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Bartonella Species in Humans and Human Pets
and Other Insect Carrying Animals
Explode in Variety All Over the Globe

Bartonella is Ahead of Labs and Clearly Proven Treatments

Read Books or Journals on Bartonella and many things become clear. First, they refer to the vast new species, subspecies and variants in public data bases. Others refer to things unexpected at locations that seem novel. The fact is that when any tick, flea of lice carried infection is given an address, as a trend it is too narrow an address, and some of these strains are found all over the world.

Further, indirect and direct testing is much like looking into the White House windows and expecting to see John F. Kennedy. The degree of dated testing at major labs in virtually all continents is stunning. Perhaps no money exists in expanding detection of Bartonella in humans and other such human infections. Frankly, while I love allopathic medicine and some tools in MD medicine, it seems outside the awareness of even medical board members the basics of the philosophy of science knowledge in which they determine proper medical service--the options we have as tools to treat are only the tools for sale from drug companies, device makers and conservative traditional laboratories. No drug company is funding a large heart study on vitamin K2. One study on the top infection with more vectors than any infection on earth—Bartonella—is being done at the National Institutes of Health. (NIH).

Below is a small taste of a mere couple hundred articles which in clear and subtle ways show that Bartonella is not simple, and those that hold that position should reconsider it for 2012 and the future. Because the future of Bartonella is like a massive lion--it will not be kept in a shoe box.

1. Trans R Soc Trop Med Hyg. 2011 Dec;105(12):740-2. Epub 2011 Sep 28.

Serological response to Bartonella species in febrile patients from Nepal.

Myint KS, Gibbons RV, Iverson J, Shrestha SK, Pavlin JA, Mongkolsirichaikul D, Kosoy MY.

U.S. Army Medical Component-Armed Forces Research Institute Of Medical Sciences, Bangkok, Thailand.

The Bartonella-associated illnesses are spread world-wide and involve a broad spectrum of signs and symptoms in humans. Several Bartonella species have been shown to be responsible for cases of febrile illnesses. Little information exists on distribution of Bartonella species and their role in human diseases in Nepal. Our preliminary study, a retrospective serological survey of archived specimens, suggests that Bartonella antibodies are prevalent among febrile patients in the Kathmandu Valley of Nepal.

Published by Elsevier Ltd.

PMID: 21955739 [PubMed - in process]

2. Genet Mol Res. 2011 Aug 26;10(3):1789-818.

Proteomic and bioinformatic analysis of outer membrane proteins of the protobacterium Bartonella henselae (Bartonellaceae).

Li DM, Liu QY, Zhao F, Hu Y, Xiao D, Gu YX, Song XP, Zhang JZ.

Department of Vector Biology and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

Bartonella henselae, an infectious agent causing cat-scratch disease and vasculoproliferative disorders in humans, is a fastidious facultative intracellular pathogen. The outer membrane proteins of B. henselae are key molecules that play a primary role in host-cell interactions. We isolated B. henselae outer membrane proteins, using the ionic detergent N-lauroyl sarcosine sodium salt and sodium carbonate, purification by two-dimensional (2-D) gel electrophoresis, and protein identification using mass spectrometry. Treatment with buffers containing ASB-14 and ZWITTERGENT 3-10 increased solubilization of B. henselae proteins, particularly proteins with basic pI. Three hundred and sixty-eight spots were detected from the sarcosine-insoluble outer membrane fraction; 94 distinct protein species were identified from 176 spots. In the outer membrane fraction from carbonate incubation, 471 spots were calculated and 259 spots were identified, which included 139 protein entries. There were six outer membrane proteins in the sarcosine-insoluble outer membrane fraction compared with nine outer membrane proteins from samples subjected to carbonate incubation. We used bioinformatic analysis to identify 44 outer membrane proteins by prediction of their domains and tertiary structures and documented the potential virulence factors. We established the 2-D reference maps of the outer membrane subproteome of B. henselae using the two different extraction methods, which were partly complementary to each other. Sodium carbonate extraction isolated low-abundance and basic proteins better than the lauroyl sarcosine sodium salt extraction, which enriched high-abundance porins.

PMID: 21948745 [PubMed - in process]

3. Vector Borne Zoonotic Dis. 2011 Dec;11(12):1549-53. Epub 2011 Sep 15.

Zoonotic bartonella species in fleas and blood from red foxes in australia.

Kaewmongkol G, Kaewmongkol S, Fleming PA, Adams PJ, Ryan U, Irwin PJ, Fenwick SG.

1 School of Veterinary and Biomedical Sciences, Murdoch University , Murdoch, Western Australia, Australia .

Abstract Bartonella are arthropod-borne, fastidious, Gram-negative, and aerobic bacilli distributed by fleas, lice, sand flies, and, possibly, ticks. The zoonotic Bartonella species, Bartonella henselae and Bartonella clarridgeiae, which are the causes of cat scratch disease and endocarditis in humans, have been reported from cats, cat fleas, and humans in Australia. However, to date, there has been no report of B. henselae or B. clarridgeiae in Australian wild animals and their ectoparasites. B. henselae and B. clarridgeiae were detected in fleas (Ctenocephalides felis) from red foxes (Vulpes vulpes), an introduced pest animal species in Australia, and only B. clarridgeiae was detected in blood from one red fox. Phylogenetic analysis of the ribosomal intergenic spacer region revealed that the B. henselae detected in the current study were related to B. henselae strain Houston-1, a major pathogenic strain in humans in Australia, and confirmed the genetic distinctness of B. clarridgeiae. The identification and characterization of Bartonella species in red foxes in the Southwest of Western Australia suggests that red foxes may act as reservoirs of infection for animals and humans in this region.

PMID: 21919728 [PubMed - in process]

4. PLoS Negl Trop Dis. 2011 Sep;5(9):e1301. Epub 2011 Sep 6.

Bacteriological and molecular identification of Bartonella species in cats from different regions of China.

Yuan C, Zhu C, Wu Y, Pan X, Hua X.

Shanghai Jiaotong University, Shanghai, People's Republic of China.

With the improvements in diagnostic techniques, Bartonella henselae (B. henselae) infection has recently been recognized to cause a widening spectrum of diseases. Cats are the natural reservoir hosts of B. henselae. The current study aims to investigate the prevalence of B. henselae infection in the cat populations in China. Polymerase chain reaction (PCR) and bacterial cultures confirm that 12.7% of the tested cats were positive for the infection. Old age and outdoor exposure were statistically associated with the infection. Multilocus sequence typing and eBURST analysis of the cat isolates collected in the present study show that 65.4% of the isolates belong to sequence type 1 (ST1). Three new STs (ST16-18) were identified in Midwestern China. These results may aid our understanding of the population structure of B. henselae in China and the relationship between human and cat strains in subsequent studies.

PMCID: PMC3167793 PMID: 21909443 [PubMed - in process]

5. Acta Crystallogr Sect F Struct Biol Cryst Commun. 2011 Sep 1;67(Pt 9):1141-7. Epub 2011 Aug 16.

Comparative analysis of glutaredoxin domains from bacterial opportunistic pathogens.

Leeper T, Zhang S, Van Voorhis WC, Myler PJ, Varani G.

School of Medicine, University of Washington, Seattle, WA 98195, USA. tleeper@uakron.edu

Glutaredoxin proteins (GLXRs) are essential components of the glutathione system that reductively detoxify substances such as arsenic and peroxides and are important in the synthesis of DNA via ribonucleotide reductases. NMR solution structures of glutaredoxin domains from two Gram-negative opportunistic pathogens, Brucella melitensis and Bartonella henselae, are presented. These domains lack the N-terminal helix that is frequently present in eukaryotic GLXRs. The conserved active-site cysteines adopt canonical proline/tyrosine-stabilized geometries. A difference in the angle of α-helix 2 relative to the β-sheet surface and the presence of an extended loop in the human sequence suggests potential regulatory regions and/or protein-protein interaction motifs. This observation is consistent with mutations in this region that suppress defects in GLXR-ribonucleotide reductase interactions. These differences between the human and bacterial forms are adjacent to the dithiol active site and may permit species-selective drug design.

PMCID: PMC3169416 PMID: 21904064 [PubMed - in process]

6. Infect Genet Evol. 2011 Dec;11(8):1868-72. Epub 2011 Aug 12.

Genetic characterization of flea-derived Bartonella species from native animals in Australia suggests host-parasite co-evolution.

Kaewmongkol G, Kaewmongkol S, McInnes LM, Burmej H, Bennett MD, Adams PJ, Ryan U, Irwin PJ, Fenwick SG.

School of Veterinary and Biomedical Sciences, Murdoch University, South Street, Murdoch 6150, Western Australia, Australia; Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand.

Fleas are important arthropod vectors for a variety of diseases in veterinary and human medicine, and bacteria belonging to the genus Bartonella are among the organisms most commonly transmitted by these ectoparasites. Recently, a number of novel Bartonella species and novel species candidates have been reported in marsupial fleas in Australia. In the present study the genetic diversity of marsupial fleas was investigated; 10 species of fleas were collected from seven different marsupial and placental mammal hosts in Western Australia including woylies (Bettongia penicillata), western barred bandicoots (Perameles bougainville), mardos (Antechinus flavipes), bush rats (Rattus fuscipes), red foxes (Vulpes vulpes), feral cats (Felis catus) and rabbits (Oryctolagus cuniculus). PCR and sequence analysis of the cytochrome oxidase subunit I (COI) and the 18S rRNA genes from these fleas was performed. Concatenated phylogenetic analysis of the COI and 18S rRNA genes revealed a close genetic relationship between marsupial fleas, with Pygiopsylla hilli from woylies, Pygiopsylla tunneyi from western barred bandicoots and Acanthopsylla jordani from mardos, forming a separate cluster from fleas collected from the placental mammals in the same geographical area. The clustering of Bartonella species with their marsupial flea hosts suggests co-evolution of marsupial hosts, marsupial fleas and Bartonella species in Australia.

PMID: 21856444 [PubMed - in process]

7. Asian Pac J Trop Med. 2011 Apr;4(4):320-2. Epub 2011 May 29.

Human seroreactivity against Bartonella species in the Democratic Republic of Congo.

Laudisoit A, Iverson J, Neerinckx S, Shako JC, Nsabimana JM, Kersh G, Kosoy M, Zeidner N.

University of Liverpool, Liverpool, United Kingdom. Anne.Laudisoit@liverpool.ac.uk

OBJECTIVE: To assess the presence and identity of Bartonella species in a pool of human blood samples from DRC Congo.

METHODS: Blood (±120μL) was collected anonymously from Congolese patients and placed on calibrated filter papers. Bartonella serology determination was performed using an indirect immunofluorescence assay (IFA) against six specific Bartonella antigens and Coxiella burnetii (C. burnetii) antigen. The end cut-off value for Bartonella sp. was a titre greater than 1:200.

RESULTS: None of the patients was positive for Bartonella elizabethae, Bartonella vinsonii subsp. vinsonii or Bartonella vinsonii subsp. arupensis nor for C. burnetti, but 4.5% of the 155 samples were positive for either Bartonella henselae, Bartonella quintana, or Bartonella clarridgeiae.

CONCLUSIONS: This preliminary study presents the first report of Bartonella species in the DR Congo and the first report of antibodies to Bartonella clarridgeiae in an African human population. Although few experimental trials have established the link between fleas and Bartonella transmission, the repeated detection of similar Bartonella species in fleas and humans in several countries suggests that Bartonellosis could be another flea-borne disease which specific reservoirs are still unknown.

PMID: 21771478 [PubMed - in process]

8. Parasit Vectors. 2011 Jul 18;4:139.

Fleas as parasites of the family Canidae.

Dobler G, Pfeffer M.

Bundeswehr Institute of Microbiology, Department of Virology and Rickettsiology, Neuherbergstrasse 11, D-80937 Munich, Germany. gerharddobler@bundeswehr.org

Historically, flea-borne diseases are among the most important medical diseases of humans. Plague and murine typhus are known for centuries while the last years brought some new flea-transmitted pathogens, like R. felis and Bartonella henselae. Dogs may play an essential or an accidental role in the natural transmission cycle of flea-borne pathogens. They support the growth of some of the pathogens or they serve as transport vehicles for infected fleas between their natural reservoirs and humans. More than 15 different flea species have been described in domestic dogs thus far. Several other species have been found to be associated with wild canids. Fleas found on dogs originate from rodents, birds, insectivores and from other Carnivora. Dogs therefore may serve as ideal bridging hosts for the introduction of flea-borne diseases from nature to home. In addition to their role as ectoparasites they cause nuisance for humans and animals and may be the cause for severe allergic reactions.

PMCID: PMC3160944 PMID: 21767354 [PubMed - indexed for MEDLINE]

9. Parasit Vectors. 2011 Jul 15;4:135.

Occurrence of Babesia spp., Rickettsia spp. and Bartonella spp. in Ixodes ricinus in Bavarian public parks, Germany.

Schorn S, Pfister K, Reulen H, Mahling M, Silaghi C.

Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-University, Munich, Germany. sabine.schorn@tropa.vetmed.uni-muenchen.de

BACKGROUND: Only limited information is available about the occurrence of ticks and tick-borne pathogens in public parks, which are areas strongly influenced by human beings. For this reason, Ixodes ricinus were collected in public parks of different Bavarian cities in a 2-year survey (2009 and 2010) and screened for DNA of Babesia spp., Rickettsia spp. and Bartonella spp. by PCR. Species identification was performed by sequence analysis and alignment with existing sequences in GenBank. Additionally, coinfections with Anaplasma phagocytophilum were investigated.

RESULTS: The following prevalences were detected: Babesia spp.: 0.4% (n = 17, including one pool of two larvae) in 2009 and 0.5 to 0.7% (n = 11, including one pool of five larvae) in 2010; Rickettsia spp.: 6.4 to 7.7% (n = 285, including 16 pools of 76 larvae) in 2009. DNA of Bartonella spp. in I. ricinus in Bavarian public parks could not be identified. Sequence analysis revealed the following species: Babesia sp. EU1 (n = 25), B. divergens (n = 1), B. divergens/capreoli (n = 1), B. gibsoni-like (n = 1), R. helvetica (n = 272), R. monacensis IrR/Munich (n = 12) and unspecified R. monacensis (n = 1). The majority of coinfections were R. helvetica with A. phagocytophilum (n = 27), but coinfections between Babesia spp. and A. phagocytophilum, or Babesia spp. and R. helvetica were also detected.

CONCLUSIONS: I. ricinus ticks in urban areas of Germany harbor several tick-borne pathogens and coinfections were also observed. Public parks are of particularly great interest regarding the epidemiology of tick-borne pathogens, because of differences in both the prevalence of pathogens in ticks as well as a varying species arrangement when compared to woodland areas. The record of DNA of a Babesia gibsoni-like pathogen detected in I. ricinus suggests that I. ricinus may harbor and transmit more Babesia spp. than previously known. Because of their high recreational value for human beings, urban green areas are likely to remain in the research focus on public health issues.

PMCID: PMC3154157 PMID: 21762494 [PubMed - indexed for MEDLINE]

10. Vector Borne Zoonotic Dis. 2011 Nov;11(11):1425-32. Epub 2011 Jul 7.

Ecological diversity of bartonella species infection among dogs and their owner in virginia.

Cherry NA, Maggi RG, Rossmeisl JH, Hegarty BC, Breitschwerdt EB.

1 Intracellular Pathogens Research Laboratory and the Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University , Raleigh, North Carolina.

Abstract Bartonella species comprise a genus of gram-negative, fastidious, intracellular bacteria that have been implicated in association with an increasing spectrum of disease manifestations in dogs and human patients. In this study, chronic canine and human disease, for which causation was not diagnostically defined, were reported by the breeder of a kennel of Doberman pinschers. In addition to other diagnostic tests, serology, polymerase chain reaction, and enrichment blood culture were used to assess the prevalence of Bartonella sp. infection in the dogs and their owner. From five dogs, Bartonella vinsonii subsp. berkhoffii genotype I, multiple Bartonella henselae strains, and a species most similar to Candidatus B. volans, a rodent-associated Bartonella sp., were amplified and sequenced from biopsy tissues, cerebrospinal fluid, or blood enrichment cultures. The owner was bacteremic with B. vinsonii subsp. berkhoffii genotype I, the same subsp. and genotype detected in one of her dogs. These results further emphasize the ecological complexity of Bartonella sp. transmission in nature.

PMID: 21736485 [PubMed - in process]

11. Southeast Asian J Trop Med Public Health. 2011 May;42(3):687-92.

Bartonella seroprevalence in rural Thailand.

Bhengsri S, Baggett HC, Peruski LF, Morway C, Bai Y, Fisk TL, Sitdhirasdr A, Maloney SA, Dowell SF, Kosoy M.

International Emerging Infections Program, Thailand MOPH-US CDC Collaboration, Nonthaburi, Thailand. saithipb@th.cdc.gov

We estimated the prevalence of anti-Bartonella antibodies among febrile and non-febrile patients presenting to community hospitals in rural Thailand from February 2002 through March 2003. Single serum specimens were tested for IgG titers to four Bartonella species, B. henselae, B. quintana, B. elizabethae and B. vinsonii subsp vinsonii using an indirect immunofluorescent assay. A titer 21:256 was considered positive. Forty-two febrile patients (9.9%) and 19 non-febrile patients (19%) had positive serology titers to at least one Bartonella species. Age-standardized Bartonella seroprevalence differed significantly between febrile (10%) and non-febrile patients (18%, p=0.047), but did not differ by gender. Among all 521 patients, IgG titers 21:256 to B. henselae were found in 20 participants (3.8%), while 17 (3.3%) had seropositivity to B. quintana, 51 (9.8%) to B. elizabethae, and 19 (3.6%) to B. vinsonii subsp vinsonii. These results suggest exposure to Bartonella species is more common in rural Thailand than previously suspected.

PMID: 21706948 [PubMed - indexed for MEDLINE]

12. Mol Ecol. 2011 Jul;20(13):2864-70. doi: 10.1111/j.1365-294X.2011.05033.x. Epub 2011 Feb 24.

Investigation of Bartonella acquisition and transmission in Xenopsylla ramesis fleas (Siphonaptera: Pulicidae).

Morick D, Krasnov BR, Khokhlova IS, Gottlieb Y, Harrus S.

Koret School of Veterinary Medicine, The Hebrew University of Jerusalem; PO Box 12, Rehovot 76100, Israel.

Comment in Mol Ecol. 2011 Jul;20(13):2660-1.

Bartonella are emerging and re-emerging pathogens affecting humans and a wide variety of animals including rodents. Horizontal transmission of Bartonella species by different hematophagous vectors is well acknowledged but vertical transmission (from mother to offspring) is questionable and was never explored in fleas. The aim of this study was to investigate whether the rodent flea, Xenopsylla ramesis, can acquire native Bartonella from wild rodents and transmit it transovarially. For this aim, Bartonella-free laboratory-reared X. ramesis fleas were placed on six naturally Bartonella-infected rodents and six species-matched Bartonella-negative rodents (three Meriones crassus jirds, two Gerbillus nanus gerbils and one Gerbillus dasyurus gerbil) for 7 days, 12-14h per day. The fleas that were placed on the Bartonella-positive rodents acquired four different Bartonella genotypes. Eggs and larvae laid and developed, respectively, by fleas from both rodent groups were collected daily for 7 days and molecularly screened for Bartonella. All eggs and larvae from both groups were found to be negative for Bartonella DNA. Interestingly, two of five gut voids regurgitated by Bartonella-positive fleas contained Bartonella DNA. The naturally infected rodents remained persistently infected with Bartonella for at least 89 days suggesting their capability to serve as competent reservoirs for Bartonella species. The findings in this study indicate that X. ramesis fleas can acquire several Bartonella strains from wild rodents but cannot transmit Bartonella transovarially.

PMID: 21692752 [PubMed - in process]

13. Comp Immunol Microbiol Infect Dis. 2011 Jul;34(4):299-314. doi: 10.1016/j.cimid.2011.04.005. Epub 2011 May 25.

Bartonella species and their ectoparasites: selective host adaptation or strain selection between the vector and the mammalian host?

Tsai YL, Chang CC, Chuang ST, Chomel BB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

A wide range of blood-sucking arthropods have either been confirmed or are suspected as important vectors in Bartonella transmission to mammals, including humans. Overall, it appears that the diversity of Bartonella species DNA identified in ectoparasites is much broader than the species detected in their mammalian hosts, suggesting a mechanism of adaptation of Bartonella species to their host-vector ecosystem. However, these mechanisms leading to the fitness between the vectors and their hosts still need to be investigated.

PMID: 21616536 [PubMed - indexed for MEDLINE]

14. Adv Exp Med Biol. 2011;715:51-70.

Adhesins of Bartonella spp.

O'Rourke F, Schmidgen T, Kaiser PO, Linke D, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum, Johann Wolfgang Goethe-Universität, Frankfurt am Main, Germany. ORourke@med.uni-frankfurt.de

Adhesion to host cells represents the first step in the infection process and one of the decisive features in the pathogenicity of Bartonella spp. B. henselae and B. quintana are considered to be the most important human pathogenic species, responsible for cat scratch disease, bacillary angiomatosis, trench fever and other diseases. The ability to cause vasculoproliferative disorders and intraerythrocytic bacteraemia are unique features of the genus Bartonella. Consequently, the interaction with endothelial cells and erythrocytes is a focus in Bartonella research. The genus harbours a variety of trimeric autotransporter adhesins (TAAs) such as the Bartonella adhesin A (BadA) of B. henselae and the variably expressed outer-membrane proteins (Vomps) of B. quintana, which display remarkable variations in length and modular construction. These adhesins mediate many of the biologically-important properties of Bartonella spp. such as adherence to endothelial cells and extracellular matrix proteins and induction of angiogenic gene programming. There is also significant evidence that the laterally acquired Trw-conjugation systems of Bartonella spp. mediate host-specific adherence to erythrocytes. Other potential adhesins are the filamentous haemagglutinins and several outer membrane proteins. The exact molecular functions of these adhesins and their interplay with other pathogenicity factors (e.g., the VirB/D4 type 4 secretion system) need to be analysed in detail to understand how these pathogens adapt to their mammalian hosts.

PMID: 21557057 [PubMed - indexed for MEDLINE]

15. Parasit Vectors. 2011 Apr 18;4:61.

Absence of zoonotic Bartonella species in questing ticks: first detection of Bartonella clarridgeiae and Rickettsia felis in cat fleas in the Netherlands.

Tijsse-Klasen E, Fonville M, Gassner F, Nijhof AM, Hovius EK, Jongejan F, Takken W, Reimerink JR, Overgaauw PA, Sprong H.

Laboratory for Zoonoses and Environmental Microbiology, National Institute for Public Health and Environment (RIVM), Bilthoven, The Netherlands.

BACKGROUND: Awareness for flea- and tick-borne infections has grown in recent years and the range of microorganisms associated with these ectoparasites is rising. Bartonella henselae, the causative agent of Cat Scratch Disease, and other Bartonella species have been reported in fleas and ticks. The role of Ixodes ricinus ticks in the natural cycle of Bartonella spp. and the transmission of these bacteria to humans is unclear. Rickettsia spp. have also been reported from as well ticks as also from fleas. However, to date no flea-borne Rickettsia spp. were reported from the Netherlands. Here, the presence of Bartonellaceae and Rickettsiae in ectoparasites was investigated using molecular detection and identification on part of the gltA- and 16S rRNA-genes.

RESULTS: The zoonotic Bartonella clarridgeiae and Rickettsia felis were detected for the first time in Dutch cat fleas. B. henselae was found in cat fleas and B. schoenbuchensis in ticks and keds feeding on deer. Two Bartonella species, previously identified in rodents, were found in wild mice and their fleas. However, none of these microorganisms were found in 1719 questing Ixodes ricinus ticks. Notably, the gltA gene amplified from DNA lysates of approximately 10% of the questing nymph and adult ticks was similar to that of an uncultured Bartonella-related species found in other hard tick species. The gltA gene of this Bartonella-related species was also detected in questing larvae for which a 16S rRNA gene PCR also tested positive for "Candidatus Midichloria mitochondrii". The gltA-gene of the Bartonella-related species found in I. ricinus may therefore be from this endosymbiont.

CONCLUSIONS: We conclude that the risk of acquiring Cat Scratch Disease or a related bartonellosis from questing ticks in the Netherlands is negligible. On the other hand fleas and deer keds are probable vectors for associated Bartonella species between animals and might also transmit Bartonella spp. to humans.

PMCID: PMC3087693 PMID: 21501464 [PubMed - indexed for MEDLINE]

16. J Med Microbiol. 2011 Sep;60(Pt 9):1281-6. Epub 2011 Apr 15.

In silico analysis of 16S rRNA gene sequencing based methods for identification of medically important aerobic Gram-negative bacteria.

Teng JL, Yeung MY, Yue G, Au-Yeung RK, Yeung EY, Fung AM, Tse H, Yuen KY, Lau SK, Woo PC.

Department of Microbiology, The University of Hong Kong, Hong Kong SAR.

This study provides guidelines on the usefulness of full and 527 bp 16S rRNA gene sequencing and Microseq databases for identifying medically important aerobic Gram-negative bacteria. Overall, full and 527 bp 16S rRNA gene sequencing can identify 26.1 % and 32.6 %, respectively, of medically important aerobic Gram-negative bacteria confidently to the species level, whereas the full-MicroSeq and 500-MicroSeq databases can identify 15.2 % and 26.1 %, respectively, of medically important aerobic Gram-negative bacteria confidently to the species level. Among the major groups of aerobic Gram-negative bacteria, the methods and databases are least useful for identification of Aeromonas, Bordetella and Bartonella species. None of the Aeromonas species can be confidently or doubtfully identified, whereas only 0 % and 0-33.3 % of Bordetella species and 0-10 % and 0-10 % of Bartonella species can be confidently and doubtfully identified, respectively. On the other hand, these methods and databases are most useful for identification of members of the families Pasteurellaceae and Legionellaceae and Campylobacter species: 29.6-59.3 % and 7.4-18.5 % of members of Pasteurellaceae, 36-52 % and 12-24 % of members of Legionellaceae, and 26.7-60 % and 0-13.3 % of Campylobacter species can be confidently and doubtfully identified, respectively. Thirty-nine medically important aerobic Gram-negative bacteria that should be confidently identified by full 16S rRNA gene sequencing are not included in the full-MicroSeq database. Twenty-three medically important aerobic Gram-negative bacteria that should be confidently identified by 527 bp 16S rRNA gene sequencing are not included in the 500-MicroSeq database. Compared with results of our previous studies on anaerobic and Gram-positive bacteria, full and 527 bp 16S rRNA gene sequencing are able to confidently identify significantly more anaerobic Gram-positive and Gram-negative bacteria than aerobic Gram-positive and Gram-negative bacteria.

PMID: 21498652 [PubMed - indexed for MEDLINE]

17. Rickettsiae.

Walker DH. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 38.

Rickettsiae are small, Gram-negative bacilli that have evolved in such close association with arthropod hosts that they are adapted to survive within the host cells. They represent a rather diverse collection of bacteria, and therefore listing characteristics that apply to the entire group is difficult. The common threads that hold the rickettsiae into a group are their epidemiology, their obligate intracellular lifestyle, and the laboratory technology required to work with them. In the laboratory, rickettsiae cannot be cultivated on agar plates or in broth, but only in viable eukaryotic host cells (e.g., in cell culture, embryonated eggs, or susceptible animals). The exception, which shows the artificial nature of using obligate intracellular parasitism as a defining phenotypic characteristic, is Bartonella (Rochalimaea) quintana, which is cultivable axenically, but was traditionally considered as a rickettsia. The diversity of rickettsiae is demonstrated in the variety of specific intracellular locations where they live and the remarkable differences in their major outer membrane proteins and genetic relatedness (Table 38-1). An example of extreme adaptation is that the metabolic activity of Coxiella burnetii is greatly increased in the acidic environment of the phagolysosome, which is a harsh location for survival for most other organisms. Obligate intracellular parasitism among bacteria is not unique to rickettsiae. Chlamydiae also have evolved to occupy an intracellular niche, and numerous bacteria (e.g., Mycobacteria, Legionella, Salmonella, Shigella, Francisella, and Brucella) are facultative intracellular parasites. In contrast with chlamydiae, all rickettsiae can synthesize ATP. Coxiella burnetii is the only rickettsia that appears to have a developmental cycle. Some organisms in the family Rickettsiaceae are closely related genetically (e.g., Rickettsia rickettsii, R akari, R prowazekii, and R typhi); others are related less closely to Rickettsia species (e.g., Ehrlichia and Bartonella); and others not related to Rickettsia species (e.g., C burnetii). The phenotypic traits of the medically important organism Orientia (Rickettsia) tsutsugamushi suggest that the species may be an example of convergent evolution in a similar ecologic niche. Rickettsioses are zoonoses that, except for Q fever, are usually transmitted to humans by arthropods (tick, mite, flea, louse, or chigger) (Table 38-2). Therefore, their geographic distribution is determined by that of the infected arthropod, which for most rickettsial species is the reservoir host. Rickettsiae are important causes of human diseases in the United States (Rocky Mountain spotted fever, Q fever, murine typhus, sylvatic typhus, human monocytic ehrlichiosis, human granulocytic ehrlichiosis, and rickettsialpox) and around the world (Q fever, murine typhus, scrub typhus, epidemic typhus, boutonneuse fever, and other spotted fevers) (Table 38-2).

PMID: 21413251 [PubMed]

18. PLoS Genet. 2011 Feb 10;7(2):e1001296.

Parallel evolution of a type IV secretion system in radiating lineages of the host-restricted bacterial pathogen Bartonella.

Engel P, Salzburger W, Liesch M, Chang CC, Maruyama S, Lanz C, Calteau A, Lajus A, Médigue C, Schuster SC, Dehio C.

Focal Area Infection Biology, Biozentrum, University of Basel, Basel, Switzerland.

Adaptive radiation is the rapid origination of multiple species from a single ancestor as the result of concurrent adaptation to disparate environments. This fundamental evolutionary process is considered to be responsible for the genesis of a great portion of the diversity of life. Bacteria have evolved enormous biological diversity by exploiting an exceptional range of environments, yet diversification of bacteria via adaptive radiation has been documented in a few cases only and the underlying molecular mechanisms are largely unknown. Here we show a compelling example of adaptive radiation in pathogenic bacteria and reveal their genetic basis. Our evolutionary genomic analyses of the α-proteobacterial genus Bartonella uncover two parallel adaptive radiations within these host-restricted mammalian pathogens. We identify a horizontally-acquired protein secretion system, which has evolved to target specific bacterial effector proteins into host cells as the evolutionary key innovation triggering these parallel adaptive radiations. We show that the functional versatility and adaptive potential of the VirB type IV secretion system (T4SS), and thereby translocated Bartonella effector proteins (Beps), evolved in parallel in the two lineages prior to their radiations. Independent chromosomal fixation of the virB operon and consecutive rounds of lineage-specific bep gene duplications followed by their functional diversification characterize these parallel evolutionary trajectories. Whereas most Beps maintained their ancestral domain constitution, strikingly, a novel type of effector protein emerged convergently in both lineages. This resulted in similar arrays of host cell-targeted effector proteins in the two lineages of Bartonella as the basis of their independent radiation. The parallel molecular evolution of the VirB/Bep system displays a striking example of a key innovation involved in independent adaptive processes and the emergence of bacterial pathogens. Furthermore, our study highlights the remarkable evolvability of T4SSs and their effector proteins, explaining their broad application in bacterial interactions with the environment.

PMCID: PMC3037411 PMID: 21347280 [PubMed - indexed for MEDLINE]

19. J Clin Microbiol. 2011 Apr;49(4):1363-8. Epub 2011 Feb 2.

Combining culture techniques for Bartonella: the best of both worlds.

Lynch T, Iverson J, Kosoy M.

Centers for Disease Control and Prevention, Division of Vector Borne Diseases, 3150 Rampart Road, Fort Collins, CO 80521, USA.

In this study we compared some common Bartonella culturing methodologies using four diverse species causing human illnesses. Based on a review of the literature, we focused on three major inconsistencies between protocols: base medium, cell coculture, and temperature. Our data showed that Bartonella tamiae demonstrated temperature-dependent growth limitations between common culturing conditions only 2°C apart. Additionally, growth of B. quintana was significantly enhanced by the presence of mammalian cell coculture under mammalian cell culture conditions; however, when the medium was modified to incorporate insect cell culture-based medium, coculturing with mammalian cells was no longer needed. In this study, we were able to overcome these temperature- and cell-dependent limitations and accommodate all of the strains tested by combining mammalian cell culture-based medium with insect cell culture-based medium.

PMCID: PMC3122786 PMID: 21289156 [PubMed - indexed for MEDLINE]

20. Cornea. 2011 Jul;30(7):807-14.

Molecular detection of Bartonella henselae for the diagnosis of cat scratch disease and bacillary angiomatosis of the conjunctiva.

Mitchell BM, Font RL.

Department of Ophthalmology, Ophthalmic Pathology Laboratory, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA.

PURPOSE: The purpose of this study was to evaluate clinical cases of cat scratch disease (CSD) and bacillary angiomatosis involving the conjunctiva by special stains and transmission electron microscopy (TEM) and to compare these findings with the results from species-specific polymerase chain reaction (PCR) analysis of the same specimens.

METHODS: Six potential cases of CSD and 2 possible cases of bacillary angiomatosis of the conjunctiva were analyzed by light microscopy, the Warthin-Starry technique, TEM, and PCR. DNA isolated from cultured Bartonella henselae, B. bacilliformis, B. quintana, and B. elizabethae were used as control templates for establishment of the PCR sensitivity and specificity. Cultured DNA was also used as appropriate positive controls during analysis of the clinical specimens.

RESULTS: The histological studies, electron microscopy, and the PCR analysis confirmed the identification of the bacilli within the involved tissues. Furthermore, molecular diagnosis by PCR allowed for speciation of the infecting Bartonella organisms in 6 of the 8 cases and correlated with the histological findings.

CONCLUSIONS: The PCR-based identification of Bartonella correlated well with the results of light microscopy and TEM and provided a simple and rapid method of diagnosis to the species level. The molecular analysis may prove to be beneficial in enhancing the current diagnostic techniques for CSD and bacillary angiomatosis.

PMID: 21282991 [PubMed - indexed for MEDLINE]

21. Vet Microbiol. 2011 May 5;149(3-4):517-21. Epub 2010 Dec 8.

Candidatus Bartonella antechini: a novel Bartonella species detected in fleas and ticks from the yellow-footed antechinus (Antechinus flavipes), an Australian marsupial.

Kaewmongkol G, Kaewmongkol S, Owen H, Fleming PA, Adams PJ, Ryan U, Irwin PJ, Fenwick SG.

