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Infections caused by Borrelia burgdorferi sensu lato

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It is justified to systematically monitor the number of those infected with Lyme disease in European countries and conduct the research on spreading of genospecies B. burgdorferi s.l. in animal reservoirs and vectors. Moreover, it is essential to take action for increasing the society’s awareness of tick-borne diseases prophylaxis. It is very important due to the observed increase in the number and activeness of ticks which leads to the increased risk of infection with spirochetes Borrelia burgdorferi sensu lato and other pathogens transmitted by these vectors.
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Wprowadzenie. Tularemia jest zoonozą wywoływaną przez wewnątrzkomórkowe, gram-ujemne bakterie Francisella tularensis. Gatunek Francisella tularensis obejmuje podgatunki: typ A – F. tularensis tularensis i typ B – F. tularensis holarctica i F. tularensis mediaasiatica. Istnieje także podgatunek pokrewny F. tularensis novicida. Podgatunki F. tularensis tularensis, holarctica i mediasiatica mogą wywoływać infekcje u ludzi, jednak jedynie F. tularensis tularensis powoduje zakażenia zagrażające życiu. Gatunek F. novicida wykazuje zjadliwość wobec osób z defektami immunologicznymi. Tularemia jest także określana jako “rabbit fever”, “hunters’ disease”, “deerfly fever”, “tick fever”, “O’Hara’s Disease” i “Francis’ Disease”. Choroba ta w ostatnich latach stała się obiektem zainteresowania badaczy głównie ze względu na jej znaczenie jako groźnej broni biologicznej. Cel. Celem pracy jest analiza występowania tularemii w aspekcie epidemiologii, odpowiedzi na zakażenie ze strony gospodarza i rodzajów manifestacji klinicznych. Opis stanu wiedzy. Tularemia jest chorobą, na wystąpienie której w większym stopniu narażeni są leśnicy, myśliwi, osoby mające kontakt z mięsem zwierząt, rolnicy i lekarze weterynarii. Kliniczne objawy tularemii uzależnione są od wirulencji bakterii, ich liczby i drogi wnikania oraz odporności człowieka. Istnieje kilka dróg transmisji F. tularensis do organizmu człowieka, jednak najistotniejsze to transmisja przez uszkodzoną skórę oraz drogą wziewną. Możliwe są również zakażenia drogą pokarmową w wyniku spożycia skażonej wody czy żywności lub w wyniku ekspozycji laboratoryjnej. Zakażenie zwykle wywołuje objawy gorączkowe, zaś inne objawy chorobowe są w znacznym stopniu zależne od drogi infekcji. Tularemia może przybierać różne formy: postać wrzodziejąco-węzłową, anginową, żołądkowo-jelitową, oczno-węzłową lub płucną. Choroba może sprawiać trudności diagnostyczne, lecz dzięki wykorzystaniu testów serologicznych, hodowli czy badań molekularnych można potwierdzić ewentualne zakażenie. Antybiotyki stosowane w leczeniu zakażeń F. tularensis to streptomycyna, gentamycyna, cyprofloksacyna i doksycyklina. Istniejąca szczepionka przeciwko tularemii stosowana jest w sytuacjach kryzysowych i dostępna jest jedynie dla osób z grupy wysokiego ryzyka (grupy zmilitaryzowane, personel laboratoryjny). Podsumowanie. Istnieje potrzeba badań wskazujących na realną liczbę zachorowań na tularemię w celu realizacji konkretnych działań prewencyjnych. Mechanizmy i procesy sygnalizacyjne, dzięki którym F. tularensis moduluje odpowiedź immunologiczną, pozostają słabo poznane. Kluczowe dla powstania szczepionki będą badania nad odpowiedzią organizmu gospodarza skierowaną przeciwko szczepom A F. tularensis. Korzystanie z ubrań ochronnych i repelentów odstraszających owady, jak również unikanie kontaktu z dzikimi i martwymi zwierzętami zapewniają ochronę przed chorobą. Aspekt ten jest szczególnie ważny dla osób mieszkających lub przebywających czasowo na terenach wiejskich. Warunki higieny w odniesieniu do żywności i napojów są niezwykle ważne w ochronie przed anginową czy żołądkowo – jelitową postacią tularemii, szczególnie w krajach, w których ta forma jest częściej spotykana.
