Neoehrlichia mikurensis in Danish immunocompromised patients: a retrospective cohort study

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Background: The tick-borne bacterium, Neoehrlichia mikurensis (N. mikurensis) can cause severe febrile illness and thromboembolic complications in immunocompromised individuals. We investigated the presence of N. mikurensis DNA in retrospectively collected plasma from a well-characterized cohort of Danish immunocompromised patients. Methods: Plasma samples from 239 patients with immune dysfunction related to hematological or rheumatological disease or due to immunosuppressive therapy, were retrieved from a transdisciplinary biobank (PERSIMUNE) at Rigshospitalet, Copenhagen, Denmark. Serving as immunocompetent controls, plasma samples from 192 blood donors were included. All samples were collected between 2015 and 2019. Real-time PCR targeting the groEL gene was used to detect N. mikurensis DNA. Sequencing was used for confirmation. Borrelia burgdorferi sensu lato IgG antibodies were detected by ELISA as a proxy of tick exposure. Prevalence was compared using Fisher’s exact test. Results: Neoehrlichia mikurensis DNA was detected in 3/239 (1.3%, 95% confidence interval (CI): 0.3 – 3.6%) patients, all of whom primarily had a hematological disease. Follow-up samples of these patients were negative. N. mikurensis DNA was not detected in any of the blood donor samples. IgG antibodies against B. burgdorferi s.l. were detected with similar prevalence in immunocompromised patients and blood donors, i.e., 18/239 (7.5%, 95% CI: 4.8–11.5%) and 11/192 (5.7%, 95%: CI 3.2–10.0%). Conclusion: In this study, patients with N. mikurensis were not identified by clinical indication and N. mikurensis may therefore be underdiagnosed in Danish patients. Further investigations are needed to explore the clinical significance and implications of this infection.

TidsskriftAnnals of Clinical Microbiology and Antimicrobials
Udgave nummer1
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
The project was partially supported by the Interreg North Sea Region programme, NorthTick, Grant no. J-No.: 38-2-7-19 and by Danish National Research Foundation, Grant no.: 126, Aase og Ejnar Danielsens Fond and Funding Copenhagen University Hospital, Rigshospitalet. The funding bodies had no role in the design of the study, collection, analysis, or interpretation of data nor in writing the manuscript.

Publisher Copyright:
© 2023, The Author(s).

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