Abstract
The presence of Francisella-like endosymbionts in tick species known to transmit tularemia poses a potential diagnostic problem for laboratories that screen tick samples by PCR for Francisella tularensis. Tick samples initially considered positive for F. tularensis based on standard 16S rRNA gene PCR were found to be positive only for Francisella-like endosymbionts using a multitarget F. tularensis TaqMan assay (ISFtu2, tul4, and iglC) and 16S rRNA gene sequencing. Specificity of PCR-based diagnostics for F. tularensis should be carefully evaluated with appropriate specimen types prior to diagnostic use.
The Francisellaceae family is composed of a group of closely related organisms that are widespread in nature. Francisella philomiragia and Francisella tularensis are the two recognized species of the Francisella genus (2, 15), with the latter being the etiologic agent of the zoonotic disease tularemia. Humans can acquire tularemia through consumption of contaminated food or water, inhalation of infectious aerosols, contact with infected animals, or the bite of an infected vector (1, 15). In North America three subspecies of F. tularensis have been described: F. tularensis subsp. tularensis, F. tularensis subsp. holarctica, and F. tularensis subsp. novicida (2, 15).
Based on a high degree of similarity in 16S rRNA gene sequences, several other organisms have been classified as probable members of the Francisellaceae family, though their genera have not been determined (15). These include the intracellular bacterium Wolbachia persica, isolated from the tick Argas arboreus, and endosymbionts of the tick species Amblyomma maculatum, Ornithodoros porcinus, and Ornithodoros moubata (8, 14, 16, 17). Francisella-like endosymbionts have also been identified in multiple Dermacentor tick species, including D. variabilis, D. andersoni, D. hunteri, D. nitens, D. occidentalis, and D. albipictus (7, 14, 17). Characterization of these organisms has largely been limited to PCR-based methods, since they are not readily culturable on microbiological agar.
The presence of closely related Francisella-like organisms in tick species capable of transmitting tularemia (D. variabilis, D. andersoni, and D. occidentalis) (5) poses a challenge for accurate identification of F. tularensis by PCR. The significance of this problem has recently been heightened by the classification of F. tularensis as a category A agent of bioterrorism (3) and the increased use of PCR-based surveillance for F. tularensis in tick and environmental samples. Here we show that tick pools initially positive for F. tularensis based on a 16S rRNA gene PCR assay (9, 10, 11) were determined to be positive only for Francisella-like endosymbionts. This report highlights the need for careful evaluation of PCR-based diagnostics in laboratories that screen ticks for F. tularensis.
In 2002 and 2003, tularemia was identified in two dead rabbits (Sylvilagus audoboni) found in an urban area of San Diego County (10). To assess potential public health risk, San Diego County Vector Control dragged for ticks on vegetation in proximity to where the rabbits had been found. A small number of ticks were also collected from animals submitted for necropsy and from owners who had pulled ticks off of their pets. A total of 3,202 ticks were identified and pooled at the San Diego County Animal Disease Diagnostic Laboratory (332 pools of D. occidentalis, 32 pools of D. variabilis, and 25 pools of ticks whose species was not determined). Each pool consisted of 1 to 12 ticks. DNA was extracted and purified from all tick pools using the DNeasy tissue extraction protocol (QIAGEN, Valencia, CA).
Ten microliters of each tick pool was screened using a proprietary 16S rRNA gene PCR assay (Engene Biotechnology, Rancho Santa Fe, CA) (Table 1). PCR amplification conditions were 94°C for 2 min 30 s followed by 40 cycles at 94°C for 30 seconds, 56°C for 1 min 30 s, and 72°C for 1 min. DNA extracted from tissues of the two F. tularensis-infected rabbits served as positive controls (Table 1). Of the 389 pools tested, positive ticks were identified in 2 pools (10 ticks) of D. occidentalis (2,948 total ticks), 14 pools (56 ticks) of D. variabilis (94 total ticks), and 5 pools (5 ticks) of ticks whose species was not determined (160 total ticks) (Table 1). 16S rRNA gene PCR positive results were also obtained using a published Francisella 16S rRNA gene primer set (F11-F5) (Tables 1 and 2) (14). PCR amplification conditions for this assay were 95°C for 5 min, followed by 35 cycles at 95°C for 1 min, 55°C for 1 min, and 72°C for 1 min, followed by a final extension at 72°C for 10 min.