The aim of the present work was to evaluate the topography of spirochetes’ cells Borrelia burgdorferi s.s. B31 in atomic force microscope (AFM). Results: The length of spirochetes B. burgdorferi has ranged between 15.38-22.68μm. The cells of spirochetes do not constitute structures of a fixed diameter and height. Thus, in order to identify real parameters of cells, the horizontal distance and vertical distance have been used in the measurements. The average value of a spirochetes’ diameter has been estimated by taking series of measures and it is 0.40 μm. The average value of a spirochetes’ height has been estimated by taking series of measures and it is 70.14 nm. The analysis of a relation between measured parameters of spirochetes: diameter and height revealed that along with the growth of diameter of a bacteria cell, its height also grows. The average value of a fibers’ diameter has been estimated by taking series of measurements and it is 0.09 μm and the average height of fibers was 7.91 nm. Conclusions: The atomic force microscope (AFM) is a modern tool with a broad spectrum of observatory and measure abilities and is a technique which has been used in biology and microbiology to investigate the topography of surface and in the evaluation properties of cells.
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Background. Candida is a strain of fungi that is found on the surface of healthy mucous membranes of the oral cavity. Yet, Candida may also be considered opportunistic microorganisms. The pathogenicity of Candida spp. depends on strain-specific characteristics including, invasiveness, adhesion, and production of biofilm abilities as well as the production of enzymes allowing the colonization of tissue. The aim of the paper was to evaluate the frequency of Candida spp. occurrence in the oral microbiota of healthy adults, and its relation with risk factors and colonization. Material and methods. This study consisted of 72 healthy participants (from the Lubelskie Voivodeship between 19 and 73 years of age). Medical history was collected to determine potential relationships to risk factors affecting oral microbiota (past oral cavity diseases, chronic diseases, and smoking). The participants who were qualified had no oral cavity infections during the study. The collected clinical samples (oral cavity swabs) were disseminated on the chromogenic base for isolation and differentiation of Candida spp. Results. The frequency of Candida spp. occurrence was at the level of 63.8%. C. albicans was the most frequently identified species (56.5%). C. glabrata (45.6%) and C. tropicalis (23.9%) were identified less often. In 21.7% of swabs, two species of Candida were identified and in 2.2% of swabs three species identified. The most common colonization risk factor was associated with smoking (32.6%). Conclusions. Yeasts of Candida species are part of the healthy microflora of the oral cavity in people of different ages and may occur as single species or coexist with other species. The coexistence of chronic diseases, propensity for oral cavity infections and smoking significantly influence the Candida colonization. This may result in future clinical consequences, for example in cases of immunodepression.
Serologiczna diagnostyka boreliozy mimo opracowania i wprowadzenia różnych metod wciąż wymaga weryfikacji. Metody przesiewowe najczęściej stosowane do oceny przeciwciał anty - Borrelia to metoda jakościowa ELFA (Enzyme Linked Fluorescent Assay, analizator Vidas), metoda immuno - fluorescencji pośredniej (IIFT) oraz metoda immunoenzymatyczna ELISA. Wszystkie wymienione metody charakteryzują się wysoką czułością. Ze względu na możliwość wystąpienia nieswoistych reakcji krzyżowych i wyników fałszywie dodatnich wskazana jest weryfikacja wyników wątpliwych i dodatnich uzyskanych metodami przesiewowymi. Weryfikacji dokonuje się testem Western biot (Wb) o wysokiej swoistości. Technika Wb pozwala na identyfikację przeciwciał dla białek wysoce specyficznych dla Borrelia burgdorferi: VIsE, p83, p39, p31 (OspA), p30, p25 (OspC), p21, p19, p17, wśród których białko VIsE jest najbardziej swoiste dla odpowiedzi w klasie IgG oraz białko OspC, którego obecność związana jest z produkcją przeciwciał IgM. Celem niniejszej pracy była analiza wyników uzyskanych metodą ELFA (z analizatorem Vidas) i metodą IIFT jako testów przesiewowych stosowanych w diagnostyce zakażeń krętkiem B. burgdorferi.
