Surveillance for and Discovery of Borrelia Species in US Patients Suspected of Tickborne Illness.

Authors:
Luke C Kingry
Luke C Kingry
Colorado State University
United States
Melissa Anacker
Melissa Anacker
University of Montana
Bobbi Pritt
Bobbi Pritt
Mayo Clinic
United States
Jenna Bjork
Jenna Bjork
Minnesota Department of Health
Grand Forks | United States
Laurel Respicio-Kingry
Laurel Respicio-Kingry
Centers for Disease Control and Prevention
Gongping Liu
Gongping Liu
Tongji Medical College of Huazhong Science and Technology University
China
Sarah Sheldon
Sarah Sheldon
University of California
United States
David Boxrud
David Boxrud
Michigan State University
United States

Clin Infect Dis 2018 Jun;66(12):1864-1871

Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado.

Background: Tick-transmitted Borrelia fall into 2 heterogeneous bacterial complexes comprised of multiple species, the relapsing fever (RF) group and the Borrelia burgdorferi sensu lato group, which are the causative agents of Lyme borreliosis (LB), the most common tickborne disease in the Northern Hemisphere. Geographic expansion of LB in the United States and discovery of emerging Borrelia pathogens underscores the importance of surveillance for disease-causing Borrelia.

Methods: De-identified clinical specimens, submitted by providers throughout the United States, for patients suspected of LB, anaplasmosis, ehrlichiosis, or babesiosis were screened using a Borrelia genus-level TaqMan polymerase chain reaction (PCR). Borrelia species and sequence types (STs) were characterized by multilocus sequence typing (MLST) utilizing next-generation sequencing.

Results: Among 7292 specimens tested, 5 Borrelia species were identified: 2 causing LB, B. burgdorferi (n = 25) and B. mayonii (n = 9), and 3 RF borreliae, B. hermsii (n = 1), B. miyamotoi (n = 8), and Candidatus B. johnsonii (n = 1), a species previously detected only in the bat tick, Carios kelleyi. ST diversity was greatest for B. burgdorferi-positive specimens, with new STs identified primarily among synovial fluids.

Conclusions: These results demonstrate that broad PCR screening followed by MLST is a powerful surveillance tool for uncovering the spectrum of disease-causing Borrelia species, understanding their geographic distribution, and investigating the correlation between B. burgdorferi STs and joint involvement. Detection of Candidatus B. johnsonii in a patient with suspected tickborne disease suggests this species may be a previously undetected cause of illness in humans exposed to bat ticks.

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Source
http://dx.doi.org/10.1093/cid/cix1107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985202PMC
June 2018
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