TABLE 1.
Identifiera | Speciesb (no. of ticks) | PCR assay resultse
|
||
---|---|---|---|---|
San Diego 16S rRNA gene standard PCR | F11-F5 16S rRNA gene standard PCR | Multitarget TaqMan assay (ISFtu2, tul4, and iglC) | ||
2022859c | Sylvilagus audoboni | + | ND | + |
2032026c | Sylvilagus audoboni | + | ND | + |
2030223 | D. variabilis (1) | + | ND | − |
2030224 | D. variabilis (1) | + | + | − |
2030362 | D. variabilis (7) | + | ND | − |
2030363 | D. variabilis (1) | + | ND | − |
2030997 | D. variabilis (1) | + | + | − |
2040278 | D. variabilis (2) | + | ND | − |
2040369 | D. variabilis (11) | + | + | − |
2040460d | D. variabilis (1) | + | + | − |
2040445 | D. variabilis (4) | + | + | − |
2040409 | D. variabilis (1) | + | + | − |
2040384d | D. variabilis (1) | + | + | − |
2040372 | D. variabilis (12) | + | + | − |
2040370 | D. variabilis (3) | + | + | − |
2040371 | D. variabilis (10) | + | + | − |
2032437 | D. occidentalis (9) | + | + | − |
2031093d | D. occidentalis (1) | + | ND | − |
2032666 | Canine (1) | + | + | − |
2040006 | Canine (1) | + | + | − |
2040431 | Cat (1) | + | + | − |
2040386 | Mountain lion (1) | + | + | − |
2032922 | Coyote (1) | + | + | − |
MV1d | D. variabilis (1) | ND | + | − |
MV2 | D. variabilis (1) | ND | ND | − |
MV3 | D. variabilis (1) | ND | ND | − |
MV1 (spiked) | ND | ND | + |
The identifier for the first 23 samples corresponds to the accession number assigned at the San Diego Animal Disease Diagnostic Laboratory.
Ticks whose species was not identified are referred to by source.
F. tularensis-positive rabbits.
Samples subjected to 16S rRNA gene sequencing.
ND, not determined.
TABLE 2.
Primer use and name | Primer sequence (5′-3′) | Reference or source |
---|---|---|
Amplification | ||
F11 (F) | TACCAGTTGGAAACGACTGT | 4 |
F5 (R) | CCTTTTTGAGTTTCGCTCC | 4 |
63F | CAGGCCTAACACATGCAAGTC | 6 |
1387R | GGGCGGWGTGTACAAGGCa | 6 |
Sequencing | ||
101F | ACTGGCGGACGGGTGAGTAA | 12 |
537R | CGTATTACCGCGGCTGCTGG | 12 |
519F | CAGCAGCCGCGGTAATAC | 13 |
926R | CCGTCAATTCCTTTGAGTTT | 13 |
327F | CTACGGGAGGCAGCAGTGGGGAATA | This study |
727F | ACCGATACTGACACTGAGGGACGAA | This study |
949F | CGATGCAACGCGAAGAACCT | This study |
W, bases T, U, or A.
Since the 16S rRNA gene sequence is highly conserved among Francisellaceae members, further testing was performed to determine whether the 16S PCR positive results were due to F. tularensis or Francisella-like endosymbionts. The F. tularensis multitarget TaqMan assay is a real-time PCR assay directed against an insertion sequence-like element (ISFtu2), a gene that encodes an outer membrane protein (tul4), and a gene expressed upon macrophage infection (iglC) (18). Identification of F. tularensis requires all three targets to be positive (18). Previous evaluation of this assay with a panel of organisms showed no cross-reactivity with non-Francisella species and the ability to differentiate between the two species F. tularensis and F. philomiragia (18).
