A fatal case of tick-borne rickettsiosis caused by mixed Rickettsia sibirica subsp. sibirica and "Candidatus Rickettsia tarasevichiae" infection in Russia.

North Asian tick-typhus (NATT), also known as Siberian tick typhus, is the main tick-borne rickettsiosis in Siberia, Russia. Recently, a fatal infection in a four-year-old girl with typical tick-borne rickettsiosis symptoms (fever, rash, eschar at the site of the tick bite, myalgia) and meningeal syndrome was registered. In order to identify the etiology of this infection, blood and brain samples from the patient were examined for the presence of a wide range of tick-transmitted agents and enteric viruses by polymerase chain reaction with subsequent sequencing. Rickettsia sibirica subsp. sibirica and "Candidatus Rickettsia tarasevichiae" DNA was identified in both blood and brain samples. Rickettsia sibirica was characterized by the gltA, ompA and ompB genes, and "Candidatus R. tarasevichiae" was characterized by the gltA and ompB genes. We report the first case of mixed R. sibirica and "Candidatus R. tarasevichiae" human infection with a fatal outcome in Russia.

Detection of members of the genera Rickettsia, Anaplasma, and Ehrlichia in ticks collected in the Asiatic part of Russia.

A total of 395 adult ixodid ticks from three genera (Dermacentor, Haemaphysalis, and Ixodes) collected from the Urals to the Far East of Russia were tested by PCR and sequencing for the presence of spotted fever rickettsiae, anaplasmae, and ehrlichiae. Four, pathogens recognized in humans were detected in ticks: Rickettsia sibirica, R. heilongjiangensis, R. helvetica, and Anaplasma phagocytophilum. In addition, rickettsiae and ehrlichiae of unknown pathogenicity were detected, including Rickettsia sp. RpA4, Rickettsia sp. DnS14, Rickettsia sp. DnS28, "Candidatus R. tarasevichiae," a rickettsia closely related to R. helvetica, A. bovis, Ehrlichia muris, "Ehrlichia-like" "Schotti variant," and bacterium "Montezuma." Our findings indicated the distribution of rickettsiae and ehrlichiae in hard ticks in Russia.

Ecology and molecular epidemiology of tick-borne rickettsioses and anaplasmoses with natural foci in Russia and Kazakhstan.

During our more than 20 years of monitoring, we have used epidemiological, field, and experimental methods for characterization of natural foci of tick-borne rickettsioses in Russia. The main results were obtained through genetic methods (PCR sequence) at the Université de la Mediterranée (Marseille, France). We describe considerable heterogeneity of tick-borne alpha(1)-proteobacteria: 16 microorganisms the of the order Rickettsiales were detected in Russia and Kazakhstan. R. sibirica-caused North Asiatic tick-borne rickettsiosis is the main tick-borne rickettsiosis in Russia, with wide distribution in Siberia and the Russian Far East and high epidemic activity of natural foci of different landscape types. Our results show circulation of different pathogenic rickettsiae in the same endemic territories. In the Far East region, R. sibirica subsp. R. sibirica, R. sibirica subsp. BJ-90, and R. heilongjiangensis were detected; in the Altay and Krasnojarsk regions, R. sibirica subsp. R. sibirica and R. heilongjiangensis; and in the Kurgan district of West Siberia, R. sibirica subsp. R. sibirica and R. slovaca. The roles of more than 15 new genotypes of alpha(1)-proteobacteria in infectious disease in Russia and Kazakhstan are in need of further study.

Molecular identification of a collection of spotted Fever group rickettsiae obtained from patients and ticks from Russia.

Thirty-one rickettsial isolates from ticks or patients in North Asian tick typhus (NATT) foci from the Ural region to the Russian Far East were obtained at the Omsk Research Institute of Natural Foci Infections between 1954 and 2001. Using citrate synthase (gltA) and outermenbrane protein a (ompA) gene sequencing, we identified these isolates as Rickettsia sibirica sensu stricto (25 isolates), R. sibirica strain BJ-90 (2 isolates), R. slovaca (1 isolate), and R. heilongjiangensis (3 isolates). We demonstrate that Ixodes persulcatus ticks should be considered potential vectors of NATT. We also demonstrate the presence of R. slovaca in Ural and R. heilongjiangensis in Siberia and Russian Far East, where they may cause human infections misdiagnosed as cases of NATT. Clinicians should be aware that several spotted fever rickettsioses with different prognoses coexist in Russia in areas where NATT was the only previously recognized rickettsiosis.

Detection of a rickettsia closely related to Rickettsia aeschlimannii, "Rickettsia heilongjiangensis," Rickettsia sp. strain RpA4, and Ehrlichia muris in ticks collected in Russia and Kazakhstan.

Using PCR, we screened 411 ticks from four genera collected in Russia and Kazakhstan for the presence of rickettsiae and ehrlichiae. In Russia, we detected "Rickettsia heilongjiangensis," Rickettsia sp. strain RpA4, and Ehrlichia muris. In Kazakhstan, we detected Rickettsia sp. strain RpA4 and a rickettsia closely related to Rickettsia aeschlimannii. These agents should be considered in a differential diagnosis of tick-borne infections in these areas.

"Candidatus Rickettsia tarasevichiae" in Ixodes persulcatus ticks collected in Russia.

We collected 209 Ixodes persulcatus ticks in various regions of Russia, including the southern Urals and western and eastern Siberia. Using PCR amplification and sequencing of the citrate synthase-encoding gene (gltA), we detected a new rickettsial genotype, which we named "Candidatus Rickettsia tarasevichiae." This bacterium was found in 9.27%, 10.0%, and 20.5% of the ticks collected in western Siberia, eastern Siberia, and the southern Urals, respectively. "Candidatus Rickettsia tarasevichiae" exhibited a 98% and 96% nucleotide sequence homology, with the 16S rDNA and gltA sequence, respectively, of R. canadensis, a rickettsia previously only found in Haemaphysalis leporispalustris ticks in North America. The phylogenetic analysis of "Candidatus Rickettsia tarasevichiae" and other Rickettsia species allowed the creation of a new cluster with high bootstrap values within the Rickettsia genus involving this rickettsia, R. canadensis, and three uncultured rickettsiae from plant insects.