International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025
Prevalence of tick-borne neoehrlichia mikurensis in individuals undergoing B-cell depleting therapy in Denmark: A prospective cohort study 2023-2024.
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Mens Helene, Gynthersen Rosa, Christensen Jeppe Romme, Blinkenberg Morten, Sellebjerg Finn, El Fassi Daniel, Glintborg Bente, Jensen Dorte Vendelbo, Jensen Jørgen Skov, Lebech Anne-Mette
Аннотация
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 1211 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.
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 1211 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.