ArticlePLoS neglected tropical diseases2023
Genomic bacterial load associated with bacterial genotypes and clinical characteristics in patients with scrub typhus in Hainan Island, Southern China.
Article in PLoS neglected tropical diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 16 citations in OpenAlex.
- Clinical, Molecular, and Immunological Characteristics of Scrub Typhus in Nepal.Open forum infectious diseases · 2026Article
- Cytokine and chemokine profiles linked to early severity of scrub typhus: multicenter validation of soluble PD-L1.Journal of clinical microbiology · 2026Article
- A Compact Closed Genome ofPathogens (Basel, Switzerland) · 2026Article
- Nasopharyngeal Swabs forPathogens (Basel, Switzerland) · 2026Article
- Comparison of Diagnostic Performance of Commercially Available Serological and Molecular Tests for Detection ofJournal of clinical medicine · 2026Article
- Differential spleen immune signatures and germinal center responses during acute infection withFrontiers in immunology · 2026Article
- Case Report: An imported severe case of paediatric scrub typhus with Karp B subgenotype in non-endemic Northern China, Beijing.Frontiers in pediatrics · 2026Article
- Genotype Analysis onTropical medicine and infectious disease · 2025Article
- Comprehensive Laboratory Analysis of a Scrub Typhus and H1N1 Influenza Co-Infection: A Case Report from Hainan, China.Pathogens (Basel, Switzerland) · 2025Article
- Severe Scrub Typhus with Acute Kidney Injury: Urine PCR Evidence from an East Coast Malaysian Cluster.Tropical medicine and infectious disease · 2025Article
- Dual-Genotype Orientia tsutsugamushi Infections, Hainan Island, China, 2023.Emerging infectious diseases · 2025Article
- Comparative virulence analysis of seven diverse strains of Orientia tsutsugamushi reveals a multifaceted and complex interplay of virulence factors responsible for disease.PLoS pathogens · 2025Article
- Patient-centric analysis of Orientia tsutsugamushi spatial diversity patterns across Hainan Island, China.PLoS neglected tropical diseases · 2025Article
- Epidemiological and clinical characteristics of scrub typhus in Guizhou Province, China: An outbreak study of scrub typhus.PLoS neglected tropical diseases · 2024Article
- Differential cellular immune responses against Orientia tsutsugamushi Karp and Gilliam strains following acute infection in mice.PLoS neglected tropical diseases · 2023Article
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Authors and funding
25 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Scrub typhus, caused by mite-borne Orientia tsutsugamushi (O. tsutsugamushi), is a major febrile disease in the Asia-Pacific region. The DNA load of O. tsutsugamushi in the blood was previously found to be significantly higher in patients with fatal disease than those with non-fatal disease and correlated with the duration of illness, presence of eschar, and hepatic enzyme levels. In this prospective observation study, we analyzed the association of bacterial DNA load with clinical features, disease severity, and genotype using real-time PCR targeting the 56 kDa TSA gene of O. tsutsugamushi in the blood samples of 117 surviving patients with scrub typhus who had not received appropriate antibiotic treatment. The median O. tsutsugamushi DNA load was 3.11×103 copies/mL (range, 44 to 3.3×106 copies/mL). The severity of patients was categorized as mild, moderate, and severe based on the number of dysfunctional organs, and no significant difference in O. tsutsugamushi DNA load was found among these groups. Patients infected with the Karp group showed a significantly higher O. tsutsugamushi DNA load than those in the Gilliam (P < 0.05) and TA763 (P < 0.01) groups. Patients belonging to the Li ethnic group showed a significantly higher DNA load than those in the Han ethnic groups. The blood bacterial DNA load of patients showed no significant difference between groups divided by gender, age, with or without eschar, or the season of disease onset. The highest body temperature recorded during fever onset was positively correlated with O. tsutsugamushi DNA load (ρ = 0.272, P = 0.022). Correlation analyses indicated that the serum total bilirubin level was positively correlated with O. tsutsugamushi DNA load. In conclusion, the findings in this study demonstrated the association of DNA load of O. tsutsugamushi with the severity and genotype in patients with scrub typhus in Hainan, China.
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