Diagnosis Of Babesiosis Research Articles

Effects of gonadectomy on the incidence rate of babesiosis and the risk of severe babesiosis in dogs aged 6 months and older at a veterinary academic hospital in South Africa: A case-control and retrospective cohort study

Gonadectomy in dogs is associated with changes in risks of a variety of non-infectious health conditions, but few studies have examined its effects on infectious disease outcomes. The objectives of our study were to estimate the causal effect of gonadectomy on the incidence rate of babesiosis diagnosis, and on the risk of severe babesiosis in diagnosed cases, in dogs 6 months and older seen at a veterinary academic hospital in South Africa from 2013 through 2020. To estimate the effect of gonadectomy on the incidence rate of babesiosis diagnosis in dogs, we conducted a case-control study with incidence density sampling of dogs seen through the hospital’s primary care service, adjusting for sex, age, breed category and weight. We identified 811 cases and selected 3244 time-matched controls. To estimate the effect of gonadectomy on disease severity in dogs with babesiosis, we conducted a retrospective cohort study among all dogs with a diagnosis of babesiosis (n=923), including these 811 cases and a further 112 referred to the hospital, also adjusting for sex, age, breed category and weight. Gonadectomy substantially reduced the incidence rate of babesiosis (total effect incidence rate ratio [IRR] 0.5; 95 % confidence interval [CI] 0.41–0.60) and the risk of severe babesiosis among diagnosed dogs (total effect risk ratio [RR] 0.72; 95 % CI 0.60–0.86). Tipping point sensitivity analysis shows that these effect estimates are robust to unmeasured confounding bias. There was no evidence for modification of the effect of gonadectomy by sex, with effect estimates qualitatively similar for males and females for both outcomes. Compared to females, males had a higher incidence rate of babesiosis (IRR 1.74; 95 % CI 1.49–2.04) and a higher risk of severe disease (RR 1.12; 95 % CI 0.98–1.28). In conclusion, our study shows a robust protective effect of gonadectomy on the incidence and severity of babesiosis in both male and female dogs 6 months of age and older, and contributes important evidence to the debate on the overall risks and benefits of gonadectomy to dogs in this population.

Tafenoquine for Relapsing Babesiosis: A Case Series.

Relapsing babesiosis often occurs in highly immunocompromised patients and has been attributed to the acquisition of resistance against drugs commonly used for treatment such as atovaquone, azithromycin, and clindamycin. Tafenoquine, which is approved for malaria prophylaxis and presumptive antirelapse treatment of Plasmodium vivax malaria, has shown activity against Babesia microti in several animal models of acute infection and in a single human case of relapsing babesiosis. Here, we report 5 cases of relapsing babesiosis treated with tafenoquine, including the previous case, and begin to define the conditions for optimal use of tafenoquine in relapsing babesiosis. A definitive diagnosis of babesiosis was made by microscopic examination of Giemsa-stained thin blood smears or a real-time polymerase chain reaction (PCR) that targets the parasite 18S rRNA gene. Clearance of B. microti infection was ascertained by use of blood smear and real-time PCR. Tafenoquine was initiated with a loading dose of 600 mg. A weekly maintenance dose consisted of 200 mg or 300 mg; the lower dose was associated with a delayed clearance of B. microti. In 2 cases, all antimicrobial agents but tafenoquine were discontinued prior to clearance of infection. In 2 other cases, clearance was achieved while tafenoquine was administered along with other antimicrobial agents. In 3 of these 4 cases, tafenoquine was used in combination with atovaquone-proguanil. Other agents included atovaquone, azithromycin, and/or clindamycin. In 1 case, tafenoquine was administered alone and failed to prevent relapse. Tafenoquine can be a useful adjunct for the treatment of highly immunocompromised patients experiencing relapsing babesiosis caused by B. microti.

Assessment of Babesia spp. prevalence in various domestic animals across Southern Punjab, Pakistan.

