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Epidemiological Aspects and Molecular Characterization of Borrelia Burgdorferi S.L

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Epidemiological Aspects and Molecular Characterization of Borrelia Burgdorferi S.L ARTICLE IN PRESS International Journal of Medical Microbiology 298 (2008) 279–290 www.elsevier.de/ijmm Epidemiological aspects and molecular characterization of Borrelia burgdorferi s.l. from southern Germany with special respect to the new species Borrelia spielmanii sp. nov. Volker Fingerlea,Ã,1, Ulrike C. Schulte-Spechtela,1, Eva Ruzic-Sabljicb, Sarah Leonhardc, Heidelore Hofmannd, Klaus Webere, Kurt Pfisterc, Franc Strlef, Bettina Wilskea aNational Reference Center for Borreliae, Max von Pettenkofer-Institut fu¨r Medizinische Mikrobiologie und Hygiene der Ludwig-Maximilians-Universita¨tMu¨nchen, Pettenkoferstraße 9a, D-80336 Munich, Germany bUniversity of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia cInstitut fu¨r Vergleichende Tropenmedizin und Parasitologie, Leopoldstr. 5, Munich, Germany dKlinik und Poliklinik fu¨r Dermatologie und Allergologie am Biederstein, TU Mu¨nchen, Munich, Germany eDermatologist, Greinwaldstr. 2, Tutzing, Germany fDepartment of Infectious Diseases, University of Ljubljana, Ljubljana, Slovenia Received 11 December 2006; received in revised form 29 May 2007; accepted 29 May 2007 Abstract In 475 Borrelia-infected Ixodes ricinus (2155 ticks investigated) from southern Germany the most common Borrelia burgdorferi sensulatospecieswasB. garinii (34.3%) followed by B. afzelii (25.1%), B. burgdorferi sensu stricto (22.0%), and B. valaisiana (12.7%). B. spielmanii sp. nov. was detected in 5.9% of the 475 infected ticks. Hints for a focal distribution were found for B. spielmanii sp. nov. and B. garinii OspA type 4. In 242 patient isolates, dominance (66.9%) of B. afzelii for skin could be confirmed, while frequency of B. garinii in cerebrospinal fluid (CSF) isolates (51.1%) was comparable to the frequency in nymphal ticks (51.6%). Four patient isolates from southern Germany and two from Slovenia, all isolated from erythema migrans, could be assigned to B. spielmanii sp.nov.Withinthisnewspecieshigh sequence identities were found for rrs, fla,andospA while rrf-rrl, ospC,anddbpA were less conserved: three new ospC and two new dbpA sequence types were found. This genetic heterogeneity reveals that B. spielmanii sp. nov. did not evolve just recently. r 2007 Elsevier GmbH. All rights reserved. Keywords: Borrelia burgdorferi; Borrelia spielmanii; Ixodes ricinus; ospA; ospC; dbpA; 16S rDNA; 5S-23S intergenic spacer Introduction infectious disorder caused by spirochaetal bacteria belong- ing to the Borrelia burgdorferi sensu lato (s.l.) complex. Lyme borreliosis (LB), the most frequent vector-borne This disease can affect different organs and organ systems, diseaseinEuropeandtheUSA,isamultisystemic most often the skin, but also nervous system, joints, or the heart may be involved (Stanek and Strle, 2003). In Europe, the principal vectors are the hard-bodied ticks Ixodes ÃCorresponding author. Tel.: +49 89 5160 5225; fax: +49 89 5160 4757. ricinus and, at the eastern range, I. persulcatus. E-mail address: [email protected] (V. Fingerle). The B. burgdorferi s.l. complex comprises at least 12 1These authors contributed equally to this work. species wherefrom B. burgdorferi sensu stricto (s.s.), 1438-4221/$ - see front matter r 2007 Elsevier GmbH. All rights reserved. doi:10.1016/j.ijmm.2007.05.002 ARTICLE IN PRESS 280 V. Fingerle et al. / International Journal of Medical Microbiology 298 (2008) 279–290 B. afzelii,andB. garinii are assured to be pathogenic I. ricinus from southern Germany. Also, B. spielmanii is for humans while the pathogenicity of B. valaisiana, present in ticks possibly in a focal manner and seems to B. lusitaniae,andB. bissettii is still unclear, although all be a relevant cause for human LB, at least for erythema three species have been detected occasionally in patient migrans. Molecular genetic analyses provide evidence specimens (Baranton et al., 1992; Canica et al., 1993; that this newly described species did not evolve just Rijpkema et al., 1997; Strle et al., 1997; Wang et al., recently. 1999b; Collares-Pereira et al., 2004). In Europe, the five species B. afzelii, B. garinii, B. burgdorferi s.s., B. valaisiana, and B. lusitaniae have been recorded in Material and methods association with I. ricinus. Thereof, B. afzelii and B. garinii appear to be the most prevalent species Study sites and collection of questing Ixodes ricinus followed by B. burgdorferi s.s. and B. valaisiana, while B. lusitaniae seems to be rare (Hubalek and Halouzka, ticks 1997; Rauter and Hartung, 2005). B. burgdorferi s.s., A total of 2155 I. ricinus were collected by flagging at the only species causing LB in the USA, is homo- eight locations in southern Germany within a radius of geneous with respect to outer surface protein (Osp) A, 150 km around the city of Munich (Tables 1 and 2). In while in Europe at least eight different OspA types