteriome of tick species with affinity to bite humans was analysed using the 16S metagenomic approach to investigate tick-related microorganisms and to improve the diagnosis of TBDs, particularly in cases with unknown etiologic agents.…”

Section: Discussionmentioning

confidence: 99%

Exploring the bacteriome in anthropophilic ticks: To investigate the vectors for diagnosis

et al. 2019

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ObjectiveThe aim of this study was to characterize the bacterial microbiome of hard ticks with affinity to bite humans in La Rioja (North of Spain).MethodsA total of 88 adult ticks (22 Rhipicephalus sanguineus sensu lato, 27 Haemaphysalis punctata, 30 Dermacentor marginatus and 9 Ixodes ricinus) and 120 I. ricinus nymphs (CRETAV collection, La Rioja, Spain), representing the main anthropophilic species in our environment, were subjected to a metagenomic analysis of the V3-V4 region of the 16S rRNA gene using an Illumina MiSeq platform. Data obtained with Greengenes database were refined with BLAST. Four groups of samples were defined, according to the four tick species.ResultsProteobacteria was the predominant phylum observed in all groups. Gammaproteobacteria was the most abundant class, followed by Alphaproteobacteria for R. sanguineus, H. punctata and D. marginatus but the relative abundance of reads for these classes was reversed for I. ricinus. This tick species showed more than 46% reads corresponding to ‘not assigned’ OTUs (Greengenes), and >97% of them corresponded to ‘Candidatus Midichloriaceae’ using BLAST. Within Rickettsiales, ‘Candidatus Midichloria’, Rickettsia, Ehrlichia, ‘Candidatus Neoehrlichia’ and Wolbachia were detected. I. ricinus was the most alpha-diverse species. Regarding beta-diversity, I. ricinus and H. punctata samples grouped according to their tick species but microbial communities of some R. sanguineus and D. marginatus specimens clustered together.ConclusionsThe metagenomics approach seems useful to discover the spectrum of tick-related bacteria. More studies are needed to identify and differentiate bacterial species, and to improve the knowledge of tick-borne diseases in Spain.

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“…Despite being often described as a mild illness, 2 FISF can be severe. Recently, the death of a middle‐aged woman due to acute infection of R. honei has been described in Queensland, 19 and another severe case was reported in New South Wales that required intensive care (Dr Stephen R. Graves, personal communication). In our surveillance data, half of cases with hospitalisation status reported were hospitalised.…”

Section: Discussionmentioning

confidence: 99%

New and old hotspots for rickettsial spotted fever acquired in Tasmania, 2012–2017

Willis

Lodo²,

McGregor

et al. 2019

Australian and New Zealand Journal of Public Health

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Objective: To describe the epidemiology and clinical characteristics of Tasmania-acquired rickettsial disease notified to the Department of Health in Tasmania from 2012 to 2017 inclusive.Methods: Data on rickettsiosis cases acquired and notified in Tasmania between 1 January 2012 and 31 December 2017 were analysed descriptively.Results: Eighteen cases of rickettsial infection notified in Tasmania 2012-17 and likely acquired in the state met one of three case definitions: 12 confirmed (67%), four probable (22%), and two possible (11%). The mean number of cases per year was 3.0 (population rate 0.6 per 100,000 population/year); 60% of cases occurred in November and December. Cases were more commonly older males. Fever, lethargy, and rash were commonly reported symptoms. Thirteen cases were likely acquired on Flinders Island, three around Great Oyster Bay and two in the Midlands. Conclusions:This study extends our knowledge of the epidemiology of rickettsial disease in Tasmania. This is the first account including confirmed cases acquired in the Midlands of Tasmania.Implications for public health: Increased knowledge and awareness of epidemiology of rickettsial infection in Tasmania is essential for timely diagnosis and appropriate treatment. These findings bear wider relevance outside Tasmania because visitors may also be at risk.

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Detection of Spotted Fever GroupRickettsiaDNA by Deep Sequencing

Cited by 13 publications

References 6 publications

The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management

The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management

Exploring the bacteriome in anthropophilic ticks: To investigate the vectors for diagnosis

New and old hotspots for rickettsial spotted fever acquired in Tasmania, 2012–2017

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