Fästingburna infektioner är ett ökande problem, och därmed även infektioner orsakade av Rickettsia spp. Syftet med studien var att undersöka risken att drabbas av en infektion efter bett av rickettsiainfekterad fästing. Specificitet och sensitivitet av Fluidigm-PCR jämfördes mot real time polymerase chain reaction (realtids-PCR) vid detektion av Rickettsia spp. i fästingar som bitit människor. Vidare undersöktes om det finns någon korrelation mellan fästingens blodsugningstid och serokonversion mot Rickettsia spp. 753 fästingar lämnades in av 104 deltagare i Sverige och på Åland. Fästingarna analyserades med realtids-PCR för att detektera gltA-genen som är specifik för Rickettsia spp. 3,5 % av fästingarna var positiva för Rickettsia spp. med realtids-PCR. Vid analysering med Fluidigm-PCR av samma material blev 1,3 % av proverna positiva. Beräkningar som gjordes med realtids-PCR som referens visade att Fluidigm-PCR har sämre specificitet och sensitivitet jämfört med realtids-PCR. Deltagare som serokonverterade (n=5) lämnade endast in rickettsianegativa fästingar som därför inte kunde kopplas till infektionen. Därmed kunde inga slutsatser dras om risken att drabbas av en infektion efter bett av rickettsiainfekterad fästing eller om det föreligger någon korrelation mellan fästingens blodsugningstid och serokonversion. / Tick-borne infections are increasing, including infections caused by Rickettsia spp. The aim of this study was to examine the risk of developing an infection after being bitten by a tick infected with Rickettsia spp. Specificity and sensitivity of a Fluidigm-PCR assay were compared to real time polymerase chain reaction (real-time PCR) assay when detecting Rickettsia spp. in ticks that had bitten humans. Possible correlation between the tick's feeding time and seroconversion against Rickettsia spp. was also investigated. A total of 753 ticks from 104 participants in Sweden and the Åland Islands (Finland) were analyzed with real-time PCR to detect the gltA gene specific for Rickettsia spp. 3.5 % of the samples were positive for Rickettsia spp. with real-time PCR, while only 1.3 % of the samples were positive with Fluidigm-PCR. Calculations showed that Fluidigm-PCR assay has lower specificity and sensitivity than the real-time PCR assay. Unfortunately, no conclusions could be drawn considering correlation between the tick's feeding time and seroconversion of the bitten humans since no participants who had seroconverted had also submitted ticks containing Rickettsia spp. Therefore, no conclusions could be drawn considering the risk of developing an infection after being bitten by a tick infected with Rickettsia spp. / STING-studien

Neste projeto, objetivou-se o diagnóstico de riquétsias, utilizando metodologia molecular, em material de humanos, carrapatos, pulgas, cães e equinos de áreas endêmicas dos estados de São Paulo (SP) e Rio de Janeiro (RJ). Diagnosticou-se Rickettsia rickettsii infectando Amblyomma cajennense e humanos no estado de SP, indicando ser esta a única espécie responsável pela doença. Rickettsia conorii foi diagnosticada em um paciente procedente de Portugal. No estado do RJ, Rickettsia felis foi detectada Ctenocephalides felis e em Am. cajennense enquanto que R. rickettsii em Amblyomma aureolatum, Am. cajennense, Anocentor nitens, Boophilus microplus, Ct. felis e Rhipicephalus sanguineus. As frequências mínimas de vetores infectados do estado do RJ apresentaram valores superiores àqueles registrados em outras regiões do país. Demonstrou-se, de forma inédita, o envolvimento de algumas destas espécies no ciclo da bactéria. R. rickettsii foi diagnosticada em cães e equinos indicando a importância dos animais domésticos na manutenção do ciclo da riquetsiose. / This project aimed to diagnose rickettsial diseases using molecular analysis methods on human, tick, flea, dog and horse samples from endemic areas in the States of São Paulo (SP) and Rio de Janeiro (RJ). A diagnosis of Rickettsia rickettsii infecting Amblyomma cajennense and humans in the State of SP was made, indicating that this is the only species responsible for the disease. Rickettsia conorii was diagnosed in a patient from Portugal. In RJ, Rickettsia felis was detected in Ctenocephalides felis and Am. cajennense, while R. rickettsii was detected in Amblyomma aureolatum, Am. cajennense, Anocentor nitens, Boophilus microplus, Ct. felis and Rhipicephalus sanguineus. In the State of RJ the minimum frequency of infected vectors presented higher values than those recorded in other regions of the country. The involvement of some of these species in the bacterium cycle has been demonstrated for the first time. R. rickettsii was diagnosed in dogs and horses indicating the importance of livestock in the maintenance cycle of rickettsial infection.

