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

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Kingry, Luke C. ; Anacker, Melissa ; Pritt, Bobbi ; Bjork, Jenna ; Respicio-Kingry, Laurel ; Liu, Gongping ; Sheldon, Sarah ; Boxrud, David ; Strain, Anna ; Oatman, Stephanie ; Berry, Jon ; Sloan, Lynne ; Mead, Paul ; Neitzel, David ; Kugeler, Kiersten J. ; Petersen, Jeannine M.
• Description:
  Background
  
  Tick-transmitted Borrelia species fall into two 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 human 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 PCR. Borrelia species and sequence types (STs) were characterized by multi-locus sequence typing (MLST) utilizing next generation sequencing.
  
  Results
  
  Among the 7,292 tested specimens tested, five different Borrelia species were identified: two causing LB, B. burgdorferi (n=25) and B. mayonii (n=9), and three 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.
  
  Conclusion
  
  These results demonstrate broad PCR screening followed by MLST is a powerful surveillance tool for uncovering the spectrum of Borrelia species causing human disease, improving understanding of 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 with exposure to bat ticks.
  
  
• Subjects:
  Amplicon Sequencing Article Borrelia Lyme Disease Molecular Surveillance Relapsing Fever
• Source:
  Clin Infect Dis. 66(12):1864-1871
• Pubmed ID:
  29272385
• Pubmed Central ID:
  PMC5985202
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHS/United States
• Volume:
  66
• Issue:
  12
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e0633db97b1658aaa16983073109cd818301ed24a1b4ae65cea3eb7eea55e083
• Download URL:
  https://stacks.cdc.gov/view/cdc/55597/cdc_55597_DS1.pdf
• File Type:
  [PDF - 534.18 KB ]