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<article xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" article-type="brief-report"><?properties open_access?><front><journal-meta><journal-id journal-id-type="nlm-ta">Emerg Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Emerging Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">EID</journal-id><journal-title-group><journal-title>Emerging Infectious Diseases</journal-title></journal-title-group><issn pub-type="ppub">1080-6040</issn><issn pub-type="epub">1080-6059</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">29664376</article-id><article-id pub-id-type="pmc">5938772</article-id><article-id pub-id-type="publisher-id">17-0323</article-id><article-id pub-id-type="doi">10.3201/eid2405.170323</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Letter</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Letter</subject></subj-group><subj-group subj-group-type="TOC-title"><subject><italic>Rickettsia asembonensis</italic> Characterization by Multilocus Sequence Typing of Complete Genes, Peru</subject></subj-group></article-categories><title-group><article-title><italic>Rickettsia asembonensis</italic> Characterization by Multilocus Sequence Typing of Complete Genes, Peru</article-title><alt-title alt-title-type="running-head"><italic>Rickettsia asembonensis</italic> Characterization by Multilocus Sequence Typing of Complete Genes, Peru</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Loyola</surname><given-names>Steev</given-names></name></contrib><contrib contrib-type="author"><name><surname>Flores-Mendoza</surname><given-names>Carmen</given-names></name></contrib><contrib contrib-type="author"><name><surname>Torre</surname><given-names>Armando</given-names></name></contrib><contrib contrib-type="author"><name><surname>Kocher</surname><given-names>Claudine</given-names></name></contrib><contrib contrib-type="author"><name><surname>Melendrez</surname><given-names>Melanie</given-names></name></contrib><contrib contrib-type="author"><name><surname>Luce-Fedrow</surname><given-names>Alison</given-names></name></contrib><contrib contrib-type="author"><name><surname>Maina</surname><given-names>Alice N.</given-names></name></contrib><contrib contrib-type="author"><name><surname>Richards</surname><given-names>Allen L.</given-names></name></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Leguia</surname><given-names>Mariana</given-names></name></contrib><aff id="aff1">US Naval Medical Research Unit No. 6, Lima, Peru (S. Loyola, C. Flores-Mendoza, A. Torre, C. Kocher, M. Leguia); </aff><aff id="aff2">Pontificia Universidad Cat&#x000f3;lica del Per&#x000fa;, Lima (A. Torre, M. Leguia); </aff><aff id="aff3">Walter Reed Army Institute of Research, Silver Spring, Maryland, USA (M. Melendrez); </aff><aff id="aff4">Naval Medical Research Center, Silver Spring (A. Luce-Fedrow, A.N. Maina, A.L. Richards)</aff></contrib-group><author-notes><corresp id="cor1">Address for correspondence: Mariana Leguia, Pontificia Universidad Cat&#x000f3;lica del Per&#x000fa;, Av. Universitaria No. 1801, San Miguel, Lima, Per&#x000fa;; email: <email xlink:href="mariana.leguia@pucp.edu.pe">mariana.leguia@pucp.edu.pe</email></corresp></author-notes><pub-date pub-type="ppub"><month>5</month><year>2018</year></pub-date><volume>24</volume><issue>5</issue><fpage>931</fpage><lpage>933</lpage><abstract><p>While studying rickettsial infections in Peru, we detected <italic>Rickettsia asembonensis</italic> in fleas from domestic animals. We characterized 5 complete genomic regions (17kDa, <italic>gltA</italic>, <italic>ompA</italic>, <italic>ompB</italic>, and <italic>sca4</italic>) and conducted multilocus sequence typing and phylogenetic analyses. The molecular isolate from Peru is distinct from the original <italic>R. asembonensis</italic> strain from Kenya.