Evidence map›Paper›PMID 34625049›Full record

ArticleBMC infectious diseases2021

Tick-transmitted co-infections among erythema migrans patients in a general practice setting in Norway: a clinical and laboratory follow-up study.

Knut Eirik Eliassen, Lukas Frans Ocias, Karen A Krogfelt, Peter Wilhelmsson, Susanne Gjeruldsen Dudman, Åshild Andreassen, Morten Lindbak, Per-Eric Lindgren

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 6 citations in OpenAlex.

  1. Review
  2. Observational
  3. Tick-borne co-infections in Europe: Clinical conundrums.New microbes and new infections · 2023
    Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 3 countries.

Knut Eirik Eliassen *Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020, Bergen, Norway. knut.eliassen@uib.no.
Lukas Frans Ocias *Department of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Artillerivej 5, 2100, Copenhagen, Denmark.
Karen A KrogfeltDepartment of Virus and Microbiological Special Diagnostics, Statens Serum Institut, Artillerivej 5, 2100, Copenhagen, Denmark.
Peter WilhelmssonDivision of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.
Susanne Gjeruldsen DudmanInstitute of Clinical Medicine, University of Oslo, 0316, Oslo, Norway.
Åshild AndreassenDepartment of Virology and Infection Immunology, Norwegian Institute of Public Health, 0213, Oslo, Norway.
Morten LindbakAntibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0316, Oslo, Norway.
Per-Eric LindgrenDivision of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 58185, Linköping, Sweden.
Linköping University · SEUniversity of Oslo · NOKarlstad Central Hospital · SENorwegian Institute of Public Health · NORoskilde University · DKUniversity of Bergen · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundErythema migrans (EM) is the most common manifestation of Lyme borreliosis. Here, we examined EM patients in Norwegian general practice to find the proportion exposed to tick-transmitted microorganisms other than Borrelia, and the impact of co-infection on the clinical manifestations and disease duration.

methodsSkin biopsies from 139/188 EM patients were analyzed using PCR for Neoehrlichia mikurensis, Rickettsia spp., Anaplasma phagocytophilum and Babesia spp. Follow-up sera from 135/188 patients were analyzed for spotted fever group (SFG) Rickettsia, A. phagocytophilum and Babesia microti antibodies, and tested with PCR if positive. Day 0 sera from patients with fever (8/188) or EM duration of ≥ 21 days (69/188) were analyzed, using PCR, for A. phagocytophilum, Rickettsia spp., Babesia spp. and N. mikurensis. Day 14 sera were tested for TBEV IgG.

resultsWe detected no microorganisms in the skin biopsies nor in the sera of patients with fever or prolonged EM duration. Serological signs of exposure against SFG Rickettsia and A. phagocytophilum were detected in 11/135 and 8/135, respectively. Three patients exhibited both SFG Rickettsia and A. phagocytophilum antibodies, albeit negative PCR. No antibodies were detected against B. microti. 2/187 had TBEV antibodies without prior immunization. There was no significant increase in clinical symptoms or disease duration in patients with possible co-infection.

conclusionsCo-infection with N. mikurensis, A. phagocytophilum, SFG Rickettsia, Babesia spp. and TBEV is uncommon in Norwegian EM patients. Despite detecting antibodies against SFG Rickettsia and A. phagocytophilum in some patients, no clinical implications could be demonstrated.

Indexed as

CoinfectionGeneral PracticeIxodesAnimalsErythemaFollow-Up StudiesHumansLaboratoriesAntibiotic guidelinesClinical microbiologyGeneral practiceTick-borne infections

Identifiers

PMID34625049
PMCPMC8501555
OpenAlexW3202970681

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.