Patient and sample-related factors that effect the success of in vitro isolation of Orientia tsutsugamushi

Rungnapa Luksameetanasan, Stuart D. Blacksell*, Thareerat Kalambaheti, Vanaporn Wuthiekanun, Wirongrong Chierakul, Sunee Chueasuwanchai, Apichat Apiwattanaporn, John Stenos, Stephen Graves, Sharon J. Peacock, Nicholas P.J. Day

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)

Abstract

Orientia tsutsugamushi is the causative agent of scrub typhus infection, a major cause of human disease in rural areas of Southeast Asia. Twenty-six blood samples collected from patients with serologically proven scrub typhus during a six month period were sent to Bangkok (535 km from the clinical site) by road at ambient temperature (average daily temperature range: 27.1-29.1°C) for attempted in vitro isolation in Vero cells. O. tsutsugamushi was isolated from 12 samples (sensitivity 46.7%) with the time to isolation ranging from 16 to 37 days [median 27 days, inter-quartile range (IQR) 22.5-33.5 days]. Patient factors such as days of fever and O. tsutsugamushi IgM antibody titer, transport factors such as transit time, and isolate genotype (Karp and Gilliam/Kawasaki) were assessed to determine their influence on the outcome of in vitro isolation. None of the factors significantly influenced the isolation outcome. This study demonstrates that O. tsutsugamushi can often be isolated in vitro from the blood of scrub typhus patients when transported at ambient tropical temperatures for many days.

Original languageEnglish
Pages (from-to)91-96
Number of pages6
JournalSoutheast Asian Journal of Tropical Medicine and Public Health
Volume38
Issue number1
Publication statusPublished - Jan 2007
Externally publishedYes

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