Features of human monocytic ehrlichiosis laboratory diagnostics
- Authors: Teterin V.Y.1, Korenberg E.I.2, Nefedova V.V.2, Vorobyova N.N.1, Sumlivaya O.N.1, Okishev M.A.1, Semerikov V.V.3
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Affiliations:
- E.A. Vagner Perm State Medical University
- N.F. Gamaleya National Research Center for Epidemiology and Microbiology
- Perm Regional Clinical Hospital of Infectious Diseases
- Issue: Vol 39, No 3 (2022)
- Pages: 73-82
- Section: Methods of diagnosis and technologies
- URL: https://ogarev-online.ru/PMJ/article/view/109367
- DOI: https://doi.org/10.17816/pmj39373-82
- ID: 109367
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Abstract
Objective. Using the data obtained in Perm Region as an example, to identify the effectiveness of polymerase chain reaction (PCR) for the diagnosis of Human Monocytic Ehrlichiosis (HME) at different periods from the onset of the disease, and to determine the role of HME in the structure of infections transmitted by ixodic ticks using PCR and enzyme-linked immunosorbent assay (ELISA)
Materials and methods. A thorough clinical and epidemiological examination of 583 patients with acute febrile diseases developed after the suction of ticks was carried out. To detect E. muris DNA, 1586 whole blood samples were examined by PCR at different periods from the onset of the disease. For the purpose of serological verification of HME, all patients were examined with ELISA for the presence of immunoglobulins M and G against E. chaffeensis.
Results. In total, using the PCR method, ehrlichial DNA was detected in 76 (4.8 %) blood samples from 53 patients. Based on two research methods (ELISA and PCR) HME was diagnosed in 58 (9.9 %) persons, while in 50 (86.2 %) of them, the diagnosis was confirmed only by PCR. The timing of E. muris genomic material detection in the blood of patients varied from 1 to 58 days from the moment of the disease. The greatest effectiveness of PCR (up to 69.4 % of positive samples) was noted by us from the 1st to the 7th day of illness. HME was found in the form of monoinfection – in 9 (15.5 %), mixed infection – in 49 (84.5 %) persons. The following was revealed: HME+Ixodid tick-borne borreliosis (ITBB) in 35 (60.3 %), HME+ITBB+Human granulocytic anaplasmosis (HGA) – in 6 (10.3 %), HME+ITBB+HGA+Tick-borne encephalitis (TBE) – in 4 (6.9 %), HME+TBE – in 2 (3.5 %), HME+TBE+ITBB – in 2 (3.5 %).
Conclusions. In the diagnosis of HME, PCR significantly increased the number (up to 86.2 %) of confirmed cases, and most often in the acute period of the disease (up to 69.4 ± 15.3 % of positive samples in the first week of the disease). For laboratory verification of HME, it is advisable to combine ELISA with the PCR method, especially in case of negative results of serological studies.
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##article.viewOnOriginalSite##About the authors
V. Yu. Teterin
E.A. Vagner Perm State Medical University
Author for correspondence.
Email: infect-perm@mail.ru
Candidate of Medical Sciences, Assistant, Department of Infectious Diseases
Russian Federation, PermE. I. Korenberg
N.F. Gamaleya National Research Center for Epidemiology and Microbiology
Email: infect-perm@mail.ru
Honoured Worker of Science of RF, Academician of RANS, Doctor of Biological Sciences, Professor, Head of Department of Natural Focal Infections
Russian Federation, MoscowV. V. Nefedova
N.F. Gamaleya National Research Center for Epidemiology and Microbiology
Email: infect-perm@mail.ru
Candidate of Biological Sciences, senior researcher of Laboratory of Infection Carriers
Russian Federation, MoscowN. N. Vorobyova
E.A. Vagner Perm State Medical University
Email: infect-perm@mail.ru
MD, PhD, Professor, Head of Department of Infectious Diseases
Russian Federation, PermO. N. Sumlivaya
E.A. Vagner Perm State Medical University
Email: infect-perm@mail.ru
MD, PhD, Professor, Department of Infectious Diseases
Russian Federation, PermM. A. Okishev
E.A. Vagner Perm State Medical University
Email: infect-perm@mail.ru
Candidate of Medical Sciences, Associate Professor, Department of Infectious Diseases
Russian Federation, PermV. V. Semerikov
Perm Regional Clinical Hospital of Infectious Diseases
Email: infect-perm@mail.ru
MD, PhD, Head of Epidemiological Department
Russian Federation, PermReferences
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