Parasitic diseases, notably babesiosis, exert a substantial impact on the global cattle industry, posing challenges to commerce, economies, and human health. This study, conducted in Southern Punjab, Pakistan, aimed to assess the prevalence of Babesia spp. across various livestock species using microscopic and PCR methods. A total of 180 blood samples (60 from each district) were systematically collected from apparently healthy animals, with 36 samples obtained from each domestic animal species, including camel, cattle, buffalo, goat, and sheep, noting that 12 samples were collected from each district for each animal species. Overall prevalence was determined to be 32.8% (59/180), with varying rates among species: 25.0% in cattle, 41.66% in buffalo, 30.55% in goats, 33.3% in sheep, and 33.3% in camels. Microscopic examination revealed slightly varied infection rates among large and small domestic animals (22.2%), while PCR results indicated a 32.8% overall infection rate in both large and small domestic animals, with no statistical significance. District-wise analysis showed regional variations, with Muzaffargarh recording a prevalence rate of 23.33% through microscopic examination, while Lodhran and Bahawalpur recorded 21.67%. PCR results revealed higher rates (38.33%, 26.67%, and 33.33%, respectively), underlining the importance of employing PCR for accurate detection. Examining ruminant types, large ruminants exhibited a 32.4% infection rate, while small domestic animals showed 33.3%, with no significant difference (p=0.897). District-wise prevalence showcased significant variation, with Muzaffargarh demonstrating a 25% prevalence, Lodhran 22%, and Bahawalpur 22%, through microscopic examination. PCR results displayed 38.33%, 27%, and 33.3%, respectively, with no statistical significance. Detailed analysis of individual districts highlighted variations in infection rates among camels, cattle, buffalo, goats, and sheep. The binomial test indicated significant differences through microscopic analysis (P=0.011) but non-significant variations through PCR (P=0.065), emphasizing the precision of PCR. Regional variations in prevalence, notably with Punjab exhibiting the highest frequency (33.87%) and KPK the lowest (13.24%), suggest potential influences from varying veterinary practices and environmental factors. This study underscores the pivotal role of PCR alongside microscopy for accurate babesiosis diagnosis. These findings contribute to the broader understanding of babesiosis prevalence, emphasizing the necessity of advanced molecular techniques for informed control measures.

The effect of transfusion of erythrocyte mass on clinical and haematological indicators of dogs with hemolytic anaemia caused by babesiosis

The relevance of the research is due to the spread of protozoal diseases of animals, which, in the absence of the necessary veterinary care, lead to death. In this regard, the aim of the study was to investigate changes in clinical and haematological parameters in dogs under complex treatment of babesiosis with simultaneous red blood cell transfusion. Transfusions were performed in five animals infected with Babesia canis by intravenous injection of red blood cells, the volume of which was calculated using the Sackmen formula. The diagnosis of babesiosis was made based on anamnesis, clinical symptoms (weakness, refusal to food, pallor of visible mucous membranes, fever up to 40°C), and confirmed by microscopic detection of babesiae in blood smears. Before transfusion, rapid tests were performed to exclude heartworm disease in donor dogs. The compatibility of the blood of the donor and recipient animal was determined using a large cross-test. The condition of the abdominal organs of the patients was assessed using ultrasound diagnostics. Clinical examination of the dogs’ blood before treatment indicated the development of anaemia. The results of biochemical blood tests indicated an increase in the activity of alanine aminotransferase and gamma-glutamyl transpeptidase, which indicates a load on the hepatobiliary system. There were no contraindications to blood transfusion. After haemotransfusion, the clinical condition of the dogs was monitored based on the results of the examination of the animals, taking into account the anamnesis and haematological studies on the second, fifth, and tenth days of treatment. During the second and fifth days, a gradual increase in blood haemoglobin content and haematocrit value was noted. On the tenth day, there was a significant positive trend in the number of red blood cells, haemoglobin content and haematocrit to the reference values. It was established that the use of red blood cell transfusion in dogs with babesiosis as part of therapy contributed to the fastest recovery of the general condition of the animal. The material of the article is of practical value for the use of red blood cell transfusion in the treatment of dogs with babesiosis

Babesiosis in humans (lecture)

Babesiosis is a natural focal infectious disease caused by protozoa of the genus Babesia, transmitted transmissibly and characterized by fever, intoxication, progressive hemolytic anemia, and often severe course in immunocompromised patients. The clinical picture of babesiosis is nonspecific. The disease should be suspected in patients with unexplained fever who have been in endemic areas for 2 months or have received a blood transfusion within 6 months. Diagnosis of babesiosis is difficult; depends on the qualifications of the doctor and the number of parasites in the blood. The aim of the work is to summarize the available information about the etiology, epidemiology, pathogenesis, clinic, diagnosis, etiotropic therapy and prevention of babesiosis in humans. A review of domestic and foreign literature over the past 30 years, including Internet resources, has been carried out.

