Galaxy Radar – Week of July 22, 2024

North Carolina State University Research Continues to Raise Babesia Awareness

Human Babesia odocoilei and Bartonella spp. Co-infections in the Americas by RG Maggi, AC Calchi, CO Moore, E Kingston & EB Breitschwerdt publishing from North Carolina State University and São Paulo State University was published on July 11^th with Dr. Breitschwerdt, Galaxy Diagnostics Cofounder and Chief Medical Officer as corresponding author. This case study of seven patients with Babesia odocoilei infection identified through a variety of PCR enhancement techniques continues to raise awareness of stealth Babesia infection and the identification of B. odocoilei as a human pathogen.

Last week, NC State News published an interview with Dr. Breitschwerdt. Now, MSN and Medical Xpress have re-published this interview.

Sequencing Turns Around a Deadly Course, Twice

Case Report: Multiple Organ Failure Caused by Japanese Spotted Fever by P Zhou et al. publishing from Third Hospital of Changsha – Rickettsia japonica is a spotted fever Rickettsia found in Japan and the surrounding region. In this case, a man was very sick and being treated with multiple antibiotics for an unknown pathogen, but he was worsening into multi-organ failure. On day three of his illness, Rickettsia japonica was identified through next-generation sequencing. His antibiotic treatment was changed and he had recovered significantly by day five.

A Case of Scrub Typhus with Meningitis as the Onset: Case Report and Literature Review by B-C Zhang et al. publishing from People’s Hospital of Dali Bai Autonomous Prefecture, First Affiliated Hospital of Kunming Medical University and Third People’s Hospital of Kunming City, China – A patient with meningitis was not improving on antibiotic treatment. Multipathogen metagenomic testing found scrub typhus (Orientia tsutsugamushi), and the patient had significant improvement after two days of correct antibiotics.

Broad sequencing is a testing approach that is not widely available and most commonly applied only in extreme situations. The fact that sequencing had such a profound impact on these cases highlights the importance of direct detection methods and of targeting testing to its best application.

Clues to Identifying Hidden Intracellular Infections

Identification and Characterization of Extracellular Vesicles from Red Cells Infected with Babesia divergens and Babesia microti by D Beri et al. publishing from the New York Blood Center and Georgetown University – Babesia species can exist as a stealth infection inside red blood cells, creating potential risks in transplants and blood transfusions. Extracellular vesicles are used by the pathogen for extracellular signaling and may be a target for clinical testing.

Cell-Selective Proteomics Reveal Novel Effectors Secreted by an Obligate Intracellular Bacterial Pathogen by AG Sanderlin et al. publishing from Massachusetts Institute of Technology – As an obligate intracellular pathogen, Rickettsia species interact with cellular functions to survive. These interactions generate unique proteins that can be researched to understand the interactions and also serve as targets for clinical testing.

Find out more about the advanced technology that makes Galaxy Diagnostics a leader in direct detection of hard-to-detect pathogens.

Transplant Rickettsia parkeri Mystery

Rickettsia parkeri Rickettsiosis in Kidney Transplant Recipient, North Carolina, USA, 2023 by GM Phadke et al. publishing from Metrolina Nephrology Associates and Carolinas Medical Center, US CDC, Oak Ridge Institute for Science and Education and NC DHHS – In North Carolina, a patient received a kidney transplant, two units of blood and Rickettsia parkeri, a tick-borne pathogen. But where did the pathogen come from?

The kidney donor and both blood donors were seronegative and PCR-negative. Even the transplant recipient, on immunosuppressive medication, was seronegative and only confirmed infected after a skin rash indicated the infection, prompting clinicians to use PCR testing.

The kidney donor had experienced frequent tick bites, but had not been sick and, to repeat, tested both seronegative and PCR-negative. Ultimately, there is no definitive proof of where the pathogen came from.

Determining Zoonotic Risk

Description and Molecular Characterisation of Babesia ailuropodae n. sp., a New Piroplasmid Species Infecting Giant Pandas by L Xiong & G Yang publishing from Sichuan Agricultural University – A newly identified species of Babesia has been discovered in giant pandas. This genetic analysis of the species finds that it is a unique evolution, suggesting that it may only infect pandas and is not a risk to people or other animals.

