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J Infect. 2014 Aug;69(2):154-60. doi: 10.1016/j.jinf.2014.03.009. Epub 2014 Mar 16.

Estimated prevalence of chronic Q fever among Coxiella burnetii seropositive patients with an abdominal aortic/iliac aneurysm or aorto-iliac reconstruction after a large Dutch Q fever outbreak.

Author information

1
Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. Electronic address: j.c.j.p.hagenaars@gmail.com.
2
Dept. of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
3
Dept. of Surgery, Bernhoven Hospital, Uden, The Netherlands.
4
Dept. of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
5
Dept. of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands.
6
Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
7
Dept. of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
8
Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.

Abstract

OBJECTIVES:

The aim of this study was to estimate the seroprevalence of Q fever and prevalence of chronic Q fever in patients with abdominal aortic and/or iliac disease after the Q fever outbreak of 2007-2010 in the Netherlands.

METHODS:

In November 2009, an ongoing screening program for Q fever was initiated. Patients with abdominal aortic and/or iliac disease were screened for presence of IgM and IgG antibodies to phase I and II antigens of Coxiella burnetii using immunofluorescence assay and presence of C. burnetii DNA in sera and/or vascular wall tissue using polymerase chain reaction (PCR).

RESULTS:

A total of 770 patients with abdominal aortic and/or iliac disease were screened. Antibodies against C. burnetii were detected in 130 patients (16.9%), of which 40 (30.8%) patients showed a serological profile of chronic Q fever. Three patients presented with acute Q fever, one of which developed to chronic Q fever over time. The number of aneurysm-related acute complications in patients with chronic Q fever was significantly higher compared to patients negative for Q fever (p = 0.013); 9.0% (30/333) vs. 30.0% (6/20). Eight out of 46 patients with past resolved Q fever (8/46, 17.4%) presented with aneurysm-related acute complications (no significant difference).

CONCLUSION:

The prevalence of chronic Q fever in C. burnetii seropositive patients with abdominal aortic and/or iliac disease living in an epidemic area in the Netherlands is remarkably high (30.8%). Patients with an aneurysm and chronic Q fever present more often with an aneurysm-related acute complication compared to patients without evidence of Q fever infection.

KEYWORDS:

Aneurysm; Chronic Q fever; Seroprevalence; Vascular graft

PMID:
24647145
DOI:
10.1016/j.jinf.2014.03.009
[Indexed for MEDLINE]

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