School of Veterinary and Biomedical Sciences, Murdoch University, South Street, Murdoch 6150, Western Australia, Australia. G.Kaewmongkol@murdoch.edu.au

Bartonella are fastidious, Gram-negative, aerobic bacilli belonging to the Alphaproteobacteria group. In the last ten years, the discovery of new Bartonella species from a variety of mammalian hosts, arthropod vectors and geographical areas has increased. More than 20 species of Bartonella have been identified, of which approximately thirteen are associated with disease in humans and animals. Recently, four novel species of Bartonella were isolated from mammalian hosts in Australia: Bartonella australis from eastern grey kangaroos (Macropus giganteus) and Bartonella rattaustraliani, Bartonella queenslandensis and Bartonella coopersplainsensis from rodents. Bartonella-like organisms have also been detected from Ixodes tasmani ticks collected from koalas (Phascolarctos cinereus). However, very little is known about Bartonella spp. in other marsupials in Australia. We report the identification of a novel Bartonella species detected from fleas (Acanthopsylla jordani) and ticks (Ixodes antechini) collected from a small carnivorous marsupial, Antechinus flavipes (Mardos or Yellow-footed antechinus) in the southwest of Western Australia. New nested-PCRs targeting the gltA gene and the ribosomal ITS region were developed as part of the present study. DNA sequencing of the 16S rRNA, gltA, ftsZ and rpoB genes and the ribosomal ITS region revealed that this detection is a distinct Bartonella species and is related to B. australis isolated from kangaroos. This is the first report of two different possible arthropod vectors in Australia (ticks and fleas) being infected with the same species of Bartonella. We propose the name Candidatus Bartonella antechini n. sp. for the recently characterized organism.

PMID: 21215534 [PubMed - in process]

22. Vector Borne Zoonotic Dis. 2011 Aug;11(8):1023-30. Epub 2010 Dec 13.

Bartonella infection in shelter cats and dogs and their ectoparasites.

Tsai YL, Lin CC, Chomel BB, Chuang ST, Tsai KH, Wu WJ, Huang CG, Yu JC, Sung MH, Kass PH, Chang CC.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California, USA.

Mainly through vector transmission, domestic cats and dogs are infected by several Bartonella spp. and represent a large reservoir for human infections. This study investigated the relationship of prevalences of Bartonella infection in shelter dogs and cats and various ectoparasite species infesting them (fleas, ticks, and lice). Moreover, relationships between Bartonella infection and animal gender and age and presence of ectoparasites were analyzed. Blood samples were collected from 120 dogs and 103 cats. There were 386 ticks and 36 fleas harvested on these dogs, and 141 fleas, 4 ticks, and 2 lice harvested on these cats. Isolation/detection of Bartonella sp. was performed by culture, polymerase chain reaction (PCR), and partial sequencing. Bartonella was isolated from 21 (20.4%) cats and detected by PCR from 20 (19.4%) cats, 2 (1.7%) dogs, 55 (39%) fleas collected from cats, 28 (10%) ticks DNA samples, and 1 (2.8%) flea collected from dogs. When combining culture and PCR data, 27 cats and 55 fleas collected on cats were positive for Bartonella henselae or Bartonella clarridgeiae, but none were coinfected. Approximately half of the B. henselae isolates from 21 cats were B. henselae type I. Moreover, B. henselae, Bartonella phoceensis, Bartonella queenslandensis, Bartonella rattimassiliensis, Bartonella elizabethae DNA was detected in ticks collected from dogs and one flea was B. clarridgeiae PCR positive. This is the first report of such a wide variety of Bartonella spp. detected in Rhipicephalus sanguineus. Further studies are required to understand the relative importance of these ectoparasites to transmit Bartonella spp. in dogs and cats.

PMID: 21142966 [PubMed - in process]

23. Future Microbiol. 2010 Nov;5(11):1719-31.

Bartonella infection: treatment and drug resistance.

Biswas S, Rolain JM.

CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 boulevard Jean-Moulin, Marseille cedex 05, France.

Bartonella species, which belong to the α-2 subgroup of Proteobacteria, are fastidious Gram-negative bacteria that are highly adapted to their mammalian host reservoirs. Bartonella species are responsible for different clinical conditions affecting humans, including Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis and peliosis hepatis. While some of these diseases can resolve spontaneously without treatment, in other cases, the disease is fatal without antibiotic treatment. In this article, we discuss the antibiotic susceptibility patterns of Bartonella species, detected using several methods. We also provide an overview of Bartonella infection in humans and animals and discuss the antibiotic treatment recommendations for the different infections, treatment failure and the molecular mechanism of antibiotic resistance in these bacteria.

PMID: 21133691 [PubMed - indexed for MEDLINE]

24. Emerg Infect Dis. 2010 Dec;16(12):1875-81.

Bartonella spp. in bats, Kenya.

Kosoy M, Bai Y, Lynch T, Kuzmin IV, Niezgoda M, Franka R, Agwanda B, Breiman RF, Rupprecht CE.

Centers for Disease Control and Prevention, Fort Collins, Colorado 80521, USA. mck3@cdc.gov

We report the presence and diversity of Bartonella spp. in bats of 13 insectivorous and frugivorous species collected from various locations across Kenya. Bartonella isolates were obtained from 23 Eidolon helvum, 22 Rousettus aegyptiacus, 4 Coleura afra, 7 Triaenops persicus, 1 Hipposideros commersoni, and 49 Miniopterus spp. bats. Sequence analysis of the citrate synthase gene from the obtained isolates showed a wide assortment of Bartonella strains. Phylogenetically, isolates clustered in specific host bat species. All isolates from R. aegyptiacus, C. afra, and T. persicus bats clustered in separate monophyletic groups. In contrast, E. helvum and Miniopterus spp. bats harbored strains that clustered in several groups. Further investigation is needed to determine whether these agents are responsible for human illnesses in the region.

PMID: 21122216 [PubMed - indexed for MEDLINE]

25. Mem Inst Oswaldo Cruz. 2010 Nov;105(7):873-8.

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats in the south of Brazil: a molecular study.

Staggemeier R, Venker CA, Klein DH, Petry M, Spilki FR, Cantarelli VV.

Laboratório de Biomedicina, Universidade Feevale, Novo Hamburgo, RS, Brasil. rstaggemeier@gmail.com

Bartonella spp are the causative agent of cat scratch disease in humans. Cats are the natural reservoir of these bacteria and may infect humans through scratches, bites or fleas. Blood samples from 47 cats aged up to 12 months were collected for this study. All animals were lodged in municipal animal shelters in the Vale do Sinos region, Rio Grande do Sul, Brazil. Bartonella spp were detected by genus-specific polymerase chain reaction (PCR) and when the PCR was positive, the species were determined by DNA sequencing. A Giemsa-stained blood smear was also examined for the presence of intraerythrocytic elements suggestive of Bartonella spp infection. Phylogenetic analysis was also performed for all positive samples. Using molecular detection methods, Bartonella spp were detected in 17.02% (8/47) of the samples. In seven out of eight samples confirmed to be positive for Bartonella spp, blood smear examination revealed the presence of intraerythrocytic elements suggestive of Bartonella spp. Phylogenetic analysis characterized positive samples as Bartonella henselae (5) or Bartonella clarridgeiae (3). To the best of our knowledge, this is the first molecular study demonstrating the presence of Bartonella spp in cats from the Southern Region of Brazil.

PMID: 21120356 [PubMed - indexed for MEDLINE]

26. Vector Borne Zoonotic Dis. 2011 Jul;11(7):985-9. Epub 2010 Nov 17.

The occurrence of spotted fever rickettsioses and other tick-borne infections in forest workers in Poland.

Podsiadły E, Chmielewski T, Karbowiak G, Kędra E, Tylewska-Wierzbanowska S.

Laboratory of Rickettsiae, Chlamydiae, and Enzotic Spirochetes, National Institute of Public Heath-National Institute of Hygiene, Warsaw, Poland.

The presence of antibodies to Rickettsia conorii, R. helvetica, R. felis, R. slovaca, R. sibirica, and R. massiliae in sera of 129 forest workers from northeastern and southern Poland was assayed by indirect immunofluorescence. Previous environmental studies revealed presence of spotted fever group (SFG) rickettsiae in ticks collected from these areas. Additionally, the workers were examinated for the presence of antibodies specific to other tick-borne bacteria: Anaplasma phagocytophilum, Bartonella spp., and B. burgdorferi. The results of the studies have shown the presence of specific SFG rickettsiae antibodies in 14.7% of tested forest workers, among them 78.9% had species-specific antibodies to R. massiliae. Contrary to previous detection R. helvetica and R. slovaca in ticks collected in the environment of the examined area, no species-specific antibodies to these species were detected in studied workers. Antibodies to B. burgdorferi (44%) were found in forest workers more often than antibodies to other tested pathogens. B. burgdorferi was also the main component of coinfections. The most frequent confirmed serologically coinfections were simultaneous infections with B. burgdorferi and Bartonella spp. found in 10% of tested individuals. So far, SFG rickettsiae infections have not been diagnosed in Poland; however, the presence of the bacteria in ticks and presence of specific antibodies in humans exposed to arthropods show the need for monitoring the situation. The list of tick-borne pathogens is increasing, but knowledge about the possibility of humans acquiring multipathogens infections after tick bite still needs evaluation.

PMID: 21083370 [PubMed - in process]

27. Appl Environ Microbiol. 2010 Dec;76(24):8062-70. Epub 2010 Oct 8.

Variability of Bartonella genotypes among small mammals in Spain.

Gil H, García-Esteban C, Barandika JF, Peig J, Toledo A, Escudero R, Jado I, Rodríguez-Vargas M, García-Amil C, Lobo B, Roales P, Rodríguez-Moreno I, Olmeda AS, García-Pérez AL, Anda P.

Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain,1 Hospital de Getafe, Getafe, Madrid, Spain. hgil@isciii.es

In order to study which Bartonella genotypes are circulating among small mammals in Spain, we analyzed the spleens of 395 animals from three different areas-247 animals from the Basque Country (northern Spain), 121 animals from Catalonia (northeastern Spain), and 27 animals from Madrid (central Spain)-by a triplex PCR combined with a reverse line blot previously described by our group. The prevalence of Bartonella was 26.8% (106/395), and in 4.8% (19/395) of the animals more than one Bartonella genotype was detected. The study of gltA and the intergenic transcribed spacer in the positive samples demonstrated a large diversity, allowing the assignation of them into 22 genotypes. The most prevalent genotypes were 2 and 3, which are closely related to Bartonella taylorii. In addition, nine genotypes were associated with specific mammal species. Genotypes close to the zoonotic Bartonella grahamii, Bartonella elizabethae, and Bartonella rochalimae were also detected. Ten genotypes showed a percentage of similarity with known Bartonella species lower than 96%, suggesting the presence of potential new species. Further studies of the impact of these pathogens on human health and especially in cases of febrile illness in Spain are strongly recommended. Furthermore, our method has been updated with 21 new probes in a final panel of 36, which represents a robust molecular tool for clinical and environmental Bartonella studies.

PMCID: PMC3008237 PMID: 20935117 [PubMed - indexed for MEDLINE]

28. Vet Clin North Am Small Anim Pract. 2010 Nov;40(6):1073-90.

Feline bartonellosis.

Guptill L.

Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison Street, West Lafayette, IN 47907, USA. guptillc@purdue.edu

Bartonella infection is common among domestic cats, but the role of Bartonella species as feline pathogens requires further study. Most Bartonella species that infect cats are zoonotic. Cats are the mammalian reservoir and vector for Bartonella henselae, an important zoonotic agent. Cat fleas transmit Bartonella among cats, and cats with fleas are an important source of human B henselae infections. New information about Bartonella as feline pathogens has recently been published, and this article summarizes much of that information. Issues surrounding diagnosis and treatment of feline Bartonella infections are described, and prevention of zoonotic transmission of Bartonella is discussed.

PMID: 20933137 [PubMed - indexed for MEDLINE]

29. Science. 2010 Oct 8;330(6001):243-6.

Species interactions in a parasite community drive infection risk in a wildlife population.

Telfer S, Lambin X, Birtles R, Beldomenico P, Burthe S, Paterson S, Begon M.

School of Biological Sciences, University of Liverpool, Crown Street, Liverpool L69 7ZB, UK. s.telfer@abdn.ac.uk

Comment in Science. 2010 Oct 8;330(6001):187-8. Science. 2011 Jan 14;331(6014):144-5; author reply 145-7.

Most hosts, including humans, are simultaneously or sequentially infected with several parasites. A key question is whether patterns of coinfection arise because infection by one parasite species affects susceptibility to others or because of inherent differences between hosts. We used time-series data from individual hosts in natural populations to analyze patterns of infection risk for a microparasite community, detecting large positive and negative effects of other infections. Patterns remain once variations in host susceptibility and exposure are accounted for. Indeed, effects are typically of greater magnitude, and explain more variation in infection risk, than the effects associated with host and environmental factors more commonly considered in disease studies. We highlight the danger of mistaken inference when considering parasite species in isolation rather than parasite communities.

PMCID: PMC3033556 PMID: 20929776 [PubMed - indexed for MEDLINE]

30. J Clin Microbiol. 2010 Dec;48(12):4630-3. Epub 2010 Oct 6.

Improved detection of Bartonella DNA in mammalian hosts and arthropod vectors by real-time PCR using the NADH dehydrogenase gamma subunit (nuoG).

Colborn JM, Kosoy MY, Motin VL, Telepnev MV, Valbuena G, Myint KS, Fofanov Y, Putonti C, Feng C, Peruski L.

Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA.

We used a whole-genome scanning technique to identify the NADH dehydrogenase gamma subunit (nuoG) primer set that is sensitive and specific enough to detect a diverse number of Bartonella species in a wide range of environmental samples yet maintains minimal cross-reactivity to mammalian host and arthropod vector organisms.

PMCID: PMC3008469 PMID: 20926707 [PubMed - indexed for MEDLINE]

31. Trans R Soc Trop Med Hyg. 2010 Nov;104(11):733-9. Epub 2010 Sep 25.

Rats as indicators of the presence and dispersal of six zoonotic microbial agents in Cyprus, an island ecosystem: a seroepidemiological study.

Psaroulaki A, Antoniou M, Toumazos P, Mazeris A, Ioannou I, Chochlakis D, Christophi N, Loukaides P, Patsias A, Moschandrea I, Tselentis Y.

University of Crete, Heraklion, Crete 71409, Greece. annapsa@med.uoc.gr

A total of 622 rats (402 Rattus norvegicus and 220 R. rattus frugivorus) were collected in 51 different areas in Cyprus during 2000-2003 and used as indicators of the presence and dispersal of six zoonotic microbial agents. IgG antibodies against Rickettsia typhi (241/496, 48.6%), R. conorii (209/500, 41.8%), Toxoplasma sp. (138/494, 27.9%), Coxiella burnetti (63/494, 12.8%), Bartonella henselae (52/494, 10.5%) and Leishmania infantum (36/494, 7.3%) were detected by indirect immunofluorescence test. There was variation in the association between the seropositivity of the six microbial agents and other factors. Rat species affected R. typhi and R. conorii seropositivity, the prefecture where the rats were caught affected R. typhi, C. burnetii, B. henselae, T. gondii and L. infantum, the sampling season impacted on R. typhi, R. conorii, T. gondii and L. infantum, and the flea species affected R. typhi, R. conorii and B. henselae. These results were analysed using geographical information system (GIS) technology and the seropositivity in rats against the pathogens tested appeared to follow the occurrence of these pathogens in humans. This suggests that rats could be used as disease sentinels and, together with GIS technology, they could be a useful tool for the identification of endemic foci and high-risk areas for each pathogen.

PMID: 20870259 [PubMed - indexed for MEDLINE]

32. Vet Microbiol. 2011 Mar 24;148(2-4):238-45. Epub 2010 Sep 21.

Combined MLST and AFLP typing of Bartonella henselae isolated from cats reveals new sequence types and suggests clonal evolution.

Mietze A, Morick D, Köhler H, Harrus S, Dehio C, Nolte I, Goethe R.

Institut für Mikrobiologie, Stiftung Tierärztliche Hochschule Hannover, Germany.

Bartonella species are Gram-negative, fastidious bacteria. Bartonella henselae is found in cats and transmitted to humans via cat scratches or bites causing cat-scratch disease, characterized by clinical symptoms with varying severity. The prevalence of bartonellosis among humans in Germany appears to be high, and severe clinical cases have been described. However, epidemiological data of B. henselae in cats are rare. In this study we determined the detection rates of Bartonella ssp. in cats by culture and real-time PCR. Furthermore, B. henselae isolates were genetically characterized by highly discriminatory amplified fragment length polymorphism (AFLP) and multilocus sequence typing (MLST). Bartonella spp. were isolated by culture from 11 (2.2%) of 507 blood samples. Out of 169 blood samples additionally analyzed by PCR, 28 (16.6%) were found positive for Bartonella spp., illustrating the advantage of PCR in Bartonella spp. detection. PCR-REA identified B. henselae in 27 cats and Bartonella clarridgeiae in one cat. B. henselae isolates from different geographical regions in Germany were genetically characterized by AFLP and MLST. Both methods confirmed genetic diversity of B. henselae on the strain level. MLST identified 11 new sequence types, all of them assigned to three clonal complexes as determined by eBURST. AFLP typing revealed genetic relation among the B. henselae isolates from the same geographical region. Combining AFLP typing and MLST/eBURST analyses revealed that B. henselae of the same AFLP subcluster belonged to the same clonal complex. Altogether these results indicate that B. henselae may evolve clonally.

PMID: 20863631 [PubMed - indexed for MEDLINE]

33. Int J Med Microbiol. 2011 Jan;301(1):7-15. Epub 2010 Sep 15.

Bartonella spp.: throwing light on uncommon human infections.

Kaiser PO, Riess T, O'Rourke F, Linke D, Kempf VA.

Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Universitätsklinikum, Johann Wolfgang Goethe-Universität, Paul Ehrlich-Str. 40, 60596 Frankfurt am Main, Germany.

After 2 decades of Bartonella research, knowledge on transmission and pathology of these bacteria is still limited. Bartonella spp. have emerged to be important pathogens in human and veterinary medicine. For humans, B. henselae is considered to represent the most relevant zoonotic Bartonella species and is responsible for cat scratch disease, bacillary angiomatosis, and other disorders. Over the years, many Bartonella species have been isolated from humans, cats, dogs, and other mammals, and infections range from an asymptomatic state (e.g., animal-specific species) to even life-threatening diseases (e.g., Oroya fever). It is obvious that the analysis of pathogenicity mechanisms underlying Bartonella infections is needed to increase our understanding of how these pathogens adapt to their mammalian hosts resulting in acute or chronic diseases.

PMID: 20833105 [PubMed - indexed for MEDLINE]

34. J Am Board Fam Med. 2010 Sep-Oct;23(5):685-6.

Cat scratch disease and arthropod vectors: more to it than a scratch?

Mosbacher M, Elliott SP, Shehab Z, Pinnas JL, Klotz JH, Klotz SA.

Third World Veterinary, Fountain Hills, AZ, USA.

PURPOSE: Cat scratch disease is a common infection, particularly in children, and clinicians need to be aware of its potential transmission to humans by arthropod vectors such as fleas and ticks in addition to animal bites and scratches. The absence of a vertebrate bite or scratch does not preclude infection with Bartonella henselae.

METHODS: Literature regarding arthropod transmission of B. henselae was reviewed.

RESULTS: B. henselae and related bacterial species are transmitted among cats and dogs by arthropod vectors. In the absence of these vectors, disease does not spread amongst the animals. On the other hand, disease can be spread to humans by bite and scratch as well as by arthropod vectors. Animals commonly infected with B. henselae and arthropod vectors are discussed.

CONCLUSIONS: Clinicians should be aware that a common illness, cat scratch disease, can be transmitted by arthropod vectors and a history of an animal scratch or bite is not necessary for disease transmission.

PMID: 20823366 [PubMed - indexed for MEDLINE]

35. Clin Dermatol. 2010 Sep-Oct;28(5):483-8.

Skin diseases associated with Bartonella infection: facts and controversies.

Piérard-Franchimont C, Quatresooz P, Piérard GE.

Department of Dermatopathology, University Hospital of Liège, Liège, Belgium.

The genus Bartonella is composed of a series of species and subspecies. Ten of them are responsible for human infections. The best-identified diseases are cat scratch disease (B henselae and possibly B clarridgeiae), trench fever (B quintana), bacillary angiomatosis (B quintana and B henselae), and the spectrum of verruga peruana, Carrion disease, and Oroya fever (B bacilliformis). Controversies exist about the implication of a few other microorganisms being involved in these diseases. Several other conditions have been associated with the presence of Bartonella spp, but these observations await confirmation.

PMID: 20797506 [PubMed - indexed for MEDLINE]

36. Am J Trop Med Hyg. 2010 Aug;83(2):298-300.

Molecular evidence of Bartonella infection in domestic dogs from Algeria, North Africa, by polymerase chain reaction (PCR).

Kernif T, Aissi M, Doumandji SE, Chomel BB, Raoult D, Bitam I.

Département de zoologie, Institut National d'Agronomie, El Harrach, Algiers, Algeria.

Bartonella species are being recognized as important bacterial human and canine pathogens, and are associated with multiple arthropod vectors. Bartonella DNA extracted from blood samples was obtained from domestic dogs in Algiers, Algeria. Polymerase chain reaction (PCR) and DNA sequence analyses of the ftsZ gene and the 16S-23S intergenic spacer region (ITS) were performed. Three Bartonella species: Bartonella vinsonii subsp. berkhoffii, Bartonella clarridgeiae, and Bartonells elizabethae were detected infecting Algerian dogs. To our knowledge, this study is the first report of detection by PCR amplification of Bartonella in dogs in North Africa.

PMCID: PMC2911174 PMID: 20682871 [PubMed - indexed for MEDLINE]

37. BMC Infect Dis. 2010 Jul 30;10:229.

Human isolates of Bartonella tamiae induce pathology in experimentally inoculated immunocompetent mice.

Colton L, Zeidner N, Lynch T, Kosoy MY.

Bacterial Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA. ant6@cdc.gov

BACKGROUND: Bartonella tamiae, a newly described bacterial species, was isolated from the blood of three hospitalized patients in Thailand. These patients presented with headache, myalgia, anemia, and mild liver function abnormalities. Since B. tamiae was presumed to be the cause of their illness, these isolates were inoculated into immunocompetent mice to determine their relative pathogenicity in inducing manifestations of disease and pathology similar to that observed in humans.

METHODS: Three groups of four Swiss Webster female mice aged 15-18 months were each inoculated with 10(6-7) colony forming units of one of three B. tamiae isolates [Th239, Th307, and Th339]. A mouse from each experimental group was sampled at 3, 4, 5 and 6 weeks post-inoculation. Two saline inoculated age-matched controls were included in the study. Samples collected at necropsy were evaluated for the presence of B. tamiae DNA, and tissues were formalin-fixed, stained with hematoxylin and eosin, and examined for histopathology.

RESULTS: Following inoculation with B. tamiae, mice developed ulcerative skin lesions and subcutaneous masses on the lateral thorax, as well as axillary and inguinal lymphadenopathy. B. tamiae DNA was found in subcutaneous masses, lymph node, and liver of inoculated mice. Histopathological changes were observed in tissues of inoculated mice, and severity of lesions correlated with the isolate inoculated, with the most severe pathology induced by B. tamiae Th239. Mice inoculated with Th239 and Th339 demonstrated myocarditis, lymphadenitis with associated vascular necrosis, and granulomatous hepatitis and nephritis with associated hepatocellular and renal necrosis. Mice inoculated with Th307 developed a deep dermatitis and granulomas within the kidneys.

CONCLUSIONS: The three isolates of B. tamiae evaluated in this study induce disease in immunocompetent Swiss Webster mice up to 6 weeks after inoculation. The human patients from whom these isolates were obtained had clinical presentations consistent with the multi-organ pathology observed in mice in this study. This mouse model for B. tamiae induced disease not only strengthens the causal link between this pathogen and clinical illness in humans, but provides a model to further study the pathological processes induced by these bacteria.

PMCID: PMC2920874 PMID: 20673363 [PubMed - indexed for MEDLINE]

38. Vet Microbiol. 2010 Dec 15;146(3-4):314-9. Epub 2010 May 12.

Enrichment culture and molecular identification of diverse Bartonella species in stray dogs.

Bai Y, Kosoy MY, Boonmar S, Sawatwong P, Sangmaneedet S, Peruski LF.

Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, 3150 Rampart Road, Fort Collins, CO 80521, USA. YBai1@cdc.gov

Using pre-enrichment culture in Bartonella alpha-Proteobacteria growth medium (BAPGM) followed by PCR amplification and DNA sequence identification that targeted a fragment of the citrate synthase gene (gltA), we provide evidence of common bartonella infections and diverse Bartonella species in the blood of stray dogs from Bangkok and Khon Kaen, Thailand. The overall prevalence of all Bartonella species was 31.3% (60/192), with 27.9% (31/111) and 35.8% (29/81) in the stray dogs from Bangkok and Khon Kaen, respectively. Phylogenetic analyzes of gltA identified eight species/genotypes of Bartonella in the blood of stray dogs, including B. vinsonii subsp. arupensis, B. elizabethae, B. grahamii, B. quintana, B. taylorii, and three novel genotypes (BK1, KK1 and KK2) possibly representing unique species with ≤ 90.2% similarities to any of the known Bartonella species B. vinsonii subsp. arupensis was the only species detected in dogs from both sites, B. quintana and BK1 were found in the dogs from Bangkok, B. elizabethae, B. taylorii, KK1 and KK2 were found in the dogs from Khon Kaen. We conclude that stray dogs in Thailand are frequently infected with Bartonella species that vary with geographic region. As some Bartonella species detected in the present study are considered pathogenic for humans, stray dogs in Thailand may serve as possible reservoirs for Bartonella causing human illnesses. Further work is needed to determine the role of those newly discovered Bartonella genotypes/species in human and veterinary medicine.

PMID: 20570065 [PubMed - indexed for MEDLINE]

39. PLoS Pathog. 2010 Jun 10;6(6):e1000946.

The Trw type IV secretion system of Bartonella mediates host-specific adhesion to erythrocytes.

Vayssier-Taussat M, Le Rhun D, Deng HK, Biville F, Cescau S, Danchin A, Marignac G, Lenaour E, Boulouis HJ, Mavris M, Arnaud L, Yang H, Wang J, Quebatte M, Engel P, Saenz H, Dehio C.

Unité Sous Contrat Bartonella, INRA, Maisons-Alfort, France. mvayssier@vet-alfort.fr

Bacterial pathogens typically infect only a limited range of hosts; however, the genetic mechanisms governing host-specificity are poorly understood. The alpha-proteobacterial genus Bartonella comprises 21 species that cause host-specific intraerythrocytic bacteremia as hallmark of infection in their respective mammalian reservoirs, including the human-specific pathogens Bartonella quintana and Bartonella bacilliformis that cause trench fever and Oroya fever, respectively. Here, we have identified bacterial factors that mediate host-specific erythrocyte colonization in the mammalian reservoirs. Using mouse-specific Bartonella birtlesii, human-specific Bartonella quintana, cat-specific Bartonella henselae and rat-specific Bartonella tribocorum, we established in vitro adhesion and invasion assays with isolated erythrocytes that fully reproduce the host-specificity of erythrocyte infection as observed in vivo. By signature-tagged mutagenesis of B. birtlesii and mutant selection in a mouse infection model we identified mutants impaired in establishing intraerythrocytic bacteremia. Among 45 abacteremic mutants, five failed to adhere to and invade mouse erythrocytes in vitro. The corresponding genes encode components of the type IV secretion system (T4SS) Trw, demonstrating that this virulence factor laterally acquired by the Bartonella lineage is directly involved in adherence to erythrocytes. Strikingly, ectopic expression of Trw of rat-specific B. tribocorum in cat-specific B. henselae or human-specific B. quintana expanded their host range for erythrocyte infection to rat, demonstrating that Trw mediates host-specific erythrocyte infection. A molecular evolutionary analysis of the trw locus further indicated that the variable, surface-located TrwL and TrwJ might represent the T4SS components that determine host-specificity of erythrocyte parasitism. In conclusion, we show that the laterally acquired Trw T4SS diversified in the Bartonella lineage to facilitate host-restricted adhesion to erythrocytes in a wide range of mammals.

PMCID: PMC2883598 PMID: 20548954 [PubMed - indexed for MEDLINE]

40. Clin Infect Dis. 2010 Jul 15;51(2):131-40.

Comprehensive diagnostic strategy for blood culture-negative endocarditis: a prospective study of 819 new cases.

Fournier PE, Thuny F, Richet H, Lepidi H, Casalta JP, Arzouni JP, Maurin M, Célard M, Mainardi JL, Caus T, Collart F, Habib G, Raoult D.

Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Centre National de la Recherche Scientifique-Institut de Recherche pour le Développement, Unité Mixte de Recherche 6236, Faculté de Médecine, Université de la Méditerranée, France.

Comment in Rev Chilena Infectol. 2010 Dec;27(6):572-3. Clin Infect Dis. 2010 Jul 15;51(2):141-2.

BACKGROUND. Blood culture-negative endocarditis (BCNE) may account for up to 31% of all cases of endocarditis. METHODS. We used a prospective, multimodal strategy incorporating serological, molecular, and histopathological assays to investigate specimens from 819 patients suspected of having BCNE. RESULTS. Diagnosis of endocarditis was first ruled out for 60 patients. Among 759 patients with BCNE, a causative microorganism was identified in 62.7%, and a noninfective etiology in 2.5%. Blood was the most useful specimen, providing a diagnosis for 47.7% of patients by serological analysis (mainly Q fever and Bartonella infections). Broad-range polymerase chain reaction (PCR) of blood and Bartonella-specific Western blot methods diagnosed 7 additional cases. PCR of valvular biopsies identified 109 more etiologies, mostly streptococci, Tropheryma whipplei, Bartonella species, and fungi. Primer extension enrichment reaction and autoimmunohistochemistry identified a microorganism in 5 additional patients. No virus or Chlamydia species were detected. A noninfective cause of endocarditis, particularly neoplasic or autoimmune disease, was determined by histological analysis or by searching for antinuclear antibodies in 19 (2.5%) of the patients. Our diagnostic strategy proved useful and sensitive for BCNE workup. CONCLUSIONS. We highlight the major role of zoonotic agents and the underestimated role of noninfective diseases in BCNE. We propose serological analysis for Coxiella burnetii and Bartonella species, detection of antinuclear antibodies and rheumatoid factor as first-line tests, followed by specific PCR assays for T. whipplei, Bartonella species, and fungi in blood. Broad-spectrum 16S and 18S ribosomal RNA PCR may be performed on valvular biopsies, when available.

PMID: 20540619 [PubMed - indexed for MEDLINE]

41. Am J Trop Med Hyg. 2010 Jun;82(6):1140-5.

Identification of Bartonella infections in febrile human patients from Thailand and their potential animal reservoirs.

Kosoy M, Bai Y, Sheff K, Morway C, Baggett H, Maloney SA, Boonmar S, Bhengsri S, Dowell SF, Sitdhirasdr A, Lerdthusnee K, Richardson J, Peruski LF.

Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA. mkosoy@cdc.gov

To determine the role of Bartonella species as causes of acute febrile illness in humans from Thailand, we used a novel strategy of co-cultivation of blood with eukaryotic cells and subsequent phylogenetic analysis of Bartonella-specific DNA products. Bartonella species were identified in 14 blood clots from febrile patients. Sequence analysis showed that more than one-half of the genotypes identified in human patients were similar or identical to homologous sequences identified in rodents from Asia and were closely related to B. elizabethae, B. rattimassiliensis, and B. tribocorum. The remaining genotypes belonged to B. henselae, B. vinsonii, and B. tamiae. Among the positive febrile patients, animal exposure was common: 36% reported owning either dogs or cats and 71% reported rat exposure during the 2 weeks before illness onset. The findings suggest that rodents are likely reservoirs for a substantial portion of cases of human Bartonella infections in Thailand.

PMCID: PMC2877425 PMID: 20519614 [PubMed - indexed for MEDLINE]

42. Mol Ecol. 2010 Jun;19(11):2241-55. Epub 2010 May 6.

Rapid diversification by recombination in Bartonella grahamii from wild rodents in Asia contrasts with low levels of genomic divergence in Northern Europe and America.

Berglund EC, Ellegaard K, Granberg F, Xie Z, Maruyama S, Kosoy MY, Birtles RJ, Andersson SG.

Department of Molecular Evolution, Uppsala University, Uppsala, Sweden.

Bartonella is a genus of vector-borne bacteria that infect the red blood cells of mammals, and includes several human-specific and zoonotic pathogens. Bartonella grahamii has a wide host range and is one of the most prevalent Bartonella species in wild rodents. We studied the population structure, genome content and genome plasticity of a collection of 26 B. grahamii isolates from 11 species of wild rodents in seven countries. We found strong geographic patterns, high recombination frequencies and large variations in genome size in B. grahamii compared with previously analysed cat- and human-associated Bartonella species. The extent of sequence divergence in B. grahamii populations was markedly lower in Europe and North America than in Asia, and several recombination events were predicted between the Asian strains. We discuss environmental and demographic factors that may underlie the observed differences.

PMID: 20465583 [PubMed - indexed for MEDLINE]

43. Wiad Parazytol. 2010;56(1):1-9.

[Bartonella spp. as a zoonotic pathogens transmitting by blood-feeding arthropods].

[Article in Polish]

Adamska M.

Katedra Genetyki, Uniwersytet Szczeciński, al. Piastów 40B, 71-065 Szczecin. adamska.us@wp.pl

Prior to 1993, Bartonella bacilliformis was the only member of the Bartonella genus. Now, the genus Bartonella currently contains over 30 species of Gram-negative bacteria that parasitize mammalian erythrocytes and endothelial cells. Bartonella spp. have been isolated from a variety of mammal species, most often from rodents, ruminants and carnivores, and these animals are implicated as reservoirs for the genus Bartonella. The persistent bacteriemia is more readily documented in the primary reservoir species and may occur less frequently or to a much lower lever in accidental hosts. In the natural host, clinical manifestations of the infection may be minimal or unrecognizable. Several insects have been implicated in Bartonella transmission, including flies and ticks. The reservoir host and vector varying depending on the Bartonella species involved, although, neither the reservoir, nor the vector has been identified definitively for many recently described Bartonella species. Humans are natural reservoir hosts for two species: Bartonella bacilliformis and Bartonella quintana, but many animal-associated Bartonella can also cause disease in humans. Members of the genus Bartonella are involved in a variety of human diseases, such as Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, pericarditis and neuroretinitis. Most cases of bartonellosis are now diagnosed by tests based on PCR or through serological tests using specific antigens.

PMID: 20450002 [PubMed - indexed for MEDLINE]

44. Hawaii Med J. 2010 Mar;69(3):68-9.

A "silent culture-negative" abdominal aortic mycotic aneurysm: Rapid detection of Bartonella species using PCR and high-throughput mass spectrometry.

Koo M, Manalili S, Bankowski MJ, Sampath R, Hofstadler SA, Koo J.

University of Hawai'i John A Burns School of Medicine, Honolulu, HI 96813, USA.

A gram-negative, rod-shaped microorganism was detected in a 69-year-old man suffering from chronic back pain but otherwise exhibiting no signs of infection. The bacterium could not be identified using any routine diagnostic modality. A research use only application utilizing PCR and Mass Spectrometry was performed on nucleic acid extracted from the tissue sample. These studies resulted in the implication of Bartonella quintana as the underlying cause of the infection. B. quintana is not a well-known cause of an abdominal aortic mycotic aneurysm. This article will discuss the B. quintana infection, its diagnosis and treatment, and reinforce the potential of B. quintana as a possible etiology in mycotic aneurysms that show no apparent indications of infection. It will also explore the potential use of polymerase chain reaction detected by electrospray ionization mass spectrometry (PCR/ESI-MS) to help identify B. quintana in a situation where other conventional methods prove non-informative.