Francisella-like endosymbiont control DNA (MV1, MV2, and MV3) isolated from D. variabilis ticks on Martha's Vineyard (Heidi Goethert, Harvard University) was utilized to test whether the F11-F5 16S primer set and the F. tularensis multitarget TaqMan assay could distinguish between F. tularensis and Francisella-like endosymbionts. Multitarget real-time PCRs were performed with 1 μl of purified DNA and previously described reaction conditions (18). Whereas D. variabilis endosymbiont DNA was positive with the F11-F5 16S rRNA gene primer set, the endosymbiont samples tested negative by the F. tularensis multitarget assay (Table 1). The negative result was not due to inhibition, as amplification of all three targets occurred when endosymbiont DNA was spiked with F. tularensis DNA (Table 1). Thus, the multitarget assay does not cross-react with D. variabilis Francisella-like endosymbionts.
All 16S rRNA gene PCR positive organisms (ticks and rabbits) from San Diego County were then tested with the multitarget TaqMan assay. Whereas both rabbit samples were positive for F. tularensis, all tick pools were negative. This suggests that the 16S PCR positive tick pools were negative for F. tularensis (Table 1).
To determine whether Francisella-like endosymbionts were present in the tick pools, a portion of 16S rRNA gene was sequenced from three tick samples: two D. variabilis samples (2040384 and 2040460) and a D. occidentalis sample (2031093). One Francisella-like endosymbiont DNA sample from D. variabilis collected on Martha's Vineyard was sequenced as a control (MV1). 16S rRNA gene was amplified using either eubacterial 16S rRNA gene primers (63F and 1387R) or Francisella-specific primers (F11-F5) when the eubacterial primers provided mixed sequence data (10 μM final concentration) (Table 2), PureTaq Ready-to-go PCR beads (Amersham Biosciences, Piscataway, NJ), and 1 μl of template DNA. The amplification program consisted of 95°C for 5 min, followed by 35 cycles of 95°C for 1 min, 55°C for 1 min, and 72°C for 1 min, and a final extension at 72°C for 10 min. Products were purified using a QIAquick PCR purification kit (QIAGEN) and sequenced using a CEQ 8000 DNA capillary sequencer (Beckman Coulter, Fullerton, CA) and its associated protocol. All nucleotide positions were sequenced at least twice, and the final sequence was analyzed to ensure that there was no mixed sequence.
Sequences were manually adjusted in CEQ 8000 (version 5.0) software and exported for assembly and analysis in Lasergene (DNASTAR, Madison, WI). A segment of 16S rRNA gene corresponding to bases 141 to 1152 of the complete F. tularensis subsp. tularensis 16S rRNA gene sequence in GenBank (Z21932) was compared against the following GenBank sequences: Z21931 (F. tularensis subsp. holarctica), Z21933 (F. philomiragia), L26084 (F. tularensis subsp. novicida), AB001522 (O. moubata symbiont B), AF166257 (O. porcinus symbiont), AF166256 (D. variabilis symbiont), AY375404 (D. variabilis symbiont, WA), AY375402 (D. occidentalis symbiont, CA), AY375403 (D. occidentalis symbiont, WA), and AF001077 (D. andersoni symbiont). Sequence identity was calculated using the ClustalW multiple alignment program (DNASTAR, Madison, WI).
The 16S rRNA gene sequences from the San Diego tick samples showed >99% identity to published Francisella-like endosymbiont 16S rRNA gene sequences compared to >97% identity to all subspecies of F. tularensis and 95.9% identity to F. philomiragia, indicating the presence of Francisella-like endosymbionts in these samples (Table 3). All sequenced samples shared nucleotide deletions and substitutions with published 16S sequences for the Francisella-like endosymbionts. The F11-F5 16S rRNA gene primer sequences were entirely conserved in all sequenced samples, indicating that the 16S rRNA gene PCR false positives were due to cross-reactivity with Francisella-like endosymbionts.
TABLE 3.
