{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:19:47Z","timestamp":1788347987208,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p><jats:italic>Babesia<\/jats:italic> is a unique apicomplexan parasite that specifically invades and proliferates in red blood cells and can be transmitted via blood transfusion, resulting in transfusion-transmitted babesiosis. However, detecting <jats:italic>Babesia<\/jats:italic> in blood before transfusion has not received enough attention, and the risk of transfusing blood containing a low density of <jats:italic>Babesia microti<\/jats:italic> (<jats:italic>B. microti<\/jats:italic>) is unclear, possibly threatening public health and wellness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to determine the lower detection limit of <jats:italic>B. microti<\/jats:italic> in blood and to evaluate the transmission risk of blood transfusion containing low-density <jats:italic>B. microti<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Infected BALB\/c mouse models were established by transfusing infected whole blood with different infection rates and densities of <jats:italic>B. microti<\/jats:italic>. Microscopic examination, nested Polymerase Chain Reaction (nested PCR), and an enzyme-linked immunosorbent assay (ELISA) were used to evaluate the infection status of the mouse models. Meanwhile, the nested PCR detection limit of <jats:italic>B. microti<\/jats:italic> was obtained using pure <jats:italic>B. microti<\/jats:italic> DNA samples with serial concentrations and whole blood samples with different densities of <jats:italic>B. microti<\/jats:italic>-infected red blood cells. Thereafter, whole mouse blood with a <jats:italic>B. microti<\/jats:italic> density lower than that of the nested PCR detection limit and human blood samples infected with <jats:italic>B. microti<\/jats:italic> were transfused into healthy mice to assess the transmission risk in mouse models. The infection status of these mice was evaluated through microscopic examination, nested PCR tests, and ELISA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mice inoculated with different densities of <jats:italic>B. microti<\/jats:italic> reached the peak infection rate on different days. Overall, the higher the blood <jats:italic>B. microti<\/jats:italic> density was, the earlier the peak infection rate was reached. The levels of specific antibodies against <jats:italic>B. microti<\/jats:italic> in the blood of the infected mice increased sharply during the first 30 days of infection, reaching a peak level at 60 days post-infection, and maintaining a high level thereafter. The nested PCR detection limits of <jats:italic>B. microti<\/jats:italic> DNA and parasite density were 3 fg and 5.48 parasites\/\u03bcL, respectively. The whole blood containing an extremely low density of <jats:italic>B. microti<\/jats:italic> and human blood samples infected with <jats:italic>B. microti<\/jats:italic> could infect mice, confirming the transmission risk of transfusing blood with low-density <jats:italic>B. microti<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Whole blood containing extremely low density of <jats:italic>B. microti<\/jats:italic> poses a high transmission risk when transfused between mice and mice or human and mice, suggesting that <jats:italic>Babesia<\/jats:italic> detection should be considered by governments, hospitals, and disease prevention and control centers as a mandatory test before blood donation or transfusion.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2024.1334426","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T04:57:25Z","timestamp":1707109045000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Transmission risk evaluation of transfusion blood containing low-density Babesia microti"],"prefix":"10.3389","volume":"14","author":[{"given":"Yuchun","family":"Cai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiufeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenwu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziran","family":"Mo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaxu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"B1","first-page":"193","article-title":"Seroprevalence of babesiosis in immunocompetent and immunocompromised individuals","volume":"49","author":"Bondarenko","year":"2021","journal-title":"Pol. 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