title: Presence of Rickettsia conorii subsp. israelensis, the causative agent of Israeli spotted fever, in Sicily, Italy, ascertained in a retrospective study.
abstract: A retrospective analysis by molecular-sequence-based techniques was performed to correctly identify the etiological agent of 24 Mediterranean spotted fever cases occurring in Western Sicily, Italy, from 1987 to 2001. Restriction analysis of a 632-bp PCR-amplified portion of the ompA gene allowed presumptive identification of five clinical isolates as belonging to Rickettsia conorii subsp. israelensis, the etiological agent of Israeli spotted fever (ISF). The remaining 19 rickettsial isolates were Rickettsia conorii subsp. conorii, the only pathogenic rickettsia of the spotted fever group reported in Italy until the present. Sequence analysis of the ompA gene confirmed the identification of all the R. conorii subsp. israelensis isolates and demonstrated that rickettsiosis caused by R. conorii subsp. israelensis can be traced back to 1991 in Sicily. The recorded clinical data of the five ISF patients support the idea that these strains could correlate to more-severe forms of human disease. Three of five patients experienced severe disease, and one of them died.
authors.affiliation: Dipartimento di Igiene eMicrobiologia, Università di Palermo, via del Vespro 133, 90127 Palermo, Italy.
authors.forename: Giovanni M
authors.initials: GM
authors.lastname: Giammanco
authors.forename: Giustina
authors.initials: G
authors.lastname: Vitale
authors.forename: Serafino
authors.initials: S
authors.lastname: Mansueto
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Capra
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Caleca
authors.forename: Pietro
authors.initials: P
authors.lastname: Ammatuna
mesh_terms: D000328:Adult; D000368:Aged; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics; D001907:Boutonneuse Fever / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007557:Israel; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012189:Retrospective Studies; D020114:Rickettsia conorii / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D017422:Sequence Analysis, DNA
chemical_list: D001425:Bacterial Outer Membrane Proteins; C078167:OMPA outer membrane proteins