Neoehrlichia mikurensis in Danish immunocompromised patients: a retrospective cohort study
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Neoehrlichia mikurensis in Danish immunocompromised patients : a retrospective cohort study. / Gynthersen, Rosa Maja Møhring; Hansen, Mette Frimodt; Ocias, Lukas Frans; Kjaer, Andreas; Petersen, Randi Føns; Ostrowski, Sisse Rye; Harritshøj, Lene; Jacobsen, Søren; Overgaard, Ulrik; Krogfelt, Karen Angeliki; Lebech, Anne Mette; Mens, Helene.
In: Annals of Clinical Microbiology and Antimicrobials, Vol. 22, No. 1, 20, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Neoehrlichia mikurensis in Danish immunocompromised patients
T2 - a retrospective cohort study
AU - Gynthersen, Rosa Maja Møhring
AU - Hansen, Mette Frimodt
AU - Ocias, Lukas Frans
AU - Kjaer, Andreas
AU - Petersen, Randi Føns
AU - Ostrowski, Sisse Rye
AU - Harritshøj, Lene
AU - Jacobsen, Søren
AU - Overgaard, Ulrik
AU - Krogfelt, Karen Angeliki
AU - Lebech, Anne Mette
AU - Mens, Helene
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023
Y1 - 2023
N2 - Background: The tick-borne bacterium, Neoehrlichia mikurensis (N. mikurensis) can cause severe febrile illness and thromboembolic complications in immunocompromised individuals. We investigated the presence of N. mikurensis DNA in retrospectively collected plasma from a well-characterized cohort of Danish immunocompromised patients. Methods: Plasma samples from 239 patients with immune dysfunction related to hematological or rheumatological disease or due to immunosuppressive therapy, were retrieved from a transdisciplinary biobank (PERSIMUNE) at Rigshospitalet, Copenhagen, Denmark. Serving as immunocompetent controls, plasma samples from 192 blood donors were included. All samples were collected between 2015 and 2019. Real-time PCR targeting the groEL gene was used to detect N. mikurensis DNA. Sequencing was used for confirmation. Borrelia burgdorferi sensu lato IgG antibodies were detected by ELISA as a proxy of tick exposure. Prevalence was compared using Fisher’s exact test. Results: Neoehrlichia mikurensis DNA was detected in 3/239 (1.3%, 95% confidence interval (CI): 0.3 – 3.6%) patients, all of whom primarily had a hematological disease. Follow-up samples of these patients were negative. N. mikurensis DNA was not detected in any of the blood donor samples. IgG antibodies against B. burgdorferi s.l. were detected with similar prevalence in immunocompromised patients and blood donors, i.e., 18/239 (7.5%, 95% CI: 4.8–11.5%) and 11/192 (5.7%, 95%: CI 3.2–10.0%). Conclusion: In this study, patients with N. mikurensis were not identified by clinical indication and N. mikurensis may therefore be underdiagnosed in Danish patients. Further investigations are needed to explore the clinical significance and implications of this infection.
AB - Background: The tick-borne bacterium, Neoehrlichia mikurensis (N. mikurensis) can cause severe febrile illness and thromboembolic complications in immunocompromised individuals. We investigated the presence of N. mikurensis DNA in retrospectively collected plasma from a well-characterized cohort of Danish immunocompromised patients. Methods: Plasma samples from 239 patients with immune dysfunction related to hematological or rheumatological disease or due to immunosuppressive therapy, were retrieved from a transdisciplinary biobank (PERSIMUNE) at Rigshospitalet, Copenhagen, Denmark. Serving as immunocompetent controls, plasma samples from 192 blood donors were included. All samples were collected between 2015 and 2019. Real-time PCR targeting the groEL gene was used to detect N. mikurensis DNA. Sequencing was used for confirmation. Borrelia burgdorferi sensu lato IgG antibodies were detected by ELISA as a proxy of tick exposure. Prevalence was compared using Fisher’s exact test. Results: Neoehrlichia mikurensis DNA was detected in 3/239 (1.3%, 95% confidence interval (CI): 0.3 – 3.6%) patients, all of whom primarily had a hematological disease. Follow-up samples of these patients were negative. N. mikurensis DNA was not detected in any of the blood donor samples. IgG antibodies against B. burgdorferi s.l. were detected with similar prevalence in immunocompromised patients and blood donors, i.e., 18/239 (7.5%, 95% CI: 4.8–11.5%) and 11/192 (5.7%, 95%: CI 3.2–10.0%). Conclusion: In this study, patients with N. mikurensis were not identified by clinical indication and N. mikurensis may therefore be underdiagnosed in Danish patients. Further investigations are needed to explore the clinical significance and implications of this infection.
KW - B-cell depleting therapy
KW - Biological treatment
KW - Immunocompromised patients
KW - Neoehrlichia mikurensis
KW - Neoehrlichiosis
KW - Tick-borne disease
U2 - 10.1186/s12941-023-00571-5
DO - 10.1186/s12941-023-00571-5
M3 - Journal article
C2 - 36941613
AN - SCOPUS:85150877105
VL - 22
JO - Annals of Clinical Microbiology and Antimicrobials
JF - Annals of Clinical Microbiology and Antimicrobials
SN - 1476-0711
IS - 1
M1 - 20
ER -
ID: 341878498