scholarly journals Early Diagnosis and Treatment of Patients with Symptomatic Acute Q Fever Do Not Prohibit IgG Antibody Responses to Coxiella burnetii

2012 ◽  
Vol 19 (10) ◽  
pp. 1661-1666 ◽  
Author(s):  
C. C. H. Wielders ◽  
L. M. Kampschreur ◽  
P. M. Schneeberger ◽  
M. M. Jager ◽  
A. I. M. Hoepelman ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Antibody Responses ◽  
Igg Antibody ◽  
Antibody Titers ◽  
Acute Q Fever

ABSTRACTLittle is known about the effect of timing of antibiotic treatment on development of IgG antibodies following acute Q fever. We studied IgG antibody responses in symptomatic patients diagnosed either before or during development of the serologic response toCoxiella burnetii. Between 15 and 31 May 2009, 186 patients presented with acute Q fever, of which 181 were included in this retrospective study: 91 early-diagnosed (ED) acute Q fever patients, defined as negative IgM phase II enzyme-linked immunosorbent assay (ELISA) and positive PCR, and 90 late-diagnosed (LD) acute Q fever patients, defined as positive/dubious IgM phase II ELISA and positive immunofluorescence assay (IFA). Follow-up serology at 3, 6, and 12 months was performed using IFA (IgG phase I and II). High IgG antibody titers were defined as IgG phase II titers of ≥1:1,024 together with IgG phase I titers of ≥1:256. At 12 months, 28.6% of ED patients and 19.5% of LD patients had high IgG antibody titers (P= 0.17). No statistically significant differences were found in frequencies of IgG phase I and IgG phase II antibody titers at all follow-up appointments for adequately and inadequately treated patients overall, as well as for ED and LD patients analyzed separately. Additionally, no significant difference was found in frequencies of high antibody titers and between early (treatment started within 7 days after seeking medical attention) and late timing of treatment. This study indicates that early diagnosis and antibiotic treatment of acute Q fever do not prohibit development of the IgG antibody response.

Infection by Coxiella burnetii in a patient from a rural area of Monteria, Colombia

2015 ◽  
Vol 16 (6) ◽  
pp. 958-961 ◽  
Author(s):  
Salim Mattar V ◽  
Verónica Contreras C ◽  
Marco Gonzalez T ◽  
Francisco Camargo ◽  
Jaime Alvarez ◽  
...  
Keyword(s):  
Phase I ◽  
Rural Area ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Indirect Immunofluorescence ◽  
Q Fever ◽  
Immunofluorescence Assay ◽  
Indirect Immunofluorescence Assay ◽  
Igg Antibody ◽  
Antibody Titers

<p>Q fever is a zoonosis caused by <em>Coxiella burnetii</em>. In Colombia, there have been very few human cases reported to date. This report describes the case of a 56-year-old patient with a background in agriculture and livestock handling. An indirect immunofluorescence assay (IFA) showed high titers of IgG for <em>C. burnetii</em> anti-phase I (1: 256) and anti-phase II (1:1024). For the next six months the patient’s IgG antibody titers remained high, and, after treatment with doxycycline, the IgG antibody titers decreased to 50 % (anti-phase I 1:128 and anti-phase II 1:512); this profile suggests an infection of <em>C. burnetii</em>.</p>

scholarly journals Predominant Immunoglobulin A Response to Phase II Antigen of Coxiella burnetii in Acute Q Fever

1999 ◽  
Vol 6 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Pierre-Edouard Fournier ◽  
Didier Raoult
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Rural Areas ◽  
Q Fever ◽  
Immunoglobulin A ◽  
Immunoglobulin M ◽  
Retrospective Case ◽  
Chronic Q Fever ◽  
Antibody Titers ◽  
Acute Q Fever