Strain | % Sequence identitya
|
||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Study samples
|
Francisella-like endosymbiont sequences (GenBank)
|
Francisella sequences (GenBank)
|
|||||||||||||
D. occidentalis 2031093 | D. variabilis 2040384 | D. variabilis 2040460 | D. variabilis symbiont MV1 | D. variabilis symbiont AF166256 | D. occidentalis symbiont (CA) AY375402 | D. occidentalis symbiont (WA) AY375403 | D. variabilis symbiont (WA) AY375404 | D. andersoni symbiont AF001077 | O. moubata symbiont (B) AB00152 | O. porcinus symbiont AF166257 | F. tularensis subsp. tularensis Z21932 | F. tularensis subsp. holarctica Z21931 | F. tularensis subsp. novicida L26084 | F. philomiragia Z21933 | |
D. occidentalis 2031093 | 99.8 | 99.8 | 99.8 | 99.6 | 100 | 99.8 | 99.8 | 99.4 | 99.4 | 99.1 | 97.4 | 97.3 | 97.6 | 95.9 | |
D. variabilis 2040384 | 100 | 99.8 | 99.6 | 99.8 | 100 | 100 | 99.4 | 99.4 | 99.1 | 97.4 | 97.3 | 97.6 | 95.9 | ||
D. variabilis 2040460 | 99.8 | 99.6 | 99.8 | 100 | 100 | 99.4 | 99.4 | 99.1 | 97.4 | 97.3 | 97.6 | 95.9 | |||
D. variabilis symbiont MV1 | 99.6 | 99.8 | 99.8 | 99.8 | 99.4 | 99.4 | 99.1 | 97.4 | 97.3 | 97.6 | 95.9 |
Sequence identity was calculated using the MegAlign program of DNASTAR, using bases 141 to 1152 of the complete F. tularensis subsp. tularensis 16S rRNA gene sequence in GenBank (Z21932).
This report highlights the need for careful evaluation of PCR-based diagnostics when testing ticks for F. tularensis. Laboratories must be aware of the issue of PCR cross-reactivity due to the presence of Francisella-like endosymbionts in ticks known to transmit F. tularensis. The Francisella-like endosymbiont of D. variabilis has been identified in D. variabilis ticks collected in Idaho, Washington, Connecticut, Massachusetts, and in this report, California. The distribution and prevalence of Francisella-like endosymbionts in tick species that transmit tularemia is largely unknown, as only a few studies have been performed (14, 17).
Here we show that F. tularensis 16S rRNA gene PCR assays cross-react with Francisella-like endosymbionts of two Dermacentor species (Table 1). Due to the high level of conservation in 16S rRNA gene of Francisellaceae members, 16S rRNA gene-based PCR should not be used to identify F. tularensis when other Francisellaceae members might be present. In addition, two different standard tul4 PCR assays have also been shown to cross-react with the Francisella-like endosymbionts of Dermacentor species (7, 14). The specificity of PCR-based tests must be considered when testing other environmental specimens, such as soil and water, for F. tularensis. Undescribed members of the Francisellaceae family are possibly widespread in nature.
In conclusion, the multitarget TaqMan assay (18) (ISFtu2, tul4, and iglC) can discriminate F. tularensis from Francisella-like tick endosymbionts of D. variabilis and D. occidentalis and may be useful in laboratories that screen these species for F. tularensis. Using multiple targets as criteria for a positive sample has the added advantage of minimizing the likelihood of cross-reactivity. Further evaluations are required for Francisella-like endosymbionts of other tick species as well as for environmental specimens.
Nucleotide sequence accession numbers.
Sequences were submitted to GenBank and possess the following accession numbers: AY805304 (D. occidentalis 2031093), AY805305 (D. variabilis 2040384), AY805306 (D. variabilis 2040460), and AY805307 (D. variabilis MV).
Acknowledgments
We thank Heidi Goethert for supplying the D. variabilis endosymbiont DNA from ticks collected on Martha's Vineyard and Patricia Lewis for technical support. We also thank Martin E. Schriefer and May C. Chu for their critical insight.
This work was supported in part by an appointment to the Emerging Infectious Diseases (EID) Fellowship Program (K.J.K.) administered by the Association of Public Health Laboratories (APHL) and funded by the CDC.
REFERENCES
- 1.Centers for Disease Control and Prevention. 2002. Tularemia-United States, 1990-2000. Morb. Mortal. Wkly. Rep. 51:182-184. [Google Scholar]
- 2.Chu, M. C., and R. Weyant. 2003. Francisella and Brucella, p. 789-797. In P. R. Murray, E. J. Baron, J. H. Jorgensen, M. A. Pfaller, and R. H. Yolken (ed.), Manual of clinical microbiology, 8th ed. American Society for Microbiology, Washington, D.C.