Correlation between Babesia Species Affecting Dogs in Taiwan and the Local Distribution of the Vector Ticks

The objective of our study was to survey Babesia infection rates by PCR and tick species on stray dogs to correlate the distribution of Babesia with the distribution of ticks infesting dogs in Taiwan. Three hundred eighty-eight blood samples and 3037 ticks were collected from 388 roaming, and free-ranging owned dogs at residential sites in Taiwan between January 2015 and December 2017. The prevalence of B. gibsoni and B. vogeli was 15.7% (61/388) and 9.5% (37/388), respectively. Most positive B. gibsoni dogs were found in the northern part of the country 56/61 (91.8%), whereas a few were found in the middle 5/61 (8.2%). Babesia vogeli infection rates were 10%, 3.6%, and 18.2% in the northern, central, and southern regions, respectively. Five species of ticks were found: Rhipicephalus sanguineus (throughout Taiwan), Rhipicephalus haemaphysaloides (in the north), Haemaphysalis hystricis (in the north and middle of Taiwan), and Amblyomma testidunarium and Ixodes ovatus (both in the north). None of the dogs in the south were infected with B gibsoni, which correlated with the absence of H. hystricis, a tick recently identified as the local vector for B gibsoni. Babesia vogeli was more equally distributed, coinciding with R. sanguineus, a tick that is present throughout Taiwan. Anaemia was detected in 86.9% of infected dogs; among these dogs, approximately 19.7% showed severe anaemia (HCT < 20). These findings provide useful advice for owners regarding outdoor activities with their dogs and local veterinarians with a regional differential diagnosis of babesiosis in Taiwan.

Babesia microti Variant With Multiple Resistance Mutations Detected in an Immunocompromised Patient Receiving Atovaquone Prophylaxis.

We report Babesia microti genomic sequences with multiple mutations in the atovaquone-target region of cytochrome b, including a newly identified Y272S mutation, plus 1 mutation of undetermined significance in the azithromycin-associated ribosomal protein L4. The parasite was sequenced from an immunocompromised patient on prophylactic atovaquone for Pneumocystis pneumonia before diagnosis of babesiosis.

Is babesiosis a rare zoonosis in Spain? Its impact on the Spanish Health System over 23 years.

Babesiosis is a zoonosis caused by an intraerythrocytic protozoan of the genus Babesia and transmitted mainly by ticks of the Ixodes spp. complex. There is no comprehensive global incidence in the literature, although the United States, Europe and Asia are considered to be endemic areas. In Europe, the percentage of ticks infected with Babesia spp. ranges from 0.78% to 51.78%. The incidence of babesiosis in hospitalized patients in Spain is 2.35 cases per 10,000,000 inhabitants/year. The mortality rate is estimated to be approximately 9% in hospitalized patients but can reach 20% if the disease is transmitted by transfusion. To analyze the epidemiological impact of inpatients diagnosed with babesiosis on the National Health System (NHS) of Spain between 1997 and 2019. A retrospective longitudinal descriptive study that included inpatients diagnosed with babesiosis [ICD-9-CM code 088.82, ICD-10 code B60.0, cases ap2016-2019] in public Spanish NHS hospitals between 1 January 1997 and 31 December 2019 was developed. Data were obtained from the minimum basic dataset (CMBD in Spanish), which was provided by the Ministerio de Sanidad, Servicios Sociales e Igualdad after the receipt of a duly substantiated request and the signing of a confidentiality agreement. Twenty-nine inpatients diagnosed with babesiosis were identified in Spain between 1997 and 2019 (IR: 0.28 cases/10,000,000 person-years). A total of 82.8% of the cases were men from urban areas who were approximately 46 years old. The rate of primary diagnoses was 55.2% and the number of readmissions was 79.3%. The mean hospital stay was 20.3±19.2 days, with an estimated cost of €186,925.66. Two patients, both with secondary diagnoses of babesiosis, died in our study. Human babesiosis is still a rare zoonosis in Spain, with an incidence rate that has been increasing over the years. Most cases occurred in middle-aged men from urban areas between summer and autumn. The Castilla-La-Mancha and Extremadura regions recorded the highest number of cases. Given the low rate of primary diagnoses (55.2%) and the high number of readmissions (79.3%), a low clinical suspicion is likely. There was a 6.9% mortality in our study. Both patients who died were patients with secondary diagnoses of the disease.

