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Prevalence of Rickettsia Species in Ticks Including Identification Of Turebekov et al. Parasites Vectors (2019) 12:197 https://doi.org/10.1186/s13071-019-3440-9 Parasites & Vectors RESEARCH Open Access Prevalence of Rickettsia species in ticks including identifcation of unknown species in two regions in Kazakhstan Nurkeldi Turebekov1,2, Karlygash Abdiyeva1,2, Ravilya Yegemberdiyeva3, Andrey Dmitrovsky3, Lyazzat Yeraliyeva4, Zhanna Shapiyeva5, Aday Amirbekov6, Aksoltan Oradova6, Zulfya Kachiyeva6, Lyazzat Ziyadina5, Michael Hoelscher1,7, Guenter Froeschl1,7, Gerhard Dobler8, Josua Zinner8, Stefan Frey8 and Sandra Essbauer8* Abstract Background: Over 60 years ago clinical patterns resembling tick-borne rickettsioses have been described for the frst time in Kazakhstan. Since 1995 the incidence of clinical cases of tick-borne rickettsioses in humans seems to be rising but studies on epidemiological data regarding the occurring etiological agents, tick vector species, prevalence and distribution throughout Kazakhstan are still scarce to date. The aim of the study was molecular investigation of ticks for spotted-fever group rickettsiae in the endemic Kyzylorda region and the so far considered as non-endemic Almaty region. A total of 2341 ticks was collected in the two regions in Kazakhstan and sorted in 501 pools: Ixodes persulcatus (243); Dermacentor marginatus (129); Haemaphysalis punctata (104); Hyalomma asiaticum (17); Dermacentor reticulatus (3); and Rhipicephalus turanicus (5). Pools were tested for Rickettsia spp. using real-time PCR. For positive samples multi- locus sequence typing (MLST) was performed. Results: The calculated minimum infection rate (MIR) for rickettsiae in the investigated ticks in Almaty region varied between 0.4–15.1% and 12.6–22.7% in the Kyzylorda region. At least four diferent Rickettsia species were identifed in the two selected regions of Kazakhstan. Two of these are already known to science: Rickettsia raoultii and R. slovaca, the latter being reported for the frst time in Almaty region One new form, “Candidatus R. yenbekshikazakhensis”, was described by MLST of six gene fragments in Almaty region and one new genotype, “genotype R. talgarensis” was detected using three gene fragments. Conclusions: Kazakh physicians should be aware of rickettsioses after tick bites in both regions studied. Both, R. raoultii and R. slovaca should be included in the diagnostics. The role for human diseases has further to be investi- gated for the newly described rickettsiae, “Candidatus R. yenbekshikazakhensis” and “Genotype R. talgarensis”. Keywords: Ticks, Rickettsia slovaca, Rickettsia raoultii, DNA isolation, Almaty region, Kyzylorda region, Kazakhstan *Correspondence: [email protected] 8 Department Virology & Rickettsiology, Bundeswehr Institute of Microbiology, German Center for Infection Research, Munich Partner site, Munich, Germany Full list of author information is available at the end of the article © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creat iveco mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creat iveco mmons .org/ publi cdoma in/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Turebekov et al. Parasites Vectors (2019) 12:197 Page 2 of 16 Background four regions in Kazakhstan (North Kazakhstan, Pav- Bacteria in the genus Rickettsia are arthropod-transmit- lodar, East Kazakhstan and Kyzylorda), which are cur- ted pathogens of vertebrates [1]. Rickettsiae are intracel- rently considered as endemic regions for tick-borne lular parasites, and are symbionts in the broad sense as rickettsioses. According to available statistical data, in these have close relationships with their hosts. Tey are total 3904 human cases of tick-borne rickettsiosis were the causative agents of numerous diseases of humans [2] ofcially registered in Kazakhstan from 1995 to 2016. In which can occur from subclinical to severe forms [1, 3]. this period the incidence rate of this disease increased According to recent data, Rickettsia spp. that cause infec- from 0.41 to 0.87 (per 100,000 inhabitants per year). tions in humans are divided into two major groups: the Te biggest increase was observed during this period in typhus group (Rickettsia prowazekii and Rickettsia typhii) Kyzylorda region (incidence of 1.64–11.1 per 100,000 and the spotted fever group (SFG) (Rickettsia rickettsii, inhabitants per year) and Pavlodar region (incidence of Rickettsia slovaca, Rickettsia sibirica, Rickettsia raoultii, 1.07–7.0 per 100,000 inhabitants per year). According to Rickettsia conorii, Rickettsia peacockii, Rickettsia honei, the currently