PMCID: PMC3104617 PMID: 20397506 [PubMed - indexed for MEDLINE]

45. Am J Pathol. 2010 Jun;176(6):2753-63. Epub 2010 Apr 15.

An immunocompromised murine model of chronic Bartonella infection.

Chiaraviglio L, Duong S, Brown DA, Birtles RJ, Kirby JE.

Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215, USA.

Bartonella are ubiquitous gram-negative pathogens that cause chronic blood stream infections in mammals. Two species most often responsible for human infection, B. henselae and B. quintana, cause prolonged febrile illness in immunocompetent hosts, known as cat scratch disease and trench fever, respectively. Fascinatingly, in immunocompromised hosts, these organisms also induce new blood vessel formation leading to the formation of angioproliferative tumors, a disease process named bacillary angiomatosis. In addition, they cause an endothelial-lined cystic disease in the liver known as bacillary peliosis. Unfortunately, there are as yet no completely satisfying small animal models for exploring these unique human pathologies, as neither species appears able to sustain infection in small animal models. Therefore, we investigated the potential use of other Bartonella species for their ability to recapitulate human pathologies in an immunodeficient murine host. Here, we demonstrate the ability of Bartonella taylorii to cause chronic infection in SCID/BEIGE mice. In this model, Bartonella grows in extracellular aggregates, embedded within collagen matrix, similar to previous observations in cat scratch disease, bacillary peliosis, and bacillary angiomatosis. Interestingly, despite overwhelming infection later in disease, evidence for significant intracellular replication in endothelial or other cell types was not evident. We believe that this new model will provide an important new tool for investigation of Bartonella-host interaction.

PMCID: PMC2877837 PMID: 20395436 [PubMed - indexed for MEDLINE]

46. J Clin Microbiol. 2010 Jun;48(6):2289-93. Epub 2010 Apr 14.

Molecular evidence of perinatal transmission of Bartonella vinsonii subsp. berkhoffii and Bartonella henselae to a child.

Breitschwerdt EB, Maggi RG, Farmer P, Mascarelli PE.

College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606-1428, USA. ed_breitschwerdt@ncsu.edu

Bartonella vinsonii subsp. berkhoffii, Bartonella henselae, or DNA of both organisms was amplified and sequenced from blood, enrichment blood cultures, or autopsy tissues from four family members. Historical and microbiological results support perinatal transmission of Bartonella species in this family. It is of clinical relevance that Bartonella spp. may adversely influence human reproductive performance.

PMCID: PMC2884525 PMID: 20392912 [PubMed - indexed for MEDLINE]

47. Parasit Vectors. 2010 Apr 8;3(1):29.

Bartonella vinsonii subsp. berkhoffii and Bartonella henselae bacteremia in a father and daughter with neurological disease.

Breitschwerdt EB, Maggi RG, Lantos PM, Woods CW, Hegarty BC, Bradley JM.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St,, Raleigh, NC, USA. ed_breitschwerdt@ncsu.edu.

ABSTRACT:BACKGROUND: Bartonella vinsonii subsp. berkhoffii is an important, emerging, intravascular bacterial pathogen that has been recently isolated from immunocompetent patients with endocarditis, arthritis, neurological disease and vasoproliferative neoplasia. Vector transmission is suspected among dogs and wild canines, which are the primary reservoir hosts. This investigation was initiated to determine if pets and family members were infected with one or more Bartonella species.

METHODS: PCR and enrichment blood culture in Bartonella alpha Proteobacteria growth medium (BAPGM) was used to determine infection status. Antibody titers to B. vinsonii subsp. berkhoffii genotypes I-III and B. henselae were determined using a previously described indirect fluorescent antibody test. Two patients were tested sequentially for over a year to assess the response to antibiotic treatment.

RESULTS: Intravascular infection with B. vinsonii subsp. berkhoffii genotype II and Bartonella henselae (Houston 1 strain) were confirmed in a veterinarian and his daughter by enrichment blood culture, followed by PCR and DNA sequencing. Symptoms included progressive weight loss, muscle weakness, lack of coordination (the father) and headaches, muscle pain and insomnia (the daughter). B. vinsonii subsp. berkhoffii genotype II was also sequenced from a cerebrospinal fluid BAPGM enrichment culture and from a periodontal swab sample. After repeated courses of antibiotics, post-treatment blood cultures were negative, there was a decremental decrease in antibody titers to non-detectable levels and symptoms resolved in both patients.

CONCLUSIONS: B. vinsonii subsp. berkhoffii and B. henselae are zoonotic pathogens that can be isolated from the blood of immunocompetent family members with arthralgias, fatigue and neurological symptoms. Therapeutic elimination of Bartonella spp. infections can be challenging, and follow-up testing is recommended. An increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflies and ticks have been confirmed or are suspected as the primary mode of transmission of Bartonella species among animal populations and may also pose a risk to human beings.

PMCID: PMC2859367 PMID: 20377863 [PubMed - in process]

48. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):62-9.

Feline hemotropic mycoplasmas.

Sykes JE.

Department of Medicine & Epidemiology, University of California - Davis, Davis, CA 95618, USA. jesykes@ucdavis.edu

OBJECTIVE: To describe the current understanding of the etiology, pathogenesis, diagnosis, and treatment of feline hemotropic mycoplasmosis (feline infectious anemia).

DATA SOURCES: Manuscripts published on hemotropic mycoplasmosis in cats and other animal species, based on a search of PubMed using the search terms 'hemoplasmas,''haemoplasmas,''hemotropic,''haemotropic,' and 'Haemobartonella,' as well as references published within manuscripts accessed.

HUMAN DATA SYNTHESIS: Although hemotropic bacteria such as Bartonella bacilliformis have been recognized in humans for over 100 years, it has only been in recent years that some of these have been identified as hemotropic mycoplasmas.

VETERINARY DATA SYNTHESIS: Three species of hemotropic mycoplasmas have been documented in cats worldwide, Mycoplasma haemofelis, 'Candidatus Mycoplasma turicensis,' and 'Candidatus Mycoplasma haemominutum.' These organisms were previously known as Haemobartonella felis, but are now known to be mycoplasmas. M. haemofelis is the most pathogenic species, and causes anemia in immunocompetent cats. Although 'Candidatus Mycoplasma turicensis' and 'Candidatus Mycoplasma haemominutum' may be more capable of causing anemia in immunosuppressed cats, their pathogenicity remains controversial. Assays based on polymerase chain reaction technology are the most sensitive and specific diagnostic tests available for these organisms, because they remain uncultivable in the laboratory setting. Blood smears are unreliable for diagnosis of hemoplasmosis because of their lack of sensitivity and specificity.

CONCLUSIONS: Cats presenting to emergency/critical care specialists with hemolytic anemia should be tested using polymerase chain reaction assays for hemotropic mycoplasmas before instituting antimicrobial therapy. Positive test results for M. haemofelis suggest involvement of this organism in hemolytic anemia. Other differential diagnoses for hemolytic anemia should be considered in cats testing positive for 'Candidatus Mycoplasma turicensis' and 'Candidatus Mycoplasma haemominutum,' because the presence of these organisms is not always associated with anemia. Blood from infected cats should be handled with care because of the potential zoonotic nature of this infection.

PMID: 20230435 [PubMed - indexed for MEDLINE]

49. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):46-61.

Conventional and molecular diagnostic testing for the acute neurologic patient.

Nghiem PP, Schatzberg SJ.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30606, USA.

Erratum in J Vet Emerg Crit Care (San Antonio). 2010 Oct;20(5):538.

OBJECTIVE: The aim of this review is to describe and evaluate both conventional and molecular diagnostic testing utilized in dogs and cats with acute neurologic diseases. Various types of polymerase chain reaction (PCR) are explored along with novel molecular diagnostic testing that ultimately may prove useful in the critical care setting.

DATA SOURCES: PUBMED was searched to obtain relevant references material using keywords: 'canine OR feline meningitis AND meningoencephalitis,''feline infectious peritonitis,''canine distemper,''canine OR feline AND toxoplasma,''canine neospora,''canine OR feline AND rickettsia,''granulomatous meningoencephalitis,''steroid responsive meningitis arteritis,''necrotizing encephalitis,''novel neurodiagnostics,''canine OR feline AND CNS borrelia,''canine OR feline AND CNS bartonella,''canine OR feline AND CNS fungal,''nested OR multiplex OR degenerate OR consensus OR CODEHOP AND PCR.' Research findings from the authors' laboratory and current veterinary textbooks also were utilized.

HUMAN DATA SYNTHESIS: Molecular diagnostic testing including conventional, real-time, and consensus and degenerate PCR and microarray analysis are utilized routinely for the antemortem diagnosis of infectious meningoencephalitis (ME) in humans. Recently, PCR using consensus degenerate hybrid primers (CODEHOP) has been used to identify and characterize a number of novel human viruses.

VETERINARY DATA SYNTHESIS: Molecular diagnostic testing such as conventional and real-time PCR aid in the diagnosis of several important central nervous system infectious agents including canine distemper virus, Toxoplasma gondii, Neospora caninum, rickettsial species, and others. Recently, broadly reactive consensus and degenerate PCR reactions have been applied to canine ME including assays for rickettsial organisms, Borrelia spp. and Bartonella spp., and various viral families.

CONCLUSIONS: In the acute neurologic patient, there are several key infectious diseases that can be pursued by a combination of conventional and molecular diagnostic testing. It is important that the clinician understands the utility, as well as the limitations, of the various neurodiagnostic tests that are available.

PMID: 20230434 [PubMed - indexed for MEDLINE]

50. J Vet Emerg Crit Care (San Antonio). 2010 Feb;20(1):8-30.

Bartonellosis: an emerging infectious disease of zoonotic importance to animals and human beings.

Breitschwerdt EB, Maggi RG, Chomel BB, Lappin MR.

Department of Clinical Sciences, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA. ed_breitschwerdt@ncsu.edu

OBJECTIVE: To provide a review of clinically relevant observations related to Bartonella species as emerging pathogens in veterinary and human medicine.

DATA SOURCES: Literature as cited in PubMed and as generated by each of the authors who have contributed to various aspects of the clinical understanding of bartonellosis.

HUMAN DATA SYNTHESIS: Important historical and recent publications illustrating the evolving role of animal reservoirs as a source of human infection.

VETERINARY DATA SYNTHESIS: Comprehensive review of the veterinary literature.

CONCLUSIONS: In addition to inducing life-threatening illnesses, such as endocarditis, myocarditis, and meningoencephalitis and contributing to chronic debilitating disease, such as arthritis, osteomyelitis, and granulomatous inflammation in cats, dogs, and potentially other animal species; pets and wildlife species can serve as persistently infected reservoir hosts for the transmission of Bartonella spp. infection to veterinary professionals and others with direct animal contact.

PMID: 20230432 [PubMed - indexed for MEDLINE]

51. Appl Environ Microbiol. 2010 May;76(9):2923-31. Epub 2010 Mar 12.

Prevalence and seasonality of tick-borne pathogens in questing Ixodes ricinus ticks from Luxembourg.

Reye AL, Hübschen JM, Sausy A, Muller CP.

Institute of Immunology, National Public Health Laboratory/CRP Santé, Luxembourg, Luxembourg.

In Europe, ixodid ticks are important arthropod vectors of human and animal pathogens, but comprehensive studies of the prevalence of all relevant pathogens in Central Europe are scarce. As a result of ecological changes, the incidences of tick-borne infections are expected to increase. In this study, 1,394 nymphal and adult Ixodes ricinus ticks sampled monthly during the active season from 33 ecologically distinct collection sites throughout Luxembourg were screened for all human tick-borne pathogens relevant in Central Europe. Species were identified by sequence analysis of detection PCR amplicons. Mean infection rates of ticks were 11.3% for Borrelia burgdorferi sensu lato, 5.1% for Rickettsia sp., 2.7% for Babesia sp., and 1.9% for Anaplasma phagocytophilum. No tick was found to be infected with Coxiella sp., Francisella tularensis subsp., or Tick-borne encephalitis virus (TBEV). A total of 3.2% of ticks were infected with more than one pathogen species, including mixed Borrelia infections (1.5%). Seasonal variations of tick infection rates were observed for Borrelia, Babesia, and Anaplasma, possibly reflecting a behavioral adaptation strategy of questing ticks. A positive correlation between the grade of urbanization and Borrelia infection rate of ticks was observed, suggesting an established urban zoonotic cycle. We also found Hepatozoon canis (0.1%) and Bartonella henselae (0.3%), which so far have not been found in questing Ixodes ricinus ticks in Central Europe.

PMCID: PMC2863427 PMID: 20228110 [PubMed - indexed for MEDLINE]

52. Emerg Infect Dis. 2010 Mar;16(3):500-3.

Candidatus Bartonella mayotimonensis and endocarditis.

Lin EY, Tsigrelis C, Baddour LM, Lepidi H, Rolain JM, Patel R, Raoult D.

Mayo Clinic, Rochester, Minnesota, USA. lin.eleanor@alumni.mayo.edu

We describe a new Bartonella species for which we propose the name Candidatus Bartonella mayotimonensis. It was isolated from native aortic valve tissue of a person with infective endocarditis. The new species was identified by using PCR amplification and sequencing of 5 genes (16S rRNA gene, ftsZ, rpoB, gltA, and internal transcribed spacer region).

PMID: 20202430 [PubMed - indexed for MEDLINE]

53. Emerg Infect Dis. 2010 Mar;16(3):385-91.

Potential for tick-borne bartonelloses.

Angelakis E, Billeter SA, Breitschwerdt EB, Chomel BB, Raoult D.

Université de la Méditerranée, Marseille, France.

As worldwide vectors of human infectious diseases, ticks are considered to be second only to mosquitoes. Each tick species has preferred environmental conditions and biotopes that determine its geographic distribution, the pathogens it vectors, and the areas that pose risk for tick-borne diseases. Researchers have identified an increasing number of bacterial pathogens that are transmitted by ticks, including Anaplasma, Borrelia, Ehrlichia, and Rickettsia spp. Recent reports involving humans and canines suggest that ticks should be considered as potential vectors of Bartonella spp. To strengthen this suggestion, numerous molecular surveys to detect Bartonella DNA in ticks have been conducted. However, there is little evidence that Bartonella spp. can replicate within ticks and no definitive evidence of transmission by a tick to a vertebrate host.

PMID: 20202411 [PubMed - indexed for MEDLINE]

54. Emerg Infect Dis. 2010 Mar;16(3):379-84.

Bartonella spp. transmission by ticks not established.

Telford SR 3rd, Wormser GP.

Tufts University Cummings School of Veterinary Medicine, North Grafton, Massachussetts, USA.

Bartonella spp. infect humans and many animal species. Mainly because PCR studies have demonstrated Bartonella DNA in ticks, some healthcare providers believe that these microorganisms are transmitted by ticks. B. henselae, in particular, is regarded as being present in and transmissible by the Ixodes scapularis tick. The presence of a microbial agent within a tick, however, does not imply that the tick might transmit it during the course of blood feeding and does not confer epidemiologic importance. After a critical review of the evidence for and against tick transmission, we conclude that transmission of any Bartonella spp. by ticks, to animals or humans, has not been established. We are unaware of any well-documented case of B. henselae transmission by I. scapularis ticks.

PMID: 20202410 [PubMed - indexed for MEDLINE]

55. BMC Genomics. 2010 Mar 4;11:152.

Genome dynamics of Bartonella grahamii in micro-populations of woodland rodents.

Berglund EC, Ehrenborg C, Vinnere Pettersson O, Granberg F, Näslund K, Holmberg M, Andersson SG.

Department of Moleculcar Evolution, Norbyvägen 18C, S-75236 Uppsala, Sweden.

BACKGROUND: Rodents represent a high-risk reservoir for the emergence of new human pathogens. The recent completion of the 2.3 Mb genome of Bartonella grahamii, one of the most prevalent blood-borne bacteria in wild rodents, revealed a higher abundance of genes for host-cell interaction systems than in the genomes of closely related human pathogens. The sequence variability within the global B. grahamii population was recently investigated by multi locus sequence typing, but no study on the variability of putative host-cell interaction systems has been performed.

RESULTS: To study the population dynamics of B. grahamii, we analyzed the genomic diversity on a whole-genome scale of 27 B. grahamii strains isolated from four different species of wild rodents in three geographic locations separated by less than 30 km. Even using highly variable spacer regions, only 3 sequence types were identified. This low sequence diversity contrasted with a high variability in genome content. Microarray comparative genome hybridizations identified genes for outer surface proteins, including a repeated region containing the fha gene for filamentous hemaggluttinin and a plasmid that encodes a type IV secretion system, as the most variable. The estimated generation times in liquid culture medium for a subset of strains ranged from 5 to 22 hours, but did not correlate with sequence type or presence/absence patterns of the fha gene or the plasmid. CONCLUSION: Our study has revealed a geographic microstructure of B. grahamii in wild rodents. Despite near-identity in nucleotide sequence, major differences were observed in gene presence/absence patterns that did not segregate with host species. This suggests that genetically similar strains can infect a range of different hosts.

PMCID: PMC2847970 PMID: 20202191 [PubMed - indexed for MEDLINE]

56. Korean J Lab Med. 2010 Feb;30(1):34-7.

A report of cat scratch disease in Korea confirmed by PCR amplification of the 16S-23S rRNA intergenic region of Bartonella henselae.

Suh B, Chun JK, Yong D, Lee YS, Jeong SH, Yang WI, Kim DS.

Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.

We report a case of cat scratch disease in an 8-yr-old girl who presented with fever and enlargement of both axillary lymph nodes. Both aerobic and anaerobic cultures of the lymph node aspirate were negative for microbial growth. Gram staining and Warthin-Starry silver staining did not reveal any organism. Purified DNA from the PCR-amplicon of the 16S-23S rRNA intergenic region was sequenced and showed 99.7% identity with the corresponding sequence of Bartonella henselae strain Houston-1. Our findings suggest that the internal transcribed spacer is a reliable region for PCR identification of Bartonella species. In patients with lymphadenitis, a history of contact with cats or dogs necessitates the use of diagnostic approaches that employ not only the conventional staining and culture but also molecular methods to detect B. henselae.

PMID: 20197720 [PubMed - indexed for MEDLINE]

57. J Appl Microbiol. 2010 Sep;109(3):743-50. doi: 10.1111/j.1365-2672.2010.04679.x.

Bartonellosis, an increasingly recognized zoonosis.

Chomel BB, Kasten RW.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

Cat scratch disease is the most common zoonotic infection caused by Bartonella bacteria. Among the many mammals infected with Bartonella spp., cats represent a large reservoir for human infection, as they are the main reservoir for Bartonella henselae, Bartonella clarridgeiae and Bartonella koehlerae. Bartonella spp. are vector-borne bacteria, and transmission of B. henselae by cat fleas occurs mainly through infected flea faeces, although new potential vectors (ticks and biting flies) have been identified. Dogs are also infected with various Bartonella species and share with humans many of the clinical signs induced by these infections. Although the role of dogs as source of human infection is not yet clearly established, they represent epidemiological sentinels for human exposure. Present knowledge on the aetiology, clinical features and epidemiological characteristics of bartonellosis is presented.

PMID: 20148999 [PubMed - indexed for MEDLINE]

58. J Wildl Dis. 2010 Jan;46(1):179-85.

Detection of bartonella species in small mammals from Zhejiang Province, China.

Liu Q, Sun J, Lu L, Fu G, Ding G, Song X, Meng F, Wu H, Yang T, Ren Z, Chen E, Lin J, Lv H, Chai C.

State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, No 155, Changping District, Beijing 102206, China. liuqiyong@icdc.cn

To estimate the prevalence of Bartonella in small mammals of different species, during different seasons, and at different study sites, and to provide baseline data for the risk assessment of human Bartonella infection, we captured small mammals using snap traps in Zhejiang Province, China. Bartonella species were detected in small-mammal samples by polymerase chain reaction and positive amplicons were sequenced. Bartonella DNA was detected in 47% (90/192) of Apodemus agrarius, 31% (14/45) of Rattus losea, 16% (7/43) of Rattus norvegicus, 24% (9/37) of Eothenomys melanogaster, 4% (1/28) of Niviventer confucianus, 30% (7/23) of Suncus murinus, 22% (2/9) of Microtus fortis, 27% (2/7) of Rattus tanezumi, and 29% (2/7) of Apodemus peninsulae. No Bartonella DNA was detected in 27 unidentified Soricidae or nine Mus musculus. This is the first report of Bartonella DNA detected in E. melanogaster and N. confucianus. The prevalence of Bartonella DNA varied among small-mammal species, study sites, and seasons; the prevalence of Bartonella DNA between genders did not vary significantly within a species. The sequences we report were most similar to Bartonella grahamii.

PMID: 20090031 [PubMed - indexed for MEDLINE]

59. Vet Pathol. 2010 Jan;47(1):163-6.

Peliosis hepatis in cats is not associated with Bartonella henselae infections.

Buchmann AU, Kempf VA, Kershaw O, Gruber AD.

Department of Veterinary Pathology, Freie Universitaet Berlin, Robert-von-Ostertag-Strasse 15, Berlin, Germany. gruber.achim@vetmed.fu-berlin.de

Peliosis hepatis is a vasculoproliferative disorder of the liver with infectious and noninfectious causes. In humans and dogs, Bartonella henselae has been linked to peliosis hepatis. Although domestic cats are the natural reservoir of B. henselae and although peliosis hepatis is common in this species, an association between this condition and infection with B. henselae has never been investigated in cats. In this study, 26 cases of peliosis hepatis in cats were tested for B. henselae infection by nested polymerase chain reaction and immunohistochemistry. The authors failed to detect B. henselae nucleic acid or antigen in any of the affected liver specimens. These findings suggest that, unlike in humans and dogs, peliosis hepatis in cats may not be significantly associated with a B. henselae infection.

PMID: 20080497 [PubMed - indexed for MEDLINE]

60. Ultrastruct Pathol. 2010 Feb;34(1):2-6.

Blood cell findings resembling Bartonella spp.

Pitassi LH, Cintra ML, Ferreira MR, Magalhães RF, Velho PE.

Department of Dermatology, Medical School, State University of Campinas (UNICAMP), Campinas, Brazil. pitassi@yahoo.com

Some Bartonella species are able to invade red blood cells (RBC) and may cause persistent infection in the susceptible host. Use of transmission electron microscopy (TEM) demonstrates, inside erythrocytes, the typical triple-walled agents. However, when examining ultrathin sections of blood cells, the authors have, on several occasions, detected intraerythrocytic abnormalities that mimic but are not typical of Bartonella spp. Small endovesicles, pseudoinclusions, cavities, and irregular hemoglobin granules distribution, resulting in regions of increased or decreased electron density, may be observed in the erythrocytes and platelets, which may be confused with bartonellas. So far, detailed ultrastructural findings of Bartonella spp. in blood cells have not yet been described. Aiming to improve TEM interpretation of blood cells changes, in routine examination of blood sections of patients with suspected bartonellosis, the authors studied the morphological findings they have observed, and present their putative nature, according to information in the literature.

PMID: 20070147 [PubMed - indexed for MEDLINE]

61. Vector Borne Zoonotic Dis. 2010 Oct;10(8):731-4. Epub 2010 Jan 8.

Molecular detection of Bartonella alsatica in European wild rabbits (Oryctolagus cuniculus) in Andalusia (Spain).

Márquez FJ.

Department of Animal Biology, Vegetal Biology and Ecology, University of Jaen, Jaen, Spain. jmarquez@ujaen.es

A sample of 279 European wild rabbits, Oryctolagus cuniculus (141 males, 138 females), captured alive in Andalusia (Spain) and belonging to the two haplotype classes previously described for this species (230 and 49 corresponding with haplotypes A and B, respectively), were tested for the presence of Bartonella alsatica DNA. Two species-specific nested polymerase chain reaction assays targeting for 16S-23S rRNA intergenic spacer region and RNA polymerase β subunit genes have been developed. Forty-eight (17.20%) rabbits were infected with B. alsatica. Two-way contingency table analyses and the calculation of Cramer's V statistic showed no differences in infection rate, considering haplotype lineage or sex. The risk of infection of human population, especially for hunters in close contact with this demonstrated human pathogen, should be considered.

PMID: 20059317 [PubMed - indexed for MEDLINE]

62. Vet Microbiol. 2010 Jan 27;140(3-4):347-59. Epub 2009 Nov 18.

Bartonellosis.

Guptill L.

Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA. guptillc@purdue.edu

Bartonellosis is a constellation of clinical conditions affecting human beings and a variety of animals. Many Bartonella infections are zoonotic, with some of the most commonly reported zoonotic manifestations of infection including cat scratch disease, bacillary angiomatosis, endocarditis, and neuroretinitis. Companion animals serve as reservoirs for several zoonotic species of Bartonella, and may also serve as sentinels for zoonotic Bartonella species harbored by wildlife. This article provides an overview of bartonellosis of dogs and cats, and discusses public health implications of animal bartonellosis.

PMID: 20018462 [PubMed - indexed for MEDLINE]

63. Wien Klin Wochenschr. 2009;121(21-22):673-83.

[Pandora's Box: pathogens in Ixodes ricinus ticks in Central Europe].

[Article in German]

Stanek G.

Institut für Hygiene und Angewandte Immunologie, Medizinische Universität Wien, Wien, Austria. gerold.stanek@ meduniwien.ac.at

Among the various species of hard ticks, Ixodes ricinus is the most frequently found tick throughout Europe. As with other ixodid ticks, the developmental cycle runs through three stages. In each stage a blood meal is required in order to develop to the next stage. Ixodes ricinus has been found to feed on more than 300 different vertebrate species. Usually, larval ticks feed on small mammals such as mice and become infected with various microorganisms and viruses, of which some are substantial pathogens to humans. The pathogens remain in the tick during molting and are thus transstadially transmitted to the next developmental stage. Pathogens transmitted to humans are the agents of Lyme borreliosis, the tick-borne encephalitis virus, Rickettsia species, Anaplasma phagocytophilum, occasionally Francisella tularensis, and protozoal Babesia species. Within the scope of an EU project Ixodes ricinus ticks from all federal states of Austria were searched by means of PCR methods for bacterial pathogens such as Anaplasma phagocytophilum, Borrelia burgdorferi sensu lato, Coxiella burnetii, Ehrlichia spp., Francisella tularensis, Rickettsia spp., and protozoal Babesia. Additionally, the prevalence of Bartonella spp. in this tick species was also determined. Besides the singular detection of Coxiella burnetii and Francisella tularensis in one tick collection site the overall prevalence of Anaplasma phagocytophilum, borreliae, rickettsae and babesiae in Ixodes ricinus amounted to 15%, 14%, 6% and surprising 36% and 51%, respectively. Bartonellae were detected in about 7%.

PMID: 19998007 [PubMed - indexed for MEDLINE]

64. Emerg Infect Dis. 2009 Dec;15(12):1984-7.

Bartonella rochalimae in raccoons, coyotes, and red foxes.

Henn JB, Chomel BB, Boulouis HJ, Kasten RW, Murray WJ, Bar-Gal GK, King R, Courreau JF, Baneth G.

Napa County Health and Human Services, Napa, California, USA.

To determine additional reservoirs for Bartonella rochalimae, we examined samples from several wildlife species. We isolated B. rochalimae from 1 red fox near Paris, France, and from 11 raccoons and 2 coyotes from California, USA. Co-infection with B. vinsonii subsp. berkhoffii was documented in 1 of the coyotes.

PMCID: PMC3044513 PMID: 19961681 [PubMed - indexed for MEDLINE]

65. Med Vet Entomol. 2009 Dec;23(4):393-8.

Detection and identification of Bartonella sp. in fleas from carnivorous mammals in Andalusia, Spain.

Márquez FJ, Millán J, Rodríguez-Liébana JJ, García-Egea I, Muniain MA.

Departamento Biología Animal, Biología Vegetal y Ecología, Universidad de Jaén, 23071 Jaén, Spain. jmarquez@ujaen.es

A total of 559 fleas representing four species (Pulex irritans, Ctenocephalides felis, Ctenocephalides canis and Spilopsyllus cuniculi) collected on carnivores (five Iberian lynx Lynx pardinus, six European wildcat Felis silvestris, 10 common genet Genetta genetta, three Eurasian badger Meles meles, 22 red fox Vulpes vulpes, 87 dogs and 23 cats) in Andalusia, southern Spain, were distributed in 156 pools of monospecific flea from each carnivore, and tested for Bartonella infection in an assay based on polymerase chain reaction (PCR) amplification of the 16 S-23 S rRNA intergenic spacer region. Twenty-one samples (13.5%) were positive and the sequence data showed the presence of four different Bartonella species. Bartonella henselae was detected in nine pools of Ctenocephalides felis from cats and dogs and in three pools of Ctenocephalides canis from cats; Bartonella clarridgeiae in Ctenocephalides felis from a cat, and Bartonella alsatica in Spilopsyllus cuniculi from a wildcat. DNA of Bartonella sp., closely related to Bartonella rochalimae, was found in seven pools of Pulex irritans from foxes. This is the first detection of B. alsatica and Bartonella sp. in the Iberian Peninsula. All of these Bartonella species have been implicated as agents of human diseases. The present survey confirms that carnivores are major reservoirs for Bartonella spp.

PMID: 19941605 [PubMed - indexed for MEDLINE]

66. Am J Trop Med Hyg. 2009 Nov;81(5):811-6.

Prevalence and genetic heterogeneity of Bartonella strains cultured from rodents from 17 provinces in Thailand.

Bai Y, Kosoy MY, Lerdthusnee K, Peruski LF, Richardson JH.

Centers for Disease Control and Prevention, Fort Collins, Colorado, USA. bby5@cdc.gov

To study the distribution and diversity of Bartonella in rodents from Thailand, 330 rodents belonging to 13 species were tested. The majority (80.6%) of rodents examined belonged to the genus Rattus. Bartonellae were cultured from 41.5% of the rodents with a wide range of prevalence by host species and regions. Sequencing of gltA revealed diverse Bartonella strains. Bartonellae from Rattus spp. belonged to 23 variants and clustered with Bartonella coopersplainensis, Bartonella elizabethae, Bartonella phoceensis, Bartonella rattimassiliensis, Bartonella tribocorum, and an unknown geno-group. Bartonellae from Bandicota spp. belonged to six variants and clustered with B. coopersplainensis, B. rattimassilliensis, and B. tribocorum. Three variants from Mus spp. clustered with B. coopersplainensis or B. rattimassilliensis. The only isolate from a Berylmys berdmorei fell into the B. tribocorum group. The observations highlight the need to study these agents for their role in human febrile illnesses of unknown etiology in Thailand and elsewhere in Asia.

PMID: 19861616 [PubMed - indexed for MEDLINE]

67. Clin Microbiol Infect. 2009 Dec;15 Suppl 2:152-3. Epub 2009 Sep 28.

Prevalence of Coxiella burnetii and Bartonella species as cases of infective endocarditis in Marseilles (1994-2007).

Casalta JP, Gouriet F, Richet H, Thuny F, Habib G, Raoult D.

Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Boulevard Jean Moulin, Marseille, cedex.

PMID: 19793124 [PubMed - indexed for MEDLINE]

68. Genome Dyn. 2009;6:158-69. Epub 2009 Aug 19.

Genomics of host-restricted pathogens of the genus bartonella.

Engel P, Dehio C.

Biozentrum, University of Basel, Basel, Switzerland.

The alpha-proteobacterial genus Bartonella comprises numerous arthropod-borne pathogens that share a common host-restricted life-style, which is characterized by long-lasting intraerythrocytic infections in their specific mammalian reservoirs and transmission by blood-sucking arthropods. Infection of an incidental host (e.g. humans by a zoonotic species) may cause disease in the absence of intra-erythrocytic infection. The genome sequences of four Bartonella species are known, i.e. those of the human-specific pathogens Bartonella bacilliformis and Bartonella quintana, the feline-specific Bartonella henselae also causing incidental human infections, and the rat-specific species Bartonella tribocorum. The circular chromosomes of these bartonellae range in size from 1.44 Mb (encoding1,283 genes) to 2.62 Mb (encoding 2,136 genes). They share a mostly synthenic core genome of 959 genes that features characteristics of a host-integrated metabolism. The diverse accessory genomes highlight dynamic genome evolution at the species level, ranging from significant genome expansion in B. tribocorum due to gene duplication and lateral acquisition of prophages and genomic islands (such as type IV secretion systems that adopted prominent roles in host adaptation and specificity) to massive secondary genome reduction in B. quintana. Moreover, analysis of natural populations of B. henselae revealed genomic rearrangements, deletions and amplifications, evidencing marked genome dynamics at the strain level.

PMID: 19696500 [PubMed - in process]

69. Future Microbiol. 2009 Aug;4(6):743-58.

Pestilence, persistence and pathogenicity: infection strategies of Bartonella.

Minnick MF, Battisti JM.

The University of Montana, Division of Biological Sciences, Missoula, MT 59812, USA. mike.minnick@mso.umt.edu

It has been nearly two decades since the discovery of Bartonella as an agent of bacillary angiomatosis in AIDS patients and persistent bacteremia and 'nonculturable' endocarditis in homeless people. Since that time, the number of Bartonella species identified has increased from one to 24, and 10 of these bacteria are associated with human disease. Although Bartonella is the only genus that infects human erythrocytes and triggers pathological angiogenesis in the vascular bed, the group remains understudied compared with most other bacterial pathogens. Numerous questions regarding Bartonella's molecular pathogenesis and epidemiology remain unanswered. Virtually every mammal harbors one or more Bartonella species and their transmission typically involves a hematophagous arthropod vector. However, many details regarding epidemiology and the public health threat imposed by these animal reservoirs is unclear. A handful of studies have shown that bartonellae are highly-adapted pathogens whose parasitic strategy has evolved to cause persistent infections of the host. To this end, virulence attributes of Bartonella include the subversion of host cells with effector molecules delivered via a type IV secretion system, induction of pathological angiogenesis through various means, including inhibition of apoptosis and activation of hypoxia-inducing factor 1, use of afimbrial adhesins that are orthologs of Yersinia adhesin A, incorporation of lipopolysaccharides with low endotoxic potency in the outer membrane, and several other virulence factors that help Bartonella infect and persist in erythrocytes and endothelial cells of the host circulatory system.

PMCID: PMC2754412 PMID: 19659429 [PubMed - indexed for MEDLINE]

70. Cardiology. 2009;114(3):208-11. Epub 2009 Jul 15.

Infective endocarditis by Bartonella quintana masquerading as antineutrophil cytoplasmic antibody-associated small vessel vasculitis.

Sugiyama H, Sahara M, Imai Y, Ono M, Okamoto K, Kikuchi K, Nagai R.