Investigation of Thiol-Disulphide Homeostasis, Total Oxidant-Antioxidant and Ischaemia-Modified Albumin Levels in Dogs with Babesiosis

This study was designed to reveal the diagnostic efficiency of total antioxidant capacity (TAC), total oxidant capacity (TOC), oxidative stress index (OSI), thiol/disulphide homeostasis (TDH), albumin (ALB) and ischaemia-modified albumin (IMA) parameters in the assessment of oxidative stress in dogs with babesiosis. While the babesiosis group consisted of a total of 7 dogs with clinical and parasitological (ELISA) diagnoses of babesiosis, the control group consisted of 7 healthy dogs. Blood samples were taken from both groups. While the levels of TAC, TOC and ALB in the blood serums of the groups were measured using a commercial kit, the levels of total thiol (TT), native thiol (NT) and IMA were measured using the method. The OSI and disulphide (Ds) levels were calculated using the formula. When compared with the control group, TAC and ALB levels significantly decreased, whereas the levels of TOC and OSI elevated in the babesiosis group (p&lt;0.05). No difference was found between the groups in terms of NT, TT, Ds, and IMA levels and the ratios of NT/TT, Ds/TT, and Ds/NT (p˃0.05). A negative significant correlation was found between TAC and OSI and between Ds/NT and NT, TT and NT/TT (p&lt;0.05; p&lt;0.001, respectively). A significant positive correlation was found between NT and TT and NT/TT and between TT and NT/TT (p&lt;0.001). The areas under the ROC curve of the variables TAC, TOC, OSI and ALB were found to be 0.918, 0.796, 0.980 and 1, respectively. The results showed that TAC, TOC, OSI and ALB performed diagnostically in the assessment of elevated oxidative stress in dogs with babesiosis.

Molecular detection of Babesia ovis and blood parameters' investigation reveal hematological and biochemical alterations in babesiosis-infected Lohi sheep in Multan, Pakistan.

Babesia infections in sheep can cause a wide range of clinical and laboratory presentations. Changes in blood parameters are a meaningful manifestation of physiological and pathological changes in an organism. Therefore, the present study was conducted to analyze and compare hematological and biochemical parameters between blood profiles of Lohi sheep naturally infected and uninfected with Babesia ovis, the main causative agent of ovine babesiosis. Initially, blood and serum samples from 67 Lohi sheep were collected, DNA was extracted and babesial infection was detected through polymerase chain reaction. The overall infection rate of B. ovis was 37% (25/67). Sixteen infected (experiment group) and 16 uninfected (control group) sheep that were apparently healthy with no history of previous treatment for babesiosis, were selected for hemato-biochemical analysis. Blood samples were analyzed through an automatic CBC analyzer, while serum collected from gel vacutainers was analyzed for blood urea, blood urea nitrogen (BUN), creatinine, and total bilirubin. Each parameter was compared between infected and uninfected animals using a paired t-test in Minitab Express™ software for statistical analyses. Erythron comparison showed a highly significant ( p < 0.0001) decrease in RBC, hemoglobin, and Hct. A nonsignificant increase in mean corpuscular volume (MCV), red cell distribution width (RDW), and RDW-standard deviation (RDW-SD), while a nonsignificant decrease in mean corpuscular haemoglobin (MCH) and MCH concentration (MCHC) values was recorded in infected sheep. Leukon comparison showed a significantly low level of total leukocyte (p < 0.001) in infected sheep. Platelet (Plt) along with platelet crit (Pct) and platelet distribution width (PDW) were nonsignificantly higher, whereas a nonsignificant decrease in mean Plt volume was recorded in infected sheep as compared to uninfected animals. Among biochemical parameters, blood urea, BUN, and total bilirubin showed significant differences (p < 0.05), while creatinine showed a nonsignificant difference. To the best of our knowledge, this is the first report on hemato-biochemical changes associated with babesiosis in the Lohi breed. Consistent with hemolytic anemia, these data would justify physical examination and, together with the medical history, would provide an excellent basis for the diagnosis of babesiosis.

