Turabi GÜNEŞ, Ömer POYRAZ, Nergiz Hacer TURGUT, Mehmet ATAŞ

The seroprevalence of Anaplasma phagocytophilum in humans from two different climatic regions of Turkey and its co-seroprevalence rate with Borrelia burgdorferi

Amaç: Bu çalışmanın amacı, iki farklı iklimsel bölgede yaşayan insanlarda Anaplasma phagocytophilum seroprevalansını araştırmak ve A. phagocytophilum’un Borrelia burgdorferi ile ko-seroprevalans oranını ortaya koymaktır. Türkiye’nin Orta Karadeniz bölgesinde yer alan Sinop ve Tokat, farklı iklimsel özelliklere sahip yörelerdir. Yöntem ve gereç: 2006-2007 yıllarında, Sinop ve Tokat’ın kırsal kesimde yaşayan insanlardan serum örnekleri elde edilmiş ve IFA yöntemiyle anti-A. phagocytophilum IgG antikorları araştırılmıştır. Pozitif örnekler, B. burgdorferi IgG antikorları yönünden tekrar incelemeye alınmıştır. Bulgular: Sinop’ta 273 serum örneğinin 29’unda (% 10,62), Tokat’ta ise 364 serum örneğinin 21’inde (% 5,77) A. phagocytophilum seropozitifliği saptanmıştır (P = 0,035). A. phagocytophilum ve B. burgdorferi ko-seroprevalansının, Sinop’ta % 3,30 ve Tokat’ta % 0,55 olduğu saptanmıştır (P = 0,012). Sonuç: Çalışma, Türkiye’nin farklı iklim bölgelerinde A. phagocytophilum enfeksiyonlarının görülebileceğini ortaya koymaktadır. I. ricinus keneleri için daha uygun yaşam alanları olan yerlerde, hem A. pahgocytophilum seroprevelansı, hem de B. burgdorferi ve A. pahgocytophilum kaynaklı miks-enfeksiyon olasılığı daha yüksektir.

Türkiye’nin iki farklı iklim bölgesinde yaşayan insanlarda Anaplasma phagocytophilum seroprevalansı ve Borrelia burgdorferi ile ko-seroprevalans oranı

Aim: To investigate the seroprevalence of Anaplasma phagocytophilum in people living in 2 different climatic regions and to evaluate the co-seroprevalence rate of A. phagocytophilum with Borrelia burgdorferi. Sinop and Tokat provinces, both in the middle Black Sea region of Turkey, have distinct climatic features. Materials and methods: In 2006-2007, serum samples were collected from people living in rural areas of Tokat and Sivas, and anti-A. phagocytophilum IgG antibodies were explored by the IFA method. Positive samples were further investigated for the possible presence of B. burgdorferi IgG antibodies. Results: A. phagocytophilum seropositivity was found in 29 (10.62%) out of 273 serum samples in Sinop and 21 (5.77%) out of 364 serum samples in Tokat (P = 0.035). Co-seroprevalence for A. phagocytophilum and B. burgdorferi was found to be 3.30% in Sinop and 0.55% in Tokat (P = 0.012). Conclusion: Th e current study suggests that A. phagocytophilum infections can be seen in humans from different climatic regions of Turkey. Both the seroprevalence of A. phagocytophilum and the possibility of mixed infections of A. phagocytophilum and B. burgdorferi are higher in places with more suitable habitats for Ixodes ricinus ticks.

