Sporadic Human Infections With Rickettsia japonica in Yichang, China, 2021–2023

IF 3 2区农林科学 Q2 INFECTIOUS DISEASES

Transboundary and Emerging Diseases Pub Date : 2025-07-25 DOI:10.1155/tbed/4832524

Yuting Ren, Yale Jiang, Zhoufu Xiang, Qi Cheng, Kehan Chen, Jianchun Ma, Jianwei Dai, Weihao Zhang, Wei Hou, Qiang Liu, Liangjun Chen

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引用次数: 0

Abstract

Japanese spotted fever (JSF) is an easily neglected infectious disease, where misdiagnosis and delayed treatment significantly contribute to poor prognoses in affected patients. Our prospective observational study (2021–2023) systematically characterized 56 JSF cases in Yichang through tripartite analysis encompassing epidemiological distributions, clinical phenotyping, and phylogenetic relationship analysis of Rickettsia japonica (R. japonica). Our study delineated distinct clinical presentations of JSF, and identified five laboratory indexes demonstrating significant associations with disease severity. Notably, thrombocytopenia (platelet deficiency) and procalcitonin (PCT) levels emerged as critical indicators, with PCT as a well-characterized inflammatory mediator showing particular prognostic value for anticipating severe complications in rickettsial infections, consistent with prior pathophysiological research. Phylogenetic analysis revealed that R. japonica strains distributed in Yichang City exhibited extremely low genomic diversity. Further, the R. japonica strains isolated in our study exhibited a high degree of homology with R. japonica isolation within the borders of China. In summary, our research identified several factors that indicate a high risk of poor outcomes in R. japonica infections. Additionally, we observed highly similar phylogenetic relationships among R. japonica strains, which have important implications for disease prevention, control, and clinical diagnosis.

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2021-2023年宜昌地区日本立克次体散发感染分析

日本斑疹热（JSF）是一种容易被忽视的传染病，其中误诊和延迟治疗显著导致受感染患者预后不良。本前瞻性观察研究（2021-2023）对宜昌56例JSF病例进行了三方分析，包括流行病学分布、临床表型和系统发育关系分析。我们的研究描述了JSF的不同临床表现，并确定了与疾病严重程度显著相关的五个实验室指标。值得注意的是，血小板减少（血小板缺乏症）和降钙素原（PCT）水平成为关键指标，PCT作为一种特征明确的炎症介质，在预测立克次体感染的严重并发症方面具有特殊的预后价值，与先前的病理生理学研究一致。系统发育分析表明，宜昌地区的粳稻株系基因组多样性极低。此外，本研究分离的粳稻株与中国境内分离的粳稻株具有高度的同源性。总之，我们的研究确定了几个因素，表明粳稻感染不良结果的高风险。此外，我们观察到粳稻株系之间高度相似的系统发育关系，这对疾病的预防、控制和临床诊断具有重要意义。

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来源期刊

Transboundary and Emerging Diseases 农林科学-传染病学

CiteScore

8.90

自引率

9.30%

发文量

350

审稿时长

1 months

期刊介绍： Transboundary and Emerging Diseases brings together in one place the latest research on infectious diseases considered to hold the greatest economic threat to animals and humans worldwide. The journal provides a venue for global research on their diagnosis, prevention and management, and for papers on public health, pathogenesis, epidemiology, statistical modeling, diagnostics, biosecurity issues, genomics, vaccine development and rapid communication of new outbreaks. Papers should include timely research approaches using state-of-the-art technologies. The editors encourage papers adopting a science-based approach on socio-economic and environmental factors influencing the management of the bio-security threat posed by these diseases, including risk analysis and disease spread modeling. Preference will be given to communications focusing on novel science-based approaches to controlling transboundary and emerging diseases. The following topics are generally considered out-of-scope, but decisions are made on a case-by-case basis (for example, studies on cryptic wildlife populations, and those on potential species extinctions): Pathogen discovery: a common pathogen newly recognised in a specific country, or a new pathogen or genetic sequence for which there is little context about — or insights regarding — its emergence or spread. Prevalence estimation surveys and risk factor studies based on survey (rather than longitudinal) methodology, except when such studies are unique. Surveys of knowledge, attitudes and practices are within scope. Diagnostic test development if not accompanied by robust sensitivity and specificity estimation from field studies. Studies focused only on laboratory methods in which relevance to disease emergence and spread is not obvious or can not be inferred (“pure research” type studies). Narrative literature reviews which do not generate new knowledge. Systematic and scoping reviews, and meta-analyses are within scope.