Features of human monocytic ehrlichiosis laboratory diagnostics

Cover Page

Cite item

Full Text

Abstract

Objective. Using the data obtained in Perm Region as an example, to identify the effectiveness of polymerase chain reaction (PCR) for the diagnosis of Human Monocytic Ehrlichiosis (HME) at different periods from the onset of the disease, and to determine the role of HME in the structure of infections transmitted by ixodic ticks using PCR and enzyme-linked immunosorbent assay (ELISA)

Materials and methods. A thorough clinical and epidemiological examination of 583 patients with acute febrile diseases developed after the suction of ticks was carried out. To detect E. muris DNA, 1586 whole blood samples were examined by PCR at different periods from the onset of the disease. For the purpose of serological verification of HME, all patients were examined with ELISA for the presence of immunoglobulins M and G against E. chaffeensis.

Results. In total, using the PCR method, ehrlichial DNA was detected in 76 (4.8 %) blood samples from 53 patients. Based on two research methods (ELISA and PCR) HME was diagnosed in 58 (9.9 %) persons, while in 50 (86.2 %) of them, the diagnosis was confirmed only by PCR. The timing of E. muris genomic material detection in the blood of patients varied from 1 to 58 days from the moment of the disease. The greatest effectiveness of PCR (up to 69.4 % of positive samples) was noted by us from the 1st to the 7th day of illness. HME was found in the form of monoinfection – in 9 (15.5 %), mixed infection – in 49 (84.5 %) persons. The following was revealed: HME+Ixodid tick-borne borreliosis (ITBB) in 35 (60.3 %), HME+ITBB+Human granulocytic anaplasmosis (HGA) – in 6 (10.3 %), HME+ITBB+HGA+Tick-borne encephalitis (TBE) – in 4 (6.9 %), HME+TBE – in 2 (3.5 %), HME+TBE+ITBB – in 2 (3.5 %).

Conclusions. In the diagnosis of HME, PCR significantly increased the number (up to 86.2 %) of confirmed cases, and most often in the acute period of the disease (up to 69.4 ± 15.3 % of positive samples in the first week of the disease). For laboratory verification of HME, it is advisable to combine ELISA with the PCR method, especially in case of negative results of serological studies.

About the authors

V. Yu. Teterin

E.A. Vagner Perm State Medical University

Author for correspondence.
Email: infect-perm@mail.ru

Candidate of Medical Sciences, Assistant, Department of Infectious Diseases

Russian Federation, Perm

E. I. Korenberg

N.F. Gamaleya National Research Center for Epidemiology and Microbiology

Email: infect-perm@mail.ru

Honoured Worker of Science of RF, Academician of RANS, Doctor of Biological Sciences, Professor, Head of Department of Natural Focal Infections

Russian Federation, Moscow

V. V. Nefedova

N.F. Gamaleya National Research Center for Epidemiology and Microbiology

Email: infect-perm@mail.ru

Candidate of Biological Sciences, senior researcher of Laboratory of Infection Carriers

Russian Federation, Moscow

N. N. Vorobyova

E.A. Vagner Perm State Medical University

Email: infect-perm@mail.ru

MD, PhD, Professor, Head of Department of Infectious Diseases

Russian Federation, Perm

O. N. Sumlivaya

E.A. Vagner Perm State Medical University

Email: infect-perm@mail.ru

MD, PhD, Professor, Department of Infectious Diseases

Russian Federation, Perm

M. A. Okishev

E.A. Vagner Perm State Medical University

Email: infect-perm@mail.ru

Candidate of Medical Sciences, Associate Professor, Department of Infectious Diseases