ABSTRACT Diagnosis of acute Q fever is usually confirmed by serology, on the basis of anti-phase II antigen immunoglobulin M (IgM) titers of ≥1:50 and IgG titers of ≥1:200. Phase I antibodies, especially IgG and IgA, are predominant in chronic forms of the disease. However, between January 1982 and June 1998, we observed anti-phase II antigen IgA titers of ≥1:200 as the sole or main antibody response in 10 of 1,034 (0.96%) patients with acute Q fever for whom information was available. In order to determine whether specific epidemiological or clinical factors were associated with these serological profiles, we conducted a retrospective case-control study that included completion of a standardized questionnaire, which was given to 40 matched controls who also suffered from acute Q fever. The mean age of patients with elevated phase II IgA titers was significantly higher than that usually observed for patients with acute Q fever (P = 0.026); the patients were also more likely than controls to live in rural areas (P = 0.026) and to have increased levels of transaminase in blood (P = 0.03). Elevated IgA titers are usually associated with chronic Q fever and are directed mainly at phase I antigens. Although the significance of our findings is unexplained, we herein emphasize the fact that IgA antibodies are not specific for chronic forms of Q fever and that they may occasionally be observed in patients with acute disease. Moreover, as such antibody profiles may not be determined by most laboratories, which test only for total antibody titers to phase I and II antigens, the three isotype-specific Ig titers should be determined as the first step in diagnosing Q fever.

scholarly journals Persistent High IgG Phase I Antibody Levels against Coxiella burnetii among Veterinarians Compared to Patients Previously Diagnosed with Acute Q Fever after Three Years of Follow-Up

PLoS ONE ◽  
2015 ◽  
Vol 10 (1) ◽  
pp. e0116937 ◽  
Author(s):  
Cornelia C. H. Wielders ◽  
Anneroos W. Boerman ◽  
Barbara Schimmer ◽  
René van den Brom ◽  
Daan W. Notermans ◽  
...  
Keyword(s):  
Phase I ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Acute Q Fever ◽  
Antibody Levels

scholarly journals Real-Time PCR with Serum Samples Is Indispensable for Early Diagnosis of Acute Q Fever

2009 ◽  
Vol 17 (2) ◽  
pp. 286-290 ◽  
Author(s):  
Peter M. Schneeberger ◽  
Mirjam H. A. Hermans ◽  
Erik J. van Hannen ◽  
Jeroen J. A. Schellekens ◽  
Alexander C. A. P. Leenders ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Phase I ◽  
Real Time ◽  
Acute Phase ◽  
Phase Ii ◽  
Real Time Pcr ◽  
Q Fever ◽  
Serum Samples ◽  
Convalescent Phase ◽  
Acute Q Fever

ABSTRACT The world's largest Q fever outbreak is ongoing in The Netherlands with around 3,000 confirmed cases since the first half of 2007. Increased awareness has resulted in early referral of patients for diagnostics. An important drawback to serological diagnosis of acute Q fever is the lag phase in antibody response. Therefore, we evaluated the performance of a real-time PCR for detection of Coxiella burnetii DNA using serum samples from patients with acute Q fever. PCR, targeting IS1111, was retrospectively performed on acute-phase and follow-up convalescent-phase serum samples from 65 patients with acute Q fever as diagnosed by immunofluorescence assay. The results obtained by PCR were related to disease stage as defined by subsequent appearance of phase II IgM, phase II IgG, phase I IgM, and phase I IgG (IgM-II, IgG-II, IgM-I, and IgG-I, respectively) antibodies and time since onset of disease. In addition, we analyzed seronegative acute-phase serum samples from patients with inconclusive Q fever serology, because no convalescent-phase serum samples were available. PCR was scored positive in 49/50 (98%) seronegative sera, 9/10 (90%) sera with isolated IgM-II antibodies, 3/13 (23%) sera with IgM-II/IgG-II antibodies, 2/41 (5%) sera with IgM-II/IgG-II/IgM-I antibodies, 0/15 (0%) sera with IgM-II/IgG-II/IgM-I/IgG-I antibodies, and 0/1 (0%) serum sample with IgM-II/IgG-II/IgG-I antibodies. The latest time point after onset of disease in which C. burnetii DNA could be detected was at day 17. In patients with inconclusive Q fever serology, PCR was positive in 5/50 (10%) cases. We conclude that real-time PCR with serum samples is indispensable for early diagnosis of acute Q fever. C. burnetii DNA becomes undetectable in serum as the serological response develops.

