LETTERS 10. Meyrick B, Christman B, Jesmok G. Ef- ompA indicated that strain TCM1 agent, R. honei from Ixodes granula- fects of recombinant tumor necrosis fac- was closely related to and clustered tus ticks in Thailand (4), was appar- tor-alpha on cultured pulmonary artery and lung microvascular endothelial mono- within the same clade as R. japonica ently different from strain TCM1 (Fig- layers. Am J Pathol. 1991;138:93–101. strain YH (98.4% identity) (Figure, ure). Phylogenetic analyses based on panel A). Also, a 17-kDa antigen gene gltA (99.4%–99.6% identity) showed Address for correspondence: Gilles Meyer, obtained from strain TCM1 showed that strain TCM1 is also closely re- UMR1225, Ecole Nationale Vétérinaire de 99.5% identity to the corresponding lated to R. japonica and Rickettsia Toulouse, 23 chemin des Capelles BP87614, gene of R. japonica (Figure, panel B). sp. strain PMK94 (data not shown). Toulouse CEDEX 3, France; email: g.meyer@ Our phylogenetic analysis with ompA Thus, we describe the R. japonica envt.fr and 17-kDa antigen gene showed that group in Thailand. DNA sequences strain TCM1 was closely related to R. of strain TCM1 were determined and japonica but distinguished from Rick- deposited in GenBank/EMBL/DDBJ ettsia sp. PMK94 (which was closely under the following accession nos.: related to R. heilongjiangensis from ompA, AB359459; 17-kDa antigen, northeastern China) (3); another SFGR AB359457; gltA, AB359458. Spotted Fever Group Rickettsia sp. Closely Related to R. japonica, Thailand To the Editor: In response to a recent report that suggested human infection with Rickettsia japonica in northeastern Thailand (1), we phylo- genetically reexamined spotted fever group rickettsiae (SFGR) from Thai- land. The organism had been isolated from a male Haemaphysalis hystricis tick found on Mt. Doi Suthep, Chiang Mai, northern Thailand, in Decem- ber 2001. The strain was designated TCM1 and was not distinguishable from R. japonica by indirect immu- noperoxidase stain using monoclonal antibody (2). After propagating strain TCM1 in L-929 cell culture, we extracted DNA by using a Wizard Genomic DNA Pu- rifi cation Kit (Promega, Madison, WI, USA). We subjected the DNA to se- Figure. Phylogenetic analysis based on ompA gene (A) and rickettsial genus–specifi c 17-kDa quencing that targeted a 491-bp frag- antigen gene (B). Sequences were aligned by using the ClustalW software package (http:// ment of rickettsial outer membrane clustalw.ddbj.nig.ac.jp/top-j.html), and neighbor-joining phylogenetic tree construction and protein A (ompA), a 394-bp fragment bootstrap analysis were conducted according to the Kimura 2-parameter method (www. of the rickettsial genus–specifi c 17- ddbj.nig.ac.jp). Pairwise alignments were performed with an open-gap penalty of 10, a gap kDa antigen gene, and a 1,250-bp frag- extension penalty of 0.5, and a gap distance of 8. Multiple alignments were also performed with the same values, and the phylogenetic branches were supported by bootstrap ment of citrate synthase gene (gltA). analysis with 1,000 replications (>800 were indicated). Rickettsia felis (CP000053) and Direct sequencing of amplicons was R. canadensis (CP000409) were used as outgroups for ompA and 17-kDa antigen gene, performed as previously described. respectively. The phylogenetic tree was constructed by using TreeView software version (3). Phylogenetic analyses based on 1.5 (http://taxonomy.zoology.gla.ac.uk/rod/treeview.html). Scale bars indicate nucleotide substitutions (%) per site. 610 Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 4, April 2009 LETTERS R. japonica is the specifi c patho- cine, Chiang Mai University, Chiang Mai, Segniliparus gen of Japanese spotted fever, which Thailand (U. Chaithong) has been found mainly in southwest- rugosus Infection, DOI: 10.3201/eid1504.081271 ern Japan (5). The present strain, Australia closely related to R. japonica, is likely References to have been isolated from H. hystricis To the Editor: Recently, a female in Thailand because R. japonica fre- 1. Gaywee J, Sunyakumthorn P, Rodkvam- teenager with cystic fi brosis who resid- quently has been isolated, or detected took W, Ruang-areerate T, Mason CJ, ed in tropical north Queensland, Aus- by PCR, from the same tick species Sirisopana N. Human infection with Rick- tralia, was found to be infected with ettsia sp. related to R. japonica, Thailand. Segniliparus rugosus. She was ho- in Japan (6). Such tick species–spec- Emerg Infect Dis. 2007;13:671–3. ifi city of SFGR should be considered 2. Fujita H, Takada N, Chaithong U. Prelimi- mozygous for the deltaF508 mutation, when speculating on any geopatholog- nary report of rickettsial strains of spotted had well-preserved lung function, and ic relationships of rickettsioses among fever group isolated from ticks of China, regularly played competitive sports. Nepal and Thailand. Annual Report of Unlike many cystic fi brosis patients, different SFGR-endemic areas. Previ- Ohara General Hospital. 