Erlangen, located about 150 km north of Munich, have been observed among the human pathogenic sampling was done in an area intensively used for species (Wilske et al., 1993, 1996; Lencakova et al., agricultural purposes at waysides between a cornfield 2006). In 1993, van Dam et al. described a B. burgdorferi s.l. and a fir wood. The study area Passau, about 150 km east-east-north of Munich, was along a dirt road strain (A14S) that could not be classified that time. through a mixed forest with lots of underbrush. The Based on its reactivity with monoclonal antibodies collection region Traunstein is located about 120 km (MAbs), ribotyping, and randomly amplified poly- east-east-south of Munich and comprises a forest track morphic DNA fingerprinting, the authors concluded through a coniferous forest with lots of underbrush, that this isolate could well represent a novel pathogenic predominantly blackberries. The Isar meadow region B. burgdorferi s.l. species (van Dam et al., 1993; Wang et is about 10 km north-west of Munich. Collection of al., 1998). In 1999, further characterization of this strain by protein profiling, reactivity with MAbs, sequences of ticks was done along a grassy dirt road in a humid deciduous forest dominated by birch trees. The English 16S rRNA (rrs), ospA, ospC, fla, and 5S-23S intergenic Garden area is part of a recreational park located in spacer (rrf-rrl) further supported that this strain the city of Munich. The sampling region was the edge represents a new B. burgdorferi s.l. species (Wang et al., of a small deciduous wood (predominant beech and 1999a). Subsequently, Richter et al. (2004) showed that oak trees, lots of underbrush) to public grassland, this new genospecies seems to have a restricted geo- which is intensively used for recreational activities. The graphic distribution and seems to be associated with study area Grafrath, situated about 35 km west of dormice, especially garden dormice, but not mice or voles. In this study, the name ‘‘B. spielmani sp. nov.’’ for Munich, comprises a grassy forest track through a mixed forest. The sampling area Schoffelding, which is this apparently new B. burgdorferi s.l. species was ¨ situated about 50 km west of Munich, was the edge proposed. In a following study, its position as a new of a deciduous forest with lots of underbrush to a species was validated by multilocus sequence analysis swampy grassland. Collection region Bad Tolz, located and its name was changed to the correct spelling ¨ about 45 km south of Munich, was a light coniferous ‘‘B. spielmanii’’ (Richter et al., 2006). forest with a lot of grass and bushes. The collection Further A14S-like or B. spielmanii isolates from areas each had a size of about 1000–1500 m2 except the patients were reported in 2002 from south-western Germany (Rauter et al., 2002), in 2003 from south- English Garden collection area, which had a size of about 400 m2. eastern Germany (Michel et al., 2003), in 2005 from After collection, ticks were assigned to tick species Hungary (Foldvari et al., 2005), and in 2006 from and stage, and individually stored in 1.5-ml reaction Slovenia (Maraspin et al., 2006). Notably, all human tubes at À20 1C until use. Before DNA extraction, each B. spielmanii isolates described so far were cultured from tick was crushed using a separate laboratory spatula. erythema migrans. The aim of this study was to gain more information about the epidemiological situation of B. burgdorferi s.l. Borrelia burgdorferi s.l. strains and cultivation, and, especially, about the new species B. spielmanii, DNA extraction including its molecular heterogeneity. The results of the present study show that all relevant B. burgdorferi s.l. All strains were derived from patient material species described so far for Europe are present in collected in the years 1984–2002 at the Max von ARTICLE IN PRESS V. Fingerle et al. / International Journal of Medical Microbiology 298 (2008) 279–290 281 Table 1. (a) Prevalence of B. burgdorferi s.l. species according to tick stage and study site Region Tick stageb n Posc (%) Posd Thereofa Bb (%) Ba (%) Bg (%) Bv (%) Bs (%) Bad A 138 25 (18.1) 25 4 (16.0) 5 (20.0) 15 (60.0) 1 (4.0) 0 To¨lze,a N 218 16 (7.3) 16 2 (12.5) 4 (25.0) 9 (56.3) 0 0 Erlangene A 49 13 (26.5) 16 0 2 (12.5) 13 (81.3) 1 (6.3) 0 N 40 2 (5.0) 2 0 0 2 (100) 0 0 Scho¨ffelding A 133 29 (21.8) 35 8 (22.9) 3 (8.6) 20 (57.1) 4 (11.4) 0 N 92 9 (9.8) 10 2 (20.0) 0 8 (80.0) 0 0 Grafrath A 240 88 (36.7) 99 20 (20.2) 30 (30.3) 32 (32.3) 12 (12.1) 5 (5.1) N 106 13 (12.3) 15 2 (13.3) 8 (53.3) 5 (33.3) 0 0 Traunsteine A 222 42 (18.9) 45 11 (24.4) 14 (31.1) 15 (33.3) 3 (6.7) 2 (4.4) N 156 15 (9.6) 15 6 (40.0) 2 (13.3) 7 (46.7) 0 0 EGf A 207 77 (37.2) 78 12 (15.4) 30 (38.5) 9 (11.5) 13 (16.7) 14 (17.9) MIRf A 207 74 (35.7) 75 23 (30.7) 15 (20.0) 23 (30.7) 11 (14.7) 3 (4.0) Passau A 211 70 (33.2) 73 21 (28.8) 14 (19.2) 15 (20.5) 19 (26.0) 4 (5.5) All regionse A 1407 418 (29.7) 446 99 (22.2) 113 (25.3) 142 (31.8) 64 (14.3) 28 (6.3) N 612 55 (9.0) 58 12 (20.7) 14 (24.1) 31 (53.4) 0 0 (b) B.
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