Neste projeto, objetivou-se o diagnóstico de riquétsias, utilizando metodologia molecular, em material de humanos, carrapatos, pulgas, cães e equinos de áreas endêmicas dos estados de São Paulo (SP) e Rio de Janeiro (RJ). Diagnosticou-se Rickettsia rickettsii infectando Amblyomma cajennense e humanos no estado de SP, indicando ser esta a única espécie responsável pela doença. Rickettsia conorii foi diagnosticada em um paciente procedente de Portugal. No estado do RJ, Rickettsia felis foi detectada Ctenocephalides felis e em Am. cajennense enquanto que R. rickettsii em Amblyomma aureolatum, Am. cajennense, Anocentor nitens, Boophilus microplus, Ct. felis e Rhipicephalus sanguineus. As frequências mínimas de vetores infectados do estado do RJ apresentaram valores superiores àqueles registrados em outras regiões do país. Demonstrou-se, de forma inédita, o envolvimento de algumas destas espécies no ciclo da bactéria. R. rickettsii foi diagnosticada em cães e equinos indicando a importância dos animais domésticos na manutenção do ciclo da riquetsiose. / This project aimed to diagnose rickettsial diseases using molecular analysis methods on human, tick, flea, dog and horse samples from endemic areas in the States of São Paulo (SP) and Rio de Janeiro (RJ). A diagnosis of Rickettsia rickettsii infecting Amblyomma cajennense and humans in the State of SP was made, indicating that this is the only species responsible for the disease. Rickettsia conorii was diagnosed in a patient from Portugal. In RJ, Rickettsia felis was detected in Ctenocephalides felis and Am. cajennense, while R. rickettsii was detected in Amblyomma aureolatum, Am. cajennense, Anocentor nitens, Boophilus microplus, Ct. felis and Rhipicephalus sanguineus. In the State of RJ the minimum frequency of infected vectors presented higher values than those recorded in other regions of the country. The involvement of some of these species in the bacterium cycle has been demonstrated for the first time. R. rickettsii was diagnosed in dogs and horses indicating the importance of livestock in the maintenance cycle of rickettsial infection.

The public health and veterinary importance of Gulf Coast ticks, Amblyomma maculatum Koch (1844) have become more apparent during the last several decades. In addition, new records of this three-host ixodid tick presently show a geographic distribution throughout much of the southern United States. Rickettsia parkeri, a spotted fever group rickettsia (SFGR) that is commonly found infecting the Gulf Coast tick, was only recently recognized as a human pathogen. Over the last decade, more than 20 human cases of disease caused by R. parkeri have been recognized in the Americas, all of which were similar in presentation to mild Rocky Mountain spotted fever. In addition, a novel, poorly characterized SFGR, “Candidatus Rickettsia andeanae”, was recently identified in A. maculatum from Peru, United States, Chile and Argentina. As the recognition of R. parkeri as a pathogen and “Ca. R. andeanae” as an additional SFGR in A. maculatum only recently occurred, a general gap exists in our understanding of the biology of these SFGRs. The overall objective of this dissertation was to contribute to our knowledge of SFGR infecting A. maculatum. In Chapter 3, we present a prevalence study of R. parkeri, and “Ca. R. andeanae” in A. maculatum from Mississippi where we detected 15.2% R. parkeri-singly infected ticks and 3.1% total “Ca. R. andeanae” infected ticks of which 1.7% were co-infected with R. parkeri. In Chapter 4, we discuss finding four genetically different populations of A. maculatum from Mississippi infected with a homogenous population of R. parkeri, using Single Strand Conformation Polymorphism analysis. Those initial data relating to “Ca. R. andeanae” provided a foundation for studies described in Chapters 5 and 6. We report the first morphological study of “Ca. R. andeanae” using transmission electron microscopy in Chapter 5 and isolation of this SFGR in ,A. maculatum cell co-culture in Chapter 6. We anticipate that results presented in this dissertation will contribute to our understanding of the ecology of ,A. maculatum as a vector for the human pathogen, R. parkeri, and increase the current understanding of both R. parkeri and “Ca. R. andeanae” in A. maculatum.