Isolation of Coxiella burnetii and of an unknown rickettsial organism from Ixodes ricinus ticks collected in Austria

Coxiella burnetii in ticks, livestock, pets and wildlife: A mini-review

Coxiella burnetii is a zoonotic bacterium with an obligatory intracellular lifestyle and has a worldwide distribution. Coxiella burnetii is the causative agent of Q fever in humans and coxiellosis in animals. Since its discovery in 1935, it has been shown to infect a wide range of animal species including mammals, birds, reptiles, and arthropods. Coxiella burnetii infection is of public and veterinary health and economic concern due to its potential for rapid spread and highly infectious nature. Livestock are the primary source of C. burnetii infection in most Q fever outbreaks which occurs mainly through inhalation of contaminated particles. Aside from livestock, many cases of Q fever linked to exposure to wildlife. Changes in the dynamics of human-wildlife interactions may lead to an increased potential risk of interspecies transmission and contribute to the emergence/re-emergence of Q fever. Although C. burnetii transmission is mainly airborne, ticks may act as vectors and play an important role in the natural cycle of transmission of coxiellosis among wild vertebrates and livestock. In this review, we aim to compile available information on vectors, domestic, and wild hosts of C. burnetii, and to highlight their potential role as bacterial reservoirs in the transmission of C. burnetii.

The Prevalence of Coxiella burnetii in Hard Ticks in Europe and Their Role in Q Fever Transmission Revisited-A Systematic Review

The zoonosis Q fever is caused by the obligate intracellular bacterium Coxiella burnetii. Besides the main transmission route via inhalation of contaminated aerosols, ticks are discussed as vectors since the first isolation of the pathogen from a Dermacentor andersonii tick. The rare detection of C. burnetii in ticks and the difficult differentiation of C. burnetii from Coxiella-like endosymbionts (CLEs) are questioning the relevance of ticks in the epidemiology of Q fever. In this review, literature databases were systematically searched for recent prevalence studies concerning C. burnetii in ticks in Europe and experimental studies evaluating the vector competence of tick species. A total of 72 prevalence studies were included and evaluated regarding DNA detection methods and collection methods, country, and tested tick species. Specimens of more than 25 different tick species were collected in 23 European countries. Overall, an average prevalence of 4.8% was determined. However, in half of the studies, no Coxiella-DNA was detected. In Southern European countries, a significantly higher prevalence was observed, possibly related to the abundance of different tick species here, namely Hyalomma spp. and Rhipicephalus spp. In comparison, a similar proportion of studies used ticks sampled by flagging and dragging or tick collection from animals, under 30% of the total tick samples derived from the latter. There was no significant difference in the various target genes used for the molecular test. In most of the studies, no distinction was made between C. burnetii and CLEs. The application of specific detection methods and the confirmation of positive results are crucial to determine the role of ticks in Q fever transmission. Only two studies were available, which assessed the vector competence of ticks for C. burnetii in the last 20 years, demonstrating the need for further research.

Coxiella burnetii in ticks and wild birds

The study objective was to get more information on C. burnetii prevalence in wild birds and ticks feeding on them, and the potentialities of the pathogen dissemination over Europe by both.

MATERIALS

Blood, blood sera, feces of wild birds and ticks removed from those birds or from vegetation were studied at two sites in Russia: the Curonian Spit (site KK), and the vicinity of St. Petersburg (site SPb), and at two sites in Bulgaria: the Atanasovsko Lake (site AL), and the vicinity of Sofia (site SR).

METHODS

C. burnetii DNA was detected in blood, feces, and ticks by PCR (polymerase chain reaction). All positive results were confirmed by Sanger's sequencing of 16SrRNA gene target fragments. The antibodies to C. burnetii in sera were detected by CFR (complement fixation reaction).

RESULTS

Eleven of 55 bird species captured at KK site hosted Ixodes ricinus. C. burnetii DNA was detected in three I. ricinus nymphs removed from one bird (Erithacus rubecula), and in adult ticks flagged from vegetation: 0.7% I. persulcatus (site SPb), 0.9% I. ricinus (site KK), 1.0% D. reticulatus (AL site). C. burnetii DNA was also detected in 1.4% of bird blood samples at SPb site, and in 0.5% of those at AL site. Antibodies to C. burnetii were found in 8.1% of bird sera (site SPb). C. burnetii DNA was revealed in feces of birds: 0.6% at AL site, and 13.7% at SR site.

CONCLUSIONS

Both molecular-genetic and immunological methods were applied to confirm the role of birds as a natural reservoir of C. burnetii. The places of wild bird stopover in Russia (Baltic region) and in Bulgaria (Atanasovsko Lake and Sofia region) proved to be natural foci of C. burnetii infection. Migratory birds are likely to act as efficient "vehicles" in dispersal of C. burnetii -infested ixodid ticks.