Objectives. The objective of the study was assessment of risk of infection with Borrelia burgdorferi in the area of southern Podlasie in Poland, near the border with Belarus, by analysis of post-exposure procedure, and evaluation of asymptomatic infection in adolescents bitten by a tick, confirmed by serologic tests. Material and methods. The study was conducted among 128 healthy individuals aged 16–20 who declared being bitten by a tick. The level of IgM and IgG class antibodies was determined using the immunoenzymatic test (Borrelia 14 kD + OspC IgM ELISA and Borrelia IgG + VlsE ELISA, DRG Diagnostics). Positive and doubtful results were confirmed using the Western blot method (EUROLINE-WB, EUROIMMUN). Results. In the study group, the largest number of respondents (59.4%) declared tick bite in the region of the lower extremities, most often in the knee pit. Among the methods for removing the tick the largest number of respondents indicated removing it with the use of tweezers, with a simple, swift steady movement (29.7%), and pulling it out with the fingers (22.7%). In the ELISA test, a positive or doubtful result in at least one class was observed in 25.0% of respondents (n=32/128): in IgM class – 23.4% (n=30/128), and in IgG class – 4.7% (n=6/128). After verification with the Western blot test, infection was confirmed in 5.5% of respondents (n=7/128): in IgM class – 1.6% (n=2/128), in IgG class – 3.9% (n=5/128). In IgM class antibodies, the Western blot test confirmed positive or doubtful results of the ELISA test in 6.7%, while in IgG class antibodies in 83.3%. Conclusion. Evaluation of the actual infection with Borrelia spp. using serologic tests is difficult due to a certain non-specificity of the ELISA test, especially in IgM class antibodies, and difficulties with performance of a wide scope of specific Western blot tests. The variety of methods of tick removal declared by adolescents suggests that a wider education of society concerning appropriate methods of removing the tick should become an especially important element of prophylactic actions in the area of borreliosis.
Background: Lyme disease is a multi-organ disease caused by spirochetes, Borrelia burgdorferi sensu lato, transmitted by Ixodes, with its clinical picture including involvement of the skin, joints, nervous system and heart. Laboratory diagnostic tests for Lyme disease are mainly based on the detection of anti-Borrelia burgdorferi antibodies by means of serological methods. Aim of the work: assessment of the level of antibodies against specific B. burgdorferi s.l. antigens in persons with suspected Lyme disease. Material and methods: the tested group consisted of 98 patients with suspected Lyme disease. During the first phase of the tests, anti-Borrelia burgdorferi IgM/IgG antibodies were marked using ELISA method, and positive and uncertain results were confirmed by Westernblot test (Wb). Results: anti-B. burgdorferi IgM/IgG antibodies were present in 60 patients (61.2%). IgM and IgG antibodies were detected as positive in 8 (8.1%) and 35 (35.7%) patients respectively. IgM and IgG were co-present in 6 persons (6.1%), including 2 persons (2%) with positive results in both classes. All patients with positive IgM (12 persons) had anti-OspC antibodies, and 2 patients had, in addition, anti-p31 antibodies. In patients with positive IgG the results were as follows: antibodies against antigen p17 - 77% of cases, VlsE - 74%, p30 - 46%, p39 - 44%, p83 - 38%, p19 - 31%, OspC/p25- 28%, p31 - 23%, p21 - 8%. Conclusions: laboratory diagnostic tests for Lyme disease must be performed in accordance with the current standards, positive and uncertain results must be confirmed by Westernblot test. Results of lab tests must correlate with patient’s symptoms.
Background. The aim of the following study was to assess the level of knowledge in the prevention of Lyme borreliosis and exposure to ticks in non-medical students, broken down by gender. Material and methods. The study group comprised 274 students from Latvia, including 229 women and 45 men aged 18-35. As for the research tool, the authors’ own questionnaire survey was used. Results. Latvian male students are more likely to use repellents and more often examine their bodies on return from green areas (86.6% and 97.8% respectively) than women (66.3% and 93.9%, respectively). The biggest group of the respondents (35.6% of the men and 41.1% of the women) considered that twisting the tick out with tweezers was the correct method of removing ticks. Slightly fewer respondents, i.e. 26.6% of the men and 36.2% of the women, opted for tweezing it out with a swift steady movement. In practice, most people do not do this on their own − 28.9% of the men turn to a doctor / nurse for help and 32.3% of the women to some other person. Students critically assess their knowledge regarding Lyme borreliosis: 60% of the men evaluate it as minimal and 53.1% of the women as average. More than 86% of the men and 73.4% of the women in the study group reported being bitten by a tick. Conclusions: The results of the study reflect the attitudes of Latvian academic youth towards Lyme borreliosis as well as knowledge about the disease and its prevention, which allows for assessing the need for intensifying public education in the subject.
