An outbreak of scrub typhus in military personnel despite protocols for antibiotic prophylaxis: doxycycline resistance excluded by a quantitative PCR-based susceptibility assay

Harris, Patrick N. A., Oltvolgyi, Csongor, Islam, Aminul, Hussain-Yusuf, Hazizul, Loewenthal, Mark R., Vincent, Gemma, Stenos, John and Graves, Stephen (2016) An outbreak of scrub typhus in military personnel despite protocols for antibiotic prophylaxis: doxycycline resistance excluded by a quantitative PCR-based susceptibility assay. Microbes and Infection, 18 6: 406-411. doi:10.1016/j.micinf.2016.03.006


Author Harris, Patrick N. A.
Oltvolgyi, Csongor
Islam, Aminul
Hussain-Yusuf, Hazizul
Loewenthal, Mark R.
Vincent, Gemma
Stenos, John
Graves, Stephen
Title An outbreak of scrub typhus in military personnel despite protocols for antibiotic prophylaxis: doxycycline resistance excluded by a quantitative PCR-based susceptibility assay
Journal name Microbes and Infection   Check publisher's open access policy
ISSN 1769-714X
1286-4579
Publication date 2016-06
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.micinf.2016.03.006
Open Access Status Not Open Access
Volume 18
Issue 6
Start page 406
End page 411
Total pages 6
Place of publication Cedex France
Publisher Elsevier Masson SAS
Collection year 2017
Language eng
Formatted abstract
Scrub typhus is caused by the obligate intracellular bacterium Orientia tsutsugamushi and is endemic to many countries in the Asia–Pacific region, including tropical Australia. We describe a recent large outbreak amongst military personnel in north Queensland. A total of 45 clinical cases were identified (36% of all potentially exposed individuals). This occurred despite existing military protocols stipulating the provision of doxycycline prophylaxis. Doxycycline resistance in O. tsutsugamushi has been described in South-East Asia, but not Australia. In one case, O. tsutsugamushi was cultured from eschar tissue and blood. Using quantitative real-time PCR to determine susceptibility to doxycycline for the outbreak strain, a minimum inhibitory concentration (MIC) of ≤0.04 μg/mL was found, indicating susceptibility to this agent. It seems most probable that failure to adhere to adequate prophylaxis over the duration of the military exercise accounted for the large number of cases encountered rather than doxycycline resistance.
Keyword Scrub typhus
Orientia tsutsugamushi
Doxycycline
Microbial sensitivity testing
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
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