NECESSITY TO IMPROVE THE EMERGENCY DIAGNOSTICS OF TICK-BORNE INFECTIONS IN PEOPLE BITTEN BY IXODID TICKS ABROAD OF THE RUSSIAN FEDERATION

Introduction. Annually, there are several patients attended the Center for Diagnosis and Prevention of Tick-borne Infections in  Irkutsk after bites of ticks that happened outside the Pribaikalye  region or abroad. In such cases, the attacking ticks do not belong to  convenient species that are usual for Eastern Siberia. Consequently,  the spectrum of pathogenic microorganisms transmitted by these  ticks may significantly differ from those that are detected by usual  laboratory tests. Thus, both physicians and laboratory personnel may  have difficulties in proper detection and identification of pathogens as well as in diagnosing and treating of such patients.

The purpose of the study was the analysis of potential risks of human infection with the pathogens that are common in foreign countries outside the Russian Federation.

Material and methods. The article uses information from electronic databases created by the authors during 2007-2017.

Results and discussion. During 11 years of observations, 52 tick bites were registered in 20 countries, with 48 of them in the Eastern  Hemisphere (92.3 %), three (5.8 %) in the United States and one  (1.9 %) in the Republic of Cuba. The results indicate a real danger of infection by tick-borne pathogens of people traveling as the tourists  and with business purposes to the countries of Europe, Asia and America.

 

Conclusion. It is necessary to improve the existing algorithm for diagnosis, prevention and treatment for people bitten by ixodid ticks  outside the Russian Federation, taking into account the possibility of  infection by inconvenient imported infections.

Approaches for Reverse Line Blot-Based Detection of Microbial Pathogens in Ixodes ricinus Ticks Collected in Austria and Impact of the Chosen Method

Ticks transmit a large number of pathogens capable of causing human disease. In this study, the PCR-reverse line blot (RLB) method was used to screen for pathogens in a total of 554 Ixodes ricinus ticks collected from all provinces of Austria. These pathogens belong to the genera Borrelia, Rickettsiae, Anaplasma/Ehrlichia (including "Candidatus Neoehrlichia"), Babesia, and Coxiella The pathogens with the highest detected prevalence were spirochetes of the Borrelia burgdorferisensu lato complex, in 142 ticks (25.6%). Borrelia afzelii (80/142) was the most frequently detected species, followed by Borrelia burgdorferisensu stricto (38/142) and Borrelia valaisiana (36/142). Borrelia garinii/Borrelia bavariensis, Borrelia lusitaniae, and Borrelia spielmanii were found in 28 ticks, 5 ticks, and 1 tick, respectively. Rickettsia spp. were detected in 93 ticks (16.8%): R. helvetica (39/93), R. raoultii (38/93), R. monacensis (2/93), and R. slovaca (1/93). Thirteen Rickettsia samples remain uncharacterized. "Candidatus Neoehrlichia mikurensis," Babesia spp. (B. venatorum, B. divergens, B. microti), and Anaplasma phagocytophilum were found in 4.5%, 2.7%, and 0.7%, respectively. Coxiella burnetii was not detected. Multiple microorganisms were detected in 40 ticks (7.2%), and the cooccurrence of Babesia spp. and "Candidatus Neoehrlichia mikurensis" showed a significant positive correlation. We also compared different PCR-RLBs for detection of Borrelia burgdorferisensu lato and Rickettsia spp. and showed that different detection approaches provide highly diverse results, indicating that analysis of environmental samples remains challenging.IMPORTANCE This study determined the wide spectrum of tick-borne bacterial and protozoal pathogens that can be encountered in Austria. Surveillance of (putative) pathogenic microorganisms occurring in the environment is of medical importance, especially when those agents can be transmitted by ticks and cause disease. The observation of significant coinfections of certain microorganisms in field-collected ticks is an initial step to an improved understanding of microbial interactions in ticks. In addition, we show that variations in molecular detection methods, such as in primer pairs and target genes, can considerably influence the final results. For instance, detection of certain genospecies of borreliae may be better or worse by one method or the other, a fact of great importance for future screening studies.

[Pandora's Box: pathogens in Ixodes ricinus ticks in Central Europe]

Among the various species of hard ticks, Ixodes ricinus is the most frequently found tick throughout Europe. As with other ixodid ticks, the developmental cycle runs through three stages. In each stage a blood meal is required in order to develop to the next stage. Ixodes ricinus has been found to feed on more than 300 different vertebrate species. Usually, larval ticks feed on small mammals such as mice and become infected with various microorganisms and viruses, of which some are substantial pathogens to humans. The pathogens remain in the tick during molting and are thus transstadially transmitted to the next developmental stage. Pathogens transmitted to humans are the agents of Lyme borreliosis, the tick-borne encephalitis virus, Rickettsia species, Anaplasma phagocytophilum, occasionally Francisella tularensis, and protozoal Babesia species. Within the scope of an EU project Ixodes ricinus ticks from all federal states of Austria were searched by means of PCR methods for bacterial pathogens such as Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Coxiella burnetii, Ehrlichia spp., Francisella tularensis, Rickettsia spp., and protozoal Babesia. Additionally, the prevalence of Bartonella spp. in this tick species was also determined. Besides the singular detection of Coxiella burnetii and Francisella tularensis in one tick collection site the overall prevalence of Anaplasma phagocytophilum, borreliae, rickettsae and babesiae in Ixodes ricinus amounted to 15%, 14%, 6% and surprising 36% and 51%, respectively. Bartonellae were detected in about 7%.