</p></abstract><kwd-group kwd-group-type="author"><title>Keywords: </title><kwd>Rickettsia asembonensis</kwd><kwd>multilocussequence typing</kwd><kwd>Peru</kwd><kwd>next-generation sequencing</kwd><kwd>Rickettsia</kwd><kwd>vector-borne infections</kwd><kwd>fleas</kwd><kwd>zoonoses</kwd><kwd>ectoparasites</kwd><kwd>parasites</kwd></kwd-group></article-meta></front><body><p><italic>Rickettsia asembonensis</italic> belongs to a group of <italic>R. felis</italic>&#x02013;like organisms (RFLOs) that are similar, yet distinct, from their closest known relative, <italic>R. felis</italic> (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>,<xref rid="R2" ref-type="bibr"><italic>2</italic></xref>). Although <italic>R. felis</italic> causes disease in humans (<xref rid="R3" ref-type="bibr"><italic>3</italic></xref>), the pathogenicity of RFLOs remains unknown (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>,<xref rid="R4" ref-type="bibr"><italic>4</italic></xref>,<xref rid="R5" ref-type="bibr"><italic>5</italic></xref>). <italic>R. asembonensis</italic> was initially identified in domestic fleas from Kenya (<xref rid="R1" ref-type="bibr"><italic>1</italic></xref>). Subsequently, reports from the Americas, Asia, and Africa established that <italic>R. asembonensis</italic> is ubiquitous and closely associated with human habitats because of its arthropod hosts (<xref rid="R4" ref-type="bibr"><italic>4</italic></xref>&#x02013;<xref rid="R7" ref-type="bibr"><italic>7</italic></xref>). However, reports of <italic>R. asembonensis</italic> rarely include robust genomic information needed to establish degrees of genetic diversity. Consequently, many rickettsial infections remain underdiagnosed, even when prevalence is high (<xref rid="R8" ref-type="bibr"><italic>8</italic></xref>). We recently described <italic>R. asembonensis</italic> in multiple ectoparasites (<italic>Ctenocephalidesfelis</italic> fleas and <italic>Rhipicephalussanguineus</italic> ticks) collected in the Peruvian Amazon (<xref rid="R9" ref-type="bibr"><italic>9</italic></xref>). Here, we detail multilocus sequence typing of a single molecular isolate using next-generation sequencing data for 5 complete genomic regions, including conserved (17kDa and <italic>gltA</italic>) and variable (<italic>ompA</italic>, <italic>ompB</italic>, and <italic>sca4</italic>) genes.</p><p>The internal review board of the US Naval Medical Research Unit No. 6 and the Institutional Animal Care and Use Committee approved the study protocol in compliance with all applicable regulations. Genomic DNA was mechanically extracted from half of a single <italic>C. felis</italic> flea as described (<xref rid="R9" ref-type="bibr"><italic>9</italic></xref>) and fragmented by Bioruptor (Diagenode, Denville, NJ, USA). Fragmented DNA served as template to prepare IonPGM libraries using IonPlus Fragment Library Kits (ThermoFisher, Lima, Peru) according to the manufacturer&#x02019;s directions. We conducted quality control using Bioanalyzer High Sensitivity chips (Agilent, Lima, Peru). We prepared libraries for sequencing using IonPGM Template OT2 200 Kits (ThermoFisher, Lima, Peru) and conducted sequencing on 318 chips using IonPGM Sequencing 200 Kits v2 (ThermoFisher). We processed raw data by reference mapping against NMRCii from Kenya (<xref rid="R10" ref-type="bibr"><italic>10</italic></xref>). Of the 20,575,878 shotgun sequencing reads generated, &#x02248;12% matched Rickettsiaceae.</p><p>Comparison of the consensus sequences we generated (GenBank accession nos. KY650696&#x02013;KY650700) with those of strain NMRCii (GenBank accession no. JWSW01000078.1) (<xref rid="R10" ref-type="bibr"><italic>10</italic></xref>) indicates high identity at the nucleotide (99.8%&#x02013;100.0%) and amino acid (99.6&#x02013;100.0%) levels (<xref ref-type="table" rid="T1">Table</xref>). As expected, conserved genes (17kDa and <italic>gltA</italic>) showed fewer substitutions than variable genes (<italic>ompA</italic>, <italic>ompB</italic>, and <italic>sca4</italic>). The 17kDa gene exhibited no mutations along its 480-nt open reading frame (ORF), whereas the <italic>gltA</italic> gene exhibited 3 mutations along its 1,314-nt ORF. Two mutations in <italic>gltA</italic> encoded silent changes, whereas the third encoded a conservative lysine-to-glutamic acid change at position 290. In the variable group, <italic>ompB</italic> exhibited no mutations along its 4,947-nt ORF; <italic>omp</italic>A