Coxiella burnetii is the agent of Q fever, or "query fever," a zoonosis first described in Australia in 1937. Since this first description, knowledge about this pathogen and its associated infections has increased dramatically. We review here all the progress made over the last 20 years on this topic. C. burnetii is classically a strict intracellular, Gram-negative bacterium. However, a major step in the characterization of this pathogen was achieved by the establishment of its axenic culture. C. burnetii infects a wide range of animals, from arthropods to humans. The genetic determinants of virulence are now better known, thanks to the achievement of determining the genome sequences of several strains of this species and comparative genomic analyses. Q fever can be found worldwide, but the epidemiological features of this disease vary according to the geographic area considered, including situations where it is endemic or hyperendemic, and the occurrence of large epidemic outbreaks. In recent years, a major breakthrough in the understanding of the natural history of human infection with C. burnetii was the breaking of the old dichotomy between "acute" and "chronic" Q fever. The clinical presentation of C. burnetii infection depends on both the virulence of the infecting C. burnetii strain and specific risks factors in the infected patient. Moreover, no persistent infection can exist without a focus of infection. This paradigm change should allow better diagnosis and management of primary infection and long-term complications in patients with C. burnetii infection.

中文翻译：

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从 Q 热到伯氏柯克斯体感染：范式转变。

伯内特立克克斯体是 Q 热或“询问热”的病原体，这种人畜共患病于 1937 年在澳大利亚首次被描述。自从首次描述以来，人们对这种病原体及其相关感染的了解急剧增加。我们在此回顾过去 20 年在该主题上取得的所有进展。伯内特梭菌是典型的严格细胞内革兰氏阴性细菌。然而，通过建立其无菌培养物，该病原体的表征迈出了重要一步。伯内特隐球菌感染多种动物，从节肢动物到人类。由于确定了该物种的几个菌株的基因组序列和比较基因组分析的成就，毒力的遗传决定因素现在更加为人所知。Q热在世界各地都有发现，但这种疾病的流行病学特征根据所考虑的地理区域而有所不同，包括地方性或高地方性的情况，以及大规模流行病暴发的发生。近年来，对人类感染伯内特念珠菌自然史的理解的重大突破是打破了“急性”和“慢性”Q热之间的旧二分法。伯内特念珠菌感染的临床表现取决于感染伯内特念珠菌菌株的毒力和受感染患者的特定危险因素。此外，如果没有感染灶，就不可能存在持续性感染。这种范式的改变应该能够更好地诊断和管理伯内特念珠菌感染患者的原发感染和长期并发症。