Prevalence of tick-borne zoonotic bacteria in questing adult ticks from northern Spain

A total of 691 questing adult ixodid ticks of the genera Ixodes, Haemaphysalis, Dermacentor, and Rhipicephalus were tested by polymerase chain reaction (PCR) and reverse line blot (RLB) for the presence of Anaplasma phagocytophilum, Coxiella burnetii, Borrelia spp., and spotted fever group (SFG) rickettsiae. Ticks were collected by blanket dragging during 2 sampling years (2003-2005) in 10 recreational areas in the Basque Country (Northern Spain). Adult ticks were collected every month of the year and eight different species were identified among which Ixodes ricinus was the most abundant and widespread. Three pathogens for humans, Borrelia burgdorferi, A. phagocytophilum, and C. burnetii, as well as rickettsiae of unknown pathogenicity were detected. The latter were identified as Rickettsia sp. RpA4/DnS14 by sequencing of the citrate synthase (gltA) gene. The infection rates varied from 0.1%-6.9%. DNA of A. phagocytophilum was detected mainly in I. ricinus, but also in Haemaphysalis punctata, H. concinna, and Rhipicephalus bursa. Coxiella burnetii was detected in only one specimen of H. punctata, and Borrelia spp. in eight ticks. Furthermore, PCR-RLB analysis specific for B. burgdorferi sensu lato detected one H. punctata with positive hybridization with the B. burgdorferi sensu stricto probe, and two I. ricinus positive for B. afzelii and B. garinii. SFG rickettsiae were the pathogens most frequently found, present in 48 of 97 D. reticulatus analyzed. Mixed infections were not found in any of the analyzed ticks. These results are compared and discussed with data obtained in previous studies carried out in the same and other regions.

Concomitant or consecutive infection with Coxiella burnetii and tickborne diseases

BACKGROUND

Q fever is a worldwide zoonosis caused by Coxiella burnetii, which can be isolated from ticks. Reports of people with both Q fever and other tickborne diseases are rare. In this study, we describe 6 patients with Q fever who were infected with 1 of the following tickborne pathogens: Rickettsia conorii (2 patients), Rickettsia slovaca (2), Rickettsia africae (1), and Francisella tularensis (1).

METHODS

Diagnoses were made on the basis of results of microimmunofluorescence assays for detection of C. burnetii, R. conorii, R. slovaca, R. africae, and F. tularensis antigens. Cross-adsorption studies and Western blots were used to confirm dual infections.

RESULTS

Among the 6 cases presented, 3 were probably due to a concomitant infection after a tick bite, whereas the remaining 3 were more likely consecutive infections.

CONCLUSIONS

Because acute Q fever is often asymptomatic, we recommend that patients infected with the tickborne pathogens mentioned above also undergo routine testing for concurrent infections with C. burnetii.

Cat or dog ownership and seroprevalence of ehrlichiosis, Q fever, and cat-scratch disease

Concerns have been raised about the role of domestic cats or dogs in the acquisition of zoonoses, in particular in pregnant women or immune-suppressed persons. We report that cat or dog ownership is not associated with an increased seroprevalence of antibodies to Anaplasma phagozytophilum, Coxiella burnetii, and Bartonella henselae in symptom-free persons in Styria, Austria.

Characterization of a new spotted fever group rickettsia detected in Ixodes ricinus (Acari: Ixodidae) collected in Slovakia

Two previously undescribed rickettsiae were detected in Ixodes ricinus Ricketts by polymerase chain reaction. Ixodes ricinus Slovakia (IRS) 3 and IRS4 were identified in ticks collected in northeastern and southwestern Slovakia, respectively. Sequences of the 16S rRNA citrate synthase (gltA) and outer membrane protein rOmpA (ompA) encoding genes of both strains were nearly identical but were distinct from those of all other known rickettsiae. Phylogenetic relationships inferred from the comparison of these sequences with those of other members of the genus Rickettsia indicate that IRS3 and IRS4 constitute a new rickettsial genotype and form a separate cluster among the spotted fever group rickettsiae.

Detection of Coxiella burnetii in cow's milk by PCR-enzyme-linked immunosorbent assay combined with a novel sample preparation method

The use of an adequate concentration of Triton X-100 enhanced immunomagnetic separation of Coxiella burnetii from milk. PCR-enzyme-linked immunosorbent assay (PCR-ELISA) could detect coxiellas more sensitively than could conventional PCR. PCR-ELISA is therefore thought to be suitable for the simultaneous assay of a large number of samples. However, the number of cows from which raw milk tested positive for coxiellas by PCR-ELISA was inconsistent with that found with the antibody to coxiella by indirect immunofluorescence assay. The inconsistency is thought to be associated with the differences in the infectious route, infectious dose, or the timing of yielding the antibody and the period of duration of the antibody.