and <italic>sca4</italic> exhibited 5 each. <italic>ompA</italic> had 2 conservative changes (leucine-to-valine at position 1454 and valine-to-alanine at position 1627) and 2 nonconservative changes (tyrosine-to-aspartic acid at position 162 and arginine-to-glycine at position 1280). <italic>sca4</italic> had 1 conservative change (glutamine-to-histidine at position 608) and 3 nonconservative changes (leucine-to-proline at position 128, arginine-to-glycine at position 754, and isoleucine-to-threonine at position 831). On the basis of these data, we conclude that the Peru molecular isolate is distinct from the original Kenya strain.</p><table-wrap id="T1" position="float"><label>Table</label><caption><title>Multilocus sequence typing analysis of complete genes from Peru <italic>Rickettsia asembonensis</italic> molecular isolate VGD7*</title></caption><table frame="hsides" rules="groups"><col width="92" span="1"/><col width="85" span="1"/><col width="76" span="1"/><col width="9" span="1"/><col width="72" span="1"/><col width="72" span="1"/><col width="74" span="1"/><thead><tr><th rowspan="2" valign="bottom" align="left" scope="col" colspan="1">Changes</th><th valign="bottom" colspan="2" align="center" scope="colgroup" rowspan="1">Conserved genes (GenBank accession no.)<hr/></th><th rowspan="2" valign="bottom" align="left" scope="col" colspan="1"/><th valign="bottom" colspan="3" align="center" scope="colgroup" rowspan="1">Variable genes (GenBank accession no.)<hr/></th></tr><tr><th valign="bottom" colspan="1" align="center" scope="colgroup" rowspan="1">17-kDa (KY650696)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1"><italic>gltA</italic> (KY650697<italic>)</italic></th><th valign="bottom" colspan="1" align="center" scope="colgroup" rowspan="1"><italic>ompA</italic> (KY650698)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1"><italic>ompB</italic> (KY650699)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1"><italic>sca4</italic> (KY650700)</th></tr></thead><tbody><tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Genome</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Complete ORF, nt</td><td valign="top" align="center" rowspan="1" colspan="1">480</td><td valign="top" align="center" rowspan="1" colspan="1">1,314</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">5,076</td><td valign="top" align="center" rowspan="1" colspan="1">4,947</td><td valign="top" align="center" rowspan="1" colspan="1">3,033</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Identity, %</td><td valign="top" align="center" rowspan="1" colspan="1">100</td><td valign="top" align="center" rowspan="1" colspan="1">99.8</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">99.9</td><td valign="top" align="center" rowspan="1" colspan="1">100</td><td valign="top" align="center" rowspan="1" colspan="1">99.8</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Mutations</td><td valign="top" align="center" rowspan="1" colspan="1">None</td><td valign="top" align="center" rowspan="1" colspan="1">C 138 T</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">T 484 G</td><td valign="top" align="center" rowspan="1" colspan="1">None</td><td valign="top" align="center" rowspan="1" colspan="1">T 383 C</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">T 537 C</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">C 828 A</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">T 807 C</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">A 868 G</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">A 3838 G</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">G 1824 T</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">C 4360 G</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">A 2260 G</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">T 4880 C</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">T 2492 C</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Total changes<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">0<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">3<hr/></td><td valign="top" align="left" rowspan="1" colspan="1"><hr/></td><td