Department of Cardiovascular Medicine, University of Tokyo Hospital, Tokyo, Japan. hsugiyama-tky@umin.ac.jp

The Bartonella species have been recently recognized as important causative agents of culture-negative bacterial endocarditis. Antineutrophil cytoplasmic antibodies (ANCAs) have been associated with the spectrum of idiopathic small vessel vasculitis. However, a variety of infections can result in a false-positive ANCA test, and especially subacute bacterial endocarditis (SBE) with the presence of ANCAs occasionally mimics the clinical manifestations of an ANCA-associated vasculitis such as skin purpura and glomerulonephritis. In contrast, noninfectious endocardial involvement is known to be part of the spectrum of the manifestations of the ANCA-associated vasculitis. Therefore, it is crucial to distinguish an ANCA-positive SBE from an ANCA-associated vasculitis with endocardial compromise, because the misdiagnosis of an SBE as an ANCA-associated vasculitis can lead to an inappropriate immunosuppressive therapy with catastrophic consequences. The differential diagnosis is sometimes difficult, especially in the case of culture-negative infective endocarditis with a positive ANCA test. We describe here a case of a culture-negative SBE caused by Bartonellaquintana, accompanied with a positive cytoplasmic ANCA test and clinical findings masquerading as ANCA-associated vasculitis. Both a serological test for Bartonella and polymerase chain reaction restriction fragment length polymorphism analysis were helpful for a correct diagnosis and appropriate treatment.

PMID: 19602882 [PubMed - indexed for MEDLINE]

71. PLoS Genet. 2009 Jul;5(7):e1000546. Epub 2009 Jul 3.

Run-off replication of host-adaptability genes is associated with gene transfer agents in the genome of mouse-infecting Bartonella grahamii.

Berglund EC, Frank AC, Calteau A, Vinnere Pettersson O, Granberg F, Eriksson AS, Näslund K, Holmberg M, Lindroos H, Andersson SG.

Department of Molecular Evolution, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden.

The genus Bartonella comprises facultative intracellular bacteria adapted to mammals, including previously recognized and emerging human pathogens. We report the 2,341,328 bp genome sequence of Bartonella grahamii, one of the most prevalent Bartonella species in wild rodents. Comparative genomics revealed that rodent-associated Bartonella species have higher copy numbers of genes for putative host-adaptability factors than the related human-specific pathogens. Many of these gene clusters are located in a highly dynamic region of 461 kb. Using hybridization to a microarray designed for the B. grahamii genome, we observed a massive, putatively phage-derived run-off replication of this region. We also identified a novel gene transfer agent, which packages the bacterial genome, with an over-representation of the amplified DNA, in 14 kb pieces. This is the first observation associating the products of run-off replication with a gene transfer agent. Because of the high concentration of gene clusters for host-adaptation proteins in the amplified region, and since the genes encoding the gene transfer agent and the phage origin are well conserved in Bartonella, we hypothesize that these systems are driven by selection. We propose that the coupling of run-off replication with gene transfer agents promotes diversification and rapid spread of host-adaptability factors, facilitating host shifts in Bartonella.

PMCID: PMC2697382 PMID: 19578403 [PubMed - indexed for MEDLINE]

72. Am J Trop Med Hyg. 2009 Jul;81(1):67-74.

Tick-borne zoonotic bacteria in ticks collected from central Spain.

Toledo A, Olmeda AS, Escudero R, Jado I, Valcárcel F, Casado-Nistal MA, Rodríguez-Vargas M, Gil H, Anda P.

Laboratorio de Espiroquetas y Patógenos Especiales, Servicio de Bacteriología, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain.

The prevalence of tick-borne and related bacteria infecting adult ticks in central Spain was assessed by molecular methods. Six areas were sampled monthly during a 2-year longitudinal study. A total of 1,038 questing and 442 feeding ticks, belonging to eight different species, were tested. The most abundant species were Hyalomma lusitanicum (54% of captures), followed by Dermacentor marginatus (23%) and Rhipicephalus sanguineus (10%). Four human pathogens, including seven Rickettsia species, Anaplasma phagocytophilum, Borrelia burgdorferi, and Francisella tularensis, were detected at percentages of 19.0, 2.2, 1.7, and 0.5, respectively, whereas Bartonella spp. was never detected. In terms of infection and tick abundance, H. lusitanicum seems to be the most significant tick species in the area, carrying three of the five agents tested, and the anthropophilic tick, D. marginatum, infected with Rickettsia spp. and F. tularensis, is the most relevant in terms of public health. The significance of these data is discussed.

PMID: 19556569 [PubMed - indexed for MEDLINE]

73. Zoonoses Public Health. 2010 Sep;57(6):439-46. doi: 10.1111/j.1863-2378.2009.01234.x.

Epidemiology of Bartonella infection in rodents and shrews in Taiwan.

Hsieh JW, Tung KC, Chen WC, Lin JW, Chien LJ, Hsu YM, Wang HC, Chomel BB, Chang CC.

Graduate Institute of Veterinary Public Health, National Chung Hsing University, Taichung, Taiwan.

During the period of August 2002 and November 2004, an epidemiological investigation for Bartonella infection was conducted in small mammals in Taiwan. Using whole blood culture on chocolate agar plates, Bartonella species were successfully isolated from 41.3% of the 310 animals tested. The isolation rate of Bartonella species varied among different animal species, including 52.7% of the 169 Rattus norvegicus, 28.6% of the 126 Sucus murinus, 10% of the 10 Rattus rattus and 66.7% of the three Rattus losea. Bacteremia prevalence also varied with the origin of the animals, as 56.2% of the animals captured on farms, 38.6% of the ones captured at harbour sites and 11.8% of the animals captured from urban areas were bacteremic. Through molecular analysis of the gltA gene and 16S/23S intergenic spacer region, genetic diversity of Bartonella organisms was identified, including strains closely related to Bartonella tribocorum, Bartonella grahamii, Bartonella elizabethae, Bartonella phoceensis and Bartonella rattimassiliensis. Moreover, this is the first report of zoonotic B. elizabethae and B. grahamii identified in R. losea, the lesser rice-field rat. Various Bartonella species were identified in R. norvegicus, compared to 97.2% of Suncus murinus with unique Bartonella species. By indirect immunofluorescence antibody test, using various rodent Bartonella species as antigens, consistently low percentage of seropositivity implied that small mammals may play a role as competent reservoirs of Bartonella species in Taiwan. Future studies need to be conducted to determine whether these Bartonella species would be responsible for human cases of unknown fever or febrile illness in Taiwan, especially zoonotic B. elizabethae and B. grahamii.

PMID: 19538457 [PubMed - indexed for MEDLINE]

74. Ann N Y Acad Sci. 2009 May;1166:127-32.

Insights in Bartonella host specificity.

Vayssier-Taussat M, Le Rhun D, Bonnet S, Cotté V.

UMR Bipar, Afssa 23 rue du Général de Gaulle, 94 700 Maisons-Alfort, France. mvayssier@vet-alfort.fr

The genus Bartonella comprises a unique group of emerging gram-negative, intracellular bacteria that can cause a long-lasting intraerythrocytic bacteremia in their reservoir hosts. In recent years, the widespread occurrence and diversity of these bacteria has been increasingly recognized. This has resulted in a dramatic expansion of the genus Bartonella to 24 currently described species or subspecies, among which at least half have been associated with human disease. Bartonella infections have been observed in virtually all species examined, extending from humans to carnivores, ungulates, rodents, lagomorphs, insectivores, and bats. Adaptation by Bartonellae to such a diverse range of mammals has resulted in host specificity, and all validated Bartonella species described to date are capable of parasitizing only a limited number of animal species. In this review, the possible mechanisms explaining the specificity of each Bartonella species for its reservoir host are discussed.

PMID: 19538272 [PubMed - indexed for MEDLINE]

75. Ann N Y Acad Sci. 2009 May;1166:120-6.

Bartonella endocarditis: a pathology shared by animal reservoirsand patients.

Chomel BB, Kasten RW, Williams C, Wey AC, Henn JB, Maggi R, Carrasco S, Mazet J, Boulouis HJ, Maillard R, Breitschwerdt EB.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California 95616, USA. bbchomel@ucdavis.edu

Bartonellae were first recognized to cause endocarditis in humans in 1993 when cases caused by Bartonella quintana, B. elizabethae, and B. henselae were reported. Since the first isolation of Bartonella vinsonii subspecies berkhoffii from a dog with endocarditis, this organism has emerged as an important pathogen in dogs and an emerging pathogen in people. Subsequently, four types of B. vinsonii subsp. berkhoffii have been described, all of which have been associated with endocarditis in dogs. A limited number of dog endocarditis cases have also been associated with B. clarridgeiae, B. washoensis, B. quintana, and B. rochalimae. The second canine B. clarridgeiae endocarditis case is presented. The clinical and pathological characteristics of Bartonella endocarditis in dogs are similar to disease observed in humans, more often affecting the aortic valve, presenting with highly vegetative lesions with accompanying calcification, and in most instances high antibody titers. Pathological features in dogs include a combination of fibrosis, mineralization, endothelial proliferation, and neovascularization with variable inflammation. Endocarditis has also been described in animal species, which are the natural reservoir of specific Bartonella species, once thought to be solely healthy carriers of these pathogens. A few Bartonella endocarditis cases, including B. henselae, have been reported in cats in the USA and Australia. The second case of B. henselae type Houston I identified in the USA is presented. Furthermore, two cases of B. bovis endocarditis were recently described in adult cows from France. Finally, on-going investigation of valvular endocarditis in free-ranging Alaskan sea otters suggests the involvement of Bartonella species.

PMID: 19538271 [PubMed - indexed for MEDLINE]

76. J Med Microbiol. 2009 Sep;58(Pt 9):1154-9. Epub 2009 Jun 15.

Rapid and cost-effective identification of Bartonella species using mass spectrometry.

Fournier PE, Couderc C, Buffet S, Flaudrops C, Raoult D.

Fédération de Microbiologie Clinique, Hôpital de la Timone, 13385 Marseille cedex 05, France.

Bacteria of the genus Bartonella are emerging zoonotic bacteria recognized in a variety of human diseases. Due to their poor chemical reactivity, these fastidious bacteria are poorly characterized using routine phenotypic laboratory tests. Identification is usually achieved using molecular techniques that are time-consuming, expensive and technically demanding. Recently, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) has emerged as a new technique for bacterial species identification. This study evaluated the use of MALDI-TOF MS for rapid genus and species identification of Bartonella species. Reference strains representing 17 recognized Bartonella species were studied. For each species, MS spectra for four colonies were analysed. The consensus spectrum obtained for each species was unique among spectra obtained for 2843 bacteria within the Bruker database, including 109 alphaproteobacteria. Thirty-nine additional blind-coded Bartonella strains were correctly identified at the species level, including 36 with a significant score. Altogether, these data demonstrate that MS is an accurate and reproducible tool for rapid and inexpensive identification of Bartonella species.

PMID: 19528172 [PubMed - indexed for MEDLINE]

77. Przegl Epidemiol. 2009;63(1):11-7.

[Current state of the knowledge of Bartonella infections].

[Article in Polish]

Welc-Faleciak R.

Zakład Parazytologii Wydział Biologii Uniwersytet Warszawski.

Bartonella spp. are gram-negative bacteria localized in erythrocytes of vertebrate hosts. Genus Bartonella contains numerous recently described species, many of them are new and emerging arthropod-borne human pathogens. In addition to humans, Bartonella spp. have also been isolated from a variety of domesticated (cats, dogs) and wild animals (carnivores, ruminants, rodents), which play a key role as reservoir hosts for these pathogens. The infectious process and the pathogenesis of bartonellosis are still poorly understood. The present paper reviews the factors influencing Bartonella infections including a range of reservoir hosts and vectors, mechanism of phatogenesis, diagnostic methods for indentification Bartonella infections in humans and animals as well as the coinfection with Bartonella and other arthropod-borne pathogens.

PMID: 19522219 [PubMed - indexed for MEDLINE]

78. J Med Assoc Thai. 2009 May;92(5):707-31.

Emerging Bartonella in humans and animals in Asia and Australia.

Saisongkorh W, Rolain JM, Suputtamongkol Y, Raoult D.

URMITE, CNRS-IRD UMR 6236, Université de la Méditerranée, Marseille, France.

Bartonella species, belonging to the alpha 2 subgroup of Proteobacteria, have either been considered or established as potential human and mammal pathogens. Five novel species of Bartonella have been reported in Thailand and Australia. Recently, three strains of B. tamiae were isolated from febrile illness patients in Thailand, while B. australis was isolated from kangaroos, and B. coopersplainsensis, B. queenslandensis, and B. rattiaustraliensis were isolated from rats in Australia. The 17 novel Bartonella strains isolated from rodents in southern China that were identified using the partial citrate synthase gene (gltA) sequence displayed a similar genetic diversity, as compared to those obtained from rodents captured in northern Thailand. Herein, the authors review and discuss the few available reports on Bartonella infection in order to raise awareness of Bartonella infection transmitted from mammalian reservoirs to humans via arthropod ectoparasitic vectors such as fleas, ticks, and lice in Asia and Australia. The identification of Bartonella species on these continents was reported in eastern Asia (China, Japan, Korea, Russia, and Taiwan), south central Asia (Afghanistan, Bangladesh, India, and Nepal), southeast Asia (Indonesia, Philippines, Singapore, and Thailand), the Middle East (Israel and Jordan), and Australia. The rate of Bartonella infection was found to be high in arthropod ectoparasitic vectors, mammals, and febrile patients in these tropical zones.

PMID: 19459536 [PubMed - indexed for MEDLINE]

79. J Clin Microbiol. 2009 Jul;47(7):2332-5. Epub 2009 May 13.

Meningitis due to a "Bartonella washoensis"-like human pathogen.

Probert W, Louie JK, Tucker JR, Longoria R, Hogue R, Moler S, Graves M, Palmer HJ, Cassady J, Fritz CL.

Microbial Diseases Laboratory, Division of Communicable Disease Control, Center for Infectious Diseases, California Department of Public Health, Richmond, CA 94804, USA. Will.Probert@cdph.ca.gov

We report the second human case of infection caused by an organism identified as the proposed Bartonella species, "B. washoensis." The organism was isolated from a blood sample from a patient presenting with meningitis and early sepsis. Oropsylla montana fleas were implicated as the vector for disease transmission in this case.

PMCID: PMC2708507 PMID: 19439538 [PubMed - indexed for MEDLINE]

80. Parasit Vectors. 2009 Mar 26;2 Suppl 1:S3.

A confusing case of canine vector-borne disease: clinical signs and progression in a dog co-infected with Ehrlichia canis and Bartonella vinsonii ssp. berkhoffii.

Breitschwerdt EB, Maggi RG.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA. ed_breitschwerdt@ncsu.edu.

ABSTRACT : Bartonella spp. are important pathogens in human and veterinary medicine, and bartonellosis is considered as an emerging zoonosis that is being reported with increasing frequency. Of 22 known species and subspecies of Bartonella, seven have been isolated from dogs, causing disease manifestations similar to those seen in human beings. The wide variety of clinical signs and the possible chronic progression of disease manifestations are illustrated in the case of an infected Labrador retriever. Here, the authors discuss the seemingly diverse spectrum of disease manifestations, the co-infections of Bartonella spp. with other vector-borne pathogens (mainly Ehrlichia spp. or Babesia spp.) and the difficulties in microbiological confirmation of an active Bartonella infection, all of which make the disease pathogenesis and clinical diagnosis more problematic.

PMCID: PMC2679395 PMID: 19426442 [PubMed - in process]

81. Emerg Infect Dis. 2009 Apr;15(4):526-32.

Exotic small mammals as potential reservoirs of zoonotic Bartonella spp.

Inoue K, Maruyama S, Kabeya H, Hagiya K, Izumi Y, Une Y, Yoshikawa Y.

Nihon University, Fujisawa, Kanagawa, Japan.

To evaluate the risk for emerging human infections caused by zoonotic Bartonella spp. from exotic small mammals, we investigated the prevalence of Bartonella spp. in 546 small mammals (28 species) that had been imported into Japan as pets from Asia, North America, Europe, and the Middle and Near East. We obtained 407 Bartonella isolates and characterized them by molecular phylogenetic analysis of the citrate synthase gene, gltA. The animals examined carried 4 zoonotic Bartonella spp. that cause human endocarditis and neuroretinitis and 6 novel Bartonella spp. at a high prevalence (26.0%, 142/546). We conclude that exotic small mammals potentially serve as reservoirs of several zoonotic Bartonella spp.

PMCID: PMC2671452 PMID: 19331727 [PubMed - indexed for MEDLINE]

82. Vet Res. 2009 Mar-Apr;40(2):29. Epub 2009 Mar 14.

Ecological fitness and strategies of adaptation of Bartonella species to their hosts and vectors.

Chomel BB, Boulouis HJ, Breitschwerdt EB, Kasten RW, Vayssier-Taussat M, Birtles RJ, Koehler JE, Dehio C.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

Bartonella spp. are facultative intracellular bacteria that cause characteristic hostrestricted hemotropic infections in mammals and are typically transmitted by blood-sucking arthropods. In the mammalian reservoir, these bacteria initially infect a yet unrecognized primary niche, which seeds organisms into the blood stream leading to the establishment of a long-lasting intra-erythrocytic bacteremia as the hall-mark of infection. Bacterial type IV secretion systems, which are supra-molecular transporters ancestrally related to bacterial conjugation systems, represent crucial pathogenicity factors that have contributed to a radial expansion of the Bartonella lineage in nature by facilitating adaptation to unique mammalian hosts. On the molecular level, the type IV secretion system VirB/VirD4 is known to translocate a cocktail of different effector proteins into host cells, which subvert multiple cellular functions to the benefit of the infecting pathogen. Furthermore, bacterial adhesins mediate a critical, early step in the pathogenesis of the bartonellae by binding to extracellular matrix components of host cells, which leads to firm bacterial adhesion to the cell surface as a prerequisite for the efficient translocation of type IV secretion effector proteins. The best-studied adhesins in bartonellae are the orthologous trimeric autotransporter adhesins, BadA in Bartonella henselae and the Vomp family in Bartonella quintana. Genetic diversity and strain variability also appear to enhance the ability of bartonellae to invade not only specific reservoir hosts, but also accidental hosts, as shown for B. henselae. Bartonellae have been identified in many different blood-sucking arthropods, in which they are typically found to cause extracellular infections of the mid-gut epithelium. Adaptation to specific vectors and reservoirs seems to be a common strategy of bartonellae for transmission and host diversity. However, knowledge regarding arthropod specificity/restriction, the mode of transmission, and the bacterial factors involved in arthropod infection and transmission is still limited.

PMCID: PMC2695021 PMID: 19284965 [PubMed - indexed for MEDLINE]

83. Vet Res. 2009 Jul-Aug;40(4):27.

Dogs are more permissive than cats or guinea pigs to experimental infection with a human isolate of Bartonella rochalimae.

Chomel BB, Henn JB, Kasten RW, Nieto NC, Foley J, Papageorgiou S, Allen C, Koehler JE.

Department of Population Health and Reproduction, School of Veterinary Medicine,University of California, Davis, CA, USA. bbchomel@ucdavis.edu

Bartonella rochalimae was first isolated from the blood of a human who traveled to Peru and was exposed to multiple insect bites. Foxes and dogs are likely natural reservoirs for this bacterium. We report the results of experimental inoculation of two dogs, five cats and six guinea pigs with the only human isolate of this new Bartonella species. Both dogs became bacteremic for 5-7 weeks, with a peak of 10(3)-10(4) colony forming units (CFU)/mL blood. Three cats had low bacteremia levels (< 200 CFU/mL) of 6-8 weeks' duration. One cat that remained seronegative had two bacterial colonies isolated at a single culture time point. A fifth cat never became bacteremic, but seroconverted. None of the guinea pigs became bacteremic, but five seroconverted. These results suggest that dogs could be a reservoir of this strain of B. rochalimae, in contrast to cats and guinea pigs.

PMCID: PMC2695131 PMID: 19272295 [PubMed - indexed for MEDLINE]

84. J Vector Ecol. 2008 Dec;33(2):353-64.

A longitudinal study of Bartonella infection in populations of woodrats and their fleas.

Morway C, Kosoy M, Eisen R, Montenieri J, Sheff K, Reynolds PJ, Powers N.

Centers for Disease Control and Prevention, Fort Collins, CO 80521, USA.

Rodent-borne bartonellae have been identified as human pathogens. Little is known about Bartonella infections in woodrat hosts and their fleas and how woodrat-flea associations may affect the dynamics of Bartonella infections. We collected blood samples and fleas from two species of woodrats (Neotoma micropus and N. albigula) from Santa Fe County, NM, from 2002-2005. The most predominant flea species were Orchopeas sexdentatus and O. neotomae. Bartonella prevalence in woodrats was 64% overall, with a lower prevalence occurring in the pre-reproductive period compared to the early and late reproductive periods. A negative correlation between Bartonella prevalence in N. micropus and weight of N. micropus was observed. Flea load in Neotoma species was highest in the early reproductive period compared to the pre- and late reproductive periods and was higher in N. micropus compared to N. albigula. Bartonella prevalence in fleas was highest in the early reproductive period and lowest in the late reproductive period, and it was higher in fleas collected from N. micropus than in fleas collected from N. albigula. Abundance of O. sexdentatus was significantly higher in N. micropus compared to N. albigula, and abundance of O. sexdentatus and O. neotomae was highest in the early reproductive period. No direct correlations were found either between Bartonella prevalence in woodrats and in fleas or between Bartonella prevalence in woodrats and flea loads. Out of 25 partially characterized Bartonella isolates from Neotoma woodrats, 24 belonged to one genogroup based on sequencing of the gltA gene.

PMID: 19263856 [PubMed - indexed for MEDLINE]

85. Vet Pathol. 2009 Mar;46(2):277-81.

Identification of Bartonella henselae in an aborted equine fetus.

Johnson R, Ramos-Vara J, Vemulapalli R.

Animal Disease Diagnostic Laboratory, Purdue University, 406 South University, West Lafayette, IN 47907, USA. johnso50@purdue.edu

This report describes the characterization of a Bartonella henselae abortion in an equine fetus by gross, histologic, immunohistochemical, ultrastructural, and molecular methods. Bartonella henselae can cause cat scratch disease, bacillary angiomatosis, bacillary peliosis, and endocarditis in humans and other animals. The bacterium has been isolated from several mammalian species but only recently from equids; however, it has not been linked to abortion in equids. An aborted equine fetus exhibited necrosis and vasculitis in multiple tissues, with intralesional Gram-negative short-to-spirillar bacteria. Nucleotide sequence analysis of the bacterial 16S rRNA gene amplified from the DNA extracted from fetal tissues revealed 99.9% homology to that of B. henselae. The presence of B. henselae in the fetal tissues was further confirmed by polymerase chain reaction amplification and nucleotide sequence analysis of other Bartonella species-specific genes. Microorganisms were immunohistochemically labeled with a monoclonal antibody to B. henselae and were ultrastructurally characterized. Attempts to detect known causative agents of equine abortion were unsuccessful. Given the severity of vasculitis and the presence of intralesional bacteria, we concluded that B. henselae infection caused the abortion of this foal.

PMID: 19261640 [PubMed - indexed for MEDLINE]

86. Vector Borne Zoonotic Dis. 2009 Dec;9(6):597-602.

Zoonotic Bartonella species in fleas collected on gray foxes (Urocyon cinereoargenteus).

Gabriel MW, Henn J, Foley JE, Brown RN, Kasten RW, Foley P, Chomel BB.

Department of Wildlife, Humboldt State University, Arcata, California, USA.

Bartonella spp. are fastidious, gram-negative, rod-shaped bacteria and are usually vector-borne. However, the vector has not been definitively identified for many recently described species. In northern California, gray foxes (Urocyon cinereoargenteus) are infected with two zoonotic Bartonella species, B. rochalimae and B. vinsonii subsp. berkhoffii. Fleas (range 1-8 fleas per fox) were collected from 22 (41.5%) of 54 gray foxes from urban and backcountry zones near Hoopa, California. The flea species were determined, and DNA was individually extracted to establish the Bartonella species harbored by these fleas. Of the 108 fleas collected, 99 (92%) were identified as Pulex simulans. Overall, 39% (42/108) of the fleas were polymerase chain reaction (PCR)-positive for Bartonella, with B. rochalimae and B. vinsonii subsp. berkhoffii identified in 34 (81%) and 8 (19%) of the PCR-positive fleas, respectively. There was no difference between the prevalence of Bartonella spp. in P. simulans for the urban and backcountry zones. Fourteen (64%) of the 22 foxes were Bartonella bacteremic at one or more of the capture dates. In 10 instances, both the foxes and the fleas collected from them at the same blood collection were Bartonella-positive. B. rochalimae was the predominant species identified in both foxes and fleas. The competency of Pulex fleas as a vector of B. rochalimae has not been confirmed and will need to be demonstrated experimentally. Pulex spp. fleas readily feed on humans and may represent a source of human exposure to zoonotic species of Bartonella.

PMID: 19125660 [PubMed - indexed for MEDLINE]

87. J Clin Microbiol. 2009 Mar;47(3):787-90. Epub 2008 Dec 24.

Infective endocarditis in a dog and the phylogenetic relationship of the associated "Bartonella rochalimae" strain with isolates from dogs, gray foxes, and a human.

Henn JB, Gabriel MW, Kasten RW, Brown RN, Koehler JE, MacDonald KA, Kittleson MD, Thomas WP, Chomel BB.

Napa County Health and Human Services, Public Health Division, 2344 Old Sonoma Rd., Bldg. G, Napa, California 94559, USA.

The first case of canine endocarditis caused by "Bartonella rochalimae" is reported. By PCR-restriction fragment length polymorphism, sequence, and phylogenetic analyses, Bartonella isolates from a dog with endocarditis, 22 gray foxes, and three dogs, described as B. clarridgeiae like, were confirmed to belong to the new species "B. rochalimae," suggesting canids as the natural reservoir.

PMCID: PMC2650912 PMID: 19109472 [PubMed - indexed for MEDLINE]

88. Enferm Infecc Microbiol Clin. 2008 Nov;26(9):573-80.

[Microbiological diagnosis of emerging bacterial pathogens: Anaplasma, Bartonella, Rickettsia, and Tropheryma whipplei].

[Article in Spanish]

Blanco JR, Jado I, Marín M, Sanfeliu I, Portillo A, Anda P, Pons I, Oteo JA.

Area de Enfermedades Infecciosas, Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores, Hospital San Pedro CIBIR, Logroño, Spain. jrblanco@riojasalud.es

Ehrlichia/Anaplasma, Bartonella, Rickettsia and Tropheryma whipplei (formerly called whippelii) are fastidious bacterial organisms, considered the causative agents of potentially severe emerging and re-emerging diseases with repercussions on public health. The recent availability of advanced molecular biology and cell culture techniques has led to the implication of many of these species in human pathologies. These issues are extensively covered in number 27 of the SEIMC microbiological procedure: Diagnóstico microbiológico de las infecciones por patógenos bacterianos emergentes: Anaplasma, Bartonella, Rickettsia y Tropheryma whippelii (Microbiological diagnosis of Anaplasma, Bartonella, Rickettsia and Tropheryma whippelii infections) (2nd ed., 2007) (www.seimc.org/documentos/protocolos/microbiologia/).

PMID: 19100178 [PubMed - indexed for MEDLINE]

89. J Med Microbiol. 2008 Dec;57(Pt 12):1496-501.

Isolation of Bartonella species from rodents in Taiwan including a strain closely related to 'Bartonella rochalimae' from Rattus norvegicus.

Lin JW, Chen CY, Chen WC, Chomel BB, Chang CC.

Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 402, Taiwan.

An increasing number of Bartonella species originally isolated from small mammals have been identified as emerging human pathogens. During an investigation of Bartonella infection in rodent populations carried out in Taiwan in 2006, a total of 58 rodents were tested. It was determined that 10.3 % (6/58) of the animals were Bartonella bacteraemic. After PCR/RFLP analysis, four isolates were identified as Bartonella elizabethae and one isolate as Bartonella tribocorum. However, there was one specific isolate with an unrecognized PCR/RFLP pattern. After further sequence and phylogenetic analyses of the gltA, ftsZ and rpoB genes, and the 16S-23S rRNA intergenic spacer region, the results indicated that this specific isolate from Rattus norvegicus was closely related to human pathogenic 'Bartonella rochalimae'. Further studies need to be conducted to evaluate whether this rodent species could be a reservoir for 'B. rochalimae'.

PMID: 19018019 [PubMed - indexed for MEDLINE]

90. Vector Borne Zoonotic Dis. 2009 Oct;9(5):469-77.

Ectoparasites and associated pathogens of free-roaming and captive animals in zoos of South Carolina.

Nelder MP, Reeves WK, Adler PH, Wozniak A, Wills W.

Department of Entomology, Soils & Plant Sciences, Clemson University, Clemson, South Carolina, USA. mnelder@rci.rutgers.edu

A survey of ectoparasites and their associated pathogens was conducted in two South Carolina zoos, from 2004 to 2007. Dead, wild birds and mammals, as well as captive animals examined during routine veterinary checks constituted the study populations. Ectoparasites were tested for species of Anaplasma, Bartonella, Coxiella burnetii, Ehrlichia, Rickettsia, and Trypanosoma. Forty-six species of ectoparasites were collected from 133 free-roaming and captive hosts and their associated nesting and bedding materials. Six vector-borne pathogens were detected molecularly in the ectoparasites, including Anaplasma phagocytophilum in the tick Ixodes dentatus Marx from an eastern cottontail rabbit, Bartonella clarridgeiae in the cat flea Ctenocephalides felis (Bouché) from a Virginia opossum, Bartonella sp. Oh6 in the squirrel flea Orchopeas howardi (Baker) from an eastern grey squirrel, Bartonella sp. T7498 in the sucking louse Neohaematopinus sciuri Jancke from a squirrel, Rickettsia sp. Rf2125 in C. felis from a zookeeper and a grizzly bear, and Rickettsiales sp. Ib 2006 in Ixodes brunneus Koch from an American crow. While the pathology of some of these pathogens is poorly known, Anaplasma phagocytophilum (causative agent of human granulocytic anaplasmosis) and Bartonella clarridgeiae (causative agent of a disease similar to cat-scratch disease) can infect humans. Ectoparasites and their pathogens, especially those originating from free-roaming animals, present a potential threat to captive animals and humans.

PMID: 18973443 [PubMed - indexed for MEDLINE]

91. J Microbiol Methods. 2009 Jan;76(1):6-11. Epub 2008 Sep 5.

Optimization of pulse-field gel electrophoresis for Bartonella subtyping.

Xu C, Liu Q, Diao B, Kan B, Song X, Li D.

National Institute for Communicatable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, P.O. Box 5, Changping, Beijing 102206, PR China.

Bartonella is a significant human pathogen and is the world's most common bacterial zoonosis acquired from companion animals. However, there is no uniform method for Pulse-Field Gel Electrophoresis (PFGE) for Bartonella population genetics studies. Further, some genes of Bartonella can mutate frequently and may affect the use of PFGE for Bartonella. Here we designed methods to solve these problems. We standardized the bacterial concentration, selected the appropriate digestion enzyme, optimized the electrophoretic parameters and characterized reproducibly two Bartonella species strains. Thus we optimized the PFGE procedure and determined how often Bartonella mutated. Our data shows a practical protocol for inter- and intra-species identification of Bartonella and was reproducible using two species strains that showed no mutation occurred after two passages for B. elizabethae; but mutation did occur in B. henselae.

PMID: 18835302 [PubMed - indexed for MEDLINE]

92. J Vet Sci. 2008 Sep;9(3):285-93.

Microbial pathogens in ticks, rodents and a shrew in northern Gyeonggi-do near the DMZ, Korea.

Chae JS, Yu do H, Shringi S, Klein TA, Kim HC, Chong ST, Lee IY, Foley J.

Department of Internal Medicine, College of Veterinary Medicine, Seoul National University, Seoul 151-742, Korea. jschae@snu.ac.kr

A total of 1,618 ticks [420 individual (adults) and pooled (larvae and nymphs) samples], 369 rodents (Apodemus agrarius, Rattus norvegicus, Tscherskia triton, Mus musculus, and Myodes regulus), and 34 shrews (Crocidura lasiura) that were collected in northern Gyeonggi-do near the Demilitarized Zone (DMZ) of Korea during 2004-2005, were assayed by PCR for selected zoonotic pathogens. From a total of 420 individual and pooled tick DNA samples, Anaplasma (A.) phagocytophilum (16), A. platys (16), Ehrlichia (E.) chaffeensis (63), Borrelia burgdorferi (16), and Rickettsia spp. (198) were detected using species-specific PCR assays. Out of 403 spleens from rodents and shrews, A. phagocytophilum (20), A. platys (34), E. chaffeensis (127), and Bartonella spp. (24) were detected with species-specific PCR assays. These results suggest that fevers of unknown causes in humans and animals in Korea should be evaluated for infections by these vector-borne microbial pathogens.

PMCID: PMC2811841 PMID: 18716449 [PubMed - indexed for MEDLINE]

93. J Clin Microbiol. 2008 Sep;46(9):2856-61. Epub 2008 Jul 16.

Bartonella sp. bacteremia in patients with neurological and neurocognitive dysfunction.

Breitschwerdt EB, Maggi RG, Nicholson WL, Cherry NA, Woods CW.

College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough St, Raleigh, NC 27606, USA. ed_breitschwerdt@ncsu.edu

We detected infection with a Bartonella species (B. henselae or B. vinsonii subsp. berkhoffii) in blood samples from six immunocompetent patients who presented with a chronic neurological or neurocognitive syndrome including seizures, ataxia, memory loss, and/or tremors. Each of these patients had substantial animal contact or recent arthropod exposure as a potential risk factor for Bartonella infection. Additional studies should be performed to clarify the potential role of Bartonella spp. as a cause of chronic neurological and neurocognitive dysfunction.

PMCID: PMC2546763 PMID: 18632903 [PubMed - indexed for MEDLINE]

94. Int J Infect Dis. 2009 Jan;13(1):3-8. Epub 2008 Jul 14.

Bartonella: emerging pathogen or emerging awareness?

Mogollon-Pasapera E, Otvos L Jr, Giordano A, Cassone M.

Sbarro Health Research Organization, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA.

The number of known Bartonella species is rapidly growing. Some of them are responsible for distinct infectious diseases and show different prevalence and antibiotic susceptibility profiles. Not only have some vectors of Bartonella not been fully characterized, but also intermediate hosts are actually much more numerous and diverse than previously thought. Among these, dogs differ from cats because they tend to suffer an overt disease similar to humans, thus providing the base for a useful animal indicator and research model. Among the debilitating conditions with an unclear impact on the course of these infections, specific conditions (e.g., homelessness, alcoholism) have been linked to a much higher prevalence and to high risk of unfavorable outcome. Due to the limited arsenal of antibiotics effective in vivo on this peculiar intracellular pathogen, the risk/benefit balance of antibiotic therapy is sometimes difficult to draw. In this evolving picture, the recent discoveries of new species highlights the importance of basic molecular biology resources that would bring major public health benefits if available in endemic areas, and specifically in many areas of Peru and Bolivia.

PMID: 18621561 [PubMed - indexed for MEDLINE]

95. Appl Environ Microbiol. 2008 Aug;74(16):5086-92. Epub 2008 Jul 7.

Prevalence and genetic diversity of Bartonella species isolated from wild rodents in Japan.

Inoue K, Maruyama S, Kabeya H, Yamada N, Ohashi N, Sato Y, Yukawa M, Masuzawa T, Kawamori F, Kadosaka T, Takada N, Fujita H, Kawabata H.

