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Francisella tularensis-specific antibody levels in sera from Swedish patients with suspected tularemia during a 13-year period
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.ORCID iD: 0000-0002-8143-8500
Umeå University, Faculty of Medicine, Department of Clinical Microbiology.ORCID iD: 0000-0002-0768-8405
2024 (English)In: Frontiers in Cellular and Infection Microbiology, E-ISSN 2235-2988, Vol. 14, article id 1381776Article in journal (Refereed) Published
Abstract [en]

Introduction: For a majority of tularemia patients, serology is the basis for the diagnosis. The aim of this study was to perform an analysis of the samples analyzed at a Swedish reference laboratory for the presence of Francisella tularensis-specific antibody levels in sera from individuals with suspected tularemia. Annual and monthly variations of the total number of samples and proportions of positive samples were analyzed, as well as the influence of age and gender.

Methods: We performed a retrospective analysis of the presence of F. tularensis-specific antibodies in serological samples from patients with suspected tularemia analyzed during the period 2010 - 2022 at the University Hospital of Umeå in Sweden, a national reference laboratory, by use of various statistical methods. In total, some 15,100 serum samples had been analyzed for the presence of IgG and IgM antibodies by ELISA during the 13-year period.

Results: Overall, there were higher number of samples with IgG positive or borderline titers, 2,522 and 921, respectively, than with IgM positive or borderline titers, 1,802 and 409, respectively. Repeated samples were obtained from some 1,930 individuals and approximately a third of the cases, which were initially seronegative, had seroconverted when resampled. Peak number of monthly samples were recorded in August and September, > 3,000. Annual numbers varied greatly and peak numbers were observed in 2015 and 2019, 1,832 and 2,250, respectively, whereas some other years the numbers were 700 – 800. There was also much variation in the annual and monthly percentages of positive samples and they varied between less than 10% to greater than 20%. The highest percentages of positive samples were recorded in September and October. IgG and IgM titers declined with age and these differences were highly significant for IgG titers, with decreasing average titers for each 20-year interval.

Discussion: Collectively, the data demonstrate the marked annual and seasonal variations in tularemia sampling occurring in Sweden. Also, the proportion of positive samples increased during months and years with peak number of samples. Another notable finding was that average antibody titers decreased with increased age.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2024. Vol. 14, article id 1381776
Keywords [en]
age-related titers, annual distribution, monthly distribution, serological response, tularemia
National Category
Microbiology in the medical area Infectious Medicine
Identifiers
URN: urn:nbn:se:umu:diva-223646DOI: 10.3389/fcimb.2024.1381776ISI: 001203847700001Scopus ID: 2-s2.0-85190392484OAI: oai:DiVA.org:umu-223646DiVA, id: diva2:1853678
Funder
Region Västerbotten, RV-939171Region Västerbotten, RV-941049Available from: 2024-04-23 Created: 2024-04-23 Last updated: 2024-04-23Bibliographically approved

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Lindgren, HelenaLiu, XijiaSjöstedt, Anders

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