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The aim of this study was to present the characteristics of infections caused by the TORCH complex pathogens, identified as “others”, in women during pregnancy and their influence on the foetus. The “other” TORCH pathogens include: Treponema pallium, Listeria monocytogenes, Parvovirus B19, Varicella zoster virus, Measles virus, Myxovirusparotitis, influenza virus, viruses such as: HIV,HCV,HBC and also Chlamydia trachomatis. These pathogens are not only responsible for developing certain clinical symptoms in pregnant women but they also have a significant influence on child’s health and might be the cause of congenital disorders in infants. The consequences of TORCH infections may be visible in children directly after the birth, during infancy, or become present later, after several years. The most serious consequences are caused by foetal infection during early pregnancy. They may result in severe congenital disorders in foetus or cause miscarriage. Tests and examinations of women who plan pregnancy, and regular checks of the course of pregnancy allow for a proper care of mother and child.
Borelioza jest powszechnie występującą na świecie wielonarządową chorobą zakaźną przenoszoną przez kleszcze. Czynnikiem etiologicznym są krętki Borrelia burgdorferi. Obraz kliniczny późnej fazy choroby bywa zróżnicowany, a wyniki badań serologicznych niekiedy trudne w interpretacji. Dwuetapowa diagnostyka boreliozy obejmuje test ELISA oraz test potwierdzenia Western-blot. Antygenami powszechnie wprowadzonymi do diagnostyki zakażeń Borrelia burgdorferi sensu lato są wysoce specyficzne białka, głównie OspC, OspA p83, p39, p17, a także VlsE wysoce immunogenne białko pojawiające się „in vivo” po transmisji krętka do organizmu człowieka. O ile antygen VlsE występuje w większości testów serologicznych, to pozostałe markery BBA36, BBO323, Crasp3, pG nie są włączone do rutynowej diagnostyki. Antygeny „in vivo” są ważnymi oznacznikami w serologii IgG dla zaawansowanego stadium boreliozy, w związku z czym testy diagnostyczne uwzględniające owe antygeny pozwalają w większym stopniu ocenić reakcję odpornościową, w stosunku do stanu klinicznego pacjenta. Celem niniejszej pracy była ocena występowania w surowicy pacjentów przeciwciał IgM i IgG przeciwko specyficznym antygenom B.burgdorferi i antygenom z grupy „in vivo”, zawartych w teście Wester-Blot.
The aim of this study was to analyze the seroprevalence of rubella and cytomegalia among young women. The study included 175 healthy women from the Biała Podlaska District, aged 16 to 35 years. Anti-rubella and anti-CMV IgG were determined by ELISA. 172 (98.3%) study subjects tested positive for rubella antibodies, 1 (0.6%) was seroindeterminate and 2 (1.1%) were seronegative. CMV antibodies were detected in 119 (68.0%) participants; the series included also 1 (0.6%) seroindeterminate and 55 (31.4%) seronegative women. The levels of rubella and CMV antibodies were not significantly affected by age, place of residence and educational level of the study subjects.
Background. The study aimed to evaluate the scope and level of rural residents’ knowledge on the prevention of Lyme borreliosis and how this knowledge is used by residents of some selected rural areas of Lublin Province. Material and methods. A survey methodology was conducted with a sample of respondents of the Firlej and Kock communes (Lubartów County) and Borki commune (Radzyń Podlaski County). The study group involved 100 rural residents aged 18-67 years (mean 43; SD 0.14). Results. Among rural residents participating in the study, 35% are engaged in agriculture, and 61% have backyard gardens. 14% of the respondents have experienced a single tick bite, while 26% multiple bites. Out of those respondents who have experienced tick bites, only 12.5% have undergone diagnostic tests for the presence of Lyme borreliosis. The reported bite sites were found mostly in the lower limb (55%), stomach (40%), upper limb (30%), and the observed symptoms included first of all: muscle pain (50%), headache (37.5%), impaired concentration (20%), fever (17.5%), bone and joint pain (12.5%). A total of 30% farmers and rural residents consider their knowledge on the prevention of tick-borne diseases as minimal. Conclusions. It is necessary to undertake educational activities that would not only contribute to an increase in the level of knowledge of countryside residents on the prevention of tick-borne diseases but also lead to taking appropriate measures when bites occur.