valign="top" align="center" rowspan="1" colspan="1">5<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">0<hr/></td><td valign="top" align="center" rowspan="1" colspan="1">5<hr/></td></tr><tr><td valign="top" align="left" scope="col" rowspan="1" colspan="1">Protein</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Complete protein, aa</td><td valign="top" align="center" rowspan="1" colspan="1">160</td><td valign="top" align="center" rowspan="1" colspan="1">438</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">1,692</td><td valign="top" align="center" rowspan="1" colspan="1">1,649</td><td valign="top" align="center" rowspan="1" colspan="1">1,011</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Identity, %</td><td valign="top" align="center" rowspan="1" colspan="1">100</td><td valign="top" align="center" rowspan="1" colspan="1">99.8</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">99.8</td><td valign="top" align="center" rowspan="1" colspan="1">100</td><td valign="top" align="center" rowspan="1" colspan="1">99.6</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Mutations</td><td valign="top" align="center" rowspan="1" colspan="1">None</td><td valign="top" align="center" rowspan="1" colspan="1">K 290 E</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Y 162 D</td><td valign="top" align="center" rowspan="1" colspan="1">None</td><td valign="top" align="center" rowspan="1" colspan="1">L 128 P</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">R 1280 G</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">Q 608 H</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">L 1454 V</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">R 754 G</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">V 1627 A</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">I 831 T</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1"> Total changes</td><td valign="top" align="center" rowspan="1" colspan="1">0</td><td valign="top" align="center" rowspan="1" colspan="1">1</td><td valign="top" align="left" rowspan="1" colspan="1"/><td valign="top" align="center" rowspan="1" colspan="1">4</td><td valign="top" align="center" rowspan="1" colspan="1">0</td><td valign="top" align="center" rowspan="1" colspan="1">4</td></tr></tbody></table><table-wrap-foot><p>*Comparisons were made against reference strain NMRCii from Kenya (GenBank accession no. JWSW01000078.1). Blank cells indicate no additional mutations or changes to report. ORF, open reading frame.</p></table-wrap-foot></table-wrap><p>To further characterize the Peru isolate, we conducted phylogenetic analysis using the conserved <italic>gltA</italic> gene. Although reference sequences are available for multiple Rickettsiaceae, <italic>R. asembonensis</italic> sequences are limited in number and length (<xref ref-type="local-data" rid="SD1">Technical Appendix</xref> Table). Nevertheless, we constructed a phylogenetic tree using almost the complete <italic>gltA</italic> gene (1,068 [81%] nt of the ORF). As expected, the Peru isolate groups with RFLOs, including other <italic>R. asembonensis</italic> isolates and <italic>R. senegalensis</italic> (<xref ref-type="local-data" rid="SD1">Technical Appendix</xref> Figure ,panel A). Construction of an additional tree using only 348 nt of <italic>gltA</italic> sequence available for an increased number of isolates (<xref ref-type="local-data" rid="SD1">Technical Appendix</xref> Table) enabled us to confirm placement and relationship with other strains from the Americas (<xref ref-type="local-data" rid="SD1">Technical Appendix</xref> Figure, panel B). This tree focuses exclusively on the transitional group and includes partial <italic>R. asembonensis</italic> references from Brazil, Colombia, and Costa Rica that were not available for inclusion in the 1,068-nt <italic>gltA</italic> tree. The Peru isolate clearly groups with other American isolates, and this subgroup is distinct from the original Kenya strain.