Abstract：
When it comes to tick-borne diseases, co-infections are often mentioned. This concept includes several entities. On the one hand, tick vectors or vertebrate reservoir host can harbor several microorganisms that can be pathogenic for humans. On the other hand, human co-infections can also be understood in different ways, ranging from seropositivity without clinical symptoms to co-disease, i.e., the simultaneous clinical expression of infections by two tick-borne microorganisms. The latter, although regularly speculated, is not often reported. Hence, we conducted a systematic review on co-infections between B. burgdorferi s.l., the etiological agent of Lyme borreliosis, and other microorganisms potentially transmitted to humans by Ixodes spp. ticks. A total of 68 relevant articles were included, presenting 655 cases of possible co-infections. Most cases of co-infections corresponded to patients with one tick-borne disease and presenting antibody against another tick-borne microorganism. Co-disease was particularly frequent in two situations: patients with clinical symptoms of high fever and erythema migrans (EM), and patients with neurological symptoms linked to the TBEv or a neuroborreliosis. No impact on severity was evidenced. Further studies are needed to better appreciate the frequency and the impact of co-infections between several tick-borne microorganisms.
摘要：
说到蜱传疾病,经常提到共感染。这个概念包括几个实体。一方面,蜱载体或脊椎动物宿主可以携带几种对人类有致病性的微生物。另一方面,人类合并感染也可以以不同的方式理解，从无临床症状的血清阳性到共病，即，两种蜱传微生物感染的同时临床表达。后者,尽管经常猜测，不经常报道。因此，我们对B.burgdorferis.l.之间的共同感染进行了系统评价，莱姆病的病因，和其他可能通过Ixodesspp传播给人类的微生物。蜱。共收录68篇相关文章,呈现655例可能的共同感染。大多数共感染病例对应于患有一种蜱传疾病并呈现针对另一种蜱传微生物的抗体的患者。共病在两种情况下尤其常见：具有高热和偏头痛红斑（EM）临床症状的患者，和神经症状与TBEv或神经性伯氏症有关的患者。没有证据表明对严重程度的影响。需要进一步的研究来更好地了解几种蜱传微生物之间共感染的频率和影响。
