期刊
JOURNAL OF CLINICAL MICROBIOLOGY
卷 49, 期 9, 页码 3245-3249出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/JCM.00940-11
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资金
- Bill and Melinda Gates Foundation (National Institute of Medical Research)
- NIAID (HIV Prevention Trials Network-Laboratory Network) [U01 AI068613]
- Johns Hopkins Center for Global Health
- Johns Hopkins School of Medicine
- National Institute of Allergy and Infectious Diseases, National Institutes of Health [K23AIO83931]
Relapsing fever (RF) is caused by tick-and louse-borne Borrelia spp., is characterized by recurrent fever, and is often misdiagnosed as malaria. Because of submicroscopic bacteremia, microscopy can be insensitive between febrile bouts. We designed a multiplex quantitative PCR (qPCR) assay to distinguish RF Borrelia from Plasmodium falciparum and P. vivax. The assay specifically (100%) amplified pathogenic RF Borrelia (1 copy/reaction). We then tested blood from participants within a Tanzanian cohort assessed at scheduled intervals and with fever. Among 8,617 blood samples from 2,057 participants surveyed routinely, 7 (0.08%) samples and 7 (0.3%) participants had RF DNA (median, 4.4 x 10(3) copies/ml). Of 382 samples from 310 febrile persons, 15 (3.9%) samples from 13 (4.2%) participants had RF DNA (median, 7.9 x 10(2) copies/ml). Five (1.3%) samples from 4 (1.3%) participants were found to harbor Borrelia by microscopy. We conclude that multiplex qPCR holds promise for improved clinical diagnosis and epidemiologic assessment of RF.
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