- 3.Dennis, D. T., T. V. Inglesby, D. A. Henderson, J. G. Barlett, M. S. Ascher, E. Eitzen, A. D. Fine, A. M. Friedlander, J. Hauer, M. Layton, S. R. Lillibridge, J. E. McDade, M. T. Osterholm, T. O'Toole, G. Parker, T. M. Perl, P. K. Russell, and K. Tonat. 2001. Tularemia as a biological weapon—medical and public health management. JAMA 285:2763-2773. [DOI] [PubMed] [Google Scholar]
- 4.Forsman, M., G. Sandström, and A. Sjöstedt. 1994. Analysis of 16S ribosomal DNA sequences of Francisella strains and utilization for determination of the phylogeny of the genus and for identification of strains by PCR. Int. J. Syst. Bacteriol. 44:38-46. [DOI] [PubMed] [Google Scholar]
- 5.Jellison, W. L. 1974. Tularemia in North America, 1930-1974. University of Montana, Missoula, Mont.
- 6.Marchesi, J. R., T. Sato, A. J. Weightman, T. A. Martin, J. C. Fry, S. J. Hiom, and W. G. Wade. 1998. Design and evaluation of useful bacterium-specific PCR primers that amplify genes coding for bacterial 16S rRNA. Appl. Environ. Microbiol. 64:795-799. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Niebylski, M. L., M. G. Peacock, E. R. Fischer, S. F. Porcella, and T. G. Schwan. 1997. Characterization of an endosymbiont infecting wood ticks, Dermacentor andersoni, as a member of the genus Francisella. Appl. Environ. Microbiol. 63:3933-3940. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.Noda, H., U. G. Munderloh, and T. J. Kurtti. 1997. Endosymbionts of ticks and their relationship to Wolbachia spp. and tick-borne pathogens of humans and animals. Appl. Environ. Microbiol. 63:3926-3932. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.ProMED mail. 14 August 2003. Tularemia, tick—USA (San Diego): alert. 20030814.2027. [Online.] http://www.promedmail.org.
- 10.San Diego County Department of Media and Public Relations. 2 May 2003. Warning issued for rural areas containing ticks. San Diego County Department of Medicine and Public Relations, San Diego, Calif. News release.
- 11.San Diego Union-Tribune. 2 August 2003. Tick infected with rabbit fever found, p. B2. San Diego Union-Tribune, San Diego, Calif.
- 12.Schmalenberger, A., F. Schwieger, and C. C. Tebbe. 2001. Effect of primers hybridizing to different evolutionarily conserved regions of the small-subunit rRNA gene in PCR-based microbial community analyses and genetic profiling. Appl. Environ. Microbiol. 67:3557-3563. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Schwieger, F., and C. C. Tebbe. 1998. A new approach to utilize PCR-single-strand-conformation polymorphism for 16S rRNA gene-based microbial community analysis. Appl. Environ. Microbiol. 64:4870-4876. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Scoles, G. 2004. Phylogenetic analysis of the Francisella-like endosymbionts of Dermacentor ticks. J. Med. Entomol. 41:277-286. [DOI] [PubMed] [Google Scholar]
- 15.Sjöstedt, A. Family XVII. FRANCISELLACEAE, genus I. Francisella. In D. J. Brenner (ed.), Bergey's manual of systematic bacteriology, in press. Springer-Verlag, New York, N.Y.
- 16.Suitor, E. C., Jr., and E. Weiss. 1961. Isolation of a rickettsialike microorganism (Wolbachia persica n. sp.) from Argas persicus (Oken). J. Infect. Dis. 108:95-106. [Google Scholar]
- 17.Sun, L. V., G. A. Scoles, D. Fish, and S. L. O'Neill. 2000. Francisella-like endosymbionts of ticks. J. Invertebr. Pathol. 76:301-303. [DOI] [PubMed] [Google Scholar]
- 18.Versage, J. L., D. D. M. Severin, M. C. Chu, and J. M. Petersen. 2003. Development of a multitarget real-time TaqMan PCR assay for enhanced detection of Francisella tularensis in complex specimens. J. Clin. Microbiol. 41:5492-5499. [DOI] [PMC free article] [PubMed] [Google Scholar]