Assessment of acute kidney injury in dogs suffering from babesiosis and leptospirosis

Acute kidney injury (AKI) is a serious complication of infectious diseases like babesiosis and leptospirosis in dogs. Both the diseases show similar clinical manifestations, due to which timely differential diagnosis often gets delayed. The present study focused on diagnosis of major infectious agents causing AKI and its grading in dogs. Peripheral blood smear examination and PCR were used for the diagnosis of babesiosis. Leptospirosis was screened using PCR and MAT and was later confirmed by MAT on paired sera sample. Diagnosis of AKI was made based on the increase in serum creatinine levels ≥0.3 mg/dL within 48 h of presentation. Staging of animals was carried out as per International Renal Interest Society (IRIS) guidelines. All the dogs with confirmed leptospirosis and 15 per cent of dogs with babesiosis were diagnosed with AKI. The timely diagnosis of AKI in dogs during their initial stages helps to regain normal renal function within short-term treatment itself.

Sensitive and rapid detection of Babesia species in dogs by recombinase polymerase amplification with lateral flow dipstick (RPA-LFD)

Canine babesiosis is a tick-borne disease caused by Babesia spp., which infects and destroys healthy erythrocytes, leading to mortality and morbidity in dogs. The diagnosis of babesiosis is tedious and time-consuming, especially in latent and chronic infections. Here, a recombinase polymerase amplification combined with a lateral flow dipstick (RPA-LFD) assay was developed for rapid and accurate detection of Babesia spp. in canine blood specimens based on the 18S rRNA region. The RPA-LFD assay using rpaBab264 gave specificity to Babesia spp. in dogs (B. vogeli and B. gibsoni) without cross-amplification to other parasites (apicomplexans and non-apicomplexans), with detection limit of at least 22.5 copies/μl (0.1 fg/µl) at 40 °C for at least 10 min. The whole process of DNA amplification by RPA and readout by LFD did not exceed 30 min. To determine the performance of the RPA-LFD assay, a total of 30 clinical samples was examined and compared with conventional PCR (cPCR) and multiplex HRM (mHRM). Eight dogs (26.67%) were detected as positive by RPA-LFD, while seven and six were found positive by cPCR and mHRM, respectively. RPA-LFD and cPCR showed high agreement with Babesia spp. detection with kappa > 0.9. We confirmed that the dogs were infected by B. vogeli from sequences of positive PCR results. Our findings suggested that RPA-LFD using the rpaBab264 assay offered a rapid, accurate, cost-effective and simple method for Babesia spp. detection that is feasibly applicable to be rapid kit at a pet hospital or point-of-care testing.

Specific and Sensitive Diagnosis of Babesia microti Active Infection Using Monoclonal Antibodies to the Immunodominant Antigen BmGPI12.

The apicomplexan pathogen Babesia microti is responsible for most cases of human babesiosis worldwide. The disease, which presents as a malaria-like illness, is potentially fatal in immunocompromised or elderly patients, making the need for its accurate and early diagnosis an urgent public health concern. B. microti is transmitted primarily by Ixodes ticks but can also be transmitted via blood transfusion. The parasite completes its asexual reproduction in the host red blood cell, where each invading merozoite develops and multiplies to produce four daughter parasites. While various techniques, such as microscopy, PCR, and indirect fluorescence, have been used over the years for babesiosis diagnosis, detection of the secreted B. microti immunodominant antigen BmGPI12 using specific polyclonal antibodies was found to be the most effective method for the diagnosis of active infection and for evaluation of clearance following drug treatment. Here, we report the development of a panel of 16 monoclonal antibodies against BmGPI12. These antibodies detected secreted BmGPI12 in the plasma of infected humans. Antigen capture assays identified a combination of two monoclonal antibodies, 4C8 and 1E11, as a basis for a monoclonal antibody-based BmGPI12 capture assay (mGPAC) to detect active B. microti infection. Using a collection of 105 previously characterized human plasma samples, the mGPAC assay showed 97.1% correlation with RNA-based PCR (transcription-mediated amplification [TMA]) for positive and negative samples. The mGPAC assay also detected BmGPI12 in the plasma of six babesiosis patients at the time of diagnosis but not in three matched posttreatment samples. The mGPAC assay could thus be used alone or in combination with other assays for accurate detection of active B. microti infection.

High Asymptomatic Cases of Babesiosis in Dogs and Comparison of Diagnostic Performance of Conventional PCR vs Blood Smears.