Russian Federation, Perm

V. V. Semerikov

Perm Regional Clinical Hospital of Infectious Diseases

Email: infect-perm@mail.ru

MD, PhD, Head of Epidemiological Department

Russian Federation, Perm

References

  1. Vorob'eva N.N. Clinic, treatment and prevention of ixodic tick-borne borreliosis. Pod. red. E.I. Korenberga. Perm 1998; 136 (in Russian).
  2. Telford S.R. III, Korenberg E.I., Goethert H.K., Kovalevskiy Yu.V., Gorelova N.B., Spielman A. Identification of natural foci of babesiosis and granulocytic ehrlichiosis in Russia. Zhurnal epidemiologii, mikrobiologii i immunobiologii 2002; 6: 21–25 (in Russian).
  3. Korenberg E.I., Gorelova N.B., Kovalevskii Y.V. Ecology of Borrelia burgdorferi sensu lato in Russia. In: J. Gray, O. Kahl, R.S. Lane, G. Stanek (ed.). Lyme Borreliosis: biology, epidemiology and control. CAB International 2002; 175–200.
  4. Grigoryan E.V., Korenberg E.I., Vorob'eva N.N. The first data on the clinical course of monocytic ehrlichiosis in Russia. Epidemiologiya i infektsionnye bolezni 2000; 6: 20–23 (in Russian).
  5. Afanas'eva M.V., Vorob'eva N.N., Korenberg E.I. Human granulocytic anaplasmosis: features of clinical manifestations in Russia. Infektsionnye bolezni 2006; 4 (2): 24–28 (in Russian).
  6. Rudakov N.V. Anaplasmas and anaplasmoses. Rukovodstvo dlya vrachey. Omsk 2017; 100 (in Russian).
  7. Provorova V.V., Krasnova E.I., Khokhlova N.I., Savel'eva M.A., Filimonova E.S., Kuznetsova V.G. Old and new tick-borne infections in Russia. Infektsionnye bolezni: novosti, mneniya, obuchenie 2019; 8 (2): 102–112 (in Russian).
  8. Grigoryan E.V. Clinical and epidemiological characteristics of human monocytic ehrlichiosis in Russia: avtoref. dis. … kand. med. nauk. Moscow 2002; 20 (in Russian).
  9. Korenberg E.I. Ehrlichiosis is a new problem of infectious pathology for Russia. Meditsinskaya parazitologiya i parazitarnye bolezni 1999; 4: 10–16 (in Russian).
  10. Vorob'eva N.N., Grigoryan E.V., Korenberg E.I. Ehrlichiosis in Russia. Problemy kleshchevykh i parazitarnykh zabolevaний. СПб. 2000: 21–25 (in Russian).
  11. Korenberg E.I. Study and prevention of mixed infections transmitted by ixodid ticks. Vestnik rossiyskoy akademii meditsinskikh nauk 2001; 11: 41–45 (in Russian)
  12. Swanson, S.J., Neitzel, D., Reed, K.D., Belongia. Coinfections acquired from Ixodes ticks. Clin. Microbiol. Rev. 2006; 19: 708–727.
  13. Grigoryan E.V., Vorob'eva N.N., Korenberg E.I. Mixed infection: monocytic human ehrlichiosis with ixodid tick-borne borreliosis and tick-borne encephalitis. Klinicheskie perspektivy v infektologii. SPb. 2001: 57–58 (in Russian).
  14. Korenberg E.I., Vorob'eva N.N., Sumlivaya O.N., Frizen V.I., Afanas'eva M.V. Infections transmitted by ixodid ticks in the Perm Region (etiology, epidemiology, pathogenesis, clinic, diagnosis, treatment and prevention); metodicheskie rekomendatsii dlya vrachey. Perm' 2007; 67 (in Russian).
  15. Afanas'eva M.V., Korenberg E.I., Frizen V.I., Vorob'eva N.N., Manokina T.E. Clinical and laboratory testing of new domestic test systems for serological verification of monocytic ehrlichiosis and granulocytic human anaplasmosis. Epidemiologiya i vaktsinoprofilaktika 2005; 1: 45–48 (in Russian).
  16. Nichols Heitman K., Dahlgren F.S., Drexler N.A., Massung R.F., Behravesh C.B. Increasing incidence of ehrlichiosis in the United States: a summary of national surveillance of Ehrlichia chaffeensis and Ehrlichia ewingii infections in the United States, 2008–2012. Am. J. Trop. Med. Hyg. 2016; 94: 52–60.
  17. Ismail N., Bloch K.C., McBride. J.W. Human ehrlichiosis and anaplasmosis. Clin. Lab. Med. 2010; 1: 261–292.
  18. Teterin V.Yu., Korenberg E.I., Nefedova V.V., Vorob'eva N.N., Frizen V.I., Pomelova V.G., Kuznetsova T.I. Clinical and laboratory diagnostics of infections transmitted by ixodid ticks in the Perm Region. Epidemiologiya i infektsionnye bolezni 2013; 4: 11–15 (in Russian).
  19. Mowla S.J., Drexler N.A., Cherry C.C., Annambholta P.D., Kracalik I.T., Basavaraju S.V. Ehrlichiosis and Anaplasmosis among Transfusion and Transplant Recipients in the United States. Infect. Dis. 2021; 27 (11): 2768–2775.
  20. Bovt O.N., Kicherova O.A., Reykhert L.I. Neurological manifestations of monocytic human ehrlichiosis on the example of one clinical case. Nevrologicheskiy zhurnal 2016; 6: 353–356 (in Russian).
  21. Teterin V.Yu., Korenberg E.I., Nefedova V.V., Vorob'eva N.N., Frizen V.I. Results of laboratory diagnostics of human monocytic ehrlichiosis by polymerase chain reaction. II Ezhegodnyy vserossiyskiy kongress po infektsionnym boleznyam. Moscow 2010; 316 (in Russian).

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. The structure of human monocytic ehrlichiosis in the form of mono- and mixed infections in patients of the Perm Region (according to the results of ELISA and PCR), %

Download (87KB)
Indexing metadata

Copyright (c) 2022 Teterin V.Y., Korenberg E.I., Nefedova V.V., Vorobyova N.N., Sumlivaya O.N., Okishev M.A., Semerikov V.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).