{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:30:09Z","timestamp":1787016609578,"version":"build-2736575974"},"reference-count":27,"publisher":"American Society for Microbiology","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Vaccine Immunol."],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Chronic Q fever develops in 1 to 5% of patients infected with\n                    <jats:named-content content-type=\"genus-species\">Coxiella burnetii<\/jats:named-content>\n                    . The risk for chronic Q fever endocarditis has been estimated to be \u223c39% in case of preexisting valvulopathy and is potentially even higher for valvular prostheses. Since 2007, The Netherlands has faced the largest Q fever outbreak ever reported, allowing a more precise risk estimate of chronic Q fever in high-risk groups. Patients with a history of cardiac valve surgery were selected for microbiological screening through a cardiology outpatient clinic in the area where Q fever is epidemic. Blood samples were analyzed for phase I and II IgG against\n                    <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                    , and if titers were above a defined cutoff level,\n                    <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                    PCR was performed. Chronic Q fever was considered proven if\n                    <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                    PCR was positive and probable if the phase I IgG titer was \u22651:1,024. Among 568 patients, the seroprevalence of\n                    <jats:named-content content-type=\"genus-species\">C. burnetii<\/jats:named-content>\n                    antibodies (IgG titer greater than or equal to 1:32) was 20.4% (\n                    <jats:italic>n<\/jats:italic>\n                    = 116). Proven or probable chronic Q fever was identified among 7.8% of seropositive patients (\n                    <jats:italic>n<\/jats:italic>\n                    = 9). Valve characteristics did not influence the risk for chronic Q fever. Patients with chronic Q fever were significantly older than patients with past Q fever. In conclusion, screening of high-risk groups is a proper instrument for early detection of chronic Q fever cases. The estimated prevalence of chronic Q fever is 7.8% among seropositive patients with a history of cardiac valve surgery, which is substantially higher than that in nonselected populations but lower than that previously reported. Older age seems to increase vulnerability to chronic Q fever in this population.\n                  <\/jats:p>","DOI":"10.1128\/cvi.00185-12","type":"journal-article","created":{"date-parts":[[2012,6,13]],"date-time":"2012-06-13T23:51:57Z","timestamp":1339631517000},"page":"1165-1169","source":"Crossref","is-referenced-by-count":34,"title":["Prevalence of Chronic Q Fever in Patients with a History of Cardiac Valve Surgery in an Area Where Coxiella burnetii Is Epidemic"],"prefix":"10.1128","volume":"19","author":[{"given":"Linda M.","family":"Kampschreur","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Jelrik","family":"Oosterheert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy I. M.","family":"Hoepelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Lestrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole H. M.","family":"Renders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Elsman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Wever","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","published-online":{"date-parts":[[2012,6,13]]},"reference":[{"key":"key20180919073615_B1","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s10096-007-0357-6","article-title":"Coxiella burnetii infection of aortic aneurysms or vascular grafts: report of 30 new cases and evaluation of outcome","volume":"26","author":"Botelho-Nevers","year":"2007","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"key20180919073615_B2","first-page":"382","article-title":"Q fever in The Netherlands from 2007 to 2010","volume":"68","author":"Delsing","year":"2010","journal-title":"Neth. J. 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Dis."},{"key":"key20180919073615_B6","doi-asserted-by":"crossref","first-page":"4919","DOI":"10.1128\/JCM.42.11.4919-4924.2004","article-title":"Molecular detection of Coxiella burnetii in the sera of patients with Q fever endocarditis or vascular infection","volume":"42","author":"Fenollar","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"key20180919073615_B7","doi-asserted-by":"crossref","first-page":"350","DOI":"10.3201\/eid1703.100882","article-title":"Q fever in France, 1985-2009","volume":"17","author":"Frankel","year":"2011","journal-title":"Emerg. Infect. 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