2002;44:15–8. ous reports on spotted fever–positive 3. Zhang JZ, Fan MY, Wu YM, Fournier she did not have a history of chronic results of human serosurveys (7,8) PE, Roux V, Raoult D. Genetic classifi - Pseudomonas aeruginosa infections, and on a clinical case (9) in northern cation of “Rickettsia heilongjiangii” and but Stenotrophomonas maltophilia “Rickettsia hulinii,” two Chinese spotted and Achromobacter xylosoxidans had Thailand may provide epidemiologic fever group rickettsiae. J Clin Microbiol. background. In Asia, multiple species 2000;38:3498–501. been previously isolated from her spu- of rickettsiea (e.g., R. japonica, R. hei- 4. Kollars TM Jr, Tippayachai B, Bodhidatta tum. In May 2007, she described re- longjiangensis, R. honei) are the caus- D. Short report: Thai tick typhus, Rickett- duced exercise tolerance and increased sia honei, and a unique Rickettsia detected cough with excess sputum production. ative agents of spotted fever rickettsi- in Ixodes granulates (Ixodidae: Acari) oses, so the agent closely related to R. from Thailand. Am J Trop Med Hyg. Lung function testing showed modest japonica could cause spotted fever in 2001;65:535–7. spirometric decline. A computed to- Thailand. Additionally, R. japonica 5. Mahara F. Rickettsioses in Japan and the mographic scan of the chest showed Far East. Ann N Y Acad Sci. 2006;1078:60– signifi cant mucus plugging and bron- has been found in Korea (10), and our 73. DOI: 10.1196/annals.1374.007 current study indicates that R. japoni- 6. Fujita H, Takada N. Diversity of genus chiectasis, uncommon without previ- ca and its genetic variants are widely Rickettsia detected from ticks in Japan. ous P. aeruginosa infection. Sputum distributed in Far Eastern countries, Acari and emerging/reemerging infectious was 3+ smear positive for acid-fast diseases [in Japanese]. Tokyo: Zenkoku bacilli (AFB), and S. rugosus was iso- including Japan (Grant-in-Aid for Noson Kyoiku Kyokai Publishing; 2007. International Cooperative Research, p. 129–39. lated from liquid culture. Empiric an- unpub. data). Therefore, the epidemi- 7. Takada N, Fujita H, Yano Y, Huang W-H, timicrobial drug therapy was changed ology and genetic variation of SFGR Khamboonruang C. Serosurveys of spot- to rifabutin and co-trimoxazole be- ted fever and murine typhus in local resi- cause these drugs have been effective throughout Asia should be examined dents of Taiwan and Thailand compared by molecular studies. with Japan. Southeast Asian J Trop Med in previous cases (1). Clinically, the Public Health. 1993;24:354–6. patient showed response to the treat- 8. Parola P, Miller RS, McDaniel P, Tel- ment. After 12 months of treatment, This work was supported in part by ford SR, Rolain J-M, Wongsrichanalai her sputum was still 3+ positive for Grant-in-Aid for International Cooperative C, et al. Emerging rickettsioses of the Thai-Myanmar border. Emerg Infect Dis. AFB, and S. rugosus was again found Research (nos. 13576005 and 19406008) 2003;9:592–5. in culture. She was referred to a pe- from the Japan Society for the Promotion 9. Sirisanthana T, Pinyopornpanit V, Sirisan- diatric teaching hospital in Brisbane of Science. thana V, Strickman D, Kelly DJ, Dasch with worsening respiratory symptoms GA.. First cases of spotted fever group rickettsiosis in Thailand. Am J Trop Med precipitated by infl uenza B infection. Nobuhiro Takada, Hiromi Fujita, Hyg. 1994;50:682–6. Antimicrobial drug therapy with in- Hiroki Kawabata, Shuji Ando, 10. Lee J-H, Park H-S, Jung K-D, Jang W-J, travenous imipenem, oral moxifl oxa- Akiko Sakata, Ai Takano, Koh S-E, Kang S-S, et al. Identifi cation of cin, and co-trimoxazole for 2 weeks the spotted fever group rickettsiae detected and Udom Chaithong from Haemaphysalis longicornis in Ko- resulted in clinical improvement but Author affi liations: University of Fukui, Fu- rea. Microbiol Immunol. 2003;47:301–4. little reduction in smear positivity. kui, Japan (N. Takada); Ohara General The initial AFB smear-positive Hospital, Fukushima, Japan (H. Fujita); Address for correspondence: Nobuhiro Takada, sputum specimen underwent routine National Institute of Infectious Diseases, University of Fukui, Faculty of Medical decontamination with sodium hydrox- Tokyo, Japan (H. Kawabata, S. Ando, A. Sciences 23, Matsuoka, Eiheiji Fukui 910-1193, ide and neutralization and was inocu- Sakata, A. Takano); and Faculty of Medi- Japan; email: [email protected] lated into radiometric 12B vials (Bec- Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 15, No. 4, April 2009 611 .