Babesiosis is one of the most important globally extended and quickly spreading tick-borne infections of dogs. Diagnosis of babesiosis in Sri Lanka is based on clinical signs followed by thin blood smears which could be error-prone due to undetected early infections, absence of clinical signs or low parasitemia. The present study investigated the prevalence of babesiosis in dogs presented to the Veterinary Teaching Hospital (VTH) at the Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, for treatments, vaccinations, and regular check-ups, and compared the diagnosis methods of microscopy and molecular analysis. Blood samples from dogs were collected from January to June 2019. First, Giemsa stained blood smears were prepared, and then the blood samples were subjected to PCR using genus-specific primers to amplify a 411-450bp region in the 18S rRNA gene. Twenty samples from PCR amplified products were sequenced for species identification and phylogenetic analysis. Clinical signs of the dogs were noted down, and ticks were also collected from dogs if any. Results show a very high prevalence of canine babesiosis (78.6%) among the dogs brought to the VTH. The parasite was identified microscopically and genetically as Babesia gibsoni. A large percentage (66.7%) of infections was asymptomatic. Out of 42 blood samples, 19 (45.2%) were microscopically positive for babesiosis while 33 (78.6%) were PCR positive, showing a significant difference in the two methods of diagnosis (chi-square test, χ2 = 9.462, p = 0.002). Three tick species: Rhipicephalus haemaphysaloides, Haemaphysalis bispinosa, and Rhipicephalus sanguineus were found attached to the dogs. This study shows a very high prevalence of canine babesiosis among dogs in the Kandy area. Most of these infections might go undetected if only microscopy was used to diagnose. An improved, rapid diagnostic method such as the novel, PCR-based point-of-care diagnostic method that detects very low parasitemia within 30min is needed. Moreover, as most infected dogs did not show clinical signs, they may act as reservoirs of infection. The ability of asymptomatic dogs to spread babesiosis should be investigated.

Babesia crassa-Like Human Infection Indicating Need for Adapted PCR Diagnosis of Babesiosis, France.

Human babesiosis in Europe is caused by multiple zoonotic species. We describe a case in a splenectomized patient, in which a routine Babesia divergens PCR result was negative. A universal Babesia spp. PCR yielded a positive result and enabled classification of the parasite into the less-described Babesia crassa–like complex.

932. Clinical Characteristics of Persistent and Relapsing Babesiosis at an Academic Medical Center in New York City, 2015-2020

Abstract Background Current guidelines recommend at least 6 weeks of therapy for immunocompromised babesiosis patients; however, limited data exists to guide management in this population. We describe our institutional experience with immunocompromised babesiosis patients. Methods We reviewed all adult patients reported to the New York City Department of Health and Mental Hygiene with a diagnosis of babesiosis at New York-Presbyterian (NYP)/Weill Cornell Medical Center and NYP/Lower Manhattan Hospital between 2015 and 2020. We compared characteristics and outcomes between patients receiving prolonged treatment (≥ 6 weeks; “cases”) and standard treatment (7-10 days; “controls”). Variables were compared using Fishers exact test or Wilcoxon Rank Sum test. Results Among 35 patients diagnosed with babesiosis, 10 (29%) received at least 6 weeks of therapy. 5/10 (50%) received extended treatment due to persistent and/or relapsing parasitemia, evidence of hemolysis and/or clinical symptoms at 6 weeks from diagnosis (Table 1). The median age was 67 years and immunocompromising conditions included: anti-CD 20 therapy (40%), history of stem cell transplant (20%), anti-TNF alpha (10%), beta-thalassemia (10%), Waldenstrom’s macroglobulinemia (10%). Among case patients, the median treatment duration was 53 days (IQR 42-153) and 100% of patients received azithromycin/atovaquone based regimens with adjunctive agents including doxycycline (60%), clindamycin (20%) and proguanil (20%). Compared to control patients, case patients had higher frequency of blood transfusions (50% vs 12%; p=0.03), however, there was no difference in median peak parasitemia (1.13% vs 0.6%), rates of hospital admission (80% vs 88%), length of stay (6 vs 4 days), organ dysfunction (10% vs 4%) and mortality (0% vs 0%) (Table 2). Conclusion We found a high frequency (29%) of babesiosis patients at our medical center received at least a 6-week treatment course due to immunocompromising conditions. Although immunocompromised patients received longer treatment courses and had more severe anemia, in contrast to prior studies, we found other complications such as hospitalization rates, length of stay, organ dysfunction and mortality were comparable between both patient groups. Disclosures Lars Westblade, PhD, Accelerate Diagnostics Inc (Grant/Research Support)BioFire Diagnostics (Grant/Research Support)Hardy Diagnostics (Grant/Research Support)Roche (Consultant, Advisor or Review Panel member)Shionogi Inc (Advisor or Review Panel member)Talis Biomedical (Advisor or Review Panel member)

