adults with Babesia who were co-infected with tick-borne zoonoses showed no increased risk of mortality or disease severity than those with Babesia based solely on data from more than 3,500 people.

Conducting the study was essential because of the increase in tick-borne infections, said lead author Paddy Ssentongo, MD, of the Division of Infectious Diseases and Epidemiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania.

“If the disease is not treated promptly, the consequences are devastating and can include serious illness, intensive care unit admission and even death,” he said. The researchers suspected that a co-infection with Babesia and other tick-borne pathogens would be associated with higher disease severity and mortality.

In a study published in Open Forum for Infectious DiseasesThe researchers examined data from 3,521 patients Babesia in the United States. Data are from the TriNetX database for the period between January 1, 1980 and July 24, 2023. The average age of the patients was 56 years; 51% were men and 78% were white. The primary endpoint was 90-day mortality after diagnosis Babesia.

A total of 42% of patients had one or more co-infections. Of these, 41% were infected Borrelia burgdorferi3.7% with Ehrlichiosis and 0.3% with Anaplasmosis. Patients with coinfections were significantly more likely to receive doxycycline than patients with coinfections Babesia only (25% vs. 18%; P

In an adjusted analysis, co-infected patients were less likely to experience 90-day mortality, but the difference was not significant (adjusted odds ratio (aOR) 0.43). Secondary endpoints included acute respiratory distress syndrome, multiorgan failure, and disseminated intravascular coagulopathy. There were no significant differences between the two in any of these outcomes BabesiaOnly and co-infection groups (aOR 1.56; aOR 0.82 and aOR 0.99, respectively).

Overall, hypertension (42%), chronic obstructive pulmonary disease (18%), and diabetes (14%) were the most common comorbidities. The overall malignancy rate was 19%.

Ssentongo said he was somewhat surprised by the increase in new babesiosis cases each year and by the high rate of co-infections with other tick-borne diseases, including Lyme disease and anaplasmosis.

The Babesia The infection rate in the United States has increased by at least 9% over the past decade, Ssentongo said Medscape Medical News. “Important, Babesia “An infection doesn't spread on its own,” and doctors should be aware that four out of 10 patients are simultaneously infected with other tick-borne diseases, each requiring different treatment, he said.

“Health care providers should have a high level of suspicion of disease in patients with typical symptoms, even if these individuals cannot remember a tick bite,” emphasized Ssentongo.

The study's biggest limitation was that the data could not be analyzed separately by state or county, which could have potentially revealed hotspots for infections, Ssentongo said. “Another limitation is the lack of blood parasitemia (the percentage of red blood cells infected), which could have been used to determine disease severity,” he noted.

Looking forward, further research is needed to determine whether red blood cell replacement improved mortality and outcomes in patients with higher parasite burdens or severe organ dysfunction, Ssentongo said Medscape Medical News. Furthermore, “little is known about the long-term consequences of the disease; There are many unanswered questions, such as the long-term effects on the brain,” he noted.

Outcomes data informs care as infection rates rise

“Human babesiosis cases are increasing in the United States, and this study helped characterize the mortality risk of babesiosis along with tick-borne co-infections,” said Shirin Mazumder, MD, associate professor and infectious disease specialist at the University of Tennessee Health Science Center, Memphis, Tennessee, in an interview.

“As a larger proportion of the population suffers from tick-borne infections, it is important to be aware of the consequences associated with tick-borne co-infections,” said Mazumder, who was not involved in the current study.

“The results of this study were surprising to me because I assumed that patients with Babesia “Infections co-infected with another tick-borne infection would result in both higher mortality and disease severity,” Mazumder said Medscape Medical News.

The current study showed that patients with Babesia Infections that were infected with B burgdorferiAnaplasmosis and Ehrlichiosis did not have a higher mortality rate or more severe disease course, Mazumder noted. “Physicians should have a low threshold to screen for other tick-borne co-infections in patients with babesiosis, and presumptive treatment with doxycycline should be considered,” she said.

This study showed a small number of co-infections with anaplasmosis and Ehrlichiosis, Mazumder said. Asplenia and the elderly are known risk factors for more severe disease; The average age in the current study was 56 years and the asplenia rate was 2%, she said. “It would be interesting to see whether conducting a similar study with a more advanced age group and higher asplenia rates would produce different results,” she noted.

Another limitation of the study is that parasitemia could not be included in the statistical analysis due to missing data from the database used in the study, Mazumder said Medscape Medical News. “Further research into parasitemia analysis could be useful,” she said. “Studying complications such as chronic fatigue, kidney failure and congestive heart disease in patients with tick-borne co-infections could also be a useful future study,” she said.

The study was supported by seed funding from the Department of Public Health Sciences, College of Medicine, Penn State, as part of a tenure-track professorship package for Ssentongo. The researchers had no financial conflicts to disclose. Mazumder had no financial conflicts to disclose.