Genomic bacterial load associated with bacterial genotypes and clinical characteristics in patients with scrub typhus in Hainan Island, Southern China

Wang G 1 , Fu R 1 , Zhang L 2 , Xue L 1 , Al-Mahdi AY 3 , Xie X 1 Show all authors , Qin A 4 , Tang C 1 , Du J 1 , Huang Y 1 , Wang Y 5 , Su J 5 , Huang S 5 , Peng R 1 , Lu Z 6 , An J 6 , Sun C 6 , Yang H 6 , He C 7 , Yuen KY 1 , Chan JF 1 , Du Y 2 , Xiao M 6 , Sun L 5 , Yin F 1

Affiliations 

  • 1 Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Medical University, Haikou, China
  • 2 Department of Infectious Disease, the Second Affiliated Hospital of Hainan Medical University, Haikou, China
  • 3 Faculty of medicine, Lincoln University College, Petaling Jaya, Malaysia
  • 4 State Key Laboratory of Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  • 5 Department of Infectious Disease, the First affiliated Hospital of Hainan Medical University, Haikou, China
  • 6 Department of Clinical Laboratory, Center for Laboratory Medicine, Hainan Women and Children's Medical Center, Haikou, China
  • 7 Hainan Center for Disease Control and Prevention, Haikou, China
PLoS Negl Trop Dis, 2023 Apr 21;17(4):e0011243.
PMID: 37083859 DOI: 10.1371/journal.pntd.0011243

Abstract

Scrub typhus, caused by mite-borne Orientia tsutsugamushi (O. tsutsugamushi), is a major febrile disease in the Asia-Pacific region. The DNA load of O. tsutsugamushi in the blood was previously found to be significantly higher in patients with fatal disease than those with non-fatal disease and correlated with the duration of illness, presence of eschar, and hepatic enzyme levels. In this prospective observation study, we analyzed the association of bacterial DNA load with clinical features, disease severity, and genotype using real-time PCR targeting the 56 kDa TSA gene of O. tsutsugamushi in the blood samples of 117 surviving patients with scrub typhus who had not received appropriate antibiotic treatment. The median O. tsutsugamushi DNA load was 3.11×103 copies/mL (range, 44 to 3.3×106 copies/mL). The severity of patients was categorized as mild, moderate, and severe based on the number of dysfunctional organs, and no significant difference in O. tsutsugamushi DNA load was found among these groups. Patients infected with the Karp group showed a significantly higher O. tsutsugamushi DNA load than those in the Gilliam (P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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