lunes, 20 de julio de 2015

Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden - Volume 21, Number 8—August 2015 - Emerging Infectious Disease journal - CDC

full-text ►

Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden - Volume 21, Number 8—August 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 8—August 2015


Infections with Candidatus Neoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden

Anna Grankvist1, Lisa Labbé Sandelin1, Jennie Andersson, Linda Fryland, Peter Wilhelmsson, Per-Eric Lindgren, Pia Forsberg, and Christine WenneråsComments to Author 
Author affiliations: University of Gothenburg, Göteborg, Sweden (A. Grankvist, J. Andersson, C. Wennerås);Sahlgrenska University Hospital, Göteborg (A. Grankvist, J. Andersson, C. Wennerås)Kalmar County Hospital, Kalmar, Sweden (L.L. Sandelin); Uppsala University, Uppsala, Sweden (L.L. Sandelin)Linköping University, Linköping, Sweden (L. Fryland, P. Wilhelmsson, P.-E. Lindgren, P. Forsberg)County Hospital Ryhov, Jönköping, Sweden (P.-E. Lindgren)


The prevalence of Candidatus Neoehrlichia mikurensis infection was determined in 102 persons bitten by ticks in Sweden. Two infected women had erythematous rashes; 1 was co-infected with a Borrelia sp., and the other showed seroconversion for Anaplasma phagocytophilum. Both patients had increased levels ofNeoehrlichia DNA and serum cytokines for several months.
Candidatus Neoehrlichia mikurensis is a tick-borne pathogen found in Europe and Asia (1). It causes an infectious disease in immunocompromised persons that is characterized by fever and thromboembolic events (2). In contrast, Candidatus N. mikurensis infection in immunocompetent hosts has been linked to asymptomatic infection (3), systemic inflammation with various symptoms (4,5), and possibly lethal infection (6). Knowledge regarding the capacity of Candidatus N. mikurensis to cause disease in immunocompetent persons is still limited. The purpose of this study was to investigate the prevalence, rate of co-infections, clinical picture, and cytokine response to Candidatus N. mikurensis infection in immunocompetent patients participating in the Tick-Borne Diseases Study (Technical Appendix[PDF - 255 KB - 3 pages]).
Dr. Grankvist is a molecular biologist in the Department of Clinical Microbiology at Sahlgrenska University Hospital, Göteborg, Sweden. Her research interests are noncultivatable infectious agents, with a focus onCandidatus N. mikurensis.


This study was supported by ALF-Göteborg (71580); the Cancer and Allergy Foundation (149781); Västra Götaland Region Research and Development (94510); Laboratory Medicine at Sahlgrenska University Hospital (6333); the Medical Research Council of South-East Sweden (FORSS-297311, -307591, and -87231); The Swedish Research Council/Medicine (2011-345); and ALF-Östergötland.


  1. Wenneras C. Infections with the tick-borne bacterium Candidatus Neoehrlichia mikurensis. Clin Microbiol Infect. 2015 Mar 11:pii: S1198-743X(15)00324-9.PubMed
  2. Grankvist AAndersson POMattsson MSender MVaht KHoper LInfections with the tick-borne bacterium “Candidatus Neoehrlichia mikurensis” mimic noninfectious conditions in patients with B cell malignancies or autoimmune diseases. Clin Infect Dis2014;58:171622 . DOIPubMed
  3. Welc-Faleciak RSinski EKowalec MZajkowska JPancewicz SAAsymptomatic “Candidatus Neoehrlichia mikurensis” infections in immunocompetent humans. J Clin Microbiol2014;52:30724DOIPubMed
  4. Fehr JSBloemberg GVRitter CHombach MLuscher TFWeber RSepticemia caused by tick-borne bacterial pathogen Candidatus Neoehrlichia mikurensis. Emerg Infect Dis2010;16:11279DOIPubMed
  5. Li HJiang JFLiu WZheng YCHuo QBTang KHuman infection with Candidatus Neoehrlichia mikurensis, China. Emerg Infect Dis.2012;18:16369DOIPubMed
  6. von Loewenich FDGeissdorfer WDisque CMatten JSchett GSakka SGDetection of “Candidatus Neoehrlichia mikurensis” in two patients with severe febrile illnesses: evidence for a European sequence variant. J Clin Microbiol2010;48:26305DOIPubMed
  7. Wormser GPNowakowski JNadelman RBVisintainer PLevin AAguero-Rosenfeld MEImpact of clinical variables on Borrelia burgdorferi−specific antibody seropositivity in acute-phase sera from patients in North America with culture-confirmed early Lyme disease. Clin Vaccine Immunol2008;15:151922DOIPubMed
  8. Hammers-Berggren SLebech AMKarlsson MSvenungsson BHansen KStiernstedt GSerological follow-up after treatment of patients with erythema migrans and neuroborreliosis. J Clin Microbiol1994;32:151925 .PubMed
  9. Aguero-Rosenfeld MENowakowski JMcKenna DFCarbonaro CAWormser GPSerodiagnosis in early Lyme disease. J Clin Microbiol.1993;31:30905 .PubMed
  10. Sjöwall JFryland LNordberg MSjogren FGarpmo UJansson CDecreased Th1-type inflammatory cytokine expression in the skin is associated with persisting symptoms after treatment of erythema migrans. PLoS ONE2011;6:e18220DOIPubMed
  11. Dumler JSDotevall LGustafson RGranstrom MA population-based seroepidemiologic study of human granulocytic ehrlichiosis and Lyme borreliosis on the west coast of Sweden. J Infect Dis1997;175:7202 and. DOIPubMed
  12. Wittesjö BBjoersdorff AEliasson IBerglund JFirst long-term study of the seroresponse to the agent of human granulocytic ehrlichiosis among residents of a tick-endemic area of Sweden. Eur J Clin Microbiol Infect Dis2001;20:1738DOIPubMed
  13. Andersson MBartkova SLindestad ORaberg LCo-infection with ‘Candidatus Neoehrlichia mikurensis’ and Borrelia afzelii in Ixodes ricinus ticks in southern Sweden. Vector Borne Zoonotic Dis2013;13:43842DOIPubMed
  14. Salazar JCPope CDSellati TJFeder HM JrKiely TGDardick KRCoevolution of markers of innate and adaptive immunity in skin and peripheral blood of patients with erythema migrans. J Immunol2003;171:266070DOIPubMed
  15. Diniz PPSchulz BSHartmann KBreitschwerdt EB“Candidatus Neoehrlichia mikurensis” infection in a dog from Germany. J Clin Microbiol.2011;49:205962 . DOIPubMed



Technical Appendix

Suggested citation for this article: Grankvist A, Sandelin LL, Andersson J, Fryland L, Wilhelmsson P, Lindgren P-E, et al. Infections with CandidatusNeoehrlichia mikurensis and cytokine responses in 2 persons bitten by ticks, Sweden. Emerg Infect Dis. 2015 Aug [date cited].
DOI: 10.3201/eid2108.150060
1These authors contributed equally to this article.

No hay comentarios:

Publicar un comentario