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Letter
Rickettsioses in South Korea,
Data Analysis
Jui-Shan Ma*
*Show-Chwan Memorial Hospital, Changhua, Taiwan
Suggested
citation for this article
To the Editor: Choi et al. (1) conducted
a study on sequence analysis of a partial rompB gene amplified
from sera of humans who were seropositive for spotted fever group (SFG)
and typhus group rickettsioses. They write, "These finding suggested
that several kinds of rickettsial diseases, including boutonneuse fever,
rickettsialpox, R. felis infection, and Japanese spotted fever…
are occurring in Korea."
These claims propagate some errors and may lead to an inadequate conclusion.
First, rompB is conserved in Rickettsia spp. and consists
of 4,968 bp with respect to the published sequence of the R. conorii
strain Seven (2,3). Fournier et al. (4)
amplified 4,682 bp of rompB and showed a high degree of nucleotide
sequence similarity (99.2%) between R. africae and R. sibirica,
R. pakeri, and R. slovaca. Choi et al. amplified ≈420
bp of rompB (position 3562–4077) for sequence analysis. This segment
is located in a highly conserved region of the gene, which may decrease
the ability to differentiate particular species from other SFG rickettsiae.
This study cannot prove the existence of specific SFG rickettsioses until
the results are confirmed further by, for example, isolating these SFG
rickettsiae from humans, animals, or ticks in South Korea. Recently, the
authors analyzed nucleotide sequences of 267-bp amplicons of rompB
(position 4762–4496) obtained from patient sera and found that R. conorii
could not be differentiated from R. sibirica (5).
This finding also supports our concerns.
Second, although partial rompB nucleotide sequence analysis of
rickettsiae obtained from 1 patient's serum showed 98.87% similarity with
R. conorii strain Seven, the finding does not indicate boutonneuse
fever is occurring in South Korea because high similarities (98.6%–99.8%)
are found among 4 subspecies of R. conorii. Multilocus sequence
typing can help differentiate among these subspecies (6).
This study provided a model to amplify SFG rickettsial DNA from sera
of patients, and it will be helpful in surveillance of these diseases.
However, the results should be interpreted more carefully in the context
of clinical and epidemiologic data and combined with different gene sequence
analyses to obtain a reliable and specific diagnosis.
References
- Choi YJ, Jang WJ, Kim JH, Ryu JS, Lee SH, Park KH,
et al. Spotted
fever group and typhus group rickettsioses in humans, South Korea.
Emerg Infect Dis. 2005;11:237–44.
- Roux V, Raoult D. Phylogenetic
analysis of members of the genus Rickettsia using the gene encoding
the outer-membrane protein rOmpB (ompB). Int J Syst Evol
Microbiol. 2000;50:1449–55.
- Ogata H, Audic S, Barbe V, Artiguenave F, Fournier PE, Raoult D, et
al. Selfish
DNA in protein-coding genes of Rickettsia. Science. 2000;290:347–50.
- Fournier PE, Dumler JS, Greub G, Zhnag J, Wu Y, Raoult D. Gene
sequence–based criteria for identification of new Rickettsia
isolates and description of Rickettsia heilongjiangensis sp.
nov. J Clin Microbiol. 2003;41:5456–65.
- Choi YJ, Lee SH, Park KH, Koh YS, Lee KH, Baik HS, et al. Evaluation
of PCR-based assay for diagnosis of spotted fever group rickettsioses
in human serum samples. Clin Diagn Lab Immunol. 2005;12:759–63.
- Zhu Y, Fournier PE, Eremeeva M, Raoult D. Proposal
to create subspecies of Rickettsia conorii based on multi-locus
sequence typing and an emended description of Rickettsia conorii.
BMC Microbiol. 2005;5:11.
Suggested citation
for this article:
Ma J-S. Rickettsioses
in South Korea, data analysis [letter]. Emerg Infect Dis [serial on the
Internet]. 2006 Mar [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol12no03/05-0957.htm
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