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Journal of Clinical Microbiology, December 2000, p. 4511-4516, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Transfusion-Acquired, Autochthonous Human Babesiosis in Japan: Isolation of Babesia microti-Like Parasites with hu-RBC-SCID Mice

Atsuko Saito-Ito,1 Masayoshi Tsuji,2,* Qiang Wei,2 Shenyi He,1 Toshimitsu Matsui,3 Masatoshi Kohsaki,4 Satoru Arai,5 Tsuneo Kamiyama,5 Kyoji Hioki,6 and Chiaki Ishihara2

Department of Medical Zoology1 and Third Division of the Department of Medicine,3 Kobe University School of Medicine, Kobe 650-0017, School of Veterinary Medicine, Rakuno-gakuen University, Ebetsu 069-8501,2 Hyogo Red Cross Blood Center, Kobe 651-0062,4 National Institute of Infectious Diseases, Shinjuku, Tokyo 162-8640,5 and Central Institute of Experimental Animals, Nogawa, Kawasaki 216-0001,6 Japan

Received 18 May 2000/Returned for modification 27 July 2000/Accepted 18 September 2000

We have isolated piroplasms from a patient who developed the first case of human babesiosis in Japan by using NOD/shi-scid mice whose circulating erythrocytes (RBCs) had been replaced with human RBCs (hu-RBC-SCID mice). Following inoculation of the patient's blood specimen into hu-RBC-SCID mice, parasites proliferated within the human RBCs in the mice, resulting in a high level of parasitemia. Parasite DNA was prepared from blood samples of the patient and the mice, and the nuclear small-subunit rRNA gene (rDNA) was amplified and sequenced. Both DNA samples gave rise to identical sequences which showed the highest degree of homology (99.2%) with the Babesia microti rDNA. Because the patient had received a blood transfusion before the onset of babesiosis, we investigated the eight donors who were involved. Their archived blood samples were analyzed for specific antibody and parasite DNA; only a single donor was found to be positive by both tests, and the parasite rDNA sequence from the donor coincided with that derived from the patient. The donor's serum exhibited a high antibody titer against the isolate from the patient, whereas it exhibited only a weak cross-reaction against B. microti strains isolated in the United States. We conclude that the first Japanese babesiosis case occurred due to a blood transfusion and that the etiological agent is an indigenous Japanese parasite which may be a geographical variant of B. microti. Our results also demonstrated the usefulness of hu-RBC-SCID mice for isolation of parasites from humans and for maintenance of the parasite infectivity for human RBCs.

* Corresponding author. Mailing address: School of Veterinary Medicine, Rakuno-gakuen University, 582-1 Bunkyodai-midorimachi, Ebetsu 069-8501, Japan. Phone and fax: 81-11-386-3144. E-mail: tsuji{at}rakuno.ac.jp.

Journal of Clinical Microbiology, December 2000, p. 4511-4516, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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