scholarly journals Evaluation of Commonly Used Serological Tests for Detection of Coxiella burnetii Antibodies in Well-Defined Acute and Follow-Up Sera

2012 ◽  
Vol 19 (7) ◽  
pp. 1110-1115 ◽  
Author(s):  
M. C. A. Wegdam-Blans ◽  
C. C. H. Wielders ◽  
J. Meekelenkamp ◽  
J. M. Korbeeck ◽  
T. Herremans ◽  
...  
Keyword(s):  
Phase Ii ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Antibody Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Igg Antibodies ◽  
Serological Tests ◽  
Content Type ◽  
Acute Q Fever

ABSTRACTIn this study, we comparedCoxiella burnetiiIgG phase I, IgG phase II, and IgM phase II detection among a commercially available enzyme-linked immunosorbent assay (ELISA) (Virion/Serion), an indirect fluorescent antibody test (IFAT) (Focus Diagnostics), and a complement fixation test (CFT) (Virion/Serion). For this, we used a unique collection of acute- and convalescent-phase sera from 126 patients with acute Q fever diagnosed by positiveCoxiella burnetiiPCR of blood. We were able to establish a reliable date of onset of disease, since DNA is detectable within 2 weeks after the start of symptoms. In acute samples, att= 0, IFAT demonstrated IgM phase II antibodies in significantly more sera than did ELISA (31.8% versus 19.7%), although the portion of solitary IgM phase II was equal for IFAT and for ELISA (18.2% and 16.7%, respectively). Twelve months after the diagnosis of acute Q fever, 83.5% and 62.2% of the sera were still positive for IgM phase II with IFAT and ELISA, respectively. At 12 months IFAT IgG phase II showed the slowest decline. Therefore, definitive serological evidence of acute Q fever cannot be based on a single serum sample in areas of epidemicity and should involve measurement of both IgM and IgG antibodies in paired serum. Based on IgG phase II antibody detection in paired samples (at 0 and 3 months) from 62 patients, IFAT confirmed more cases than ELISA and CFT, but the differences were not statically significant (100% for IFAT, 95.2% for ELISA, and 96.8% for CFT). This study demonstrated that the three serological tests are equally effective in diagnosing acute Q fever within 3 months of start of symptoms. In follow-up sera, more IgG antibodies were detected by IFAT than by ELISA or CFT, making IFAT more suitable for prevaccination screening programs.

scholarly journals Animals withCoxiella burnetiiInfection Demonstrate a Western Immunoblot Profile of Chronic Q Fever in Humans

1996 ◽  
Vol 7 (1) ◽  
pp. 45-48
Author(s):  
TJ Marrie ◽  
Linda Yates
Keyword(s):  
Immune Response ◽  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Western Immunoblotting ◽  
Western Immunoblot ◽  
Chronic Q Fever

Western immunoblotting was used to compare the immune response toCoxiella burnetiiphase I and phase II antigens of humans with acute and chronic Q fever with that of infected cats, rabbits, cows and raccoons. The cats, rabbits, cows and raccoons had an immunoblot profile similar to that of the human with chronic Q fever.

scholarly journals Truckin' pneumonia—an outbreak of Q fever in a truck repair plant probably due to aerosols from clothing contaminated by contact with newborn kittens

1989 ◽  
Vol 102 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Thomas J. Marrie ◽  
Donald Langille ◽  
Vasilia Papukna ◽  
Linda Yates
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Attack Rate ◽  
Q Fever ◽  
The Other ◽  
High Antibody ◽  
First Case ◽  
The Family ◽  
Antibody Titres

SUMMARYWe describe an outbreak of Q fever affecting 16 of 32 employees at a truck repair plant. None of the cases were exposed to cattle, sheep or goats. the traditional reservoirs of Q fever. The cases did not work, live on, or visit farms or attend livestock auctions. One of the employees had a cat which gave birth to kittens 2 weeks prior to the first case of Q fever in the plant. The cat owner fed the kittens every day before coming to work as the cat would not let the kittens suckle. Serum from the cat had high antibody titres to phase I and phase IICoxiella burnetiiantigens. The attack rate among the employees where the cat owner worked. 13 of 19 (68%), was higher than that of employees elsewhere, 3 of 13 (28%) [P <0·01]. The cat owner's wife and son also developed Q fever. None of the family members of the other employees with Q fever was so affected.We conclude that this outbreak of Q fever probably resulted from exposure to the contaminated clothing of the cat owner.

