RESUMO
BACKGROUND: Infections caused by tick-borne pathogens such as Bartonella spp., Borrelia burgdorferi s.l., Coxiella burnetii, and Rickettsia spp. are capable of causing serious lesions of the mitral and aortic valves, leading to a need for valve replacement. OBJECTIVES: The aim of the study was to determine whether such cases are sporadic or frequent. An additional goal was to establish effective diagnostic methods to detect these infections. MATERIAL AND METHODS: The study involved 148 patients undergoing valve replacement. Blood samples were drawn for serological testing. Samples of the removed mitral and aortic valves were tested with polymerase chain reaction and immunohistochemical staining. RESULTS: Specific antibodies to Bartonella spp. were detected in 47 patients (31.7%) and in 1 of the healthy controls (1%) (p < 0.05). Antibodies to B. burgdorferi spirochetes were found in 18 of the patients (12.2%) and in 6 blood donors from the control group (5.8%) (p < 0.1). Antibodies to Rickettsia spp. were detected in 12 (8.1%) and to C. burnetii phase I and II antigens in the serum of 1 patient. All the participants in the control group were seronegative to C. burnetii and Rickettsia spp. antigens. Polymerase chain reaction (PCR) tests for detection of Bartonella spp., B. burgdorferi s.l., C. burnetii and Rickettsia spp. DNA in the valve samples were all negative. Inflammation foci with mononuclear lymphoid cells in the aortic and mitral valves were seen in sections stained with hematoxiline and eozine. In sections dyed using the indirect immunofluorescence method with hyperimmune sera, Bartonella spp. and Rickettsia spp. were found. CONCLUSIONS: The results obtained indicate that laboratory diagnostics for patients with heart disorders should be expanded to include tests detecting tick-borne zoonoses such as bartonelloses, Lyme borreliosis, rickettsioses and Q fever.
Assuntos
Valva Aórtica/microbiologia , Infecções Bacterianas/microbiologia , Bartonella/isolamento & purificação , Borrelia/isolamento & purificação , Coxiella burnetii/isolamento & purificação , Endocardite/microbiologia , Valva Mitral/microbiologia , Rickettsia/isolamento & purificação , Doenças Transmitidas por Carrapatos/complicações , Animais , Bartonella/genética , Borrelia/classificação , Borrelia/genética , Estudos de Casos e Controles , Coxiella burnetii/genética , Endocardite/sangue , Humanos , Reação em Cadeia da Polimerase em Tempo Real , Rickettsia/classificação , Rickettsia/genética , Rickettsiales/classificação , Rickettsiales/genética , Rickettsiales/isolamento & purificação , Doenças Transmitidas por Carrapatos/sangue , Doenças Transmitidas por Carrapatos/diagnóstico , CarrapatosRESUMO
BACKGROUND: Leptospirosis is a zoonotic disease caused by spirochetes of the Leptospiraceae family. In both humans and animals the main route of infection is indirect contact - through water or other products contaminated with urine containing spirochetes. Infection most commonly occurs through ingestion of water or food contaminated with Leptospira spp. OBJECTIVES: The aim of the study was to characterize cases of leptospirosis imported to Poland from Germany in 2014 and to analyze methods that are helpful for making a diagnosis. MATERIAL AND METHODS: The 10 patients examined were reported as suspected leptospirosis cases on the basis of clinical symptoms and epidemiological investigations. They originated from different regions of Poland and had been working together at a strawberry plantation in the Cloppenburg district of Lower Saxony in Germany. Blood and urine samples were tested by PCR and serum samples by serology. All ELISA positive and negative cases were examined using a reference microscopic agglutination test (MAT). RESULTS: In the tested group, 6 individuals (60%) were seropositive according to the ELISA, and 2 of them were confirmed by the MAT. The PCR results for the blood and urine samples were negative. CONCLUSIONS: Using the ELISA in the diagnosis of leptospirosis allowed the disease to be identified much faster, differentiating classes of antibodies and recognizing levels of them that are too low to be detectable by the MAT.
Assuntos
Leptospirose/epidemiologia , Adolescente , Adulto , Testes de Aglutinação/métodos , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Surtos de Doenças , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Alemanha/epidemiologia , Humanos , Leptospirose/sangue , Leptospirose/imunologia , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade , Adulto JovemRESUMO
INTRODUCTION: Tick-borne diseases, such as rickettsioses, anaplasmosis, Lyme boreliosis and bartonellosis are often difficult to correctly diagnose. All these disease are present in Poland. OBJECTIVES: The aim of the study was to estimate a prevalence of Rickettsia spp. infections in humans in Poland in 2006 to 2012 based on the results made in the Laboratory of Rickettsiae, Chlamydiae and Spirochetes, NIPH-NIH in Warsaw. MATERIAL AND METHODS: The levels of Rickettsia spp. and Anaplasma phagocytophilum IgM and IgG antibodies were determined by indirect immunofluorescent assay (IFA). From 2006 to 2012, serum samples derived from 180 humans suspected for rickettsioses, including 84 patients suspected for the infections with typhus and spotted fever group (SFG) rickettsiae, and 96 patients suspected for anaplasmosis. RESULTS: Specific serum antibodies to the SFG rickettsiae have been detected in 5 persons (2.7%). Granulocytic anaplasmosis has been recognized in 9 patients (4.9%). While the reporting and registration of rickettsioses are obligatory in Poland less than 50% of detected cases are reported. CONCLUSIONS: Presented date indicate that in Poland rickettsioses are often unrecognized resulting in their underestimation. If research for rickettsiosis are made immediately after infection, antibodies will not be detect.