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1. Dumler JS, Madigan JE, Pusterla N, Bakken JS. Ehrlichioses in humans: epidemiology, clinical presentation, diagnosis, and treatment. Clin Infect Dis 2007; 45: 45-51.
2. Blanco JR, Oteo JA. Human granulocytic ehrlichiosis in Europe. Clin Microbiol Infect 2002; 8: 763-72.
3. Bratton RL, Corey GR. Tick-borne disease. Am Fam Physician 2005; 71: 2323-30.
4. Pantanowitz L, Telford SR, Cannon ME. Tick-borne diseases in transfusion medicine. Transfus Med 2002; 12: 85-106.
5. Derdakova M, Halanova M, Stanko M, Stefancikova A, Cislakova L, Petko B. Molecular evidence for Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato in Ixodes ricinus ticks from eastern Slovakia. Ann Agric Environ Med 2003; 10: 269-71.
6. Morozova OV, Dobrotvorsky AK, Livanova NN, Tkachev SE, Bakhvalova VN, Beklemishev AB et al. PCR detection of Borrelia burgdorferi sensu lato, tick-borne encephalitis virus, and the human granulocytic ehrlichiosis agent in Ixodes persulcatus ticks from Western Siberia, Russia. J Clin Microbiol 2002; 40: 3802-4.
7. Skotarczak B, Rymaszewska A, Wodecka B, Sawczuk M. Molecular evidence of coinfection of Borrelia burgdorferi sensu lato, human granulocytic ehrlichiosis agent, and Babesia microti in ticks from northwestern Poland. J Parasitol 2003; 89: 194-6.
8. Magnarelli LA, Bushmich SL, IJdo JW, Fikrig E. Seroprevalence of antibodies against Borrelia burgdorferi and Anaplasma phagocytophilum in cats. Am J Vet Res 2005; 66: 1895-9.
9. Fingerle V, Goodman JL, Johnson RC, Kurtti TJ, Munderloh UG, Wilske B. Human granulocytic ehrlichiosis in southern Germany: increased seroprevalence in high-risk groups. J Clin Microbiol 1997; 35: 3244-7.
10. Skarphedinsson S, Sogaard P, Pedersen C. Seroprevalence of human granulocytic ehrlichiosis in high-risk groups in Denmark. Scand J Infect Dis 2001; 33: 206-10.
11. Santino I, Cammarata E, Franco S, Galdiero F, Oliva B, Sessa R et al. Multicentric study of seroprevalence of Borrelia burgdorferi and Anaplasma phagocytophila in high-risk groups in regions of central and southern Italy. Int J Immunopathol Pharmacol 2004; 17: 219-23.
12. Walls JJ, Aguero-Rosenfeld M, Bakken JS, Goodman JL, Hossain D, Johnson RC et al. Inter- and intralaboratory comparison of Ehrlichia equi and human granulocytic ehrlichiosis (HGE) agent strains for serodiagnosis of HGE by the immunofl uorescentantibody test. J Clin Microbiol 1999; 37: 2968-73.
13. Aydin L, Bakirci S. Geographical distribution of ticks in Turkey. Parasitol Res 2007; 101: 63-166.
14. Güneş T, Kaya S, Poyraz O, Engin A. The prevalence of Borrelia burgdorferi sensu lato in Ixodes ricinus ticks in the Sinop Region of Turkey. Turk J Vet Anim Sci 2007; 31: 153-58.
15. Tonbak S, Aktas M, Altay K, Azkur AK, Kalkan A, Bolat Y et al. Crimean-Congo hemorrhagic fever virus: genetic analysis and tick survey in Turkey. J Clin Microbiol 2006; 44: 4120-4.
16. Thomas DR, Sillis M, Coleman TJ, Kench SM, Ogden NH, Salmon RL et al. Low rates of ehrlichiosis and Lyme borreliosis in English farmworkers. Epidemiol Infect 1998; 121: 609-14.
17. Cizman M, Avsic-Zupanc T, Petrovec M, Ruzic-Sabljic E, Pokorn M. Seroprevalence of ehrlichiosis, Lyme borreliosis and tickborne encephalitis infections in children and young adults in Slovenia. Wien Klin Wochenschr 2000; 112: 842-5.
18. Ongut G, Ogunc D, Mutlu G, Colak D, Gultekin M, Gunseren F et al. Seroprevalence of antibodies to Anaplasma phagocytophilum in Antalya, Turkey. Infection 2006; 34: 107-9.
19. Güneş T, Poyraz O, Kaya S, Gençer L, Alim A. Investigation of vectors for Borrelia burgdorferi and Lyme seropositivity in Sivas region. Mikrobiyol Bul 2005; 39: 503-8.
20. Kılıç H, Gürcan Ş, Kunduracılar H, Eskiocak M. Kene ısırığı öyküsü olan kişilerde anaplazmoz seropozitifliği. Trakya Üniversitesi Tıp Fakültesi Dergisi 2010; 27: 79-82.
21. Amusategui I, Sainz A, Tesouro MA. Serological evaluation of Anaplasma phagocytophilum infection in livestock in northwestern Spain. Ann N Y Acad Sci 2006; 1078: 487-90.
22. Passamonti F, Veronesi F, Cappelli K, Capomaccio S, Coppola G, Marenzoni ML et al. Anaplasma phagocytophilum in horses and ticks: a preliminary survey of Central Italy. Comp Immunol Microbiol Infect Dis 2010; 33: 73-83.
23. Gokce HI, Genc O, Akca A, Vatansever Z, Unver A, Erdogan HM. Molecular and serological evidence of Anaplasma phagocytophilum infection of farm animals in the Black Sea Region of Turkey. Acta Vet Hung 2008; 56: 281-92.
24. Ünver A, Şahın M, Erdoğan HM, Çelebi Ö. Koyunlarda Anaplasma phagocytophilu’a karşı antikorların western blot yöntemi ile araştırılması. Kafk as Üniv Vet Vak Derg 2005; 11: 99-102.
25. Stanczak J, Gabre RM, Kruminis-Łozowska W, Racewicz M, Kubica-Biernat B. Ixodes ricinus as a vector of Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum and Babesia microti in urban and suburban forests. Ann Agric Environ Med 2004; 11: 109-14.
26. Aktas M, Vatansever Z, Altay K, Aydin MF, Dumanli N. Molecular evidence for Anaplasma phagocytophilum in Ixodes ricinus from Turkey. Trans R Soc Trop Med Hyg 2010; 104: 10-5.