scholarly journals Culture under normoxic conditions and enhanced virulence of phase II Coxiella burnetii transformed with a RSF1010-based shuttle vector

2019 ◽  
Author(s):  
Shengdong Luo ◽  
Zemin He ◽  
Zhihui Sun ◽  
Yonghui Yu ◽  
Yongqiang Jiang ◽  
...  
Keyword(s):  
Phase I ◽  
Phase Ii ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Shuttle Vector ◽  
Axenic Culture ◽  
Hypoxic Condition ◽  
Kanamycin Resistance ◽  
Temperature Sensitive ◽  
Egfp Gene

AbstractCoxiella burnetii is a Gram-negative, facultative intracellular microorganism that can cause acute or chronic Q fever in human. It was recognized as an obligate intracellular organism until the revolutionary design of an axenic cystine culture medium (ACCM). Present axenic culture of C. burnetii strictly requires a hypoxic condition (<10% oxygen). Here we investigated the normoxic growth of C. burnetii strains in ACCM-2 with or without tryptophan supplementation. Three C. burnetii strains - Henzerling phase I, Nine Mile phase II and a Nine Mile phase II transformant, were included. The transformant contains a pMMGK plasmid that is composed of a RSF1010 ori, a repABC operon, an eGFP gene and a kanamycin resistance cassette. We found that, under normoxia if staring from an appropriate concentration of fresh age inocula, Nine Mile phase II can grow significantly in ACCM-2 with tryptophan, while the transformant can grow robustly in ACCM-2 with or without tryptophan. In contrast, long-term frozen stocks of phase II and its transformant, and Henzerling phase I of different ages had no growth capability under normoxia under any circumstances. Furthermore, frozen stocks of the transformant consistently caused large splenomegaly in SCID mice, while wild type Nine Mile phase II induced a lesser extent of splenomegaly. Taken together, our data show that normoxic cultivation of phase II C. burnetii can be achieved under certain conditions. Our data suggests that tryptophan and an unknown temperature sensitive signal are involved in the expression of genes for normoxic growth regulated by quorum sensing in C. burnetii.

Solitary IgM phase II response has a limited predictive value in the diagnosis of acute Q fever

2012 ◽  
Vol 140 (11) ◽  
pp. 1950-1954 ◽  
Author(s):  
C. F. H. RAVEN ◽  
J. L. A. HAUTVAST ◽  
T. HERREMANS ◽  
A. C. A. P. LEENDERS ◽  
P. M. SCHNEEBERGER
Keyword(s):  
Phase Ii ◽  
Predictive Value ◽  
Q Fever ◽  
Immunofluorescence Assay ◽  
Immunoglobulin M ◽  
Enzyme Linked Immunosorbent Assay ◽  
Initial Sample ◽  
Acute Q Fever ◽  
Diagnostic Criterion

SUMMARYWe investigated the positive predictive value (PPV) of a solitary positive immunoglobulin M (IgM) phase II response for the serodiagnosis of acute Q fever detected with either an indirect immunofluorescence assay (IFA) or an enzyme-linked immunosorbent assay (ELISA). Initial and follow-up sera from patients suspected of acute Q fever were included if initially only IgM phase II tested positive with IFA in 2008 (n=92), or ELISA in 2009 (n=85). A seroconversion for Q fever was defined as an initial sample being IgG phase II negative but positive in the follow-up sample. The PPV of an initial isolated IgM phase II result detected by IFA or ELISA was 65% and 51%, respectively, and therefore appeared not to adequately predict acute Q fever. For this reason it cannot be used as a diagnostic criterion nor should it be included in public health notification without confirmation with other markers or a follow-up serum sample.

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