MONITORING OF THE ASSOCIATED COURSE OF LEPTOSPIROSIS AND BABESIOSIS IN DOGS OF THE SUMY REGION OF UKRAINE

Leptospirosis and babesiosis in dogs may be associated. These diseases often have similar symptoms and mask each other, or are asymptomatic, which complicates the diagnosis, significantly worsens the prognosis and reduces the survival of sick animals. Monitoring of the associated course of leptospirosis and babesiosis in dogs makes it possible to study the frequency of this parasitocenosis in dogs and the peculiarities of its course, which is the basis for improving the diagnosis and treatment of sick animals.&#x0D; The aim of the research. Monitor the associated course of leptospirosis and babesiosis in dogs.&#x0D; Methods. The research was conducted in the private veterinary clinic “Vetservice” in Sumy and in the serology department of the Sumy Regional State Laboratory of the Civil Service of Ukraine for Food Safety and Consumer Protection. Blood samples were taken from dogs came for treatment to the “Vetservice” clinic. The diagnosis of babesiosis was established directly in the clinic by the results of erythrocyte microscopy in thin smears of peripheral blood of sick dogs stained by Giemsa. The diagnosis of leptospirosis was established in the serology department of the Sumy Regional State Laboratory based on the results of a study of the serum of sick dogs in the microagglutination reaction. The subjects of the study were clinically ill and suspected dogs with the associated course of leptospirosis and babesiosis, as well as blood samples from these animals. Babesium trophozoites were detected in erythrocytes under an immersion microscope, a magnification of ocular 10 x 90, and the presence of antibodies to leptospira was detected by the presence of agglutination of leptospira in microagglutination reaction.&#x0D; Results. In the study of the incidence of dogs associated with leptospirosis and babesiosis during 2014–2019, according to the clinic “Vetservice” found that the number of reported cases of associated leptospirosis and babesiosis annually varies from 9 to 28 cases. This parasitocenosis is registered all year round with peaks in spring and autumn, moderately in summer and rarely in winter. Purebred animals get sick several times more often than non pedigree ones. During the period from 2016 to 2019, the number of diseases in females and males was approximately the same. During the period from 2014 to 2015, males were more often ill.&#x0D; Conclusions. The prevalence of the associated course of leptospirosis and babesiosis in dogs of the Sumy region of Ukraine was determined with the determination of seasonal, breed and sexual dynamics of this parasitocenosis

Etiopathogenetic Assessment of Tick Skin Injuries in Vacationers of Suburban Resorts and Tourists of Ukraine as a Component of a Complex Diagnostic Algorithm of Babesiosis

Aim: The aim of the study is to improve the complex diagnostic algorithm of babesiosis by etiopathogenetic assessment of tick skin lesions in vacationers of suburban resorts and tourists of Ukraine. Material and Methods: In order to objectify the etiopathogenetic assessment of tick skin lesions in vacationers of suburban resorts and tourists of Ukraine, animals affected by attacks of active stages of Ixodes, to determine their role as a component in a comprehensive diagnostic algorithm of babesiosis, we used a set of epidemic, epizootological, clinical and diagnostic measures. Skin lesions were considered acaroidal only in cases when ticks from the superfamily Ixodoidea of the family Ixodidea of the species Ixodes ricinus and Ixodes persulcatus (n=34), Dermacentor marginatus and Dermacentor pictus (n=128) were detected on it or on the clothes of the bitten person. Ticks of the species Ixodes ricinus, Ixodes persulcatus, Dermacentor marginatus and Dermacentor pictus were studied and photographed on an Olympus BX-41 microscope (Japan) using a digital camera. The surveyed 64 people of both sexes, aged 17 to 68, belonged to different categories of vacationers or tourists (organized, semi-organized, «savages»). The morphological material (skin with underlying soft tissues) was collected in cases of attacks of Ixodes on pets (dogs), accompanying the owners on vacation, when it was possible. Microspecimens stained with hematoxylin and eosin, picrofuxin according to van Gizon, according to Mallory were studied using an Olympus BX-41 microscope (Japan) with subsequent processing with the Olympus DP-soft version 3.1 software. Results: Climatotherapy is a popular treatment and prevention measure in the coordinate system «doctor-patient». This treatment method is characterized by both positive health effects and negative consequences, among which are the development of such dangerous parasitic disease as babesiosis. Etiopathogenetic assessment of tick skin lesions in vacationers of suburban resorts and tourists of Ukraine is an important component of a comprehensive diagnostic algorithm for babesiosis. Its objectification is based on the effective application of the data informative potential on the cycle and period of development of one generation of carriers (imago), the specifics of active stages (differentiation into three-host mites), habitat characteristics (shrubs, deciduous trees), seasonality (April-June, August-September), climatic zonation (temperate climate of the forest-steppe), their ability to inoculate babesiosis pathogens into the body of warm-blooded vertebrates. Macroscopic and microscopic features of the skin with underlying soft tissues at the sites of fixation and feeding of mites in susceptible to pathogens babesiosis humans and animals depend on the duration of this damaging factor exposure. Conclusions: Etiopathogenetic assessment of tick skin lesions in vacationers of suburban resorts and tourists of Ukraine is of great importance in the diagnosis of babesiosis.