</p><p><italic>R. asembonensis</italic> is a new species (<xref rid="R2" ref-type="bibr"><italic>2</italic></xref>) with potential as a ubiquitous human pathogen. Despite worldwide distribution, whether <italic>R. asembonensis</italic> and other RFLOs are pathogenic to humans, as is their closest relative <italic>R. felis</italic>, remains unknown. Complete genomic data, which are largely lacking from public repositories, are required to assess genetic diversity. Using next-generation sequencing, we generated complete sequences for 2 conserved (17 kDa and <italic>gltA</italic>) and 3 variable (<italic>ompA</italic>, <italic>ompB</italic>, and <italic>sca4</italic>) genes of an <italic>R. asembonensis</italic> molecular isolate from Peru. Although characterization of 1 isolate is not sufficient to evaluate strain diversity within Peru, much less among American strains, these sequences represent a major contribution toward the expansion of availability of much needed genomic information. Our multilocus sequence typing and phylogenetic analyses indicate that the Peru isolate is closer to American strains than to the original strain from Kenya. Characterization of additional isolates, derived from a variety of ectoparasites in which <italic>R. asembonensis</italic> has been detected, is needed to further validate our findings and to conduct in-depth diversity studies. In turn, these results should help decrease the chronic underdiagnosis of rickettsial diseases throughout the Americas.</p><supplementary-material content-type="local-data" id="SD1"><caption><title>Technical Appendix</title><p>Reference sequences used for phylogenetic analysis of Peru <italic>Rickettsia asembonensis</italic> molecular isolate.</p></caption><media mimetype="application" mime-subtype="pdf" xlink:href="17-0323-Techapp-s1.pdf" xlink:type="simple" id="d35e667" position="anchor"/></supplementary-material></body><back><fn-group><fn fn-type="citation"><p><italic>Suggested citation for this article</italic>: Loyola S, Flores-Mendoza C, Torre A, Kocher C, Melendrez M, Luce-Fedrow A, et al. <italic>Rickettsia asembonensis</italic> characterization by multilocus sequence typing of complete genes, Peru. Emerg Infect Dis. 2018 May [<italic>date cited</italic>]. <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3201/eid2405.170323">https://doi.org/10.3201/eid2405.170323</ext-link></p></fn></fn-group><ack><p>This work was supported by work unit no. 800000.82000.25GB.B0016, Promis ID#MLeguia-PO166-14, for FY2014, from the Global Emerging Infections Surveillance and Response System of the Armed Forces Health Surveillance Center.</p></ack><bio id="d35e686"><p>Mr. Loyola is a researcher in the Genomics &#x00026; Pathogen Discovery Unit at the US Naval Medical Research Unit No. 6, in Lima, Peru. His primary research interest is the characterization of new and emerging pathogens.</p></bio><ref-list><title>References</title><ref id="R1"><label>1. </label><mixed-citation publication-type="journal"><string-name><surname>Jiang</surname>
<given-names>J</given-names></string-name>, <string-name><surname>Maina</surname>
<given-names>AN</given-names></string-name>, <string-name><surname>Knobel</surname>
<given-names>DL</given-names></string-name>, <string-name><surname>Cleaveland</surname>
<given-names>S</given-names></string-name>, <string-name><surname>Laudisoit</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Wamburu</surname>
<given-names>K</given-names></string-name>, <etal>et al.</etal>
<article-title>Molecular detection of <italic>Rickettsia felis</italic> and <italic>Candidatus Rickettsia asemboensis</italic> in fleas from human habitats, Asembo, Kenya.</article-title>
<source>Vector Borne Zoonotic Dis</source>. <year>2013</year>;<volume>13</volume>:<fpage>550</fpage>&#x02013;<lpage>8</lpage>. <pub-id pub-id-type="doi">10.1089/vbz.2012.1123</pub-id><pub-id pub-id-type="pmid">23675818</pub-id></mixed-citation></ref><ref id="R2"><label>2. </label><mixed-citation publication-type="journal"><string-name><surname>Maina</surname>
<given-names>AN</given-names></string-name>, <string-name><surname>Luce-Fedrow</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Omulo</surname>
<given-names>S</given-names></string-name>, <string-name><surname>Hang</surname>
<given-names>J</given-names></string-name>, <string-name><surname>Chan</surname>