Laboratory of Veterinary Public Health, Department of Veterinary Medicine, College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-8510, Japan.

Here, we describe for the first time the prevalence and genetic properties of Bartonella organisms in wild rodents in Japan. We captured 685 wild rodents throughout Japan (in 12 prefectures) and successfully isolated Bartonella organisms from 176 of the 685 rodents (isolation rate, 25.7%). Those Bartonella isolates were all obtained from the rodents captured in suburban areas (rate, 51.8%), but no organism was isolated from the animals captured in city areas. Sequence analysis of rpoB and gltA revealed that the Bartonella isolates obtained were classified into eight genetic groups, comprising isolates closely related to B. grahamii (A-I group), B. tribocorum and B. elizabethae (B-J group), B. tribocorum and B. rattimassiliensis (C-K group), B. rattimassiliensis (D-L group), B. phoceensis (F-N group), B. taylorii (G-O group), and probably two additional novel Bartonella species groups (E-M and H-P). B. grahamii, which is one of the potential causative agents of human neuroretinitis, was found to be predominant in Japanese rodents. In terms of the relationships between these Bartonella genetic groups and their rodent species, (i) the A-I, E-M, and H-P groups appear to be associated with Apodemus speciosus and Apodemus argenteus; (ii) the C-K, D-L, and F-N groups are likely implicated in Rattus rattus; (iii) the B-J group seems to be involved in Apodemus mice and R. rattus; and (iv) the G-O group is probably associated with A. speciosus and Clethrionomys voles. Furthermore, dual infections with two different genetic groups of bartonellae were found in A. speciosus and R. rattus. These findings suggest that the rodent in Japan might serve as a reservoir of zoonotic Bartonella infection.

PMCID: PMC2519277 PMID: 18606803 [PubMed - indexed for MEDLINE]

96. Mem Inst Oswaldo Cruz. 2008 May;103(3):221-35.

Human bartonellosis: seroepidemiological and clinical features with an emphasis on data from Brazil - a review.

Lamas C, Curi A, Bóia M, Lemos E.

Laboratório de Hantaviroses e Rickettsioses, Rio de janeiro, Brazil. cristianelamas@gmail.com

Bartonellae are fastidious Gram-negative bacteria that are widespread in nature with several animal reservoirs (mainly cats, dogs, and rodents) and insect vectors (mainly fleas, sandflies, and human lice). Thirteen species or subspecies of Bartonella have been recognized as agents causing human disease, including B. bacilliformis, B. quintana, B. vinsonii berkhoffii, B. henselae, B. elizabethae, B. grahamii, B. washoensis, B. koehlerae, B. rocha-limaea, and B. tamiae. The clinical spectrum of infection includes lymphadenopathy, fever of unknown origin, endocarditis, neurological and ophthalmological syndromes, Carrion's disease, and others. This review provides updated information on clinical manifestations and seroepidemiological studies with an emphasis on data available from Brazil.

PMID: 18592096 [PubMed - indexed for MEDLINE]

97. Rev Med Suisse. 2008 Apr 9;4(152):901-7.

[Cat scratch disease and other human infections caused by Bartonella species].

[Article in French]

Boillat N, Greub G.

Centre des maladies infectieuses, Institut central des hôpitaux valaisans, 1950 Sion.

The different Bartonella species can cause various human infections such as cat scratch disease, chronic bacteremia (homeless patient with nonspecific symptom), endocarditis, bacillary angiomatosis, peliosis, and Carrion's disease. Diagnostic approaches include serology, culture and molecular approaches. PCR is especially useful on lymph nodes biopsies from patients with cat-scratch disease and on valvular samples taken from culture-negative endocarditis. Serology exhibits a very high sensitivity in the latter situation. The treatment should be chosen according to the clinical presentation.

PMID: 18578430 [PubMed - indexed for MEDLINE]

98. Appl Environ Microbiol. 2008 Aug;74(16):5224-7. Epub 2008 Jun 20.

Analysis of a novel insect cell culture medium-based growth medium for Bartonella species.

Riess T, Dietrich F, Schmidt KV, Kaiser PO, Schwarz H, Schäfer A, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, Elfriede-Aulhorn-Str. 6, D-72076 Tübingen, Germany.

Human- and animal-pathogenic Bartonella species are fastidious and slow-growing bacteria difficult to isolate and cultivate. We describe a novel, easy-to-prepare liquid medium for the fast and reliable growth of several Bartonella spp. that does not affect bacterial protein expression patterns or interactions with host cells.

PMCID: PMC2519262 PMID: 18567689 [PubMed - indexed for MEDLINE]

99. Medicine (Baltimore). 2008 May;87(3):167-76.

High prevalence of fastidious bacteria in 1520 cases of uveitis of unknown etiology.

Drancourt M, Berger P, Terrada C, Bodaghi B, Conrath J, Raoult D, LeHoang P.

Fédération de Microbiologie Clinique et Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Marseille, France.

The etiologic evaluation of uveitis is frequently unsuccessful when noninvasive methods are used. We conducted a prospective study to evaluate systematic screening for pathogens of uveitis. All patients with uveitis referred to the participating tertiary ophthalmology departments from January 2001 to September 2007 underwent intraocular and serum specimen collection. The standardized protocol for laboratory investigations included universal polymerase chain reaction (PCR)-based detection of any bacteria and mycoses, specific PCR-based detection of fastidious (difficult-to-grow) bacteria and herpes viruses, and culture of vitreous fluid. Sera were tested for fastidious bacteria. Among the 1321 included patients (1520 specimens), infection was diagnosed in 147 (11.1%) patients: 78 (53%) were caused by fastidious bacteria that included spirochetes, Bartonella species, intracellular bacteria (Chlamydia species, Rickettsia species, Coxiella burnetii), and Tropheryma whipplei; 18 by herpes viruses; and 9 by fungi. Bartonella quintana, Coxiella burnetii, Paracoccus yeei, Aspergillus oryzae, and Cryptococcus albidus were found to be associated with uveitis for the first time, to our knowledge. We recommend applying a 1-step diagnostic procedure that incorporates intraocular, specific microbial PCR with serum analyses in tertiary centers to determine the etiology of uveitis.

PMID: 18520326 [PubMed - indexed for MEDLINE]

100. Circ J. 2008 Jun;72(6):1022-4.

First report of Bartonella quintana endocarditis in Japan.

Yoda M, Hata M, Sezai A, Unosawa S, Furukawa N, Minami K.

Department of Thoracic and Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Ooyaguchi-kamimachi, Itabashi-ku, Tokyo 173-8610, Japan. myoda@med.nihon-u.ac.jp

Bartonella (Rochalimaea) species are increasingly recognized as a cause of endocarditis, but the total number of cases remains low. Especially, Bartonella quintana endocarditis is very rare and there have been no reports in Japan. A 66-year-old man was hospitalized because of dyspnea and fever. An echocardiogram showed severe mitral valve regurgitation, mild aortic valve regurgitation, and echogenic masses on the mitral and aortic valve. Six sets of blood cultures were negative. Replacement of the mitral- and aortic-valve with a mechanical valve was performed. However, due to symptomatic para-valvular leakage a re-mitral valve replacement was later performed. Unfortunately, the patient died 1 month after the operation owing to multiple organ failure. Four weeks after the second operation, blood culture yielded a Gram-negative bacillus. DNA was extracted from the colony and subjected to polymerase chain reaction amplification. Nucleotide sequence analysis (1,500 nucleotide positions) and a BLAST search of the EMBL/GENBANK database revealed 99.9% homology with the Bartonella quintana 16S rRNA gene. This is the first report of Bartonella quintana endocarditis in Japan, and should be considered with the view of culture negative endocarditis.

PMID: 18503234 [PubMed - indexed for MEDLINE]

101. Cell Microbiol. 2008 Aug;10(8):1591-8. Epub 2008 Jul 30.

Infection-associated type IV secretion systems of Bartonella and their diverse roles in host cell interaction.

Dehio C.

Focal Area Infection Biology, Biozentrum of the University of Basel, Klingelbergstrasse 70, CH-4056 Basel, Switzerland. christoph.dehio@unibas.ch

Type IV secretion systems (T4SSs) are transporters of Gram-negative bacteria that mediate interbacterial DNA transfer, and translocation of virulence factors into eukaryotic host cells. The alpha-proteobacterial genus Bartonella comprises arthropod-borne pathogens that colonize endothelial cells and erythrocytes of their mammalian reservoir hosts, thereby causing long-lasting intraerythrocytic infections. The deadly human pathogen Bartonella bacilliformis holds an isolated position in the Bartonella phylogeny as a sole representative of an ancestral lineage. All other species evolved in a separate 'modern' lineage by radial speciation and represent highly host-adapted pathogens of limited virulence potential. Unlike B. bacilliformis, the species of the modern lineage encode at least one of the closely related T4SSs, VirB/VirD4 or Vbh. These VirB-like T4SSs represent major host adaptability factors that contributed to the remarkable evolutionary success of the modern lineage. At the molecular level, the VirB/VirD4 T4SS was shown to translocate several effector proteins into endothelial cells that subvert cellular functions critical for establishing chronic infection. A third T4SS, Trw, is present in a sub-branch of the modern lineage. Trw does not translocate any known effectors, but produces multiple variant pilus subunits critically involved in the invasion of erythrocytes. The T4SSs laterally acquired by the bartonellae have thus adopted highly diverse functions during infection, highlighting their versatility as pathogenicity factors.

PMCID: PMC2610397 PMID: 18489724 [PubMed - indexed for MEDLINE]

102. Zoonoses Public Health. 2008 Oct;55(8-10):514-20. Epub 2008 May 16.

Molecular evidence for Bartonella spp. in cat and dog fleas from Germany and France.

Just FT, Gilles J, Pradel I, Pfalzer S, Lengauer H, Hellmann K, Pfister K.

Institute for Comparative Tropical Medicine and Parasitology, Veterinary Faculty, Ludwig-Maximilians-University Munich, Germany. frank.just@lgl.bayern.de

Nine hundred and fifty-two fleas were collected from 148 cats and 133 dogs at 18 widely distributed geographic locations in Germany and France and examined for the presence of six different Bartonella spp. (Bartonella bacilliformis, Bartonella clarridgeiae, Bartonella elizabethae, Bartonella henselae, Bartonella quintana, Bartonella vinsonii subsp. berkhoffii) by PCR. Thirty-five specimens (3.7%) tested positive for either B. henselae (14 positive fleas) or B. clarridgeiae (21 positive fleas). DNA of other Bartonella spp. were not detected. Bartonella clarridgeiae was the dominating species in samples from France (19 out of 22 positive fleas), whereas B. henselae was more frequent in Germany (11 out of 13 positive fleas). With 3.5% (22 out of 632 fleas) in France and 4.1% (13 out of 320 fleas) in Germany, the overall prevalences of pathogen did not vary significantly between the flea populations of both countries. 5.4% of cats in France versus 16.1% of cats from Germany were infested by fleas carrying Bartonella, whereas 9.5% of dogs in France but none of the examined dogs from Germany were infested by Bartonella positive fleas. The molecular evidence of Bartonella infections reveals that agents of zoonotic potential are established in flea populations in Germany and France and that the spectrum of species can vary significantly from country to country.

PMID: 18489542 [PubMed - indexed for MEDLINE]

103. BMC Infect Dis. 2008 May 1;8:58.

Seroprevalence of Bartonella spp. infection in HIV patients in Catalonia, Spain.

Pons I, Sanfeliu I, Nogueras MM, Sala M, Cervantes M, Amengual MJ, Segura F.

Infectious Diseases Program, Hospital de Sabadell Institut Universitari Parc Taulí UAB, Sabadell, Spain. ipons@tauli.cat

BACKGROUND: Although the first clinical descriptions of Bartonella infection were associated with immunocompromised patient with bacillary angiomatosis, we currently know that this organism is directly involved in diseases affecting a large number of patients, regardless of their immune status. Cat scratch disease, hepatic peliosis, and some cases of bacteraemia and endocarditis, are directly caused by some species of the genus Bartonella. The purpose of this study was to determinate the prevalence of IgG antibodies against Bartonella henselae and B. quintana in HIV patients and to identify the epidemiological factors involved.

METHODS: Serum samples were collected from HIV patients treated at Hospital de Sabadell. Antibodies to B. henselae and B. quintana from 340 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical test were determined by the Mann-Whitney U test and chi2 test.

RESULTS: Of 340 patients, 82 were women and 258 men, with a median age of 42.21 +/- 10.35 years (range 16-86 years). Seventy-six (22.3%) patients reacted with one or more Bartonella antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, intravenous drugs use, alcohol consumption, CD4 levels, AIDS, HCV, HBV, residential area), only age was statistically significant. CONCLUSION: A high percentage of HIV patients presents antibodies to Bartonella and is increasing with age.

PMCID: PMC2390557 PMID: 18452613 [PubMed - indexed for MEDLINE]

104. Mikrobiyol Bul. 2008 Jan;42(1):163-75.

[Bartonella henselae and its infections].

[Article in Turkish]

Celebi B.

Refik Saydam Hifzissihha Merkezi Başkanliği, Salgin Hastaliklar Araştirma Müdürlüğü, Bakteriyel Zoonozlar Araştirma Laboratuvari, Ankara. bekir.celebi@rshm.gov.tr

In recent years the number of identified Bartonella species has increased rapidly and several species in Bartonella genus isolated from various mammalian reservoirs were recognized as zoonotic agents in humans. Three Bartonella species are considered to be pathogenic for humans; B. henselae, B. quintana and B. bacilliformis. B. henselae causes asymptomatic intraerythrocytic bacteraemia in the feline reservoir host and is the most important zoonotic species as the cause of human diseases including cat scratch disease, bacillary angiomatosis, bacillary peliosis, bacteraemia, endocarditis and neurological disorders. In this review article general characteristics of B. henselae, infection types and clinical features, laboratory diagnosis, treatment and preventive measures have been discussed.

PMID: 18444576 [PubMed - indexed for MEDLINE]

105. Bull Acad Natl Med. 2007 Jun;191(6):1037-44; discussion 1047-9.

[Persistent Bartonella infection: epidemiological and clinical implications].

[Article in French]

Boulouis HJ, Haddad N, Vayssier-Taussat M, Maillard R, Chomel B.

UMR BIPAR ENVA/AFSSA/INRA/UPVM Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Gal de Gaulle, 94704, Maisons-Alfort. hjboulouis@vet-alfort.fr

Bartonella are Gram-negative hemotropic bacteria that infect a wide range of mammals. At least 14 Bartonella species or subspecies have been reported to be pathogenic for humans and animals. Wild and domestic animals represent a large reservoir. Reservoir species usually display chronic bacteremia. This explains some aspects of the epidemiology of these infections, and especially vector-borne transmission. The molecular mechanisms of persistent infection have clinical consequences both for occasional hosts and for human and animal reservoirs. An increasing number of clinical cases are being described in reservoir species that were previously considered to remain asymptomatic.

PMID: 18402163 [PubMed - indexed for MEDLINE]

106. J Feline Med Surg. 2008 Aug;10(4):332-7. Epub 2008 Apr 8.

Bartonella species antibodies and DNA in cerebral spinal fluid of cats with central nervous system disease.

Leibovitz K, Pearce L, Brewer M, Lappin MR.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, 300 West Drake Road, Fort Collins, CO 80523, USA.

Bartonella species infection is associated with central nervous system (CNS) disease in some humans and cats but the diagnosis is difficult to confirm with blood or serum test results. In this retrospective study of 100 client-owned cats, serum and cerebral spinal fluid (CSF) were assayed for Bartonella species IgG antibodies and CSF was assayed for Bartonella species DNA. Bartonella species IgG antibodies were detected in serum of 36 cats, Bartonella species C-values>1 (suggesting antibody production by the CNS) were detected in CSF of 11 cats, and B henselae DNA was amplified from the CSF of 10 cats. While the clinical significance of these findings cannot be assessed without a control group, the development of neurological signs in some cats inoculated with B henselae and the results of this study warrant prospective evaluation of the association of Bartonella species with feline CNS disease.

PMID: 18400536 [PubMed - indexed for MEDLINE]

107. Vector Borne Zoonotic Dis. 2008 Aug;8(4):467-74.

Bartonella spp. infection in rodents from different habitats in the Mazury Lake District, Northeast Poland.

Welc-Faleciak R, Paziewska A, Bajer A, Behnke JM, Siński E.

Department of Parasitology, Institute of Zoology, University of Warsaw, Warsaw, Poland.

Four rodent species (Clethrionomys glareolus, Apodemus flavicollis, Microtus arvalis, M. oeconomus) were captured in the period 2004-2006 in the Mazury Lake District, Northeast Poland, to determine the prevalence and genetic diversity of Bartonella species. The presence of bartonellae was assessed using polymerase chain reaction (PCR) with primers CS140f and BhCS1137n, amplifying a fragment of the gltA gene. Bartonella DNA was detected in 313 (30.6%) of 1024 rodents sampled: in 181 C. glareolus, 68 A. flavicollis, 50 M. arvalis, and 14 M. oeconomus, representing prevalence of 31.0%, 42.2%, 32.9%, and 11.1%, respectively. Comparison of the Bartonella gltA gene sequences from 38 isolates revealed six phylogenetic subgroups, out of 15 unique gltA sequences, and therein from one to five genotypic variants with homology of 88.6-99.1%. Six of 13 (46.2%) isolates from C. glareolus were identical to B. grahamii, species associated with human illness. These results have important public health implication, notably in relation to the risk of infection in humans following exposure to rodent bartonellae.

PMID: 18399782 [PubMed - indexed for MEDLINE]

108. Med Vet Entomol. 2008 Mar;22(1):1-15.

Vector transmission of Bartonella species with emphasis on the potential for tick transmission.

Billeter SA, Levy MG, Chomel BB, Breitschwerdt EB.

Center for Comparative Medicine and Transitional Research, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina 27606, USA.

Bartonella species are gram-negative bacteria that infect erythrocytes, endothelial cells and macrophages, often leading to persistent blood-borne infections. Because of the ability of various Bartonella species to reside within erythrocytes of a diverse number of animal hosts, there is substantial opportunity for the potential uptake of these blood-borne bacteria by a variety of arthropod vectors that feed on animals and people. Five Bartonella species are transmitted by lice, fleas or sandflies. However, Bartonella DNA has been detected or Bartonella spp. have been cultured from numerous other arthropods. This review discusses Bartonella transmission by sandflies, lice and fleas, the potential for transmission by other vectors, and data supporting transmission by ticks. Polymerase chain reaction (PCR) or culture methods have been used to detect Bartonella in ticks, either questing or host-attached, throughout the world. Case studies and serological or molecular surveys involving humans, cats and canines provide indirect evidence supporting transmission of Bartonella species by ticks. Of potential clinical relevance, many studies have proposed co-transmission of Bartonella with other known tick-borne pathogens. Currently, critically important experimental transmission studies have not been performed for Bartonella transmission by many potential arthropod vectors, including ticks.

PMID: 18380649 [PubMed - indexed for MEDLINE]

109. Congenit Heart Dis. 2007 Jan-Feb;2(1):79-84.

Bartonella endocarditis in complex congenital heart disease.

Hoffman RM, AboulHosn J, Child JS, Pegues DA.

Division of Infectious Diseases, Department of Internal Medicine, UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA. rhoffman@mednet.ucla.edu

Bartonella species are an important cause of culture-negative endocarditis, with recognized risk factors of alcoholism, homelessness, cat exposure, and pre-existing valvular disease. We report a case of Bartonella henselae endocarditis in a 36-year-old woman with complex congenital heart disease who presented with a 7-month history of hemolytic anemia, leukocytoclastic vasculitis, and recurrent fevers. Transesophageal echocardiogram revealed vegetations on the patient's native aortic valve and in the right ventricular to pulmonary artery conduit and associated bioprosthetic valve. Diagnosis of B. henselae was confirmed with serum antibody and polymerase chain reaction (PCR) testing and tissue stains. The patient was treated successfully with surgical resection and prolonged antimicrobial therapy with ceftriaxone, gentamicin, and doxycycline. A review of the literature suggests prosthetic valves and complex congenital heart disease are risk factors for Bartonella endocarditis, and a high index of suspicion with antibody and PCR testing can expedite diagnosis and improve outcomes.

PMID: 18377522 [PubMed - indexed for MEDLINE]

110. Vet Immunol Immunopathol. 2008 May 15;123(1-2):167-71. Epub 2008 Jan 19.

Feline bartonellosis and cat scratch disease.

Breitschwerdt EB.

College of Veterinary Medicine, North Carolina State University, Dipl. ACVIM, 4700 Hillsborough Street, Raleigh, NC 27606, United States. ed_breitschwerdt@ncsu.edu

Bartonella species are important emerging zoonotic pathogens. Transmission of these organisms in nature may be much more complex than is currently appreciated. Cats can be infected with five Bartonella species, including, Bartonella henselae, Bartonella clarridgeae, Bartonella bovis, Bartonella koehlerae and Bartonella quintana. In addition to cats, numerous domestic and wild animals, including bovine, canine, human, and rodent species can serve as chronically infected reservoir hosts for various intra-erythrocytic Bartonella species. In addition, an increasing number of arthropod vectors, including biting flies, fleas, keds, lice, sandflys and potentially ticks have been implicated in the transmission of various Bartonella species to animals or human beings. In the reservoir host, Bartonella species cause chronic intra-erythrocytic and vascular endothelial infections, with a relapsing bacteremia documented in experimentally infected cats. Although the immunopathology induced by Bartonella infection requires additional study, the organisms can localize to the heart valve (endocarditis), cause granulomatous inflammation in lymph nodes, liver or spleen, induce central nervous system dysfunction with or without cerebrospinal fluid changes, and may contribute to inflammatory polyarthritis. Hematological abnormalities are infrequent, but thrombocytopenia, lymphocytosis, neutropenia, and eosinophilia have been reported in B. henselae-infected cats. Serology, PCR and culture can be used to support a diagnosis of feline bartonellosis, however, due to the high rate of sub-clinical infections among various cat populations, documenting causation in an individual cat is difficult, if not impossible. Response to treatment can be used in conjunction with serology or organism isolation to support a clinical diagnosis of feline bartonellosis. As fleas are involved in the transmission among cats, the use of acaracide products to eliminate fleas from the environment is of critical importance to decrease the risk of B. henselae transmission among cats and to humans.

PMID: 18295347 [PubMed - indexed for MEDLINE]

111. Epidemiol Infect. 2008 Dec;136(12):1712-6. Epub 2008 Feb 25.

Serological evidence of Bartonella henselae infection in healthy people in Catalonia, Spain.

Pons I, Sanfeliu I, Cardeñosa N, Nogueras MM, Font B, Segura F.

Infectious Diseases Program, Department of Internal Medicine, Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain. ipons@tauli.cat

Cat scratch disease (CSD), bacillary angiomatosis, hepatic peliosis and some cases of bacteraemia, endocarditis, and osteomyelitis are directly caused by some species of the genus Bartonella. The purpose of this study was to determine the prevalence of IgG antibodies against Bartonella henselae in healthy people and to identify the epidemiological factors involved. Serum samples from 218 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical analysis were determined by the Mann-Whitney U test, chi2 test and Fisher's exact test. Of 218 patients, 99 were female and 119 male, with a median age of 34.36 years (range 0-91 years). Nineteen (8.7%) reacted with B. henselae antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, contact with animals, residential area), only age was statistically significant. Our serological data seems to indicate that B. henselae is present in Catalonia and could be transmitted to humans.

PMCID: PMC2870778 PMID: 18294428 [PubMed - indexed for MEDLINE]

112. Am J Pathol. 2008 Apr;172(4):1005-18. Epub 2008 Feb 21.

Lymphadenopathy in a novel mouse model of Bartonella-induced cat scratch disease results from lymphocyte immigration and proliferation and is regulated by interferon-alpha/beta.

Kunz S, Oberle K, Sander A, Bogdan C, Schleicher U.

Immunologie und Hygiene, Universitätsklinikum Erlangen, Wasserturmstrasse 3-5, Erlangen, Germany.

In immunocompetent humans, cat scratch disease (CSD) is elicited by the Gram-negative bacterium Bartonella henselae and is characterized by a benign regional lymphadenopathy, the pathogenesis of which is poorly understood. Here, we describe a novel mouse model of Bartonella-induced CSD-like disease that allowed us to investigate the mechanisms leading to lymphadenopathy in vivo. In wild-type mice, a subcutaneous inoculation of either viable or inactivated B. henselae led to a strong swelling of the draining lymph node, which was long-lasting despite the rapid elimination of the bacteria. Carboxyfluorescein- and bromodesoxyuridine-labeling experiments showed that lymph node enlargement resulted from modified immigration and enhanced proliferation of lymphocytes, preferentially of B cells. A comparative analysis of B. henselae and the rodent pathogen B. grahamii in wild-type versus interferon-alpha/beta-receptor I chain-deficient mice revealed that interferon-alpha/beta is not only differentially induced by these two Bartonella species but also exerts an inhibitory effect on the development of lymphadenopathy both in vitro and in vivo. These data demonstrate that the lymphadenopathy of human CSD can be reproduced and studied in a mouse model and provide the first insights into the underlying immunological mechanisms.

PMCID: PMC2276426 PMID: 18292236 [PubMed - indexed for MEDLINE]

113. Emerg Infect Dis. 2007 Dec;13(12):1948-50.

Bartonella DNA in dog saliva.

Duncan AW, Maggi RG, Breitschwerdt EB.

North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA.

Bartonella species, transmitted by arthropods or animal bites and scratches, are emerging pathogens in human and veterinary medicine. PCR and DNA sequencing were used to test oral swabs collected from dogs. Results indicated the presence of 4 Bartonella species: B. bovis, B. henselae, B. quintana, and B. vinsonii subspecies berkhoffii.

PMCID: PMC2876763 PMID: 18258056 [PubMed - indexed for MEDLINE]

114. Vector Borne Zoonotic Dis. 2008 Spring;8(1):1-5.

Characterization of Bartonella strains isolated from black-tailed prairie dogs (Cynomys ludovicianus).

Bai Y, Kosoy M, Martin A, Ray C, Sheff K, Chalcraft L, Collinge SK.

Department of Ecology and Evolutionary Biology, University of Colorado, Boulder, CO, USA. bby5@cdc.gov

Thirty bartonella strains were isolated from the blood of black-tailed prairie dogs (Cynomys ludovicianus) from Boulder County, Colorado, USA. The bacteria appeared as small, fastidious, aerobic, Gram-negative rods. The partial sequences of the citrate synthase gene (gltA) demonstrated five unique genetic variants. Phylogenetic analysis based on sequences of gltA, 16S rRNA, rpoB, ftsZ, and ribC showed that the black-tailed prairie dog-related Bartonella variants comprise a distinct monophyletic clade that is closely related to Bartonella washoensis, a species isolated from a human patient and subsequently from ground squirrels. These variants, however, are grouped together in 100% of the bootstrapped trees. These variants were not found in other small mammals trapped during the same study, showing some evidence of host specificity. We believe that the group being described here is typical of the black-tailed prairie dog. We propose to name the bacteria Candidatus Bartonella washoensis subsp. cynomysii. The type strain is CL8606co(T)(=ATCC BAA-1342(T) = CCUG 53213(T)), which is the representative isolate of the dominant variant of the characterized group.

PMID: 18237261 [PubMed - indexed for MEDLINE]

115. Comp Med. 2008 Feb;58(1):76-80.

Susceptibility of owl monkeys (Aotus nancymaae) to experimental infection with Bartonella bacilliformis.

Bentzel DE, Espinosa BJ, Canal E, Blazes DL, Hall ER.

Laboratory Animal Program, Naval Medical Research Center Detachment, Lima, Peru. david.bentzel@med.navy.mil

Bartonellosis, caused by Bartonella bacilliformis, is a clinically significant disease in parts of South America, where it is characterized by fever and hemolytic anemia during the often-fatal acute stage and warty skin eruptions during chronic disease. In this study, we evaluated owl monkeys (Aotus nancymaae) as a potential model for studying the immunogenicity and pathology of bartonellosis. Two groups of animals (n = 3 per group) received either 9.5 x 10(7) CFU B. bacilliformis by the ID route or 1.1 x 10(6) CFU by the IV route and were followed for 140 d. Animals were evaluated by physical exam, complete blood count or hematocrit (or both); infection was confirmed by Giemsa staining of blood smears, PCR amplification, and blood culture. On days 7 and 21, Giemsa-stained blood smears from both groups contained organisms (1% to 4% of erythrocytes). All blood cultures and PCR tests were negative. Complete blood counts and chemistry panels showed no difference from baseline. Serology revealed a greater than 4-fold increase in the IgM titer (compared with baseline levels) in the 3 animals from the ID group and 1 animal from the IV group. On day 35, a dermal lesion was excised from the inguinal region of 1 monkey from each group, with a second lesion excised on day 84 from the same monkey in the IV group. However the histopathology and immunostaining of these samples were not consistent with B. bacilliformis. The present study shows that owl monkeys can be infected with B. bacilliformis, but additional dosage studies are necessary to evaluate the usefulness of this species as a disease model for human bartonellosis.

PMCID: PMC2703158 PMID: 19793460 [PubMed - indexed for MEDLINE]

116. Syst Appl Microbiol. 2008 Mar;31(1):1-16. Epub 2008 Jan 28.

Genetic diversity and phylogenetic relationships of bacteria belonging to the Ochrobactrum-Brucella group by recA and 16S rRNA gene-based comparative sequence analysis.

Scholz HC, Al Dahouk S, Tomaso H, Neubauer H, Witte A, Schloter M, Kämpfer P, Falsen E, Pfeffer M, Engel M.

Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, D-80937 Munich, Germany. Holger1Scholz@bundeswehr.org

The genetic diversity and phylogenetic interrelationships among 106 Ochrobactrum strains (O. anthropi: 72, O. intermedium: 22, O. tritici: 5, O. oryzae: 2, O. grignonense: 2, O. gallinifaecis: 1, O. lupini: 2), the type strains of the eight Brucella species and other closely related taxa were studied by recA and rrs gene (16S rRNA) comparative sequence analysis. Both markers correctly delineated the various Ochrobactrum species; however, resolution at the subspecies level was considerably higher in the recA gene-based approach. Phylogenetic analyses using neighbor-joining, parsimony, and maximum likelihood algorithms generated trees with similar topologies but the overall branching order, and also the order of the subclades, were not stable in either assay, which could be explained by generally high recA and rrs sequence similarities. Ochrobactrum and Pseudochrobactrum formed separate clades distinct from other Alphaproteobacteria with Bartonella, Agrobacterium, and Rhizobium as the closest relatives. O. gallinifaecis was the most distinct member, when compared to the type species O. anthropi, with rrs and recA similarities of 96.2% and 81.4%. Brucella species were indistinguishable, exhibiting high rrs and recA gene similarities of 98.6% and 85.5% compared with Ochrobactrum intermedium. At the protein level, all RecA sequences among the various Ochrobactrum species and between Ochrobactrum and Brucella were highly similar with only a few amino acid substitutions. O. anthropi and O. tritici were indistinguishable by means of their RecA proteins. A set of initially biochemically classified strains did not cluster within their assigned species and they either grouped within other known species or grouped as potential novel Ochrobactrum species. In further investigations, these strains were reclassified and described as novel species. In summary, Ochrobactrum is a highly diverse genus comprising several novel species. We recommend recA- in addition to rrs gene-analysis for correct species allocation and subtyping of novel Ochrobactrum isolates.

PMID: 18222618 [PubMed - indexed for MEDLINE]

117. Ultrastruct Pathol. 2007 Nov-Dec;31(6):369-72.

Bartonella henselae infects human erythrocytes.

Pitassi LH, Magalhães RF, Barjas-Castro ML, de Paula EV, Ferreira MR, Velho PE.

Department of Dermatology, Medical School, State University of Campinas (UNICAMP), Sao Paulo, Brazil. pitassi@yahoo.com

Bartonella henselae, a facultative intracellular bacterium, has been known as the agent of cat scratch disease, bacillary angiomatosis, peliosis hepatis, endocarditis, and bacteremic syndrome in humans. Bartonella species can cause intraerythrocytic infections and have been isolated from the bloodstream of patients by several methods. It was demonstrated that B. bacilliformis and B. quintana infect human endothelial cells and human erythrocytes and B. henselae infects erythrocytes of cats. The aim of this study was to investigate through transmission electron microscopy whether B. henselae infects mature human erythrocytes. One red blood cell (RBC) unit received an experimentally standard strain of B. henselae. Blood aliquots were collected from the infected unit immediately after inoculation, at 30 min and 1, 5, 10, and 72 h for ultrastructural evaluation. B. henselae was seen adhering to human erythrocytes 10 h after inoculation and inside the erythrocyte after 72 h. This study demonstrates that B. henselae adheres to and invades mature human erythrocytes. The results favor the possibility that erythrocytes can serve as a primary target in Bartonella spp. infections. From this observation, further studies are warranted to prevent Bartonella spp. transfusional transmission.

PMID: 18098053 [PubMed - indexed for MEDLINE]

118. PLoS One. 2007 Dec 19;2(12):e1346.

Multi-locus sequence typing of Bartonella henselae isolates from three continents reveals hypervirulent and feline-associated clones.

Arvand M, Feil EJ, Giladi M, Boulouis HJ, Viezens J.

Institut für Medizinische Mikrobiologie, Virologie und Hygiene, Universität Rostock, Rostock, Germany. mardjan.arvand@med.uni-rostock.de

Bartonella henselae is a zoonotic pathogen and the causative agent of cat scratch disease and a variety of other disease manifestations in humans. Previous investigations have suggested that a limited subset of B. henselae isolates may be associated with human disease. In the present study, 182 human and feline B. henselae isolates from Europe, North America and Australia were analysed by multi-locus sequence typing (MLST) to detect any associations between sequence type (ST), host species and geographical distribution of the isolates. A total of 14 sequence types were detected, but over 66% (16/24) of the isolates recovered from human disease corresponded to a single genotype, ST1, and this type was detected in all three continents. In contrast, 27.2% (43/158) of the feline isolates corresponded to ST7, but this ST was not recovered from humans and was restricted to Europe. The difference in host association of STs 1 (human) and 7 (feline) was statistically significant (P< or =0.001). eBURST analysis assigned the 14 STs to three clonal lineages, which contained two or more STs, and a singleton comprising ST7. These groups were broadly consistent with a neighbour-joining tree, although splits decomposition analysis was indicative of a history of recombination. These data indicate that B. henselae lineages differ in their virulence properties for humans and contribute to a better understanding of the population structure of B. henselae.

PMCID: PMC2147075 PMID: 18094753 [PubMed - indexed for MEDLINE]

119. J Clin Microbiol. 2008 Feb;46(2):776-9. Epub 2007 Dec 19.

Molecular method for Bartonella species identification in clinical and environmental samples.

García-Esteban C, Gil H, Rodríguez-Vargas M, Gerrikagoitia X, Barandika J, Escudero R, Jado I, García-Amil C, Barral M, García-Pérez AL, Bhide M, Anda P.

Laboratorio de Espiroquetas y Patógenos Especiales, Servicio de Bacteriología, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain.