CULTURAL METHOD IN BABESIOSIS PATHOGENS DIAGNOSIS: CURRENT STATE OF THE PROBLEM

The aim is to show the effectiveness of the cultural method in the diagnosis of babesiosis. Materials and methods: The study material was the blood from 10 healthy humans and animals, 30 humans with borreliosis, 41 animals with babesiosis. A cultural research method was used. Results: The use of cultural method contributed to the optimization of the etiopathogenetic diagnosis of babesiosis. The method objectively proved the ability of protozoa (Babesia spp.) to asexual reproduction in vitro on the multicomponent growth medium with erythrocytes; proved the role of erythrocytes as acceptable for Babesia spp. of target cells. Absolute and relative parameters of detection of Babesia spp. by cultural method in the blood samples of the groups of the examined persons/species were different, making on average 19.7% (with the highest rates among the domestic dogs (62.5%) and cattle (20.0%)). Negative result (0%) was identified among the patients with borreliosis. Conclusions: Detection of Babesia spp. by the cultural method objectively confirmed its value as an apparent laboratory criterion for the etiopathogenetic diagnosis of babesiosis.

746. Comparing Hospital Course in Hospitalized Patients Infected with Babesiosis Versus Patients Coinfected with Lyme Disease and Babesiosis

BackgroundResearch is currently lacking on the interplay between Babesiosis and Lyme disease (LD) and how this coinfection may translate into morbidity and mortality. The aim of this study is to compare the clinical features of patients with single-infection with Babesia microti to those co-infected with Borrelia burgdorferi and Babesia microti.MethodsA retrospective review of all adult patients diagnosed with babesiosis and tested for LD at Stony Brook University Hospital between 2014 and 2019 was performed (n=40). Patients with single babesia infection (Group 1, n=22) were compared to those with Babesia and LD (Group 2, n=18). Babesiosis diagnosis was determined by microscopic visualization of Babesia spp under peripheral blood smear, and confirmed by PCR for B. microti. LD inclusion criteria included a positive screened ELISA test for lyme followed by positive IgM antibody by western blot per CDC criteria (2-3 positive bands). Statistical analysis of the data involved Fisher exact test, Chi-square test, independent t-test, and Wilcoxon rank sum tests. Statistical significance was considered as a p-value less than 0.05.ResultsThere was no significant difference in gender, race, and age (p >.75) between both groups as well as comorbidities including hypertension, diabetes, heart conditions, and immunocompromised state (p=1.0). Maximum parasitemia (Group 1: 1.1%, Group 2: 1.7%, p= 0.26) and percentage admitted to the ICU (Group 1: 18.18%, Group 2: 22.22%, p=1.0) were similar among both groups. While lab values on admission including WBC, hemoglobin, platelets, LDH, ALT, and AST did not significantly differ (p >.09), the length of hospital stay in group 2 was significantly longer than group 1 (Group 1: 3.0 days, Group 2: 5.5 days; p=0.03). There was a 0% mortality rate among both groups.Table 2: Biomarkers of Patients Monoinfected with Babesiosis Versus Patients Coinfected with Babesiosis and Lyme Disease. Table 1: Demographics of Patients Monoinfected with Babesiosis Versus Patients Coinfected with Babesiosis and Lyme Disease. ConclusionIt is remarkable that despite no differences in lab values on admission, comorbidities, and demographics, patients with a coinfection had a longer hospital stay than those with only babesiosis. This suggests that having a coinfection with babesiosis and LD may lead to a more severe illness than a single infection with babesiosis.Disclosures All Authors: No reported disclosures