A total of 123 Coxiella burnetii strains detected in cattle from a nationwide survey in Korea were classified into five genomic groups: I (0.8%), II (14.6%), III (12.2%), IV (66.7%), and V (5.7%). Acute Q-fever strains (Groups I, II, and III) comprised 27.6% and chronic strains (Groups IV and V) comprised 72.4%. At a dairy farm where both types were present, the detection rate was 6.7-times higher than that of another farm where only chronic strains were detected. Both acute and chronic Q-fever strains are widespread in Korea, and their presence could represent an active transmission to livestock and humans.
Agriculture ; Animals ; Cattle ; Coxiella burnetii ; Coxiella ; Humans ; Korea ; Livestock

In 1993, I reported that Coxiella burnetii transforms human B cells into hairy cells (cbHCs), the first hairy cell reported outside of hairy cell leukemia (HCL). Over last few decades, advances in molecular biology have provided evidence supporting that C. burnetii induces hairiness and inhibits the apoptosis of host cells. The present review summarizes new information in support of cbHC. C. burnetii was shown to induce reorganization of the cytoskeleton and to inhibit apoptosis in host cells. Peritoneal B1a cells were found to be permissive for virulent C. burnetii Nine Mile phase I (NMI) strains in mice. C. burnetii severely impaired E-cad expression in circulating cells of Q fever patients. B-cell non-Hodgkin lymphoma was linked to C. burnetii. Mutation of BRAF V600E was pronounced in HCL, but “hairiness” was not linked to the mutation. Risk factors shared among coxiellosis and HCL in humans and animals were reported in patients with Q-fever. Accordingly, I propose that C. burnetii induces reorganization of the cytoskeleton and inhibits apoptosis as cytopathic effects that are not target cell specific. The observed hairiness in cbHC appears to be a fixed image of dynamic nature, and hairy cells in HCL are distinct among lymphoid cells in circulation. As the cytoskeleton plays key roles in maintaining cell structural integrity in health and disease, the pathophysiology of similar cytopathic effects should be addressed in other diseases, such as myopathies, B-cell dyscrasias, and autoimmune syndromes.
Animals ; Apoptosis ; B-Lymphocytes ; Coxiella burnetii ; Coxiella ; Cytoskeleton ; Humans ; Leukemia, Hairy Cell ; Lymphocytes ; Lymphoma, Non-Hodgkin ; Mice ; Molecular Biology ; Muscular Diseases ; Q Fever ; Risk Factors

In a population-based study with 4 years of follow up, we evaluated the prevalence of Coxiella burnetii in cattle on Ulleung Island, Korea. In this study, the rates of C. burnetii infection in cattle on Ulleung Island were determined by PCR and were found to be 0.3–1.0% in the period 2011–2014. All 17 C. burnetii partial 16S rRNA gene sequences from PCR-positive cattle were identical and 2 geographic representatives were included in our analysis. The nucleotide sequences of the 2 samples showed high (98.4–100%) identity with C. burnetii sequences obtained from the GenBank. In this long-term tracking study, the number of cattle positive for C. burnetii on Ulleung Island was low. To prevent the transmission of C. burnetii on Ulleung Island, control strategy should include biosecurity improvement in surveillance, livestock management, administering suitable tests before purchasing animals to detect C. burnetii shedders, and restricting movements between herds.
Animals ; Base Sequence ; Cattle ; Coxiella burnetii ; Coxiella ; Databases, Nucleic Acid ; Follow-Up Studies ; Genes, rRNA ; Korea ; Livestock ; Phylogeny ; Polymerase Chain Reaction ; Prevalence

BACKGROUND: The zoonotic disease Q fever is caused by Coxiella burnetii and usually affects high-risk human populations. We conducted a serological survey of dairy cattle farmers in Korea to determine seroreactivity and identify risk factors for C. burnetii infection. METHODS: This cross-sectional study included 1,824 of 7,219 dairy cattle farms (25.3%) in the study region. The selected dairy cattle farmers visited the nearest public health centers or branches with completed questionnaires. Serum samples from the farmers were tested using an indirect immunofluorescence assay to detect phase II C. burnetii immunoglobulin (Ig) G or M antibodies. RESULTS: A total of 1,222 dairy cattle farmers from 784 dairy cattle farms (43.0%) participated in this study, and 11.0% (134/1,222) exhibited seroreactivity, defined as a phase II antigen IgG or IgM titer ≥ 1:16. In the multivariate analysis, male sex, residence in Gyeonggi Province, a larger herd size, and ocular/oral contact with birth products during calf delivery were significantly associated with a higher risk of C. burnetii infection. Furthermore, the risk was significantly lower among farmers who always wore protective gloves while cleaning cattle excretion, compared to those who sometimes or rarely wore protective gloves. CONCLUSION: Dairy cattle farmers should exercise caution by avoiding ocular/oral contact with birth products during calf delivery and by using protective equipment (including gloves).
Agriculture ; Animals ; Antibodies ; Cattle* ; Coxiella burnetii* ; Coxiella* ; Cross-Sectional Studies ; Farmers* ; Fluorescent Antibody Technique, Indirect ; Gloves, Protective ; Gyeonggi-do ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Korea* ; Male ; Multivariate Analysis ; Parturition ; Public Health ; Q Fever* ; Risk Factors* ; Serologic Tests ; Zoonoses