<given-names>TC</given-names></string-name>, <string-name><surname>Ade</surname>
<given-names>F</given-names></string-name>, <etal>et al.</etal>
<article-title>Isolation and characterization of a novel <italic>Rickettsia</italic> species (<italic>Rickettsia asembonensis</italic> sp. nov.) obtained from cat fleas (<italic>Ctenocephalides felis</italic>).</article-title>
<source>Int J Syst Evol Microbiol</source>. <year>2016</year>;<volume>66</volume>:<fpage>4512</fpage>&#x02013;<lpage>7</lpage>. <pub-id pub-id-type="doi">10.1099/ijsem.0.001382</pub-id><pub-id pub-id-type="pmid">27506201</pub-id></mixed-citation></ref><ref id="R3"><label>3. </label><mixed-citation publication-type="journal"><string-name><surname>P&#x000e9;rez-Osorio</surname>
<given-names>CE</given-names></string-name>, <string-name><surname>Zavala-Vel&#x000e1;zquez</surname>
<given-names>JE</given-names></string-name>, <string-name><surname>Arias Le&#x000f3;n</surname>
<given-names>JJ</given-names></string-name>, <string-name><surname>Zavala-Castro</surname>
<given-names>JE</given-names></string-name>. <article-title><italic>Rickettsia felis</italic> as emergent global threat for humans.</article-title>
<source>Emerg Infect Dis</source>. <year>2008</year>;<volume>14</volume>:<fpage>1019</fpage>&#x02013;<lpage>23</lpage>. <pub-id pub-id-type="doi">10.3201/eid1407.071656</pub-id><pub-id pub-id-type="pmid">18598619</pub-id></mixed-citation></ref><ref id="R4"><label>4. </label><mixed-citation publication-type="journal"><string-name><surname>Maina</surname>
<given-names>AN</given-names></string-name>, <string-name><surname>Fogarty</surname>
<given-names>C</given-names></string-name>, <string-name><surname>Krueger</surname>
<given-names>L</given-names></string-name>, <string-name><surname>Macaluso</surname>
<given-names>KR</given-names></string-name>, <string-name><surname>Odhiambo</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Nguyen</surname>
<given-names>K</given-names></string-name>, <etal>et al.</etal>
<article-title>Rickettsial infections among <italic>Ctenocephalides felis</italic> and host animals during a flea-borne rickettsioses outbreak in Orange County, California.</article-title>
<source>PLoS One</source>. <year>2016</year>;<volume>11</volume>:<fpage>e0160604</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pone.0160604</pub-id><pub-id pub-id-type="pmid">27537367</pub-id></mixed-citation></ref><ref id="R5"><label>5. </label><mixed-citation publication-type="journal"><string-name><surname>Troyo</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Moreira-Soto</surname>
<given-names>RD</given-names></string-name>, <string-name><surname>Calderon-Arguedas</surname>
<given-names>&#x000d3;</given-names></string-name>, <string-name><surname>Mata-Somarribas</surname>
<given-names>C</given-names></string-name>, <string-name><surname>Ortiz-Tello</surname>
<given-names>J</given-names></string-name>, <string-name><surname>Barbieri</surname>
<given-names>AR</given-names></string-name>, <etal>et al.</etal>
<article-title>Detection of rickettsiae in fleas and ticks from areas of Costa Rica with history of spotted fever group rickettsioses.</article-title>
<source>Ticks Tick Borne Dis</source>. <year>2016</year>;<volume>7</volume>:<fpage>1128</fpage>&#x02013;<lpage>34</lpage>. <pub-id pub-id-type="doi">10.1016/j.ttbdis.2016.08.009</pub-id><pub-id pub-id-type="pmid">27592065</pub-id></mixed-citation></ref><ref id="R6"><label>6. </label><mixed-citation publication-type="journal"><string-name><surname>Kolo</surname>
<given-names>AO</given-names></string-name>, <string-name><surname>Sibeko-Matjila</surname>
<given-names>KP</given-names></string-name>, <string-name><surname>Maina</surname>
<given-names>AN</given-names></string-name>, <string-name><surname>Richards</surname>
<given-names>AL</given-names></string-name>, <string-name><surname>Knobel</surname>
<given-names>DL</given-names></string-name>, <string-name><surname>Matjila</surname>
<given-names>PT</given-names></string-name>. <article-title>Molecular detection of zoonotic <italic>Rickettsiae</italic> and <italic>Anaplasma</italic> spp. in domestic dogs and their ectoparasites in Bushbuckridge, South Africa.</article-title>
