Prevalence of Tick-borne Neoehrlichia mikurensis in Individuals Undergoing B-cell Depleting Therapy in Denmark: A Prospective Cohort Study 2023-2024.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-09-17 DOI:10.1016/j.ijid.2025.108069

Helene Mens, Rosa Gynthersen, Jeppe Romme Christensen, Morten Blinkenberg, Finn Sellebjerg, Daniel El Fassi, Bente Glintborg, Dorte Vendelbo Jensen, Jørgen Skov Jensen, Anne-Mette Lebech

{"title":"Prevalence of Tick-borne Neoehrlichia mikurensis in Individuals Undergoing B-cell Depleting Therapy in Denmark: A Prospective Cohort Study 2023-2024.","authors":"Helene Mens, Rosa Gynthersen, Jeppe Romme Christensen, Morten Blinkenberg, Finn Sellebjerg, Daniel El Fassi, Bente Glintborg, Dorte Vendelbo Jensen, Jørgen Skov Jensen, Anne-Mette Lebech","doi":"10.1016/j.ijid.2025.108069","DOIUrl":null,"url":null,"abstract":"Background: Neoehrlichia mikurensis is an emerging tick-borne pathogen posing a particular risk to individuals undergoing B-cell depleting therapy (BCDT).Objective: To establish a rational testing strategy for N. mikurensis among individuals on BCDT METHODS: We conducted a prospective cohort study between January 2023 and December 2024 on Adults receiving BCDT, in the Capital Region of Denmark. A digital questionnaire covered tick exposure and symptoms. Blood was tested for N. mikurensis DNA by real-time PCR.Results: Of 1,211 eligible individuals, 443 (37%) were enrolled. The median age was 54 years, and 62% were female. PCR testing was performed on 389 participants, detecting N. mikurensis DNA in 1.0% (4/389; 95% CI: 0.4-2.6). All infected individuals reported prolonged symptoms (e.g., fatigue, fever, unintended weight loss) and responded rapidly to doxycycline therapy. Notably, only one of the four cases exhibited elevated CRP. Symptom-based screening yielded a high likelihood ratio of 25 for identifying positive cases.Conclusions: Our results indicate that employing a symptom-based testing strategy for N. mikurensis is a rational approach for individuals undergoing BCDT.","PeriodicalId":14006,"journal":{"name":"International Journal of Infectious Diseases","volume":" ","pages":"108069"},"PeriodicalIF":4.3000,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijid.2025.108069","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Neoehrlichia mikurensis is an emerging tick-borne pathogen posing a particular risk to individuals undergoing B-cell depleting therapy (BCDT).

Objective: To establish a rational testing strategy for N. mikurensis among individuals on BCDT METHODS: We conducted a prospective cohort study between January 2023 and December 2024 on Adults receiving BCDT, in the Capital Region of Denmark. A digital questionnaire covered tick exposure and symptoms. Blood was tested for N. mikurensis DNA by real-time PCR.

Results: Of 1,211 eligible individuals, 443 (37%) were enrolled. The median age was 54 years, and 62% were female. PCR testing was performed on 389 participants, detecting N. mikurensis DNA in 1.0% (4/389; 95% CI: 0.4-2.6). All infected individuals reported prolonged symptoms (e.g., fatigue, fever, unintended weight loss) and responded rapidly to doxycycline therapy. Notably, only one of the four cases exhibited elevated CRP. Symptom-based screening yielded a high likelihood ratio of 25 for identifying positive cases.

Conclusions: Our results indicate that employing a symptom-based testing strategy for N. mikurensis is a rational approach for individuals undergoing BCDT.

查看原文本刊更多论文

2023-2024年丹麦接受b细胞消耗治疗的个体中蜱传mikurenihia的患病率：一项前瞻性队列研究

背景：mikurenneehrichia是一种新兴的蜱传病原体，对接受b细胞消耗治疗（BCDT）的个体构成特殊风险。目的：建立合理的BCDT个体mikurensis检测策略方法：我们在2023年1月至2024年12月期间对丹麦首都地区接受BCDT的成人进行了前瞻性队列研究。一份数字调查问卷涵盖了蜱虫接触和症状。采用实时荧光定量PCR法检测血样中米库氏乳杆菌的DNA。结果：在1211名符合条件的个体中，443人（37%）入选。中位年龄为54岁，62%为女性。对389名参与者进行PCR检测，1.0% （4/389;95% CI: 0.4-2.6）检测到mikurensis DNA。所有受感染的个体都报告了持续的症状（如疲劳、发烧、意外体重减轻），并对强力霉素治疗迅速作出反应。值得注意的是，四个病例中只有一个表现出CRP升高。基于症状的筛查在识别阳性病例方面产生了25的高似然比。结论：我们的研究结果表明，采用基于症状的检测策略对接受BCDT的个体来说是一种合理的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.