The Polymicrobial Nature of the Oral Cavity and Claws of Cats Diagnosed by Mass Spectrometry and Next-Generation Sequencing by FVR Portilho et al. publishing from São Paulo State University and University of Western São Paulo – Researchers identified bacteria, including Bartonella, in the mouths and under the claws of 100 cats. They also identified the antibiotics most likely to treat the range of pathogens found, taking into account the antibiotic resistance found in many of the samples.

Insights from Mayaro Virus Tracking

Molecular Epidemiology of Mayaro Virus among Febrile Patients, Roraima State, Brazil, 2018-2021 by J Forato et al. publishing from São Paulo, Boa Vista, & Manaus, Brazil; London; Lexington, KY; Baltimore, MD; and Galveston, TX – Mayaro virus was found in 3.4% of patients with fever in this study. There is a theory that the virus could develop a human-amplified outbreak in an urban area, but this study did not collect enough information to establish that. Although the mosquito-borne virus has been identified since the 1950s, little is known about it.

Scientists Surprised by Virus Discovery in Brazil’s Amazon by S McDonagh in Newsweek – In the course of performing the study above, researchers had thought that Mayaro virus and chikungunya may lead to antibodies that cross-react, reducing the odds of concurrent outbreaks. However, a concurrent outbreak of mosquito-borne Mayaro virus, chikungunya and dengue that occurred during the study period has required a deeper analysis.

Emerging vector-borne pathogens are often neglected, leading to a lack of understanding of their health impacts. Until research and/or clinical testing becomes widespread, the true impact of these pathogens is not known. Additionally, these pathogens are often competing in the same ecological niche. This leads to interactions in the environment and the possibility of co-infections in patients that are under-researched. In this case, the concurrent outbreak seemed unlikely based on what little was known about antibodies in recovered patients.

Preferred Organ of Rickettsia heilongjiangensis

Stomach as the Target Organ of Rickettsia heilongjiangensis Infection in C57BL/6 Mice Identified by Click Chemistry by J Wang et al. publishing from China – R. heilongjiangensis has been associated with gastrointestinal symptoms. In this study, researchers looked at genetic reasons why the pathogen may prefer gastrointestinal tissue. They also reviewed other spotted fever group Rickettsia species with similar genetics. They used a mouse model to confirm the presence of the pathogen in stomach tissue. Preferential tissue for infection affects strategies for clinical testing and for treatment. This is an emerging area of research across tick-borne pathogens.

Homelessness, Body Lice, and Bartonella Quintana

Body Louse Pathogen Surveillance among Persons Experiencing Homelessness, Canada, 2020-2021 by C Boodman et al. publishing from the Institute of Tropical Medicine, University of Manitoba and the Public Health Agency of Canada – In a study of body lice from seven people experiencing homelessness in Canada, one person had lice that tested positive for Bartonella quintana. This does not necessarily mean only one infected person, as the lice and possibly lice feces can transmit infection in crowded underhousing conditions.

SFTSV Seroprevalence

Seroprevalence Study in Humans and Molecular Detection in Rhipicephalus sanguineus Ticks of Severe Fever with Thrombocytopenia Syndrome Virus in Thailand by PMS Villarroel et al. publishing from Thailand and France – SFTSV is carried by ticks and associated with the Asian longhorned tick in particular. It has a fatality rate of up to 30% in humans and also causes disease in animals. One concern about the expansion of this tick’s range into North America was that it would bring this virus. So far, the virus has not been found in North America but it is being found in Southeast Asia. This Thai study reports on seroprevalence in people in Thailand and molecular detection in ticks and also reviews seroprevalence across the region.

In completing this review, the researchers noted a discrepancy in seroprevalence versus how many positive ticks they were finding. Is it possible that the serology test used cross-reacts, indicating prior infection with a different pathogen? This One Health research that brings together research in humans and research on the entire ecology of the pathogen was able to surface a question that could have a profound impact on patient care.

Galaxy Diagnostics Calendar

The Alzheimer’s Pathobiome Initiative Symposium on July 27, 2024 – Edward Breitschwerdt, DVM, DACVIM (SAIM), is presenting with Janice Bush, CVM, on “Bartonella henselae, Neurobartonellosis and Alzheimer’s Disease: Is there a link?”

Project Lyme Gala on September 24, 2024 – Meet Galaxy Diagnostics CEO Nicole Bell and Cofounder Amanda Elam at the event.

ILADS Annual Scientific Conference, November 7-10, 2024 – Galaxy Diagnostics speakers will include CEO Nicole Bell. Find us in the exhibitor hall.