<source>Vector Borne Zoonotic Dis</source>. <year>2016</year>;<volume>16</volume>:<fpage>245</fpage>&#x02013;<lpage>52</lpage>. <pub-id pub-id-type="doi">10.1089/vbz.2015.1849</pub-id><pub-id pub-id-type="pmid">26974185</pub-id></mixed-citation></ref><ref id="R7"><label>7. </label><mixed-citation publication-type="journal"><string-name><surname>Oteo</surname>
<given-names>JA</given-names></string-name>, <string-name><surname>Portillo</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Portero</surname>
<given-names>F</given-names></string-name>, <string-name><surname>Zavala-Castro</surname>
<given-names>J</given-names></string-name>, <string-name><surname>Venzal</surname>
<given-names>JM</given-names></string-name>, <string-name><surname>Labruna</surname>
<given-names>MB</given-names></string-name>. <article-title>&#x02018;<italic>Candidatus Rickettsia asemboensis</italic>&#x02019; and <italic>Wolbachia</italic> spp. in <italic>Ctenocephalides felis</italic> and <italic>Pulex irritans</italic> fleas removed from dogs in Ecuador.</article-title>
<source>Parasit Vectors</source>. <year>2014</year>;<volume>7</volume>:<fpage>455</fpage>.<pub-id pub-id-type="pmid">25266919</pub-id></mixed-citation></ref><ref id="R8"><label>8. </label><mixed-citation publication-type="journal"><string-name><surname>Forshey</surname>
<given-names>BM</given-names></string-name>, <string-name><surname>Stewart</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Morrison</surname>
<given-names>AC</given-names></string-name>, <string-name><surname>G&#x000e1;lvez</surname>
<given-names>H</given-names></string-name>, <string-name><surname>Rocha</surname>
<given-names>C</given-names></string-name>, <string-name><surname>Astete</surname>
<given-names>H</given-names></string-name>, <etal>et al.</etal>
<article-title>Epidemiology of spotted fever group and typhus group rickettsial infection in the Amazon basin of Peru.</article-title>
<source>Am J Trop Med Hyg</source>. <year>2010</year>;<volume>82</volume>:<fpage>683</fpage>&#x02013;<lpage>90</lpage>. <pub-id pub-id-type="doi">10.4269/ajtmh.2010.09-0355</pub-id><pub-id pub-id-type="pmid">20348519</pub-id></mixed-citation></ref><ref id="R9"><label>9. </label><mixed-citation publication-type="journal"><string-name><surname>Kocher</surname>
<given-names>C</given-names></string-name>, <string-name><surname>Morrison</surname>
<given-names>AC</given-names></string-name>, <string-name><surname>Leguia</surname>
<given-names>M</given-names></string-name>, <string-name><surname>Loyola</surname>
<given-names>S</given-names></string-name>, <string-name><surname>Castillo</surname>
<given-names>RM</given-names></string-name>, <string-name><surname>Galvez</surname>
<given-names>HA</given-names></string-name>, <etal>et al.</etal>
<article-title>Rickettsial disease in the Peruvian Amazon basin.</article-title>
<source>PLoS Negl Trop Dis</source>. <year>2016</year>;<volume>10</volume>:<fpage>e0004843</fpage>. <pub-id pub-id-type="doi">10.1371/journal.pntd.0004843</pub-id><pub-id pub-id-type="pmid">27416029</pub-id></mixed-citation></ref><ref id="R10"><label>10. </label><mixed-citation publication-type="journal"><string-name><surname>Jima</surname>
<given-names>DD</given-names></string-name>, <string-name><surname>Luce-Fedrow</surname>
<given-names>A</given-names></string-name>, <string-name><surname>Yang</surname>
<given-names>Y</given-names></string-name>, <string-name><surname>Maina</surname>
<given-names>AN</given-names></string-name>, <string-name><surname>Snesrud</surname>
<given-names>EC</given-names></string-name>, <string-name><surname>Otiang</surname>
<given-names>E</given-names></string-name>, <etal>et al.</etal>
<article-title>Whole-genome sequence of &#x0201c;<italic>Candidatus Rickettsia asemboensis</italic>&#x0201d; strain NMRCii, isolated from fleas of western Kenya.</article-title>
<source>Genome Announc</source>. <year>2015</year>;<volume>3</volume>:<fpage>e00018</fpage>&#x02013;<lpage>15</lpage>. <pub-id pub-id-type="doi">10.1128/genomeA.00018-15</pub-id><pub-id pub-id-type="pmid">25767219</pub-id></mixed-citation></ref></ref-list></back></article>