Ixodes scapularis can be infected with Borrelia burgdorferi, Anaplasma phagocytophilum, Bartonella spp., Babesia microti, and Rickettsia spp., including spotted-fever group Rickettsia. As all of these microorganisms have been reported in Maryland, the potential for these ticks to have concurrent infections exists in this region. To assess the frequency of these complex infections, 348 I. scapularis nymphs collected in 2003 were screened for these microorganisms by PCR with positives being confirmed by DNA sequencing. Borrelia burgdorferi was detected in 14.7% of nymphs. Anaplasma phagocytophilum (0.3%), Rickettsia spp. (19.5%), and an uncategorized agent (0.9%) was also detected. Dual infections were detected with B. burgdorferi and Rickettsia spp. as well as a triple infection with B. burgdorferi, Rickettsia spp., and an uncategorized agent. Infections with B. burgdorferi and Rickettsia spp. were statistically independent of one another. However, infection with B. burgdorferi and any one of these other microorganisms appears to occur more frequently than by chance alone, probably as a result of shared enzootic cycles. This study confirms that multiple microorganisms co-circulate with B. burgdorferi in I. scapularis in Maryland and demonstrates that Rickettsia spp. and B. burgdorferi circulate independently and at nearly equal frequencies, while A. phagocytophilum and other unrecognized organisms are less common.
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