A new, efficient molecular method for detection of Bartonella, based on the 16S-23S rRNA intergenic spacer and 16S rRNA amplification by multiplex PCR combined with reverse line blotting, was designed. This assay could simultaneously detect 20 different known species and other Bartonella species not described previously.

PMCID: PMC2238138 PMID: 18094134 [PubMed - indexed for MEDLINE]

120. MedGenMed. 2007 Sep 13;9(3):54.

Do bartonella infections cause agitation, panic disorder, and treatment-resistant depression?

Schaller JL, Burkland GA, Langhoff PJ.

Professional Medical Services of Naples, Naples and Tampa, Florida, USA. jschaller@embarqmail.com

INTRODUCTION: Bartonella is an emerging infection found in cities, suburbs, and rural locations. Routine national labs offer testing for only 2 species, but at least 9 have been discovered as human infections within the last 15 years. Some authors discuss Bartonella cases having atypical presentations, with serious morbidity considered uncharacteristic of more routine Bartonella infections. Some atypical findings include distortion of vision, abdominal pain, severe liver and spleen tissue abnormalities, thrombocytopenic purpura, bone infection, arthritis, abscesses, heart tissue and heart valve problems. While some articles discuss Bartonella as a cause of neurologic illnesses, psychiatric illnesses have received limited attention. Case reports usually do not focus on psychiatric symptoms and typically only as incidental comorbid findings. In this article, we discuss patients exhibiting new-onset agitation, panic attacks, and treatment-resistant depression, all of which may be attributed to Bartonella.

METHODS: Three patients receiving care in an outpatient clinical setting developed acute onset personality changes and agitation, depression, and panic attacks. They were retrospectively examined for evidence of Bartonella infections. The medical and psychiatric treatment progress of each patient was tracked until both were significantly resolved and the Bartonella was cured.

RESULTS: The patients generally seemed to require higher dosing of antidepressants, benzodiazepines, or antipsychotics in order to function normally. Doses were reduced following antibiotic treatment and as the presumed signs of Bartonella infection remitted. All patients improved significantly following treatment and returned to their previously healthy or near-normal baseline mental health status. DISCUSSION: New Bartonella species are emerging as human infections. Most do not have antibody or polymerase chain reaction (PCR) diagnostic testing at this time. Manual differential examinations are of unknown utility, due to many factors such as low numbers of infected red blood cells, the small size of the infecting bacteria, uncertainty of current techniques in viewing such small bacteria, and limited experience. As an emerging infection, it is unknown whether Bartonella occurrence in humans worldwide is rare or common, without further information from epidemiology, microbiology, pathology, and treatment outcomes research. CONCLUSION: Three patients presented with acute psychiatric disorders associated with Bartonella-like signs and symptoms. Each had clear exposure to ticks or fleas and presented with physical symptoms consistent with Bartonella, eg, an enlarged lymph node near an Ixodes tick bite and bacillary angiomatosis found only in Bartonella infections. Laboratory findings and the overall general course of the illnesses seemed consistent with Bartonella infection. The authors are not reporting that these patients offer certain proof of Bartonella infection, but we hope to raise the possibility that patients infected with Bartonella can have a variety of mental health symptoms. Since Bartonella can clearly cause neurologic disorders, we feel the presence of psychiatric disorders is a reasonable expectation.

PMCID: PMC2100128 PMID: 18092060 [PubMed - indexed for MEDLINE]

121. J Clin Microbiol. 2008 Feb;46(2):772-5. Epub 2007 Dec 12.

Bartonella tamiae sp. nov., a newly recognized pathogen isolated from three human patients from Thailand.

Kosoy M, Morway C, Sheff KW, Bai Y, Colborn J, Chalcraft L, Dowell SF, Peruski LF, Maloney SA, Baggett H, Sutthirattana S, Sidhirat A, Maruyama S, Kabeya H, Chomel BB, Kasten R, Popov V, Robinson J, Kruglov A, Petersen LR.

Centers for Disease Control and Prevention, Division of Vector Borne Infectious Diseases, 3150 Rampart Road, Fort Collins, CO 80521, USA. mkosoy@cdc.gov

Three strains of a novel Bartonella species (Bartonella tamiae) were isolated from human patients from Thailand. Sequence analysis of six chromosomal regions (16S rRNA, gltA, groEL, ftsZ, rpoB, and the intergenic spacer region) and phenotypical analysis supported the similarity of the three strains and placed them within the genus Bartonella separately from previously described species.

PMCID: PMC2238074 PMID: 18077632 [PubMed - indexed for MEDLINE]

122. Infect Immun. 2008 Feb;76(2):788-95. Epub 2007 Dec 10.

A SacB mutagenesis strategy reveals that the Bartonella quintana variably expressed outer membrane proteins are required for bloodstream infection of the host.

MacKichan JK, Gerns HL, Chen YT, Zhang P, Koehler JE.

Microbial Pathogenesis and Host Defense Program and Division of Infectious Diseases, Department of Medicine, University of California at San Francisco, San Francisco, California 94143-0654, USA.

Bartonella bacteria adhere to erythrocytes and persistently infect the mammalian bloodstream. We previously identified four highly conserved Bartonella quintana adhesin genes that undergo phase variation during prolonged bloodstream infection. The variably expressed outer membrane proteins (Vomp) encoded by these genes are members of the trimeric autotransporter adhesin family. Each B. quintana Vomp appears to contribute a different adhesion phenotype, likely mediated by the major variable region at the adhesive tip of each Vomp. Although studies document that the Vomp adhesins confer virulence phenotypes in vitro, little is known about in vivo virulence strategies of Bartonella. We sought to determine whether the B. quintana Vomp adhesins are necessary for infection in vivo by using a vomp null mutant. It first was necessary to develop a system to generate in-frame deletions of defined genes by allelic exchange in a wild-type Bartonella background, which had not been achieved previously. We utilized sacB negative selection to generate a targeted, in-frame, markerless deletion of the entire vomp locus in B. quintana. We also recently developed the first animal model for B. quintana infection, and using this model, we demonstrate here that the deletion of the entire vomp locus, but not the deletion of two vomp genes, results in a null mutant strain that is incapable of establishing bloodstream infection in vivo. The Vomp adhesins therefore represent critical virulence factors in vivo, warranting further study. Finally, our allelic exchange strategy provides an important advance in the genetic manipulation of all Bartonella species and, combined with the animal model that recapitulates human disease, will facilitate pathogenesis studies of B. quintana.

PMCID: PMC2223462 PMID: 18070893 [PubMed - indexed for MEDLINE]

123. Dev Med Child Neurol. 2007 Dec;49(12):931-4.

Encephalopathy with retinitis due to cat-scratch disease.

Smith RA, Scott B, Beverley DW, Lyon F, Taylor R.

Department of Paediatrics, York Hospital, York, UK. robert.a.smith@york.nhs.uk

Cat-scratch disease is one of several diseases known to be caused by Bartonella species. Some infections due to Bartonella resolve spontaneously without treatment with antibiotics, but in other cases the disease can be fatal without treatment. This case study reports a 7-year-old male who presented with an unexplained encephalopathy and unusual retinal findings associated with evidence supporting infection by B. henselae. The 7-year-old male presented with a 2-week history of general malaise and cervical lymphadenopathy progressing onto fever, headache, vomiting, and confusion associated with meningism. Lumbar puncture revealed a raised cerebrospinal fluid protein, low glucose, and raised white cell count. Abnormal retinal findings and raised antibodies titres to B. quintana indicated a diagnosis of cat-scratch disease. He was treated with azithromycin orally for 3 weeks and made a complete recovery.

PMID: 18039241 [PubMed - indexed for MEDLINE]

124. J Clin Microbiol. 2007 Dec;45(12):4081-4. Epub 2007 Oct 17.

Bivalvular Bartonella henselae prosthetic valve endocarditis.

Vikram HR, Bacani AK, DeValeria PA, Cunningham SA, Cockerill FR 3rd.

Division of Infectious Diseases, Mayo Clinic (Phoenix Campus), Phoenix, AZ 85054, USA. vikram.hr@mayo.edu

Prosthetic valve endocarditis is an uncommon manifestation of infection with Bartonella species. Herein, we report a case of Bartonella henselae endocarditis involving prosthetic mitral and aortic valves. The patient had a favorable outcome with combined medical and surgical therapy. Concomitant crescentic glomerulonephritis led to an initial mistaken diagnosis of Wegener's granulomatosis.

PMCID: PMC2168553 PMID: 17942646 [PubMed - indexed for MEDLINE]

125. J Microbiol Methods. 2007 Nov;71(2):147-55. Epub 2007 Aug 24.

Identification of bacteria from clinical samples using Bartonella alpha-Proteobacteria growth medium.

Cadenas MB, Maggi RG, Diniz PP, Breitschwerdt KT, Sontakke S, Breithschwerdt EB.

In an effort to overcome historical problems associated with the isolation of Bartonella species from animal and human blood samples, our laboratory developed a novel, chemically modified, insect-based, liquid culture medium (Bartonella alpha-Proteobacteria growth medium, BAPGM). In this study, we describe the isolation of non-Bartonella bacteria from aseptically obtained human blood and tissue samples that were inoculated into BAPGM pre-enrichment culture medium, and were obtained during attempts to define each individuals Bartonella infection status. After incubation for at least 7 days in liquid BAPGM, pre-enriched inoculums were sub-cultured onto a BAPGM/blood agar plate. Bacterial DNA was extracted from pooled plated colonies and amplified using conventional PCR targeting the 16S rRNA gene. Subsequently, amplicons were cloned, sequenced and compared to GenBank database sequences using the BLAST program. Regardless of the patient's Bartonella status, seventeen samples generated only one 16S rDNA sequence, representing the following genera: Arthrobacter, Bacillus, Bartonella, Dermabacter, Methylobacterium, Propionibacterium, Pseudomonas, Staphylococcus and bacteria listed as "non-cultured" in the GenBank database. Alkalibacterium, Arthrobacter, Erwinia, Kineococcus, Methylobacterium, Propionibacterium, Sphingomonas, and Staphylococcus were isolated from nine Bartonella-infected individuals. Co-isolation of Acinetobacter, Sphingomonas, Staphylococcus spp. and bacteria listed as "non-cultured" in the GenBank database was achieved for four samples in which Bartonella spp. were not detected. Despite the phylogenetic limitations of using partial 16S rRNA gene sequencing for species and strain identification, the investigational methodology described in this study may provide a complementary approach for the isolation and identification of bacteria from patient samples.

PMID: 17889384 [PubMed - indexed for MEDLINE]

126. Am J Trop Med Hyg. 2007 Sep;77(3):567-70.

Bartonella strains in small mammals from Dhaka, Bangladesh, related to Bartonella in America and Europe.

Bai Y, Montgomery SP, Sheff KW, Chowdhury MA, Breiman RF, Kabeya H, Kosoy MY.

Centers for Disease Control and Prevention, Division of Vector Borne Infectious Diseases, Fort Collins, Colorado, USA.

Ecological and bacteriologic observations of small mammals captured in Dhaka, Bangladesh, indicated that Bartonella infections occurred in high prevalence among lesser bandicoot rats (Bandicota bengalensis), black rats (Rattus rattus), and house shrews (Suncus murinus). Sequence analysis of the citrate synthase gene of Bartonella isolates showed that small mammals in Bangladesh harbored a diverse assemblage of strains. Some cultures were genetically related to Bartonella elizabethae, a species identified from a human patient in the United States. Sequences of some other cultures from Bandicota and Rattus rats were identical to sequences of cultures from domestic rats in France, Portugal, and the United States. The finding of Bartonella species in a high proportion of the mammalian samples from Dhaka suggests the need to study whether these agents might be responsible for human cases of febrile illness of unknown etiology in Bangladesh and elsewhere in south Asia.

PMID: 17827381 [PubMed - indexed for MEDLINE]

127. Klin Mikrobiol Infekc Lek. 2007 Jun;13(3):119-21.

[Abscessing lymphadenitis in a 1.5-year-old boy].

[Article in Czech]

Sedlácková L, Bartosová D, Vydrzalová P, Crhová K, Zarosská E, Holcíková A, Habanec T, Janecek D.

Clinic of Chilren's Infectious Diseases, Brno, Czech Republic. sedlaluc@centrum.cz

At present, Bartonella species are increasingly important as infectious agents in both animals and humans. Bartonella henselae, the most frequently diagnosed species, is known to cause numerous clinical syndromes in both immunocompetent and immunocompromised patients. In healthy individuals, the infection is most commonly manifested as the so-called cat scratch disease. The manifestations include erythema or papule at the point of entry of infection (site of injury) and regional lymphadenitis. The aim of the case report is to present the disease as one of possible causes of colliquative cervical lymphadenitis.

PMID: 17703405 [PubMed - indexed for MEDLINE]

128. Rev Sci Tech. 2007 Apr;26(1):203-15.

Vaccines for emerging infections.

Marano N, Rupprecht C, Regnery R.

Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Emerging infectious diseases represent a grave threat to animal and human populations in terms of their impact on global health, agriculture and the economy. Vaccines developed for emerging infections in animals can protect animal health and prevent transmission of zoonotic diseases to humans. Examples in this paper illustrate how industry and public health can collaborate to develop a vaccine to prevent an emerging disease in horses (West Nile virus vaccine), how poultry vaccination can protect animals and prevent transmission to people (avian influenza vaccine), how regulatory changes can pave the way for vaccines that will control the carrier state in animals and thus prevent infection in humans (Bartonella henselae vaccine in cats) and how novel technologies could be applied to vaccinate wildlife reservoir species for rabies. Stemming from the realisation that zoonotic diseases are the predominant source of human emerging infectious diseases, it behoves academic, public health, and animal health agencies to consider creative constructive approaches to combat serious public health challenges. Vaccination of vector/reservoir species, when efficacious vaccines are available, offers significant advantages to combating zoonotic human disease.

PMID: 17633303 [PubMed - indexed for MEDLINE]

129. BMC Microbiol. 2007 Jun 25;7:59.

Microarray for serotyping of Bartonella species.

Bonhomme CJ, Nappez C, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, Faculté de Médecine de Marseille, Marseille cedex 05, France. cyrille.bomhomme@medecine.univ-mrs.fr

BACKGROUND: Bacteria of the genus Bartonella are responsible for a large variety of human and animal diseases. Serological typing of Bartonella is a method that can be used for differentiation and identification of Bartonella subspecies.

RESULTS: We have developed a novel multiple antigenic microarray to serotype Bartonella strains and to select poly and monoclonal antibodies. It was validated using mouse polyclonal antibodies against 29 Bartonella strains. We then tested the microarray for serotyping of Bartonella strains and defining the profile of monoclonal antibodies. Bartonella strains gave a strong positive signal and all were correctly identified. Screening of monoclonal antibodies towards the Gro EL protein of B. clarridgeiae identified 3 groups of antibodies, which were observed with variable affinities against Bartonella strains. CONCLUSION: We demonstrated that microarray of spotted bacteria can be a practical tool for serotyping of unidentified strains or species (and also for affinity determination) by polyclonal and monoclonal antibodies. This could be used in research and for identification of bacterial strains.

PMID: 17593301 [PubMed - indexed for MEDLINE]

130. Vet Res. 2007 Sep-Oct;38(5):697-710. Epub 2007 Jun 23.

Canine bartonellosis: serological and molecular prevalence in Brazil and evidence of co-infection with Bartonella henselae and Bartonella vinsonii subsp. berkhoffii.

Diniz PP, Maggi RG, Schwartz DS, Cadenas MB, Bradley JM, Hegarty B, Breitschwerdt EB.

Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.

The purpose of this study was to determine the serological and molecular prevalence of Bartonella spp. infection in a sick dog population from Brazil. At the São Paulo State University Veterinary Teaching Hospital in Botucatu, 198 consecutive dogs with clinicopathological abnormalities consistent with tick-borne infections were sampled. Antibodies to Bartonella henselae and Bartonella vinsonii subsp. berkhoffii were detected in 2.0% (4/197) and 1.5% (3/197) of the dogs, respectively. Using 16S-23S rRNA intergenic transcribed spacer (ITS) primers, Bartonella DNA was amplified from only 1/198 blood samples. Bartonella seroreactive and/or PCR positive blood samples (n=8) were inoculated into a liquid pre-enrichment growth medium (BAPGM) and subsequently sub-inoculated onto BAPGM/blood-agar plates. PCR targeting the ITS region, pap31 and rpoB genes amplified B. henselae from the blood and/or isolates of the PCR positive dog (ITS: DQ346666; pap31 gene: DQ351240; rpoB: EF196806). B. henselae and B. vinsonii subsp. berkhoffii (pap31: DQ906160; rpoB: EF196805) co-infection was found in one of the B. vinsonii subsp. berkhoffii seroreactive dogs. We conclude that dogs in this study population were infrequently exposed to or infected with a Bartonella species. The B. henselae and B. vinsonii subsp. berkhoffii strains identified in this study are genetically similar to strains isolated from septicemic cats, dogs, coyotes and human beings from other parts of the world. To our knowledge, these isolates provide the first Brazilian DNA sequences from these Bartonella species and the first evidence of Bartonella co-infection in dogs.

PMID: 17583666 [PubMed - indexed for MEDLINE]

131. Clin Infect Dis. 2007 Jul 15;45(2):149-57. Epub 2007 Jun 5.

Counterpoint: long-term antibiotic therapy improves persistent symptoms associated with lyme disease.

Stricker RB.

International Lyme and Associated Diseases Society, Bethesda, MD, USA. rstricker@usmamed.com

Comment on Clin Infect Dis. 2007 Jul 15;45(2):143-8.

BACKGROUND: Controversy exists regarding the diagnosis and treatment of Lyme disease. Patients with persistent symptoms after standard (2-4-week) antibiotic therapy for this tickborne illness have been denied further antibiotic treatment as a result of the perception that long-term infection with the Lyme spirochete, Borrelia burgdorferi, and associated tickborne pathogens is rare or nonexistent.

METHODS: I review the pathophysiology of B. burgdorferi infection and the peer-reviewed literature on diagnostic Lyme disease testing, standard treatment results, and coinfection with tickborne agents, such as Babesia, Anaplasma, Ehrlichia, and Bartonella species. I also examine uncontrolled and controlled trials of prolonged antibiotic therapy in patients with persistent symptoms of Lyme disease.

RESULTS: The complex "stealth" pathology of B. burgdorferi allows the spirochete to invade diverse tissues, elude the immune response, and establish long-term infection. Commercial testing for Lyme disease is highly specific but relatively insensitive, especially during the later stages of disease. Numerous studies have documented the failure of standard antibiotic therapy in patients with Lyme disease. Previous uncontrolled trials and recent placebo-controlled trials suggest that prolonged antibiotic therapy (duration, >4 weeks) may be beneficial for patients with persistent Lyme disease symptoms. Tickborne coinfections may increase the severity and duration of infection with B. burgdorferi.

CONCLUSIONS: Prolonged antibiotic therapy may be useful and justifiable in patients with persistent symptoms of Lyme disease and coinfection with tickborne agents.

PMID: 17578772 [PubMed - indexed for MEDLINE]

132. N Engl J Med. 2007 Jun 7;356(23):2381-7.

Bacteremia, fever, and splenomegaly caused by a newly recognized bartonella species.

Eremeeva ME, Gerns HL, Lydy SL, Goo JS, Ryan ET, Mathew SS, Ferraro MJ, Holden JM, Nicholson WL, Dasch GA, Koehler JE.

Centers for Disease Control and Prevention, Atlanta, USA.

Comment in N Engl J Med. 2007 Jun 7;356(23):2346-7.

Bartonella species cause serious human infections globally, including bacillary angiomatosis, Oroya fever, trench fever, and endocarditis. We describe a patient who had fever and splenomegaly after traveling to Peru and also had bacteremia from an organism that resembled Bartonella bacilliformis, the causative agent of Oroya fever, which is endemic to Peru. However, genetic analyses revealed that this fastidious bacterium represented a previously uncultured and unnamed bartonella species, closely related to B. clarridgeiae and more distantly related to B. bacilliformis. We characterized this isolate, including its ability to cause fever and sustained bacteremia in a rhesus macaque. The route of infection and burden of human disease associated with this newly described pathogen are currently unknown.

PMID: 17554119 [PubMed - indexed for MEDLINE]

133. N Engl J Med. 2007 Jun 7;356(23):2346-7.

Discovery of new infectious diseases - bartonella species.

Wormser GP.

Division of Infectious Diseases at New York Medical College, Valhalla, USA.

Comment on N Engl J Med. 2007 Jun 7;356(23):2381-7.

PMID: 17554115 [PubMed - indexed for MEDLINE]

134. Emerg Infect Dis. 2007 Jun;13(6):938-41.

Bartonella species in blood of immunocompetent persons with animal and arthropod contact.

Breitschwerdt EB, Maggi RG, Duncan AW, Nicholson WL, Hegarty BC, Woods CW.

North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina 27606, USA. ed_breitschwerdt@ncsu.edu

Using PCR in conjunction with pre-enrichment culture, we detected Bartonella henselae and B. vinsonii subspecies berkhoffii in the blood of 14 immunocompetent persons who had frequent animal contact and arthropod exposure.

PMCID: PMC2792845 PMID: 17553243 [PubMed - indexed for MEDLINE]

135. Pol J Microbiol. 2007;56(1):33-8.

Presence of Bartonella spp. in various human populations.

Chmielewski T, Podsiadły E, Tylewska-Wierzbanowska S.

National Institute of Hygiene, Warsaw, Poland.

Bartonella spp. bacteria are significant human pathogens and the agents of bacterial zoonosis acquired from an animal companion. The aim of the study was to determine the seroprevalence of two of the most common Bartonella species B. henselae and B. quintana in various human populations. The studied groups included: alcoholics, intravenous drug users, veterinarians, cats' owners. Blood samples were collected and cultured on chocolate agar plates and in mouse fibroblasts L-929 cell line culture. The levels of Bartonella henselae IgM and IgG antibodies were determined by indirect immunofluorescence assay. Specific B. henselae IgG were detected in 48.3% of homeless alcoholics, in 45.0% veterinarians and in 53.3% cats' owners. The differences in the prevalence of B. henselae antibodies between the studied groups and a control group were statistically supported. No homeless intravenous drug users had specific B. henselae and B. quintana antibodies. High titers of B. quintana IgG antibodies were detected in two homeless alcoholics. Bartonella spp. was cultured on chocolate blood agar plates from blood samples from 2 alcoholics. The isolates were identified as B. henselae by PCR amplification of the riboflavin synthase gene (ribC). The results prove that B. henselae and B. quintana, emerging human pathogens, are present and widely distributed in Poland in such specific risk groups as: alcoholics, veterinarians and cats' owners.

PMID: 17419187 [PubMed - indexed for MEDLINE]

136. Med Trop (Mars). 2006 Oct;66(5):429-35.

[Phlebotomine sandflies and transmission of disease agents around the Mediterranean basin].

[Article in French]

Izri A, Depaquit J, Parola P.

L'Unité de Parasitologie de I'Hôpital Avicenne, UFR SMBH, Université Paris. arezki.izri@avc.aphp.fr

Around 800 species of phlebotomine sandflies are widely distributed in tropical and temperate areas. Some sand flies are documented vectors of human disease agents including parasitic protozoa, (Leishmania spp), bacteria (Bartonella bacilliformis) and viruses (phlebovirus). In addition to presenting morphologic, taxonomic and biologic aspects of Phlebotomine sandflies, this report focuses on ecologic, epidemiologic, ethologic, and anthropic factors contributing to the proliferation of sand flies as exemplified by zoonotic cutaneous and visceral leishmaniases around the Mediterranean basin.

PMID: 17201284 [PubMed - indexed for MEDLINE]

137. Enferm Infecc Microbiol Clin. 2006 Nov;24(9):597.

[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].

[Article in Spanish]

Pérez-Irezábal J, Aguirrebengoa K, Cilla G.

Comment on Enferm Infecc Microbiol Clin. 2006 May;24(5):297-301.

PMID: 17125688 [PubMed - indexed for MEDLINE]

138. Ann N Y Acad Sci. 2006 Oct;1078:410-5.

Bartonella infection in domestic cats and wild felids.

Chomel BB, Kasten RW, Henn JB, Molia S.

D.V.M., Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, CA 95616, USA. bbchomel@ucdavis.edu

Bartonella are vector-borne, fastidious Gram-negative bacteria causing persistent bacteremia in their reservoir hosts. Felids represent a major reservoir for several Bartonella species. Domestic cats are the main reservoir of B. henselae, the agent of cat-scratch disease. Prevalence of infection is highest in warm and humid climates that are optimal for the survival of cat fleas, as fleas are essential for the transmission of the infection. Flea feces are the likely infectious substrate. Prevalence of B. henselae genotypes among cat populations varies worldwide. Genotype Houston I is more prevalent in the Far East and genotype Marseille is dominant in western Europe, Australia, and the western United States. Cats are usually asymptomatic, but uveitis, endocarditis, neurological signs, fever, necrotic lesions at the inoculation site, lymphadenopathy, and reproductive disorders have been reported in naturally or experimentally infected cats. Domestic cats are also the reservoir of B. clarridgeiae and co-infection has been demonstrated. B. koehlerae has been isolated from domestic cats, and was identified in cat fleas and associated with a human endocarditis case. B. bovis was isolated from a few cats in the United States and B. quintana DNA was recently identified in a cat tooth. Bartonella spp. have also been isolated from free-ranging and captive wild felids from North America and Africa. Whereas, B. henselae was identified in African lions and a cheetah, some strains specific to these wild cats have also been identified, leading to the concept of a B. henselae group including various subspecies, as previously described for B. vinsonii.

PMID: 17114749 [PubMed - indexed for MEDLINE]

139. Ann N Y Acad Sci. 2006 Oct;1078:223-35.

Arthropod-borne diseases in homeless.

Brouqui P, Raoult D.

Unité des rickettsies, CNRS UMR 6020, IFR 48, Faculté de médecine, 27 bd, J Moulin, 13385 Marseille, cedex 5, France. philippe.brouqui@medecine.univ-mrs.fr

Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people.

PMID: 17114713 [PubMed - indexed for MEDLINE]

140. Curr Opin Infect Dis. 1998 Apr;11(2):189-93.

Bartonella infections: diagnostic and management issues.

Maurin M, Raoult D.

Unité des Rickettsies, CNRS UPRES A 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France.

Bartonella species are emerging pathogens. Renewed interest in this group of bacteria has been highlighted by the recent description of new species, which are pathogenic for humans (Bartonella elizabethae and Bartonella clarridgeae), and their association with an increasing number of clinical manifestations, the more prevalent being cat scratch disease, bacillary angiomatosis, and culture-negative endocarditis.

PMID: 17033388 [PubMed]

141. J Antimicrob Chemother. 2006 Oct;58(4):784-8. Epub 2006 Aug 17.

In vitro susceptibility of Bartonella species to 17 antimicrobial compounds: comparison of Etest and agar dilution.

Dörbecker C, Sander A, Oberle K, Schülin-Casonato T.

Institute for Medical Microbiology and Hygiene, University of Freiburg, Germany. christina.doerbecker@uk-koeln.de

OBJECTIVES: In vitro susceptibility testing of 31 Bartonella spp. strains including 21 Bartonella henselae isolates was performed for 17 antimicrobial agents (telithromycin, four macrolides, five fluoroquinolones, five aminoglycosides, doxycycline and rifampicin).

METHODS: MICs were determined by agar dilution and Etest using chocolate agar containing 5% defibrinated sheep blood as assay medium. Longer incubation periods of 3-5 days in a humid atmosphere with 5% CO(2) were required until bacterial growth became visible and MICs could be read.

RESULTS: The ketolide telithromycin was the most active agent exhibiting the lowest MICs. The Bartonella spp. were also highly susceptible to macrolides, particularly clarithromycin, and to doxycycline and rifampicin, with MICs of

CONCLUSIONS: Telithromycin, macrolides, doxycycline and rifampicin were the most effective agents against Bartonella spp. Our data confirm that Etest may be a reliable method for determining susceptibility of Bartonella spp.

PMID: 16916864 [PubMed - indexed for MEDLINE]

142. Int J Syst Evol Microbiol. 2006 Aug;56(Pt 8):1823-9.

Description of Pseudochrobactrum gen. nov., with the two species Pseudochrobactrum asaccharolyticum sp. nov. and Pseudochrobactrum saccharolyticum sp. nov.

Kämpfer P, Rosselló-Mora R, Scholz HC, Welinder-Olsson C, Falsen E, Busse HJ.

Institut für Angewandte Mikrobiologie, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 26-32, D-35392 Giessen, Germany. peter.kaempfer@agrar.uni-giessen.de

Two Gram-negative, rod-shaped, oxidase-positive, non-spore-forming, non-motile bacteria (CCUG 46016(T) and CCUG 33852(T)), isolated from a knee aspirate of a 66-year-old man and an industrial glue, respectively, were studied for their taxonomic position. On the basis of chemotaxonomic data [i.e. major ubiquinone (Q-10), major polar lipids (phosphatidylethanolamine, phosphatidylglycerol and phosphatidylcholine) and major fatty acids (C(18 : 1)omega7c and C(19 : 0) cyclo omega8c)] and 16S rRNA gene sequence similarity, both strains belong to the Alphaproteobacteria. The presence of spermidine and putrescine as the predominant polyamines in CCUG 46016(T) were in agreement with its phylogenetic affiliation in the vicinity of the genus Ochrobactrum. 16S rRNA gene sequence similarities between both strains and established species within the genera Bartonella, Ochrobactrum and Brucella were less than 95 %. Although both organisms showed highest 16S rRNA gene sequence similarity to members of Brucella, phenotypic features (including chemotaxonomic features) were more like those of members of the genus Ochrobactrum. Sequence comparison of the recA genes confirmed the separate phylogenetic position of the two strains. On the basis of DNA-DNA pairing results and physiological and biochemical data, the two strains can be clearly differentiated from each other and from all known Ochrobactrum species. It is evident that these organisms represent two novel species in a new genus, Pseudochrobactrum gen. nov., for which the names Pseudochrobactrum asaccharolyticum sp. nov. (the type species, type strain CCUG 46016(T)=CIP 108977(T)) and Pseudochrobactrum saccharolyticum sp. nov. (type strain CCUG 33852(T)=CIP 108976(T)) are proposed.

PMID: 16902015 [PubMed - indexed for MEDLINE]

143. J Wildl Dis. 2006 Apr;42(2):391-6.

Bartonella spp. in deer keds, Lipoptena mazamae (Diptera: Hippoboscidae), from Georgia and South Carolina, USA.

Reeves WK, Nelder MP, Cobb KD, Dasch GA.

Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop G-13, Atlanta, Georgia 30333, USA. wreeves@alumni.clemson.edu

Deer keds, Lipoptena mazamae (Diptera: Hippoboscidae), were collected from white-tailed deer (Odocoileus virginianus) and humans in Georgia and South Carolina, USA (1 October 2001-6 January 2005) and screened for the presence of DNA from Bartonella spp. Forty deer keds were screened for Bartonella spp. by polymerase chain reaction using primers specific to the riboflavin synthase gene (ribC) of Bartonella. Bartonella species closely related to Bartonella schoenbuchensis and to the etiologic agent of cat-scratch disease (Bartonella henselae) were detected in 10 keds and one ked, respectively.

PMID: 16870863 [PubMed - indexed for MEDLINE]

144. Am J Trop Med Hyg. 2006 Jul;75(1):41-8.

Surveillance of Egyptian fleas for agents of public health significance: Anaplasma, Bartonella, Coxiella, Ehrlichia, Rickettsia, and Yersinia pestis.

Loftis AD, Reeves WK, Szumlas DE, Abbassy MM, Helmy IM, Moriarity JR, Dasch GA.

Viral and Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia 30333. aloftis@cdc.gov

Serologic surveys in Egypt have documented human and animal exposure to vector-borne bacterial pathogens, but the presence and distribution of these agents in arthropods has not been determined. Between July 2002 and July 2003, fleas were collected from 221 mammals trapped in 17 cities throughout Egypt. A total of 987 fleas were collected, representing four species (Ctenocephalides felis, Echidnophaga gallinacea, Leptopsylla segnis, and Xenopsylla cheopis); 899 of these fleas were X. cheopis from rats (Rattus spp.). Fleas were tested for DNA from Anaplasma spp., Bartonella spp., Coxiella burnetii, Ehrlichia spp., Rickettsia spp., and Yersinia pestis. Rickettsia typhi, the agent of murine typhus, was detected in X. cheopis and L. segnis from rats from nine cities. A spotted-fever group Rickettsia sp. similar to "RF2125" was detected in E. gallinacea, and two unidentified spotted fever group Rickettsia were detected in two X. cheopis. Novel Bartonella genotypes were detected in X. cheopis and L. segnis from three cities. Coxiella burnetii was detected in two fleas. Anaplasma, Ehrlichia, and Y. pestis were not detected.

PMID: 16837707 [PubMed - indexed for MEDLINE]

145. Emerg Infect Dis. 2006 Jul;12(7):1081-6.

Rodent-associated Bartonella febrile illness, Southwestern United States.

Iralu J, Bai Y, Crook L, Tempest B, Simpson G, Mckenzie T, Koster F.

US Public Health Service, Gallup, New Mexico, USA.

Serum specimens from 114 patients hospitalized with a febrile illness were tested with an indirect immunofluorescence assay (IFA) using Bartonella antigens prepared from 6 species of sigmodontine rodents and 3 known human Bartonella pathogens: B. henselae, B. quintana, and B. elizabethae. Acute- and convalescent-phase serum samples from 5 of these patients showed seroconversion with an IFA titer >512 to rodent-associated Bartonella antigens. The highest titer was against antigen derived from the white-throated woodrat (Neotoma albigula), although this rodent is not necessarily implicated as the source of infection. Three of the 5 who seroconverted showed no cross-reaction to the 3 Bartonella human pathogens. Common clinical characteristics were fever, chills, myalgias, leukopenia, thrombocytopenia, and transaminasemia. Although antibodies to Bartonella are cross-reactive, high-titer seroconversions to rodent-associated Bartonella antigens in adults with common clinical characteristics should stimulate the search for additional Bartonella human pathogens.

PMID: 16836824 [PubMed - indexed for MEDLINE]

146. Exp Appl Acarol. 2006;39(3-4):321-9. Epub 2006 Jul 5.

Borrelia, Coxiella, and Rickettsia in Carios capensis (Acari: Argasidae) from a brown pelican (Pelecanus occidentalis) rookery in South Carolina, USA.

Reeves WK, Loftis AD, Sanders F, Spinks MD, Wills W, Denison AM, Dasch GA.

Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS G-13, Atlanta, GA 30333, USA. cui8@cdc.gov

Argasid ticks are vectors of viral and bacterial agents of humans and animals. Carios capensis, a tick of seabirds, infests the nests of brown pelicans, Pelecanus occidentalis, and other ground nesting birds along the coast of South Carolina. This tick is associated with pelican nest abandonment and could pose a threat to humans visiting pelican rookeries if visitors are exposed to ticks harboring infectious agents. We collected ticks from a pelican rookery on Deveaux Bank, South Carolina and screened 64 individual ticks, six pools of larvae, and an egg mass for DNA from Bartonella, Borrelia, Coxiella, and Rickettsia by polymerase chain reaction amplification and sequencing. Ticks harbored DNA from "Borrelia lonestari", a novel Coxiella sp., and three species of Rickettsia, including Rickettsia felis and two undescribed Rickettsia spp. DNA from the Coxiella and two undescribed Rickettsia were detected in unfed larvae that emerged in the laboratory, which implies these agents are transmitted vertically by female ticks. We partially characterize the novel Coxiella by molecular means.