available data, the Kyzylorda region is sup- Rickettsia japonica, Rickettsia montanensis, Rickettsia posed to be an endemic area for tick-borne rickettsioses massiliae, Rickettsia ripicephali, Rickettsia amblyommii, in Kazakhstan [14]. Rickettsia africae, Rickettsia parkeri, Rickettsia heilongji- Tere exist some data on Rickettsia species that might angensis, Rickettsia phillipi). Te major typhus group circulate in the endemic regions of Kazakhstan. Rickett- includes the typhus group itself and the “ancestral” group sia raoultii was reported in Dermacentor spp. and Ixodes with R. bellii subgroup and R. canadensis subgroup. spp. in three regions (Kyzylorda, Karaganda and East Te major spotted fever group consists of the “classical” Kazakhstan) [15–20] and R. conorii caspia, R. raoultii spotted fever group (R. rickettsia subgroup, R. conorii and R. aeschlimannii were detected in ticks collected in subgroup, R. australis subgroup) and two transitional the western, northern and central regions of Kazakhstan groups, R. felis group and R. akari group. Rickettsiae are [21]. Rickettsia aeschlimannii was reported in Haema- widespread among arthropods including lice, feas and physalis punctata originating from Almaty region [17, most species of ixodid ticks [4–6]. 18]. Recently, Hay et al. (2016) [22] demonstrated the Te knowledge on the tick-associated rickettsiae and presence of R. conorii caspia in ticks engorged on four- their signifcance of inducing human diseases has been striped grass rats (Rhabdomys pumilio) collected in the considerably enhanced in the past three decades Te West Kazakhstan region. In 2017, Rickettsia asembonen- main reason for progress is that molecular methods such sis and Rickettsia felis/“Candidatus Rickettsia senegalen- as multilocus sequence typing (MLST) or next-genera- sis” were detected in feas collected in Almaty region [22, tion sequencing have helped to identify new and previ- 23]. ously recognized rickettsiae in ticks [7]. MLST led to the So far data concerning Rickettsia spp. from the spot- description of several new “Candidatus” Rickettsia spe- ted fever group circulating in the Almaty region are lim- cies by describing at least four or fve gene fragments or ited and there are no registered epidemiological data on new Rickettsia genotypes if less than four sequences are human infections from this region [24]. Currently, there characterized [4, 8–10]. are still large gaps regarding the knowledge on circulating Te clinical pictures of human cases of tick-born Rickettsia species in ticks and their geographical distribu- rickettsioses were frst described in Kazakhstan dur- tion in Kazakhstan. Here, we present data of a molecu- ing expeditions to Almaty region in 1949–1951 [11]. A lar study of ticks for SFG rickettsiae in two regions, the few years later, clinical pictures of tick-borne rickettsi- Almaty region, which is considered so far non-endemic oses were described further in fve districts i.e. South but remains the most densely populated region in Kazakhstan, West Kazakhstan, Pavlodar, North Kazakh- Kazakhstan, and in the endemic Kyzylorda region. stan and Akmola regions [12]. Te causative agent of the North Asian tick-borne rickettsiosis (R. sibirica) was frst Methods described and isolated in 1961 by intra-abdominal infec- Tick sampling tion of guinea pig males with homogenates containing Ticks were collected by fagging the vegetation in three Dermacentor marginatus and Haemaphysalis punctata districts of Almaty region (Talgar, Yeskeldy and Yenbek- ticks, which were collected in Yenbekshikazakh district shikazakh districts) and Kyzylorda region (Syrdarya, Shy- of Almaty region [13]. Since 1995, clinical case defni- eli and Zhanakorgan districts), Kazakhstan, in May-June tion criteria and a complement fxation test (CFT) with 2015. R. sibirica are used in Kazakhstan for diagnostics and Te sampling sites of the ticks of Almaty region consequently ofcial registration of tick-borne rickett- have the following characteristics: Yeskeldi district siosis cases in humans. Currently, annual data exist for (44°54′12″N, 78°29′42″E) with Tekeli city (44°49′48″N, Turebekov et al. Parasites Vectors (2019) 12:197 Page 3 of 16 78°49′26″E) is located in Almaty region adjacent to the (BioloT, Saint-Petersburg, Russia) to each tube. Follow- Peopleʼs Republic of China and is characterized by conif- ing Kazakh guidelines for biosafety and biosecurity, ali- erous forests and open steppe vegetation. Te region is quots containing tick homogenates were inactivated in a mountainous with an altitude of 1400–2200 m above sea water bath at 56 °C
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