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Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam.
PLoS Negl Trop Dis. 2017 02; 11(2):e0005397.PN

Abstract

BACKGROUND

Scrub typhus is a rickettsiosis which is caused by Orientia tsutsugamushi and occurs throughout the Asia-Pacific region. Molecular diagnosis of rickettsioses using eschar swabs has recently emerged, and may be very useful for the diagnosis of these diseases in tropical settings.

METHODOLOGY/PRINCIPAL FINDINGS

Quantitative polymerase chain reaction (qPCR) was used to detect O. tsutsugamushi DNA in whole blood and eschar swab specimens of 67 patients who were clinically suspected of scrub typhus in Quang Nam province, Vietnam. Among the 20 patients for whom both eschar and whole blood were obtained, 17 (85%) of the eschar specimens and 5 (25%) of the whole blood specimens tested positive for O. tsutsugamushi. Genetic analysis of the 56-kDa TSA gene sequences demonstrated that the 14 sequences obtained in this study, including 12 eschar swabs and 2 whole blood specimens, were related to 4 groups: Karp, Kawasaki, Gilliam (JG-v and TG-v) and TA716. The majority (9/14; 64.4%) of contemporary O. tsutsugamushi genotypes in Quang Nam province were related to the Karp group.

CONCLUSIONS

These results suggest that polyclonal antigen pools used for serological testing in the future should contain at least Karp, Kawasaki, Gilliam and TA716 antigens for Vietnamese patients, as well as patients who have traveled to Vietnam. qPCR after eschar swabbing should be considered for molecular diagnosis of scrub typhus in endemic patients as well as in travelers, since it is easy to perform and appears very useful for the rapid detection of Orientia tsutsugamushi in the early phase of infection.

Authors+Show Affiliations

URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France. Department of Tropical Diseases, Quang Nam Central General Hospital, Quang Nam, Vietnam.URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France.Department of Infectious Diseases, University of Medicine and Pharmacy of Ho Chi Minh City, Ho Chi Minh City, Vietnam.Department of Internal Medicine, Quang Nam Central General Hospital, Quang Nam, Vietnam.URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France.URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France.URMITE, Aix Marseille Université, UM63, CNRS 7278, IRD 198, INSERM 1095, IHU - Méditerranée Infection, Marseille, France.

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

28241043

Citation

Le Viet, Nhiem, et al. "Use of Eschar Swabbing for the Molecular Diagnosis and Genotyping of Orientia Tsutsugamushi Causing Scrub Typhus in Quang Nam Province, Vietnam." PLoS Neglected Tropical Diseases, vol. 11, no. 2, 2017, pp. e0005397.
Le Viet N, Laroche M, Thi Pham HL, et al. Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam. PLoS Negl Trop Dis. 2017;11(2):e0005397.
Le Viet, N., Laroche, M., Thi Pham, H. L., Viet, N. L., Mediannikov, O., Raoult, D., & Parola, P. (2017). Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam. PLoS Neglected Tropical Diseases, 11(2), e0005397. https://doi.org/10.1371/journal.pntd.0005397
Le Viet N, et al. Use of Eschar Swabbing for the Molecular Diagnosis and Genotyping of Orientia Tsutsugamushi Causing Scrub Typhus in Quang Nam Province, Vietnam. PLoS Negl Trop Dis. 2017;11(2):e0005397. PubMed PMID: 28241043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of eschar swabbing for the molecular diagnosis and genotyping of Orientia tsutsugamushi causing scrub typhus in Quang Nam province, Vietnam. AU - Le Viet,Nhiem, AU - Laroche,Maureen, AU - Thi Pham,Hoa L, AU - Viet,Nho L, AU - Mediannikov,Oleg, AU - Raoult,Didier, AU - Parola,Philippe, Y1 - 2017/02/27/ PY - 2016/07/19/received PY - 2017/02/07/accepted PY - 2017/03/09/revised PY - 2017/2/28/pubmed PY - 2017/6/24/medline PY - 2017/2/28/entrez SP - e0005397 EP - e0005397 JF - PLoS neglected tropical diseases JO - PLoS Negl Trop Dis VL - 11 IS - 2 N2 - BACKGROUND: Scrub typhus is a rickettsiosis which is caused by Orientia tsutsugamushi and occurs throughout the Asia-Pacific region. Molecular diagnosis of rickettsioses using eschar swabs has recently emerged, and may be very useful for the diagnosis of these diseases in tropical settings. METHODOLOGY/PRINCIPAL FINDINGS: Quantitative polymerase chain reaction (qPCR) was used to detect O. tsutsugamushi DNA in whole blood and eschar swab specimens of 67 patients who were clinically suspected of scrub typhus in Quang Nam province, Vietnam. Among the 20 patients for whom both eschar and whole blood were obtained, 17 (85%) of the eschar specimens and 5 (25%) of the whole blood specimens tested positive for O. tsutsugamushi. Genetic analysis of the 56-kDa TSA gene sequences demonstrated that the 14 sequences obtained in this study, including 12 eschar swabs and 2 whole blood specimens, were related to 4 groups: Karp, Kawasaki, Gilliam (JG-v and TG-v) and TA716. The majority (9/14; 64.4%) of contemporary O. tsutsugamushi genotypes in Quang Nam province were related to the Karp group. CONCLUSIONS: These results suggest that polyclonal antigen pools used for serological testing in the future should contain at least Karp, Kawasaki, Gilliam and TA716 antigens for Vietnamese patients, as well as patients who have traveled to Vietnam. qPCR after eschar swabbing should be considered for molecular diagnosis of scrub typhus in endemic patients as well as in travelers, since it is easy to perform and appears very useful for the rapid detection of Orientia tsutsugamushi in the early phase of infection. SN - 1935-2735 UR - https://www.unboundmedicine.com/medline/citation/28241043/Use_of_eschar_swabbing_for_the_molecular_diagnosis_and_genotyping_of_Orientia_tsutsugamushi_causing_scrub_typhus_in_Quang_Nam_province_Vietnam_ DB - PRIME DP - Unbound Medicine ER -