title: Estimated prevalence of chronic Q fever among Coxiella burnetii seropositive patients with an abdominal aortic/iliac aneurysm or aorto-iliac reconstruction after a large Dutch Q fever outbreak.
abstract: OBJECTIVE
  The aim of this study was to estimate the seroprevalence of Q fever and prevalence of chronic Q fever in patients with abdominal aortic and/or iliac disease after the Q fever outbreak of 2007-2010 in the Netherlands.
  
  
  METHODS
  In November 2009, an ongoing screening program for Q fever was initiated. Patients with abdominal aortic and/or iliac disease were screened for presence of IgM and IgG antibodies to phase I and II antigens of Coxiella burnetii using immunofluorescence assay and presence of C. burnetii DNA in sera and/or vascular wall tissue using polymerase chain reaction (PCR).
  
  
  RESULTS
  A total of 770 patients with abdominal aortic and/or iliac disease were screened. Antibodies against C. burnetii were detected in 130 patients (16.9%), of which 40 (30.8%) patients showed a serological profile of chronic Q fever. Three patients presented with acute Q fever, one of which developed to chronic Q fever over time. The number of aneurysm-related acute complications in patients with chronic Q fever was significantly higher compared to patients negative for Q fever (p = 0.013); 9.0% (30/333) vs. 30.0% (6/20). Eight out of 46 patients with past resolved Q fever (8/46, 17.4%) presented with aneurysm-related acute complications (no significant difference).
  
  
  CONCLUSIONS
  The prevalence of chronic Q fever in C. burnetii seropositive patients with abdominal aortic and/or iliac disease living in an epidemic area in the Netherlands is remarkably high (30.8%). Patients with an aneurysm and chronic Q fever present more often with an aneurysm-related acute complication compared to patients without evidence of Q fever infection.
authors.affiliation: Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands. Electronic address: j.c.j.p.hagenaars@gmail.com.
authors.forename: Julia C J P
authors.initials: JC
authors.lastname: Hagenaars
authors.affiliation: Dept. of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Wever
authors.affiliation: Dept. of Surgery, Bernhoven Hospital, Uden, The Netherlands.
authors.forename: André S
authors.initials: AS
authors.lastname: van Petersen
authors.affiliation: Dept. of Internal Medicine, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Lestrade
authors.affiliation: Dept. of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands.
authors.forename: Monique G L
authors.initials: MG
authors.lastname: de Jager-Leclercq
authors.affiliation: Molecular Diagnostics, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Mirjam H A
authors.initials: MH
authors.lastname: Hermans
authors.affiliation: Dept. of Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.affiliation: Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Olivier H J
authors.initials: OH
authors.lastname: Koning
authors.affiliation: Dept. of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Nicole H M
authors.initials: NH
authors.lastname: Renders
mesh_terms: D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015897:Comorbidity; D016997:Coxiella burnetii / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000097:blood / Q000302:isolation & purification; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011778:Q Fever / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D016036:Seroepidemiologic Studies
chemical_list: D000907:Antibodies, Bacterial; D004269:DNA, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M
keywords: Aneurysm; Chronic Q fever; Seroprevalence; Vascular graft