Epidemiological,clinical and genetic characterization of scrub typhus in patients presenting with acute febrile illness in New Delhi |
| |
| Affiliation: | 1. Max Hospital, New Delhi, India;2. PGIMER, Chandigarh, India;1. Institute of Hygiene, Medical Microbiology and Public Health, Medical University of Innsbruck, Austria;2. Mycology Reference Lab, Spain;3. Department of Microbiology, Institute of Human Behaviour and Allied Sciences, Delhi, India;4. Postgraduate Institute of Medical Education and Research, Chandigarh, India;1. Department of Clinical Microbiology, CMC Vellore, Tamil Nadu, India;2. Department of Infectious Diseases, CMC Vellore, Tamil Nadu, India;1. Department of Community Medicine, Maulana Azad Medical College, New Delhi, India;2. Department of Clinical Virology, Institute of Liver and Biliary Sciences, New Delhi, India;3. Indian Institute of Public Health – Delhi, Public Health Foundation of India, New Delhi, India;4. Directorate General Health Services, Government of NCT, New Delhi, India;1. Department of Experimental Animal Facility, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, 282004, India;2. Clinical Division, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, 282004, India;3. Department of Biochemistry, National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, 282004, India;4. National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Agra, Uttar Pradesh, 282004, India |
| |
| Abstract: | PurposeScrub typhus (ST) is a zoonotic disease, caused by O. tsutsugamushi is a major cause of acute febrile illness (AFI) in India. There is a need to study the prevalence and risk factors in various regions of India.MethodsA study to estimate the prevalence and study the risk factors of ST in patients presenting with acute febrile illness (AFI) was performed. All patients underwent serology for IgM antibodies to Orientia tsutsugamushi (In Bios International Inc, Seattle, WA) as per the manufacturers’ protocol. Following this, Polymerase Chain reaction (PCR) (real time SYBR green based targeting groEL gene and conventional PCR targeting 56 ?kDa type specific antigen gene) was performed from stored serum samples.ResultsDuring the study period, 473 patients were admitted. Of these 56 (11.8%) patients were ST positive by IgM serology. The conventional PCR targeting 56 ?kDa type specific antigen gene of O. tsutsugamushi was positive in six patients while Ot groEL SYBR green based PCR) was positive in five. PCR was positive in patients who had demonstrated a higher OD value in ELISA. Conventional PCR positive amplicons were sent for Sanger sequencing and confirmed to be O. tsutsugamushi. The mean age of the patients was 49 ?± ?18.3 years and males constituted a higher number of patients (67.9%, n ?= ?38). The pathognomonic eschar was present in 7 (12.5%) patients. Phylogenetic analysis revealed that sequences clustered close to Kato-like Hualein-20 strain and Karp-like Linh DT strains. All patients were administered doxycycline in our study. Mortality was recorded in 8.9% of the patients.ConclusionsIn patients presenting with acute febrile illness, ST should be considered as a differential diagnosis, especially in post-monsoon season. Along with serology, serum can also be used as sample for PCR in an intracellular bacterium like O. tsutsugamushi. |
| |
| Keywords: | Scrub typhus Kato-like Karp-like |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