BACKGROUND: This study aimed to evaluate the epidemiology, clinical and microbiological features, treatment, and outcomes of infective endocarditis (IE) on the island of Crete, a region with high levels of antimicrobial resistance. MATERIALS AND METHODS: Medical records of all hospitalized patients diagnosed with IE at the University Hospital of Heraklion, Crete, Greece, from 1995 to 2015, were retrospectively reviewed. Patients who met the modified Duke's criteria for definite or possible IE were included. RESULTS: A total of 82 IE patients (median age 67 [range 21–86] years) were included. Most patients suffered from left-sided IE (94%), while most cases of infection occurred in native valves (53.6%). Systemic inflammatory response syndrome criteria were lacking in almost half of the patient population. The leading causative microorganism was Staphylococcus aureus, isolated in 24 cases (29%), followed by Streptococcus spp. in 15 (18%) and Enterococcus spp. in 12 (14.5%). A number of rare and difficult to treat microorganisms had been identified, such as Gemella morbillorum in four cases (4.5%), Streptococcus lugdunensis in two (2.5%) and Streptococcus pneumoniae in one (1%). One patient was serologically positive for Coxiella burnetii (1%). All patients received empirical antimicrobial treatment, proven appropriate in 39 blood culture-positive patients (56.5%). Thirteen (16%) patients were classified as culture negative. Seven patients (8.5%) were surgically treated. In-hospital death occurred in 9 patients (11%). CONCLUSION: Changes in IE profile requires continuous epidemiological updates. Staphylococcus and Streptococcus spp. remain the most common etiologic agents. However, the presence of uncommon and/or difficult to treat pathogens raise concerns on the appropriate prophylaxis as well as empirical treatment.
Coxiella burnetii ; Endocarditis* ; Enterococcus ; Epidemiology* ; Gemella ; Greece* ; Humans ; Medical Records ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Systemic Inflammatory Response Syndrome ; Treatment Outcome

BACKGROUND: This study aimed to evaluate the epidemiology, clinical and microbiological features, treatment, and outcomes of infective endocarditis (IE) on the island of Crete, a region with high levels of antimicrobial resistance. MATERIALS AND METHODS: Medical records of all hospitalized patients diagnosed with IE at the University Hospital of Heraklion, Crete, Greece, from 1995 to 2015, were retrospectively reviewed. Patients who met the modified Duke's criteria for definite or possible IE were included. RESULTS: A total of 82 IE patients (median age 67 [range 21–86] years) were included. Most patients suffered from left-sided IE (94%), while most cases of infection occurred in native valves (53.6%). Systemic inflammatory response syndrome criteria were lacking in almost half of the patient population. The leading causative microorganism was Staphylococcus aureus, isolated in 24 cases (29%), followed by Streptococcus spp. in 15 (18%) and Enterococcus spp. in 12 (14.5%). A number of rare and difficult to treat microorganisms had been identified, such as Gemella morbillorum in four cases (4.5%), Streptococcus lugdunensis in two (2.5%) and Streptococcus pneumoniae in one (1%). One patient was serologically positive for Coxiella burnetii (1%). All patients received empirical antimicrobial treatment, proven appropriate in 39 blood culture-positive patients (56.5%). Thirteen (16%) patients were classified as culture negative. Seven patients (8.5%) were surgically treated. In-hospital death occurred in 9 patients (11%). CONCLUSION: Changes in IE profile requires continuous epidemiological updates. Staphylococcus and Streptococcus spp. remain the most common etiologic agents. However, the presence of uncommon and/or difficult to treat pathogens raise concerns on the appropriate prophylaxis as well as empirical treatment.
Coxiella burnetii ; Endocarditis* ; Enterococcus ; Epidemiology* ; Gemella ; Greece* ; Humans ; Medical Records ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Streptococcus pneumoniae ; Systemic Inflammatory Response Syndrome ; Treatment Outcome