Background. Laboratory diagnosis of Lyme borreliosis is based on the detection of anti-B. burgdorferi antibodies. Mononucleosis infection can lead to false positive results in serological diagnosis of Lyme borreliosis. Materials and methods. The experimental group comprised 60 patients diagnosed with Lyme borreliosis and 106 individuals professionally exposed to tick bites, with a positive result of ELISA anti-B. burgdorferi IgM test. The control group consisted of 150 healthy individuals. Immunoassay of antibodies to the Epstein-Barr viral capside antigen (EB-VCA) in the IgM class was carried out by the means of Western blot assay. Results. In two patients diagnosed with borreliosis the presence of IgM antibodies to EB-VCA was confirmed. In the group of individuals professionally exposed to tick bites and in the control group no anti-EB-VCA IgM antibodies were found. Conclusions. Anti-EBV IgM antibodies can lead to obtaining false positive results in Lyme borreliosis diagnostics. In the cases when clinical symptoms are not characteristic for Lyme borreliosis, and are accompanied by a positive result of anti-B. burgdorferi antibodies assay only in the IgM class, one has to take into consideration the occurrence of cross-reaction in the Western blot test and carry out differential diagnosis with infectious mononucleosis.
Background. Lyme borreliosis is the most frequent tick-borne disease in Europe and North America, and the number of registered cases is on the increase. Frequent presence in the habitats of ticks enhances the risk of tick bites and possible infection with Borrelia burgdorferi spirochetes. Objective. The aim of the study was to assess the risk of B. burgdorferi infection posed to hunters and other individuals exposed to activity-related contact with ticks. Material and methods. The study was carried out in the northern part of the Lublin Province (eastern Poland) and involved 150 individuals exposed to tick bites (110 hunters and 40 individuals exposed to activity-related contact with ticks). The analysis of sera for the presence of B. burgdorferi IgM and IgG antibodies was carried out. All 150 individuals were tested with the ELISA assay, and positive and borderline results of the assay were verified with the Western blot test. All study participants completed a questionnaire, which provided information about exposure to ticks, application of prophylactic measures, and awareness of Lyme borreliosis. Results. The ELISA assay revealed a positive or borderline result in at least one of the classes of B. burgdorferi antibodies in 63.3% (95/150) of the individuals (IgM 14.0%, IgG 63.3%). Verification carried out with the Western blot test showed a positive or borderline result in at least one of the antibody classes in 38.0% (57/150) of the examined persons (IgM 2.7%, IgG 36.7%). Abdomen (56.0%) and legs (53.7%) were the most frequently bitten body regions. Tick bites on the abdomen were significantly more frequently declared by hunters. Inspection of the body after returning from natural areas was more popular prophylactic method than use of repellents. Inspection of the body was significantly more often used in the group of the hunters. Conclusions. The risk of B. burgdorferi infection among hunters and other individuals undertaking activities associated with exposure to tick bites in the study area is high.
The aim of the study was determination of selected parameters of immunological response among hop growers and farmers in conditions of intensive exposure to means of plant protection. Survey data was collected from 238 males aged 25-70 living in the area of Wilkow near Pulawy (Lublin Region). Control group were males from the area of Witoszyn (Lublin Region) - 53 people aged 25-70 occupied mainly with land cultivation. Based on an environmental survey conducted among hop growers and farmers, the respondents were divided into 3 age groups: 25-40, 41-55 and 56-70. Laboratory tests covered the determination of selected morphological parameters, phagocytic test, NBT test, and myeloperoxidasis (MPO) concentration in blood serum of hop growers and farmers.A significant decrease was noted in the number of platelets in the general population of hop growers and in individual age groups, compared to the control groups of farmers. Analysis of individual sub-populations of leukocytes showed a significantly higher number statistically of basophils and lymphocytes among hop growers, compared to farmers. A detailed analysis of the degree of phagocytic and bactericidal activity of neutrophils allowed us to presume that during the period of spraying there occured a mobilisation of the granulocytic system, manifested by the presence of over 90% of neutrophils of intensified phagocytic activity, and 20% of neutrophils of intensified bactericidal activity. The preparations prepared by the routine NBT test method were analysed with the use of LUCIA computer programme (version 4.51). The analysis of the level of MPO in blood serum in the populations examined showed the presence of statistically significant differences. In hop growers, the MPO level was significantly higher statistically (60.0 ng/ml), compared to the control group of farmers (43.4 ng/ml).
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