We assessed the seroprevalence of Coxiella burnetii (C. burnetii) in cattle on Ulleung Island, Korea in a population-based follow up study for 4 years and determined the spatial distribution and risk factors associated with C. burnetii. The seroprevalence of C. burnetii was determined to be 1.4–2.0% during 2011–2014. Overall, nine cattle from three farms that tested seropositive showed C. burnetii antibody seroconversions between 2011 and 2014. The number of seropositive cattle was low, suggesting that movement of and contact between animals was possible risk factors for the transmission of C. burnetii.
Agriculture ; Animals ; Cattle ; Coxiella burnetii ; Coxiella ; Enzyme-Linked Immunosorbent Assay ; Follow-Up Studies ; Korea ; Q Fever ; Risk Factors ; Seroconversion ; Seroepidemiologic Studies

Although Q fever is an important zoonotic infection with a worldwide distribution, no human isolates of Coxiella burnetii have been identified in Korea. For the first time, we identified the nucleotide sequence of C. burnetii from a 32-year-old man with an acute febrile illness in Korea. Diagnosis of acute Q fever was confirmed by seroconversion using indirect immunofluorescence antibody assays. Phylogenetic analysis demonstrated high sequence similarity (99.6%–100%) with C. burnetii 16S rRNA sequences identified from the reservoir. These results are the first genetic analysis of C. burnetii in a human case of Q fever in Korea.
Adult ; Base Sequence ; Coxiella burnetii* ; Coxiella* ; Diagnosis ; Fluorescent Antibody Technique, Indirect ; Humans ; Korea* ; Q Fever ; Seroconversion ; Zoonoses

OBJECTIVES: Q fever is a zoonotic disease that occurs worldwide; however, little is known about its prevalence in South Korea. We attempted to determine the prevalence of Q fever seroreactivity among Korean slaughterhouse workers and the risk factors for seroreactivity according to the type of work. METHODS: The study was conducted among 1503 workers at a total of 73 slaughterhouses and 62 residual-product disposal plants. During the study period, sites were visited and surveys were administered to employees involved in slaughterhouse work, and serological tests were performed on blood samples by indirect immunofluorescence assays. Serological samples were grouped by job classification into those of slaughter workers, residual-product handlers, inspectors and inspection assistants, and grading testers and testing assistants. Employee risk factors were analyzed according to the type of work. RESULTS: Out of 1481 study subjects who provided a blood sample, 151 (10.2%) showed reactive antibodies. When these results were analyzed in accordance with the type of work, the result of slaughter workers (11.3%) was similar to the result of residual-product handlers (11.4%), and the result of inspectors and assistants (5.3%) was similar to the result of grading testers and assistants (5.4%). Among those who answered in the affirmative to the survey question, “Has there been frequent contact between cattle blood and your mouth while working?” the proportions were 13.4 and 4.6%, respectively, and this was identified as a risk factor that significantly varied between job categories among slaughterhouse workers. CONCLUSIONS: This study found a Q fever seroreactivity rate of 10.2% for slaughterhouse workers, who are known to be a high-risk population. Contact with cattle blood around the mouth while working was the differential risk factor between job categories among slaughterhouse workers.
Abattoirs* ; Animals ; Antibodies ; Cattle ; Classification ; Coxiella burnetii ; Fluorescent Antibody Technique, Indirect ; Korea* ; Mouth ; Prevalence ; Q Fever* ; Risk Factors ; Serologic Tests ; Zoonoses

Q fever is a zoonosis caused by a Coxiella burnetii. Q fever is clinically variable, presenting as asymptomatic infection, pneumonia, hepatitis and endocarditis. Treatment of acute Q fever with doxycycline is usually successful. Autoantibodies, such as anti-mitochondrial antibodies, smooth muscle antibodies (SMA), anti-cardiolipin and lupus anticoagulant, often rise in acute Q fever infection. Some cases may occasionally meet the criteria for autoimmune disease like systemic lupus erythematosus. We report a first case of Q fever that may mimic systemic lupus erythematosus in Korea.
Antibodies ; Asymptomatic Infections ; Autoantibodies ; Autoimmune Diseases ; Coxiella burnetii ; Doxycycline ; Endocarditis ; Hepatitis ; Hydrazines ; Korea ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Muscle, Smooth ; Pneumonia ; Q Fever