PMID: 16821092 [PubMed - indexed for MEDLINE]

147. Enferm Infecc Microbiol Clin. 2006 May;24(5):297-301.

[Endocarditis due to Bartonella spp. Three new clinical cases and Spanish literature review].

[Article in Spanish]

Oteo JA, Castilla A, Arosey A, Blanco JR, Ibarra V, Morano LE.

Area de Enfermedades Infecciosas, Complejo Hospitalario San Millán-San Pedro de La Rioja, Hospital de La Rioja, Logroño, España. jaoteo@riojasalud.es

Comment in Enferm Infecc Microbiol Clin. 2006 May;24(5):295-6. Enferm Infecc Microbiol Clin. 2006 Nov;24(9):597.

INTRODUCTION: Infections by Bartonella spp. include a wide spectrum of emerging and re-emerging infectious diseases, such as culture-negative endocarditis.

METHODS: Description of 3 cases of endocarditis due to Bartonella spp. and review of those previously reported in Spain.

RESULTS: Including these 3 new cases of endocarditis due to Bartonella spp., a total of 6 cases have been reported in Spain. The median age of the patients was 51.6 years and 83.3% were men. There was history of contact with cats in 66.7%, and 50% were alcoholic. Only one patient had prior valvular disease. There were no clinical manifestations typical to any of the Bartonella species. The aortic valve was the one most commonly affected. In all cases, B. henselae was the agent implicated. The diagnosis was made by serology in 5 cases (83.3%). The outcome was favorable in all patients, although 4 of them (66.7%) required valve replacement. CONCLUSION: Endocarditis due to Bartonella spp. is present in Spain and is likely to be underestimated. We should suspect this pathogen in patients with negative blood cultures and a history of chronic alcoholism, homeless patients, and those who have had contact with cats or who have been bitten by fleas or lice, as well as patients with endocarditis and positive serology against Chlamydia spp.

PMID: 16762254 [PubMed - indexed for MEDLINE]

148. Ann Med. 2006;38(4):263-73.

Aetiological diagnosis of infective endocarditis by direct amplification of rRNA genes from surgically removed valve tissue. An 11-year experience in a Finnish teaching hospital.

Kotilainen P, Heiro M, Jalava J, Rantakokko V, Nikoskelainen J, Nikkari S, Rantakokko-Jalava K.

Department of Medicine, Turku University Hospital, Finland. pirkko.kotilainen@utu.fi

BACKGROUND/AIMS: The aetiology of infective endocarditis (IE) can be determined directly from surgically removed valve tissue using broad-range bacterial rDNA polymerase chain reaction (PCR) followed by sequencing. We sought to assess the value of this methodology in a routine clinical setting.

METHODS: Broad-range PCR with primers targeting conserved bacterial rDNA sequences was applied to directly analyse valve samples from 56 patients operated on for diagnosed or suspected IE. Identification of the aetiological agent was performed by partial DNA sequencing of the 16S and 23S rDNA genes.

RESULTS: The final diagnosis was definite IE in 36 patients and possible IE in 2 patients, while the diagnosis of IE was rejected in 18 patients. PCR analysis from removed valve tissue was positive in 25 patients with IE. Molecular identification was consistent with the blood culture finding in 20 of these patients. The PCR approach was the only method to yield the aetiological diagnosis in additional 4 patients (2 Staphylococcus species, 1 Streptococcus bovis, 1 Bartonella quintana), all of whom had received antimicrobials before blood cultures were taken. The mean duration of preoperative antimicrobial treatment for the patients with PCR-positive valves was 19.6 (range 1-58) days.

CONCLUSIONS: Bacterial DNA may persist during treatment in infected valves for long periods. The PCR method is especially useful when the causative agent of IE is fastidious or when the specimen is taken during antimicrobial treatment.

PMID: 16754257 [PubMed - indexed for MEDLINE]

149. J Parasitol. 2006 Apr;92(2):313-8.

Louse-borne bacterial pathogens in lice (Phthiraptera) of rodents and cattle from Egypt.

Reeves WK, Szumlas DE, Moriarity JR, Loftis AD, Abbassy MM, Helmy IM, Dasch GA.

Centers for Disease Control and Prevention; 1600 Clifton Rd. NE, MS G-13, Atlanta, Georgia 30333, USA. wreeves@alumni.clemson.edu

We collected 1,023 lice, representing 5 species, from rats and domestic cattle throughout 13 governorates in Egypt and tested these lice for Anaplasma marginale, Bartonella spp., Brucella spp., Borrelia recurrentis, Coxiella burnetii, Francisella tularensis, and Rickettsia spp. by PCR amplification and sequencing. Five different louse-borne bacterial agents were detected in lice from rodents or cattle, including "Bartonella rattimassiliensis", "B. phoceensis", and Bartonella sp. near Bartonella tribocorum, Coxiella burnetii, and Rickettsia typhi. More lice from governorates bordering the Mediterranean and Red Seas contained pathogens. Our data indicate that lice of urban and domestic animals harbor pathogenic or potentially pathogenic bacterial agents throughout Egypt.

PMID: 16729688 [PubMed - indexed for MEDLINE]

150. Infect Immun. 2006 Jun;74(6):3251-61.

Environmental signals generate a differential and coordinated expression of the heme receptor gene family of Bartonella quintana.

Battisti JM, Sappington KN, Smitherman LS, Parrow NL, Minnick MF.

Division of Biological Sciences, The University of Montana, Missoula, MT 59812, USA.

Of all bacteria, Bartonella quintana has the highest reported in vitro hemin requirement, yet an explanation for this remains elusive. To produce diseases such as trench fever, endocarditis, and bacillary angiomatosis, B. quintana must survive and replicate in the disparate environments of the Pediculus humanus corporis (body louse) gut and the human vasculature. We previously identified a five-member family of hemin binding proteins (Hbps) synthesized by B. quintana that bind hemin on the outer surface but share no similarity to known bacterial heme receptors. In the present study, we examine the transcription, regulation, and synthesis of this virulence factor family by cultivation of the bacterium in environments that simulate natural heme, oxygen, and temperature conditions encountered in the host and insect vector. First, quantitative real-time PCR data show that hbpC expression is regulated by temperature, where a >100-fold increase in transcript quantity was seen at 30 degrees C relative to 37 degrees C, suggesting that HbpC synthesis would be greatest in the cooler temperature of the louse. Second, cultivation at human bloodstream oxygen concentration (5% relative to 21% atmospheric) significantly decreases the transcript quantity of all hbp genes, indicating that expression is influenced by O2 and/or reactive oxygen species. Third, a differential expression pattern within the hbp family is revealed when B. quintana is grown in a range of hemin concentrations: subgroup I (hbpC and hbpB) predominates in a simulated louse environment (high heme), and subgroup II (hbpA, hbpD, and hbpE) is preferentially expressed in a simulated human background (low heme). By using two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis, immunoblotting, and matrix-assisted laser desorption ionization-time of flight mass spectrometry fingerprinting, we demonstrate that synthesis of HbpA correlates with hbpA transcript increases observed at low hemin concentrations. Finally, an hbpA promoter-lacZ reporter construct in B. quintana demonstrates that a transcriptional regulator(s) is controlling the expression of hbpA through a cis-acting regulatory element located in the hbpA promoter region.

PMCID: PMC1479232 PMID: 16714552 [PubMed - indexed for MEDLINE]

151. J Infect Dis. 2006 Jun 15;193(12):1711-7. Epub 2006 May 12.

Autoimmunohistochemistry: a new method for the histologic diagnosis of infective endocarditis.

Lepidi H, Coulibaly B, Casalta JP, Raoult D.

Unite des Rickettsies et des Pathogenes Emergents, Centre National de la Recherche Scientifique, Unite Mixte de Recherche 6020, Institut Federatif de Recherche 48, Universite de la Mediterranee, Marseille, France. hubert.lepidi@medecine.univ-mrs.fr

BACKGROUND: Although the pathologic examination of cardiac valves remains the reference standard for the diagnosis of infective endocarditis, the detection of microorganisms often poses a challenge for pathologists. This can be done by use of nonspecific histochemical stains or by immunohistochemical analysis, but specific antibodies are often not available. We describe a novel method for the detection of microorganisms in valve specimens from patients with infective endocarditis.

METHODS: Detection of microorganisms was performed in valve specimens from patients with endocarditis caused by gram-positive cocci (25 specimens), blood culture-negative endocarditis (15 specimens: 6 cases caused by Coxiella burnetii, 5 caused by Tropheryma whipplei, and 4 caused by Bartonella species), or noninfective degenerative damage (30 specimens, used as negative controls), using the patients' own serum. This technique, called "autoimmunohistochemistry," is an immunohistochemical peroxidase-based method that we compared with results of culture and polymerase chain reaction (PCR) assay.

RESULTS: Bacteria were detected by autoimmunohistochemistry in 20 (80%) specimens from patients with endocarditis caused by gram-positive cocci and in 15 (100%) specimens from patients with blood culture-negative endocarditis but in no control specimens. The rate of detection of bacteria by autoimmunohistochemistry was significantly higher than that by culture but was similar to that by PCR.

CONCLUSIONS: Autoimmunohistochemistry may be useful for the detection of microorganisms in samples of valves from patients with infective endocarditis. This new diagnostic tool may be particularly useful in cases of blood culture-negative endocarditis.

PMID: 16703515 [PubMed - indexed for MEDLINE]

152. Zhonghua Liu Xing Bing Xue Za Zhi. 2005 Nov;26(11):868-70.

[Study on Bartonella species in rodents in western Yunnan, China].

[Article in Chinese]

Bai HM, Yang FL, Yang H, Zhang Q.

Yunnan Institute of Endemic Disease Control and Prevention, Dali 671000, China.

OBJECTIVE: To study the infection status of Bartonella spp. in rodents in western part of Yunnan province.

METHODS: Blood samples were collected from four species of rodents captured in four counties in western Yunnan in 2004. Bartomella was isolated through being cultured in brain and heart infusion agar media containing 5% rabbit blood. Suspective Bartomella strains isolates were confirmed by amplification of 379 bp of citrate synthase (gltA) gene with specific primer by polymerase chin reaction (PCR).

RESULTS: Fifty-four strains of Bartomella isolates were obtained from 397 samples including four rodent species captured in the fields with an overall isolation-rate of 13.6% (54/397). The rates of isolation among different species were: 22.0% (22/100) in Rattus nitidus, 14.8% (31/210) in Rattus flavipectus and 1.2%(1/87) in Rattus norvegicus while in R. t. yunnanensis it was negative. CONCLUSION: These findings demonstrated that the local rodents in western Yunnan were widely infected by Bartomella spp. It is indispensable to study the vector and the route of transmission to discover the relations between Bartomella and human diseases.

PMID: 16676607 [PubMed - indexed for MEDLINE]

153. Vet Res. 2006 Jul-Aug;37(4):565-77. Epub 2006 Apr 28.

Cat-scratch disease in veterinary-associated populations and in its cat reservoir in Taiwan.

Chang CC, Lee CC, Maruyama S, Lin JW, Pan MJ.

Graduate Institute of Veterinary Public Health, School of Veterinary Medicine, National Chung Hsing University, Taichung 402, Taiwan.

In Taiwan, the first human case of cat-scratch disease (CSD) was diagnosed by a serologic test in 1998. Since then, no studies have been conducted to understand the epidemiology of the infection in Taiwan. Therefore, this study is the first epidemiologic survey of CSD in cats and humans in this country. Using veterinary-associated individuals as the study population, it was identified that 1.7% of them were seropositive for B. henselae, and residence was the only factor associated with seropositivity. Bartonella species were successfully isolated from 25 (19.1%) of the 131 cats tested. Only B. henselae and B. clarridgeiae were obtained from bacteremic cats. Furthermore, 9.2% of 131 cats were dually-infected with genotypes I and II of B. henselae. It is the highest prevalence of co-infection that has ever been reported worldwide. In cats, the seroprevalence was 23.7% by indirect immunofluorescence antibody assay with B. henselae Houston-1 (type I) as the antigen. When 12 bacteremic but seronegative cats were re-tested by IFA slides coated with B. henselae U-4 antigen (type II), 9 cats were identified to be seropositive. Our study further suggested that using only direct PCR of 16S-23S rRNA intergenic region or the combination of the PCR method and indirect immuno-fluorescence test will be useful to diagnose Bartonella-free cats.

PMID: 16641017 [PubMed - indexed for MEDLINE]

154. Southeast Asian J Trop Med Public Health. 2005 Nov;36(6):1523-9.

Bartonella species in rodents and shrews in the greater Jakarta area.

Winoto IL, Goethert H, Ibrahim IN, Yuniherlina I, Stoops C, Susanti I, Kania W, Maguire JD, Bangs MJ, Telford SR 3rd, Wongsrichanalai C.

U.S. Naval Medical Research Unit No. 2, Jakarta, Indonesia.

In February 2004, we captured 221 rodents and shrews in the Greater Jakarta area as part of a study to determine the prevalence of rodent-associated vector-borne infections. Microscopic examination of blood smears revealed 6% (13/218) to be positive for Bartonella spp. The corresponding DNA samples, either from blood blots or frozen spleen pieces and from fleas collected on these animals, were tested for evidence of Bartonella infection by PCR, targeting the portions: 378bp and 930bp of the citrate synthase gene (g/tA). The sequences from our sample clusters with a Peruvian entity, B. phoceensis, B. rattimassiliensis and B. elizabethae, the latter species has been associated with endocarditis and neuroretinitis in humans. As previous analyses have shown, there appears to be little geographic or host consistency with phylogenetic placement. The public health significance of these findings remains to be determined.

PMID: 16610656 [PubMed - indexed for MEDLINE]

155. Am J Trop Med Hyg. 2006 Apr;74(4):526-31.

Experimental infection of human body lice with Acinetobacter baumannii.

Houhamdi L, Raoult D.

Unité des Rickettsies, Institut Fédératif de Recherche 48, Centre National de Recherche Scientifique, Marseille, France.

The human body louse is currently recognized as a vector of Rickettsia prowazekii, Borrelia recurrentis, and Bartonella quintana. Previous studies have reported the isolation of Acinetobacter baumannii from the body lice of homeless patients. To study how the body louse acquires A. baumannii, we infected a rabbit by infusing 2 x 10(6) colony-forming units of the louse strain of A. baumannii. Two hundred body lice were infected by feeding on the bacteremic rabbit and compared with 200 uninfected lice and two groups of 200 lice feeding on rabbits infected either with another strain of A. baumannii or A. lwoffii. Each louse group received maintenance feedings once a day on another seronegative rabbit. Body lice that fed on rabbits infused with each Acinetobacter species demonstrated a generalized infection. The body lice did not transmit their infection to the nurse rabbit by bite while feeding or to their progeny (eggs and larvae). The lice excreted living Acinetobacter species within their feces. Only the louse strain of A. baumannii was pathogenic for the body louse. An increased mortality rate was observed between the second and third days post-infection; however, they remained infected for their lifespan.

PMID: 16606978 [PubMed - indexed for MEDLINE]

156. J Vector Ecol. 2005 Dec;30(2):339-41.

Molecular evidence for novel bartonella species in Trichobius major (Diptera: Streblidae) and Cimex adjunctus (Hemiptera: Cimicidae) from two southeastern bat caves, U.S.A.

Reeves WK, Loftis AD, Gore JA, Dasch GA.

Centers for Disease Control and Prevention, Viral and Rickettsial Zoonoses Branch, 1600 Clifton Rd NE, Mailstop G-13, Atlanta, GA 30333, USA.

PMID: 16599175 [PubMed - indexed for MEDLINE]

157. J Vector Ecol. 2005 Dec;30(2):310-5.

Bartonella and Rickettsia in fleas and lice from mammals in South Carolina, U.S.A.

Reeves WK, Nelder MP, Korecki JA.

Centers for Disease Control and Prevention, Viral and Rickettsial Zoonoses Branch, Mailstop G-13, 1600 Clifton Rd NE, Atlanta, GA 30333, USA.

Species in the genera Bartonella and Rickettsia are vector-borne pathogens of humans and domestic animals. The natural reservoirs and enzootic transmission cycles of these bacteria are poorly known in South Carolina. Thirteen species of lice and fleas were collected from urban animals and screened for the presence of Bartonella and Rickettsia by PCR amplification using genus-specific primers. Bartonella henselae was present in cat fleas (Ctenocephalides felis) from Virginia opossums (Didelphis virginiana) and a novel genotype of Bartonella was detected in Orchopeas howardi from an eastern gray squirrel (Sciurus carolinensis). We detected R. typhi and three novel genotypes Rickettsia in other species of fleas and lice. Rickettsia typhi, the causative agent of murine typhus, was detected in two pools of lice (Enderleinellus marmotae) from the woodchuck (Marmota monax). Cat fleas harbored one of two novel genotypes of Rickettsia. A third novel Rickettsia was detected in Orchopeas howardi from an eastern gray squirrel.

PMID: 16599169 [PubMed - indexed for MEDLINE]

158. Eur J Oncol Nurs. 2006 Apr;10(2):117-27. Epub 2006 Apr 3.

Pet ownership in immunocompromised children--a review of the literature and survey of existing guidelines.

Hemsworth S, Pizer B.

Oncology Unit, Royal Liverpool Children's NHS Trust, Eaton Road, Liverpool, UK. Sue.Hemsworth@rlc.nhs.uk

Pet ownership has been associated with both emotional and physical health benefits. However, owning pets may also pose health risks to immunocompromised patients through zoonotic transmission of disease. Our initial impression was that there is a lack of any evidence base in information given by health care professionals regarding these risks. We therefore aimed to produce evidence-based guidelines addressing this issue. A Pubmed search was undertaken and a variety of literature on zoonoses reviewed. Existing guidelines were evaluated and a survey of all Paediatric Oncology Centres in the UK performed. There is a paucity of level 1 and 2 data addressing this issue and clearly more studies, particularly Randomised Controlled Trials (RCTs), are required. Nevertheless, general themes emerged and certain specific guidance was produced based on that produced by the Centres for Disease Control and Prevention in the US. Animal-associated pathogens of concern include Toxoplasma gondii, Cryptosporidium spp., Salmonella spp., Campylobacter spp., Giardia lamblia, Rhodococcus equi, Bartonella spp., Bordetella bronchiseptica, Chlamydia psittaci and dermatophytes. Despite this, the literature would suggest that with the exception of Bartonella henselae and dermatophytes only a relatively small number of infections in people are likely to be associated with pet contact. The majority of pet species do not appear to pose a major risk to immunocompromised children. Some animals, particularly reptiles, should be avoided because of the high risk of salmonellosis. Guidelines include general advice on good hygiene practices, veterinary care, pet foods, purchasing of new pets and age restrictions. Health care professionals should actively enquire about household pets and provide accurate information and practical advice on how to minimise the risk of infection. However, the overall benefits of the human-animal bond must be considered and with proper handling and husbandry immunocompromised patients should be able to continue to enjoy the significant benefits of pet ownership.

PMID: 16581294 [PubMed - indexed for MEDLINE]

159. Am J Trop Med Hyg. 2006 Mar;74(3):436-9.

Molecular detection of Bartonella quintana, B. Elizabethae, B. Koehlerae, B. Doshiae, B. Taylorii, and Rickettsia felis in rodent fleas collected in Kabul, Afghanistan.

Marié JL, Fournier PE, Rolain JM, Briolant S, Davoust B, Raoult D.

Secteur Vétérinaire Interarmées, Service de Santé des Armées, Toulouse, France. jean-lou.marie@wanadoo.fr

The prevalences of Bartonella spp. and Rickettsia spp. were investigated using molecular methods in 77 rodent fleas collected in November 2002 by the French forces detachment in Kabul, Afghanistan. Overall, Bartonella DNA was detected in 15.5% of gerbil fleas and 40.5% of rat fleas, whereas Rickettsia felis was found in 9% of gerbil fleas. We described for the first time in this country Bartonella quintana, B. koehlerae, B. taylorii, and Rickettsia felis in fleas from the gerbil species Meriones lybicus, and B. elizabethae and B. doshiae in rat fleas. Of these, B. quintana, B. elizabethae, B. koehlerae, and R. felis are recognized human pathogens. These results emphasize the potential risk of flea-borne infections transmitted by rodents in this area, and suggest that preventive measures should be taken in the general framework of zoonoses management.

PMID: 16525103 [PubMed - indexed for MEDLINE]

160. Med Hypotheses. 2006;67(1):21-6. Epub 2006 Mar 3.

Do dogs harbour risk factors for human breast cancer?

Laumbacher B, Fellerhoff B, Herzberger B, Wank R.

Institute of Immunology, Klinikum Innenstadt, University of Munich, Goethestrasse 31, 80336 Muenchen, Germany.

We ask consulting patients regularly whether they keep pets in order to identify zoonotic factors. It became apparent that patients with breast carcinoma (N=69) owned significantly more often dogs but not cats compared to age matched female controls. We compared the frequencies of dog and pet ownership with data from public available statistics on women (N=1320) of the same age group in Bavaria. The most striking result was that more than twice the number of patients kept dogs permanently in the last 10 years and at the time of interrogation as compared to control individuals at the time of interrogation (p=0.0000003, relative risk 3.5). Further internet search on the morbidity of breast carcinoma showed in dogs a protracted course of disease and metastases into lung, liver and bones, resembling the course of disease in human breast cancer. In contrast with this, breast cancer presented in cats a dramatically short course and the main but unusual location of metastasis presents in the hind legs. A recent publication in Norway reported on a high frequency (53.3%) of breast carcinomas in 14,401 investigated dogs. Which transmissible factor or factors come into question? Variants of the mouse mammary tumor virus (MMTV) can productively replicate in human cells and in different animals, including dogs. Many investigators, but not all, could identify MMTV-like sequences in sporadic human breast cancer. MMTV or MMTV-like sequences have not been investigated in canine breast carcinomas until now. It is also conceivable that other microbes from the dog, for example bacteria, could participate in the first steps of carcinogenesis in human. It was recently shown that bartonella species promote vascularization and prevent apoptosis of infected cells with the same methods as helicobacter pylori. Our considerations require further research. Epidemiologic cohort studies and identification of potential carcinogenic microbial factors will prove or disprove our hypothesis that risk factors from dogs could contribute to the carcinogenesis of human breast cancer.

PMID: 16516398 [PubMed - indexed for MEDLINE]

161. J Med Entomol. 2006 Jan;43(1):110-2.

First molecular evidence of Bartonella quintana in Pediculus humanus capitis (Phthiraptera: Pediculidae), collected from Nepalese children.

Sasaki T, Poudel SK, Isawa H, Hayashi T, Seki N, Tomita T, Sawabe K, Kobayashi M.

Department of Medical Entomology, National Institute of Infectious Diseases, Toyama 1-23-1, Shinjuku-ku, Tokyo, Japan.

Comment in J Med Entomol. 2006 Sep;43(5):787; author reply 788.

Trench fever is a body louse-borne disease caused by Bartonella quintana Brenner. The recent status of louse infestation in Nepalese children is not well known. We collected head and body lice, Pediculus humanus capitis De Geer and Pediculus humanus humanus L., respectively, from 30 children, including 11 cases of double infestation with both head and body lice. Detection of B. quintana in both louse species identified was carried out by polymerase chain reaction (PCR). PCR products with B. quintana DNA sequences were detected in both head and body lice from two children as well as in body lice derived from two other children. These results demonstrate that head lice may also play a role in the transmission of trench fever.

PMID: 16506456 [PubMed - indexed for MEDLINE]

162. Ann N Y Acad Sci. 2005 Dec;1063:286-98.

Bartonella bacilliformis GroEL: effect on growth of human vascular endothelial cells in infected cocultures.

Smitherman LS, Minnick MF.

Division of Biological Sciences, University of Montana, Missoula, MT 59812-4824, USA.

Bartonella are the only bacteria known to induce angioproliferative lesions of the human vasculature and liver during infection. Previous work from our lab suggests that GroEL participates in the mitogenic response observed in HUVEC cultures supplemented with the soluble fraction of Bartonella bacilliformis. Work in this study shows that exposure to high concentrations of the fraction is actually cytotoxic for HUVECs. To analyze this phenomenon, live B. bacilliformis-HUVEC cocultures were employed to study the effect of excess bacterial GroEL on the host cell during active infection. Four B. bacilliformis strains were generated to produce varying levels of GroEL. HUVEC cocultures with LSS100, a strain that synthesizes markedly greater quantities of GroEL relative to others, significantly accelerates apoptosis of the cocultured HUVECs relative to other strains. Acceleration of apoptosis can be inhibited by Z-VAD-FMK, a pan-caspase inhibitor. Time course data show that, at 18 h of infection, both LSS100 and control strains significantly inhibit spontaneous apoptosis of cocultured HUVECs, as previously reported for other Bartonella species. However, by 48 h, LSS100 significantly increases apoptosis of the host cell. We hypothesize that intracellular Bartonella GroEL functions as an Hsp60 analogue, a eukaryotic orthologue known to accelerate pro-caspase 3 activation by enhancing its vulnerability to upstream activator caspases. These data suggest another strategy whereby Bartonella may regulate host cell growth.

PMCID: PMC1817666 PMID: 16481529 [PubMed - indexed for MEDLINE]

163. Ann N Y Acad Sci. 2005 Dec;1063:270-9.

Bartonellae as elegant hemotropic parasites.

Birtles RJ.

Disease Ecology Unit, Centre for Comparative Infectious Diseases, Faculty of Veterinary Science, University of Liverpool, Cheshire CH64 7TE, UK. richard.birtles@liverpool.ac.uk

Bartonella species are hemotropic bacterial parasites of a wide range of mammals that occasionally cause disease in humans. The low prevalence of clinical manifestations compared to the high prevalence of infection underlines the elegance of these parasites that carefully exploit their hosts in a manner that optimizes their transmission. Recent research efforts have begun to determine the strategies involved in this exploitation, and significant progress has been made in unraveling an unusually complex natural cycle. Studies aimed at determining bacterial attributes involved in parasitism characterized several "virulence" factors and explored their modes of action. These efforts have provided an intriguing foundation on which future efforts aimed at comprehending these sophisticated parasites can be soundly based.

PMID: 16481527 [PubMed - indexed for MEDLINE]

164. Mem Inst Oswaldo Cruz. 2005 Dec;100(8):853-9. Epub 2006 Jan 20.

Antibodies to Rickettsia rickettsii, Rickettsia typhi, Coxiella burnetii, Bartonella henselae, Bartonella quintana, and Ehrlichia chaffeensis among healthy population in Minas Gerais, Brazil.

da Costa PS, Brigatte ME, Greco DB.

Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. psgcosta@powerline.com.br

Rickettsial diseases except those belonging to spotted fever group rickettsioses are poorly studied in South America particularly in Brazil where few epidemiological reports have been published. We describe a serosurvey for Rickettsia rickettsii, R. typhi, Coxiella burnetii, Bartonella henselae, B. quintana, and Ehrlichia chaffeensis in 437 healthy people from a Brazilian rural community. The serum samples were tested by indirected micro-immunoflourescence technique and a cutoff titer of 1:64 was used. The seroprevalence rates for R. rickettsii, R. typhi, C. burnetii, B. henselae, B. quintana, and E. chaffeensis were respectively 1.6% (7 samples); 1.1% (5 samples); 3.9% (17 samples); 13.7% (60 samples); 12.8% (56 samples), and 10.5% (46 samples). Frequent multiple/cross-reactivity was observed in this study. Age over 40 years old, urban profession, and rural residence were significantly associated with some but not all infections rate. Low seropositivity rates for R. rickettsii, R. typhi, and C. burnetii contrasted with higher rates of seropositivity for B. quintana, B. henselae, and E. chaffeensis. These results show that all tested rickettsial species or antigenically closely related possible exist in this particular region.

PMID: 16444416 [PubMed - indexed for MEDLINE]

165. Vector Borne Zoonotic Dis. 2005 Winter;5(4):402-9.

Rodent-associated Bartonella in Saskatchewan, Canada.

Jardine C, Appleyard G, Kosoy MY, McColl D, Chirino-Trejo M, Wobeser G, Leighton FA.

Department of Veterinary Pathology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. claire_jardine@usask.ca

Six species of wild rodents were sampled at 10 sites in 2002 and 2003 to determine the prevalence of Bartonella infections in rodent communities near Saskatoon, Saskatchewan, Canada. Isolates were characterized genotypically and compared with isolates found at other locations. Of 104 wild rodents examined, 57% were infected with Bartonella and prevalence within species varied from 49% for Richardson's ground squirrels (Spermophilus richardsonii) to 90% for Franklin's ground squirrels (S. franklinii). Infected rodents were found at all sites. Sequencing of a 379-bp portion of the citrate synthase gene was performed on 54 isolates and revealed 13 distinct genotypes, eight of which had not been described previously. The most common genotype detected in red-backed voles (Clethrionomys gapperi) was 99.1% similar to B. grahamii, a known human pathogen. Two of 10 Franklin's ground squirrels were concurrently infected with multiple Bartonella genotypes. All genotypes, with the exception of one detected in both Franklin's and thirteen-lined ground squirrels (S. tridecemlineatus), were found in only one host, and all genotypes from each species, with the exception of genotypes detected in red-backed voles, clustered together within the same relatedness group, suggesting that at least some Bartonella genotypes are specific to some rodent hosts.

PMID: 16417436 [PubMed - indexed for MEDLINE]

166. Herz. 2005 Dec;30(8):761-3.

Aortic valve endocarditis with Bartonella quintana - a rare entity.

Christiansen S, Fehske W, Autschbach R.

Department of Cardiothoracic Surgery, University of Aachen, Germany. schristiansen@ukaachen.de

Endocarditis caused by Bartonella species is difficult to diagnose and still remains a rare entity. Therefore, a young male patient undergoing aortic valve replacement for culture-negative endocarditis is reported in whom the diagnosis of a Bartonella quintana infection was made with a great delay postoperatively.

PMID: 16331372 [PubMed - indexed for MEDLINE]

167. DNA Res. 2005;12(2):91-102.

Codon and amino acid usage in two major human pathogens of genus Bartonella--optimization between replicational-transcriptional selection, translational control and cost minimization.

Das S, Paul S, Chatterjee S, Dutta C.

Bioinformatics Centre, Indian Institute of Chemical Biology, Kolkata, India.

Intra-genomic variation in synonymous codon and amino acid usage in two human pathogens Bartonella henselae and B. quintana has been carried out through multivariate analysis. Asymmetric mutational bias, coupled with replicational-transcriptional selection, has been identified as the prime selection force behind synonymous codon selection--a characteristic of the genus Bartonella, not exhibited by any other alpha-proteobacterial genome. Distinct codon usage patterns and low synonymous divergence values between orthologous sequences of highly expressed genes from the two Bartonella species indicate that there exists a residual intra-strand synonymous codon bias in the highly expressed genes, possibly operating at the level of translation. In the case of amino acid usage, the mean hydropathy level and aromaticity are the major sources of variation, both having nearly equal impact, while strand-specific mutational pressure and gene expressivity strongly influence the inter-strand variations. In both species under study, the highly expressed gene products tend not to contain heavy and/or aromatic residues, following the cost-minimization hypothesis in spite of their intracellular lifestyle. The codon and amino acid usage in these two human pathogens are, therefore, consequences of a complex balance between replicational-transcriptional selection, translational control, protein hydropathy and cost minimization.

PMID: 16303741 [PubMed - indexed for MEDLINE]

168. Bull Acad Natl Med. 2005 Mar;189(3):465-77; discussion 477-80.

[Zoonotic diseases caused by bacteria of the genus Bartonella genus: new reservoirs ? New vectors?].

[Article in French]

Chomel BB, Boulouis HJ.

Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, California 95616, USA. bbchomel@ucdavis.edu

Domestic animals and wildlife represent a large reservoir for bartonellae, at least eight species or subspecies of which have been reported to cause zoonotic infections. In addition, numerous orphan clinical syndromes are now being attributed to Bartonella henselae infection. Many mammalian species, including cats, dogs, rodents and ruminants are the main bartonellae reservoirs. Cats are the main reservoir for B. henselae. It appears that domestic dogs, at least in non tropical regions, are more likely to be accidental hosts than reservoirs, and constitute excellent sentinels for human infections. Bartonellae are vector-borne bacteria. The mode of B. henselae transmission by cat fleas is now better understood, but new potential vectors have recently been identified, including ticks and biting flies. This articles summarizes current knowledge of the etiology, new clinical features and epidemiological characteristics of these emerging zoonoses.

PMID: 16149211 [PubMed - indexed for MEDLINE]

169. J Clin Microbiol. 2005 Sep;43(9):4921-2.

Potential limitations of the 16S-23S rRNA intergenic region for molecular detection of Bartonella species.

Dillon B, Iredell J, Breitschwerdt EB, Maggi RG.

Comment on J Clin Microbiol. 2005 Mar;43(3):1171-6.

PMCID: PMC1234122 PMID: 16145180 [PubMed - indexed for MEDLINE]

170. J Bacteriol. 2005 Sep;187(17):6155-65.

Characterization of the genome composition of Bartonella koehlerae by microarray comparative genomic hybridization profiling.

Lindroos HL, Mira A, Repsilber D, Vinnere O, Näslund K, Dehio M, Dehio C, Andersson SG.

Department of Molecular Evolution, Evolutionary Biology Center, Norbyvägen 18C, 752 36 Uppsala, Sweden.

Bartonella henselae is present in a wide range of wild and domestic feline hosts and causes cat-scratch disease and bacillary angiomatosis in humans. We have estimated here the gene content of Bartonella koehlerae, a novel species isolated from cats that was recently identified as an agent of human endocarditis. The investigation was accomplished by comparative genomic hybridization (CGH) to a microarray constructed from the sequenced 1.93-Mb genome of B. henselae. Control hybridizations of labeled DNA from the human pathogen Bartonella quintana with a reduced genome of 1.58 Mb were performed to evaluate the accuracy of the array for genes with known levels of sequence divergence. Genome size estimates of B. koehlerae by pulsed-field gel electrophoresis matched that calculated by the CGH, indicating a genome of 1.7 to 1.8 Mb with few unique genes. As in B. quintana, sequences in the prophage and the genomic islands were reported absent in B. koehlerae. In addition, sequence variability was recorded in the chromosome II-like region, where B. koehlerae showed an intermediate retention pattern of both coding and noncoding sequences. Although most of the genes missing in B. koehlerae are also absent from B. quintana, its phylogenetic placement near B. henselae suggests independent deletion events, indicating that host specificity is not solely attributed to genes in the genomic islands. Rather, the results underscore the instability of the genomic islands even within bacterial populations adapted to the same host-vector system, as in the case of B. henselae and B. koehlerae.

PMCID: PMC1196136 PMID: 16109957 [PubMed - indexed for MEDLINE]

171. Diagn Mol Pathol. 2005 Sep;14(3):146-51.

Diagnosis of cat scratch disease with Bartonella henselae infection in formalin-fixed paraffin-embedded tissues by two different PCR assays.

Qian X, Jin L, Hayden RT, Macon WR, Lloyd RV.

Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Cat scratch disease (CSD) is commonly caused by Bartonella henselae infection. Clinical history and histologic findings are often insufficient to establish a definitive diagnosis of CSD. We retrospectively studied formalin-fixed, paraffin-embedded (FFPE) lymph nodes from 35 patients with histologically suspected CSD by 2 different PCR assays and immunohistochemistry (IHC). The first primer pair amplified a 163-bp fragment of the 16S rRNA gene in 19 of the 35 cases (54%). The second primer pair amplified a 191-bp fragment of the henselae citrate synthase (gltA) gene in 17 of the 35 cases (49%). IHC identified the organisms in 8 of 33 cases (24%). Fresh cultures of various Bartonella species showed a specific PCR product with an analytical sensitivity of 0.5 to 5 pg bacterial DNA. Bartonella species were identified by the unique size of the amplified PCR product. Twenty-two lymph nodes without morphologic evidence or a history of CSD were negative by PCR and immunostaining. Tissues from a patient with Legionella pneumophila were also negative by PCR and immunostaining for CSD supporting the specificity of the PCR reaction. The specific PCR products of the B. henselae were confirmed by sequencing. Human beta-actin for each case was amplified to check the integrity of the DNA. Our data indicate that detection of Bartonella DNA by PCR is useful to confirm the diagnosis of CSD.

PMID: 16106195 [PubMed - indexed for MEDLINE]

172. BMC Infect Dis. 2005 Aug 12;5:63.

A nested-PCR with an Internal Amplification Control for the detection and differentiation of Bartonella henselae and B. clarridgeiae: an examination of cats in Trinidad.

Rampersad JN, Watkins JD, Samlal MS, Deonanan R, Ramsubeik S, Ammons DR.

Dept. of Life Sciences, The University of the West Indies, St. Augustine, Trinidad, Trinidad and Tobago. uwimdl@hotmail.com

BACKGROUND: Bartonella species are bacterial blood parasites of animals capable of causing disease in both animals and man. Cat-Scratch Disease (CSD) in humans is caused mainly by Bartonella henselae and is acquired from the cat, which serves as a reservoir for the bacteria. A second species, B. clarridgeiae is also implicated in the disease. Diagnosis of Bartonellosis by culture requires a week or more of incubation on enriched media containing blood, and recovery is often complicated by faster growing contaminating bacteria and fungi. PCR has been explored as an alternative to culture for both the detection and species identification of Bartonella, however sensitivity problems have been reported and false negative reactions due to blood inhibitors have not generally been addressed in test design.

METHODS: A novel, nested-PCR was designed for the detection of Bartonella henselae and B. clarridgeiae based on the strategy of targeting species-specific size differences in the 16S-23S rDNA intergenic regions. An Internal Amplification Control was used for detecting PCR inhibition. The nested-PCR was utilized in a study on 103 blood samples from pet and stray cats in Trinidad.

RESULTS: None of the samples were positive by primary PCR, but the Nested-PCR detected Bartonella in 32/103 (31%) cats where 16 were infected with only B. henselae, 13 with only B. clarridgeiae and 3 with both species. Of 22 stray cats housed at an animal shelter, 13 (59%) were positive for either or both species, supporting the reported increased incidence of Bartonella among feral cats. CONCLUSION: The usefulness of a single PCR for the detection of Bartonella henselae and B. clarridgeiae in the blood of cats is questionable. A nested-PCR offers increased sensitivity over a primary PCR and should be evaluated with currently used methods for the routine detection and speciation of Bartonella henselae and B. clarridgeiae. In Trinidad, B. henselae and B. clarridgeiae are the predominant species in cats and infection appears highest with stray cats, however B. clarridgeiae may be present at levels similar to that of B. henselae in the pet population.

PMCID: PMC1208886 PMID: 16098227 [PubMed - indexed for MEDLINE]

173. J Thorac Cardiovasc Surg. 2005 Aug;130(2):567-8.

Bartonella species-induced prosthetic valve endocarditis associated with rapid progression of valvular stenosis.

Kreisel D, Pasque MK, Damiano RJ Jr, Medoff G, Kates A, Kreisel FH, Lawton JS.

Division of Cardiothoracic Surgery, Washington University, St Louis, MO 63110, USA.

PMID: 16077432 [PubMed - indexed for MEDLINE]

174. N Z Vet J. 1997 Oct;45(5):185-7.

Bartonella henselae bacteraemia in domestic cats from Auckland.

Joseph AK, Wood CW, Robson JM, Paul SL, Morris AJ.

Epsom Central Veterinary Centre, Epsom, Auckland, New Zealand.

Bartonella henselae causes most cases of cat scratch disease, a self-limited localised lymphadenopathy illness of humans. Bartonella henselae also causes disseminated cutaneous and visceral disease in immunocompromised people. Cat blood (1-5 ml) collected from cats in the Auckland area was processed and plated on to 5% sheep blood brain heart infusion agar and incubated at 35 degrees C in 5% CO2 for 14 days. Bartonella henselae was identified by colony morphology, Gram's stain, twitching motility, biochemical tests and molecular methods. Eight of 48 cats (17%) had Bartonella bacteraemia. Species-specific probes and biochemical profiles identified all isolates as B. henselae. Infected cats pose a risk to humans they lick, scratch or bite. People should be made aware of the risk cats pose.

PMID: 16031983 [PubMed]

175. Med Parazitol (Mosk). 2005 Apr-Jun;(2):44-8.

[Bartonellosis and a possible role of Ixodes ticks (family Ixodidae, order Parasitiformes) in the transmission of pathogenic Bartonella bacteria].

[Article in Russian]

Vasil'eva IS.

The papers reviews the literature on bartonellosis and a role of Ixodes ticks, including the representatives of the genus Ixodes, in the circulation and transmission of Bartonella bacteria. It shows that man can be infected with pathogenic Bartonella bacteria by the bite of ticks. The paper also presents data on tick-transmitted human and animal mixed infections, including bartonellosis.

PMID: 15984622 [PubMed - indexed for MEDLINE]

176. J Clin Microbiol. 2005 Jun;43(6):2651-5.

Novel chemically modified liquid medium that will support the growth of seven bartonella species.

Maggi RG, Duncan AW, Breitschwerdt EB.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.

Bacteria of the genus Bartonella, a member of the Alphaproteobacteria, are fastidious, gram-negative, aerobic bacilli that comprise numerous species, subspecies, and subtypes. In human and veterinary medicine, species isolation remains a vital component of the diagnostic and therapeutic management of Bartonella infection. We describe a novel, chemically modified, insect-based liquid culture medium that supports the growth of at least seven Bartonella species. This medium will also support cocultures consisting of different Bartonella species, and it facilitated the primary isolation of Bartonella henselae from blood and aqueous fluid of naturally infected cats. This liquid growth medium may provide an advantage over conventional direct blood agar plating for the diagnostic confirmation of bartonellosis.

PMCID: PMC1151927 PMID: 15956379 [PubMed - indexed for MEDLINE]

177. Am J Trop Med Hyg. 2005 May;72(5):503-7.

High prevalence of Bartonella quintana endocarditis in Sfax, Tunisia.

Znazen A, Rolain JM, Hammami N, Kammoun S, Hammami A, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France.

Bartonella quintana is a fastidious microorganism associated with blood culture negative endocarditis. In this study, 40 sera with cross-reactivity between Chlamydia species from patients from Sfax, Tunisia, were serologically tested for Bartonella. Thirteen sera were positive for Bartonella with IgG titers >/=1:800. Western blot and cross-absorption confirmed the diagnosis of Bartonella quintana endocarditis in 12 cases and Bartonella henselae endocarditis in 1 case. These sera were also positive by LightCycler nested PCR amplification for the rnpb (7 of 13) and fur (11 of 13) genes. Eleven patients had a definite diagnosis of endocarditis, which represents 9.8% of all endocarditis. Because Bartonella endocarditis seems to be very common in Tunisia, we suggest that its serology be performed systematically whenever endocarditis is suspected.

PMID: 15891120 [PubMed - indexed for MEDLINE]

178. Medicine (Baltimore). 2005 May;84(3):162-73.

Blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases.

Houpikian P, Raoult D.

Unitué des Rickettsies, Université de la Méditerraneé, Faculté de médecine, CNRS UPRES A 6020, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.

To identify the current etiologies of blood culture-negative infective endocarditis and to describe the epidemiologic, clinical, laboratory, and echocardiographic characteristics associated with each etiology, as well as with unexplained cases, we tested samples from 348 patients suspected of having blood culture-negative infective endocarditis in our diagnostic center, the French National Reference Center for Rickettsial Diseases, between 1983 and 2001. Serology tests for Coxiella burnettii, Bartonella species, Chlamydia species, Legionella species, and Aspergillus species; blood culture on shell vial; and, when available, analysis of valve specimens through culture, microscopic examination, and direct PCR amplification were performed. Physicians were asked to complete a questionnaire, which was computerized. Only cases of definite infective endocarditis, as defined by the modified Duke criteria, were included. A total of 348 cases were recorded-to our knowledge, the largest series reported to date. Of those, 167 cases (48%) were associated with C. burnetii, 99 (28%) with Bartonella species, and 5 (1%) with rare, fastidious bacterial agents of endocarditis (Tropheryma whipplei, Abiotrophia elegans, Mycoplasma hominis, Legionella pneumophila). Among 73 cases without etiology, 58 received antibiotic drugs before the blood cultures. Six cases were right-sided endocarditis and 4 occurred in patients who had a permanent pacemaker. Finally, no explanatory factor was found for 5 remaining cases (1%), despite all investigations.Q fever endocarditis affected males in 75% of cases, between 40 and 70 years of age. Ninety-one percent of patients had a previous valvulopathy, 32% were immunocompromised, and 70% had been exposed to animals. Our study confirms the improved clinical presentation and prognosis of the disease observed during the last decades. Such an evolution could be related to earlier diagnosis due to better physician awareness and more sensitive diagnostic techniques. As for Bartonella species, B. quintana was recorded more frequently than B. henselae (53 vs 17 cases). For 18 patients with Bartonella endocarditis, the responsible species was not identified. Species determination was achieved through culture and/or PCR in 49 cases and through Western immunoblotting in 22. Comparison of B. quintana and B. henselae endocarditis revealed distinct epidemiologic patterns. The 2 cases due to T. whipplei reflect the emerging role of this agent as a cause of infective endocarditis. Because identification of the bacterium was possible only through analysis of excised valves by histologic examination, PCR, and culture on shell vial, the prevalence of the disease might be underestimated. Among patients who received antibiotic drugs before blood cultures, 4 cases (7%) were found to be associated with Streptococcus species (2 S. bovis and 2 S. mutans) through 16S rDNA gene amplification directly from the valve, which shows the usefulness of this technique in overcoming the limitations of previous antibiotic treatment. Right-sided endocarditis occurred classically in young patients (mean age, 36 yr), intravenous drug users in 50% of cases, and suffering more often from embolic complications. Finally, 5 cases without etiology or explaining factors were all immunocompetent male patients with previous aortic valvular lesions, and 3 of the 5 presented with an aortic abscess. Further investigations should be focused on this group to identify new agents of infective endocarditis.

PMID: 15879906 [PubMed - indexed for MEDLINE]

179. Ital Heart J Suppl. 2005 Mar;6(3):128-34.

[New etiologies responsible for infective endocarditis with negative blood cultures].

[Article in Italian]

Enia F, Di Stefano G, Floresta AM, Matassa C.

U.O. di Cardiologia II, Centro di Riferimento Regionale per l'Epidemiologia Clinica dell'Insufficienza Cardiaca, Azienda Ospedaliera V Cervello, Palermo. fenia@tin.it

The prevalence of infective endocarditis with negative blood cultures varies in the different series from 5 to 25%. There are certain explanations of negative blood culture endocarditis: previous incorrect antibiotic therapy before obtaining blood samples (antibiotic treatment inhibits the growth of germs, and therefore bacteremia, without sterilizing the vegetations); infective endocarditis due to fastidious microorganism, that is of difficult cultivation and identification; infective endocarditis due to cell-dependent organism (e.g. Coxiella burnetii); infective endocarditis due to fungi; non-infectious involvement of the endocardium (at times with vegetations) during the course of certain disease. We underline three etiologies (Coxiella burnetii, Bartonella species and Whipple's disease bacterium) because their study have constituted the stimulus for the introduction into clinical evaluation of patients with suspected infective endocarditis of different diagnostic approaches, based on a correct sequential application of blood cultures, serodiagnosis and molecular microbiology.

PMID: 15875498 [PubMed - indexed for MEDLINE]

180. J Clin Microbiol. 2005 May;43(5):2529-33.

Bartonella species as a potential cause of epistaxis in dogs.

Breitschwerdt EB, Hegarty BC, Maggi R, Hawkins E, Dyer P.

Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA. ed_breitschwerdt@ncsu.edu

Infection with a Bartonella species was implicated in three cases of epistaxis in dogs, based upon isolation, serology, or PCR amplification. These cases, in conjunction with previously published reports, support a potential role for Bartonella spp. as a cause of epistaxis in dogs and potentially in other animals, including humans.

PMCID: PMC1153741 PMID: 15872304 [PubMed - indexed for MEDLINE]

181. Blood. 2005 Aug 15;106(4):1215-22. Epub 2005 Apr 28.

Infection of human CD34+ progenitor cells with Bartonella henselae results in intraerythrocytic presence of B. henselae.

Mändle T, Einsele H, Schaller M, Neumann D, Vogel W, Autenrieth IB, Kempf VA.

Institut für Medizinische Mikrobiologie und Hygiene, Elfriede-Aulhorn-Str 6, D-72076, Tübingen, Germany.

Although there is evidence that endothelial cells are important targets for human pathogenic Bartonella species, the primary niche of infection is unknown. Here we elucidated whether human CD34+ hematopoietic progenitor cells (HPCs) internalize B. henselae and may serve as a potential niche of the pathogen. We showed that B. henselae does not adhere to or invade human erythrocytes. In contrast, B. henselae invades and persists in HPCs as shown by gentamicin protection assays, confocal laser scanning microscopy (CLSM), and electron microscopy (EM). Fluorescence-activated cell sorting (FACS) analysis of glycophorin A expression revealed that erythroid differentiation of HPCs was unaffected following infection with B. henselae. The number of intracellular B. henselae continuously increased over a 13-day period. When HPCs were infected with B. henselae immediately after isolation, intracellular bacteria were subsequently detectable in differentiated erythroid cells on day 9 and day 13 after infection, as shown by CLSM, EM, and FACS analysis. Our data provide, for the first time, evidence that a bacterial pathogen is able to infect and persist in differentiating HPCs, and suggest that HPCs might serve as a potential primary niche in Bartonella infections.

PMID: 15860668 [PubMed - indexed for MEDLINE]

182. Infect Immun. 2005 May;73(5):3128-36.

The Bartonella vinsonii subsp. arupensis immunodominant surface antigen BrpA gene, encoding a 382-kilodalton protein composed of repetitive sequences, is a member of a multigene family conserved among bartonella species.

Gilmore RD Jr, Bellville TM, Sviat SL, Frace M.

Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, P.O. Box 2087, Foothills Campus, Fort Collins, CO 80521, USA. rbg9@cdc.gov

Bartonella proteins that elicit an antibody response during an infection are poorly defined; therefore, to characterize antigens recognized by the host, a Bartonella genomic expression library was screened with serum from an infected mouse. This process led to the discovery of a Bartonella vinsonii subsp. arupensis gene encoding a 382-kDa protein, part of a gene family encoding large proteins, each containing multiple regions of repetitive segments. The genes were termed brpA to -C (bartonella repeat protein) and bore significant similarity to genes encoding the BadA adhesin protein and members of the variably expressed outer membrane protein family of proteins from Bartonella henselae and Bartonella quintana, respectively.

PMCID: PMC1087387 PMID: 15845521 [PubMed - indexed for MEDLINE]

183. Vet Res. 2005 May-Jun;36(3):383-410.

Factors associated with the rapid emergence of zoonotic Bartonella infections.

Boulouis HJ, Chang CC, Henn JB, Kasten RW, Chomel BB.

Microbiologie-Immunologie, Ecole Nationale Vétérinaire d'Alfort, 7 avenue du Général de Gaulle, 94704 Maisons-Alfort, France.

Within the last 15 years, several bacteria of the genus Bartonella were recognized as zoonotic agents in humans and isolated from various mammalian reservoirs. Based on either isolation of the bacterium or PCR testing, eight Bartonella species or subspecies have been recognized as zoonotic agents, including B. henselae, B. elizabethae, B. grahamii, B. vinsonii subsp. arupensis, B. vinsonii subsp. berkhoffii, B. grahamii, B. washoensis and more recently B. koehlerae. The present manuscript reviews the factors associated with the emergence of these zoonotic pathogens, including better diagnostic tools and methods to identify these fastidious bacteria, host immunosuppression (caused by infectious agents, cancer, aging or induced by immunosuppressive drugs), the interaction of co-infection by several infectious agents that may enhanced the pathogenecity of these bacteria, increased outdoor activity leading to exposure to wildlife reservoirs or vectors, poverty and low income associated with infestation by various ectoparasites, such as body lice and finally the dispersal of Bartonellae around the world. Furthermore, a description of the main epidemiological and clinical features of zoonotic Bartonellae is given. Finally, the main means for diagnosis, treatment and prevention of these diseases are presented.

PMID: 15845231 [PubMed - indexed for MEDLINE]

184. BMC Infect Dis. 2005 Apr 5;5:21.

Bartonella seropositivity in children with Henoch-Schonlein purpura.

Robinson JL, Spady DW, Prasad E, McColl D, Artsob H.

Department of Pediatrics and Stollery Children's Hospital, University of Alberta, Edmonton AB, Canada. jr3@ualberta.ca

BACKGROUND: An association between Henoch-Schonlein purpura (HSP) and seropositivity for Bartonella henselae (BH) has been described. The objective of this study was to see if such an association exists in northern Alberta.

METHODS: Immunofluorescent antibody testing utilizing an antigen prepared from B. henselae was undertaken on sera from six children with current HSP, 22 children with remote HSP, and 28 controls that were matched for age. Blood from the six children with current HSP was analysed by polymerase chain reaction (PCR) assay with primers derived from the citrate synthase (gltA) gene for the detection of Bartonella DNA.

RESULTS: The seropositivity rate for BH was 61% in cases versus 21% in controls (p < 0.03). The PCR assay was negative in all six current cases. CONCLUSION: There is an increased seropositivity rate for BH in children with HSP. However, it is not clear if infection with B. henselae or a related Bartonella species can result in HSP, or if the increased seropositivity is from non-specific or cross-reacting antibodies.

PMCID: PMC1274276 PMID: 15807903 [PubMed - indexed for MEDLINE]

185. Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Nov;25(11):934-7.

[Study on the prevalence of Bartonella species in rodent hosts from different environmental areas in Yunnan].

[Article in Chinese]

Li DM, Yu DZ, Liu QY, Gong ZD.

Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

OBJECTIVE: To investigate Bartonella infections in small mammalian reservoir hosts from different environments and types of climate in Yunnan.

METHODS: Femoral blood samples were collected from the anesthetic captured animals from five counties including three types of climate. All isolates were grown on brain and heart infusion agar plates containing 5% defibrinated rabbit blood. The agar plates were incubated at 35 degrees C in a humidified with 5% CO2 environment for at least 4 weeks. Bartonella-like isolates were confirmed by the polymerase chain reaction and visualizing the target gene fragment by gel electrophoresis.

RESULTS: Bartonella species were isolated from 69 of 176 small animals including 4 species of 3 genera from 4 counties and the total prevalence in rodents was 39.2%. The maximal prevalence was 42.0% of Rattus tanezumi flavipectus usually inhabiting indoors and courtyard and contacting closely to human. Moreover, Bartonella isolates were obtained from Rattus noruegicus, Eothenomys miletus and Mus pahari. Life environments of captured animals involved indoors, courtyard, brush and forest in mountain. CONCLUSION: The finding in this study suggested the characteristic of diversity of Bartonella infections in rodent hosts in southern China included Bartonella species parasiting in a wide range of animal hosts in different environments as well as climate types. Further investigations were needed in different areas in China to confirm more mammalian reservoir hosts with Bartonella infections.

PMID: 15769319 [PubMed - indexed for MEDLINE]

186. Circulation. 2005 Mar 22;111(11):1415-21. Epub 2005 Mar 7.

Impact of a molecular approach to improve the microbiological diagnosis of infective heart valve endocarditis.

Breitkopf C, Hammel D, Scheld HH, Peters G, Becker K.

Institute of Medical Microbiology, University of Münster Hospital, Münster, Germany.

Comment in Circulation. 2005 Mar 22;111(11):1352-4.

BACKGROUND: Even today, infective endocarditis (IE) remains a severe and potentially fatal disease demanding sophisticated diagnostic strategies for detection of the causative microorganisms. Despite the use of appropriate laboratory techniques, classic microbiological diagnostics are characterized by a high rate of negative results. METHODS AND RESULTS: Broad-range polymerase chain reaction (PCR) targeting bacterial and fungal rDNA followed by direct sequencing was applied to excised heart valves (n=52) collected from 51 patients with suspected infectious endocarditis and from 16 patients without any signs of IE during an 18-month period. The sensitivity, specificity, and the positive and negative predictive values for the bacterial broad-range PCR were 41.2%, 100.0%, 100.0%, and 34.8%, respectively, compared with 7.8%, 93.7%, 80.0%, and 24.2% for culture and 11.8%, 100.0%, 100.0%, and 26.2% for Gram staining. Without exception, database analyses allowed identification up to the (sub)species level comprising streptococcal (n=13), staphylococcal (n=4), enterococcal (n=2), and other signature sequences such as Bartonella quintana and Nocardia paucivorans. Fungal ribosomal sequences were not amplified. All valve tissues of the reference group were negative for both PCR and conventional methods, except one sample that was contaminated by molds.

CONCLUSIONS: Culture-independent molecular methods substantially improve the diagnostic outcome of microbiological examination of excised heart valves. Importantly, this was true not only for fastidious, slow-growing, and/or nonculturable microorganisms but also for easy-to-culture pathogens such as streptococci and staphylococci. Both patient management and empiric antibiotic therapy of IE are likely to benefit from improved knowledge of the spectrum of pathogens now causing IE.

PMID: 15753218 [PubMed - indexed for MEDLINE]

187. Circulation. 2005 Mar 1;111(8):1054-62. Epub 2005 Feb 21.

Activation of hypoxia-inducible factor-1 in bacillary angiomatosis: evidence for a role of hypoxia-inducible factor-1 in bacterial infections.

Kempf VA, Lebiedziejewski M, Alitalo K, Wälzlein JH, Ehehalt U, Fiebig J, Huber S, Schütt B, Sander CA, Müller S, Grassl G, Yazdi AS, Brehm B, Autenrieth IB.

Institut für Medizinische Mikrobiologie und Hygiene, Eberhard-Karls Universität, Tübingen, Germany. volkhard.kempf@med.uni-tuebingen.de

BACKGROUND: Bartonella species are the only known bacterial pathogens causing vasculoproliferative disorders in humans (bacillary angiomatosis [BA]). Cellular and bacterial pathogenetic mechanisms underlying the induction of BA are largely unknown. METHODS AND RESULTS: Activation of hypoxia-inducible factor-1 (HIF-1), the key transcription factor involved in angiogenesis, was detected in Bartonella henselae-infected host cells in vitro by immunofluorescence, Western blotting, electrophoretic mobility shift, and reporter gene assays and by immunohistochemistry in BA tissue lesions in vivo. Gene microarray analysis revealed that a B henselae infection resulted in the activation of genes typical for the cellular response to hypoxia. HIF-1 was essential for B henselae-induced expression of vascular endothelial growth factor as shown by inhibition with the use of HIF-1-specific short-interfering RNA. Moreover, infection with B henselae resulted in increased oxygen consumption, cellular hypoxia, and decreased ATP levels in host cells. Infection with a pilus-negative variant of B henselae did not lead to cellular hypoxia or activation of HIF-1 or vascular endothelial growth factor secretion, suggesting a crucial role of this bacterial surface protein in the angiogenic reprogramming of the host cells.

CONCLUSIONS: B henselae induces a proangiogenic host cell response via HIF-1. Our data provide for the first time evidence that HIF-1 may play a role in bacterial infections.

PMID: 15723970 [PubMed - indexed for MEDLINE]

188. Rev Prat. 2004 Nov 30;54(18):1982-6.

[Bartonellosis: emerging infection].

[Article in French]

Boulouis HJ, Chomel B.

Microbiologie-immunologie, Ecole nationale vétérinaire d'Alfort, 94704 Maisons-Alfort. hjboulouis@vet-alfort.fr

The spectrum of Bartonella infections in humans shows a constant increase. The number of Bartonella species responsible of zoonoses has increased from one to 7 during the past ten years. In addition numerous orphan clinical manifestations are now associated to Bartonella henselae infections. Animals and particularly domestic cat are the main reservoirs of Bartonella. Cats are healthy carriers of B. henselae and B. clarridgeiae, and can be bacteremic for months to years. Cat-to-cat transmission of the bacteria involves the cat flea in ab-sence of transmission by direct contact. Present knowledge on the etiology, clinical features and epidemiological characteristics of these emerging infections are presented.

PMID: 15673067 [PubMed - indexed for MEDLINE]

189. J Clin Microbiol. 2005 Jan;43(1):163-7.

PCR detection of bacteria on cardiac valves of patients with treated bacterial endocarditis.

Rovery C, Greub G, Lepidi H, Casalta JP, Habib G, Collart F, Raoult D.

Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, Hôpital dde la Timone, Marseille, France.

We used broad-range PCR amplification and sequencing to detect and identify bacterial DNA in 156 valves of patients treated for infective endocarditis (IE). Bacterial DNA was found more frequently in patients who underwent valve replacement while on antibiotic treatment for IE (60%) than in patients who had completed antibiotic treatment for IE (37%; P = 0.02). We found specific bacterial DNA in valves removed from 11 of 30 patients who had completed antibiotic treatment for IE. Six had no histological evidence of IE. The presence of DNA was significantly correlated with the presence of histologic lesions (P = 0.001) and with the presence of bacteria detected by Gram staining (P < 0.001). Bartonella and streptococci were detected for much longer after antibiotic treatment by PCR than other species (P = 0.047 and 0.04, respectively), and coagulase-negative staphylococci were detected for much shorter periods (P = 0.02). The finding that bacterial DNA was more likely to be detected in valves of patients with active IE than in patients who had completed antibiotic treatment for IE shows that bacterial DNA is cleared slowly. There was no significant correlation between the duration of antibiotic therapy and the presence of bacterial DNA in valves. Since the persistence of bacterial DNA in valves does not necessarily indicate the persistence of viable bacteria, the detection of bacterial DNA in valves from IE patients should be interpreted with caution, in particular in those patients with a past history of treated IE.

PMCID: PMC540121 PMID: 15634966 [PubMed - indexed for MEDLINE]

190. J Clin Microbiol. 2005 Jan;43(1):41-8.

Multispacer typing technique for sequence-based typing of Bartonella quintana.

Foucault C, La Scola B, Lindroos H, Andersson SG, Raoult D.

Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France.

Bartonella quintana is a worldwide fastidious bacterium of the Alphaproteobacteria responsible for bacillary angiomatosis, trench fever, chronic lymphadenopathy, and culture-negative endocarditis. The recent genome sequencing of a B. quintana isolate allowed us to propose a genome-wide sequence-based typing method. To ensure sequence discrimination based on highly polymorphic areas, we amplified and sequenced 34 spacers in a large collection of B. quintana isolates. Six of these exhibited polymorphisms and allowed the characterization of 4 genotypes. However, the strain variants suggested by the noncoding sequences did not correlate with the results of pulsed-field gel electrophoresis (PFGE), which suggested a higher degree of variability. Modification of the PFGE profile of one isolate after nine subcultures confirmed that rearrangement frequencies are high in this species, making PFGE unreliable for epidemiological purposes. The low extent of sequence heterogeneity in the species suggests a recent emergence of this bacterium as a human pathogen. Direct typing of natural samples allowed the identification of a fifth genotype in the DNA extracted from a human body louse collected in Burundi. We have named the typing technique herein described multispacer typing.

PMCID: PMC540158 PMID: 15634949 [PubMed - indexed for MEDLINE]

191. Acta Microbiol Immunol Hung. 2004;51(3):321-32.

Bacterial models for tumor development. Mini-review.

Gyémánt N, Molnár A, Spengler G, Mándi Y, Szabó M, Molnár J.

Department of Medical Microbiology and Immunobiology, Faculty of Medicine, Szent-Györgyi Albert Medical Centre, University of Szeged, Dóm tér 10, H-6720 Szeged, Hungary.

The tumor-inducing effects of Agrobacterium, Bartonella and Helicobacter bacterial species are compared step by step. An analogy for the existence of these individual steps is considered in connection with the development of cancer. The transformations of eukaryotic cells occur in particular in the type IV secretion system, i.e. involving the simultaneous transmission of DNA and protein from bacterial cells to eukaryotic cells. Thus, transfected cells facilitate the indefinite growth of tissue cells and additionally produce growth factors, triggering further bacterial multiplication. The higher numbers of bacteria then produce more transfection and the cycle repeats as long as the host lives. The main limiting factor is the frequency of bacterial infection, while the secondary rate-limiting factors are the levels of transforming growth factors and factors triggering bacteria growth. CONCLUSIONS: Analogous processes are probably responsible for the tumor induction by the three different bacterial species; however, the critical points for eradication are different. The early eradication or limitation of B. henselae or H. pylori can prevent hemangiomas, stomach cancer and malignant cell proliferation. The crown gall formation by A. tumefaciens can only be avoided by prevention of the transforming activity of a single bacterial infection. Questions arise as to what is common in the three processes, and the nature of the rate-limiting step in the three different models. The frequency of transformation is the rate-limiting step, but the co-transmission of the DNA-protein complex is common in the three systems.

PMID: 15571072 [PubMed - indexed for MEDLINE]

192. Klin Mikrobiol Infekc Lek. 2004 Oct;10(5):207-13.

[Bartonelloses].

[Article in Czech]

Medková Z.

Dept. of Immunology, BIO-PLUS, Polní 23/25, 639-00 Brno, Czech Republic. zm.bioplus@volny.cz

Bartonellae belong to less known causal agents of many human diseases. They are gram-negative bacteria growing slowly on culture media enriched with hemin or bovine serum. The genus Bartonella, which currently involves more than 15 species, is present worldwide. Bartonellae live in natural foci in dependence on the occurrence of natural host (rodents, felines, canidae, human) and insect vector (flea, tick, louse). By reservoir animals they usually cause permanent intraerythrocytic bacteraemia without system inflammation symptoms. A classical example of a human disease is cat scratch disease (CSD) caused by Bartonella henselae and characterised by regional lymphagoitis and lymphadenitis. Increasing interest is being devoted to the ability of Bartonella sp. (e.i. B. quintana) to cause the opportune infections with diverse clinical manifestation: bacillary angiomatosis, specific liver and spleen vasculitis (peliosis hepatis, splenis), endocarditis and others. The issue of Bartonella infections is relatively new and its importance is still growing with increasing knowledge in this field.

PMID: 15558448 [PubMed - indexed for MEDLINE]

193. Annu Rev Microbiol. 2004;58:365-90.

Molecular and cellular basis of bartonella pathogenesis.

Dehio C.

Division of Molecular Microbiology, Biozentrum, University of Basel, 4056 Basel, Switzerland. christoph.dehio@unibas.ch.

The genus Bartonella comprises several important human pathogens that cause a wide range of clinical manifestations: cat-scratch disease, trench fever, Carrion's disease, bacteremia with fever, bacillary angiomatosis and peliosis, endocarditis, and neuroretinitis. Common features of bartonellae include transmission by blood-sucking arthropods and the specific interaction with endothelial cells and erythrocytes of their mammalian hosts. For each Bartonella species, the invasion and persistent intracellular colonization of erythrocytes are limited to a specific human or animal reservoir host. In contrast, endothelial cells are target host cells in probably all mammals, including humans. Bartonellae subvert multiple cellular functions of human endothelial cells, resulting in cell invasion, proinflammatory activation, suppression of apoptosis, and stimulation of proliferation, which may cumulate in vasoproliferative tumor growth. This review summarizes our understanding of Bartonella-host cell interactions and the molecular mechanisms of bacterial virulence and persistence. In addition, current controversies and unanswered questions in this area are highlighted.

PMID: 15487942 [PubMed - indexed for MEDLINE]

194. Proteomics. 2004 Oct;4(10):3021-33.

Proteomic analysis of the sarcosine-insoluble outer membrane fraction of the bacterial pathogen Bartonella henselae.

Rhomberg TA, Karlberg O, Mini T, Zimny-Arndt U, Wickenberg U, Röttgen M, Jungblut PR, Jenö P, Andersson SG, Dehio C.

Division of Molecular Microbiology, Biozentrum of the University of Basel, Basel, Switzerland.

Bartonella henselae is an emerging zoonotic pathogen causing a wide range of disease manifestations in humans. In this study, we report on the analysis of the sarcosine-insoluble outer membrane fraction of B. henselae ATCC 49882 Houston-1 by one-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis (1-D SDS-PAGE) and two-dimensional nonequilibrium pH gradient polyacrylamide gel electrophoresis (2-D NEPHGE). Protein species were identified by matrix-assisted laser desorption/ionization-time of flight-mass spectrometry (MALDI-TOF-MS) and subsequent database query against the B. henselae genome sequence. Subcellular fractionation, application of the ionic detergent lauryl sarcosine, assessment of trypsin sensitivity, and heat modifiability of surface-exposed proteins represented valuable tools for the analysis of the outer membrane subproteome of B. henselae. 2-D NEPHGE was applied to display and catalogue a substantial number of proteins associated with the B. henselae sarcosine-insoluble outer membrane fraction, resulting in the establishment of a first 2-D reference map of this compartment. Thus, 53 distinct protein species associated with the outer membrane subproteome fraction were identified. This study provides novel insights into the membrane biology and the associated putative virulence factors of this pathogen of increasing medical importance.

PMID: 15378747 [PubMed - indexed for MEDLINE]

195. Scand J Infect Dis. 2004;36(8):604-6.

Low seroprevalence of bartonella species in danish elite orienteers.

Schiellerup P, Dyhr T, Rolain JM, Christensen M, Damsgaard R, Ethelberg S, Fisker N, Frost Andersen N, Raoult D, Krogfelt KA.

Unit of Gastrointestinal Infections, Department of Bacteriology, Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark. pet@ssi.dk

In the 1990s, studies were conducted to investigate 16 episodes of sudden unexpected cardiac death (SUCD) among Swedish elite orienteers during the period from 1979 to 1992. A case control study revealed that a significantly higher proportion of Swedish elite orienteers were B. elizabethae seropositive compared to controls. The aim of our study, designed as a case-control study, was to determine whether similarly high rates of B. elizabethae seropositivity were present among Danish elite orienteers. Cases were 43 elite orienteers; controls were 159 blood donors and 63 elite indoor sportsmen. All participants were tested for antibodies against B. henselae, B. quintana and B. elizabethae using immunofluorescent antibody tests. Surprisingly, Bartonella antibodies were only detected in sera from 5 persons: B. henselae from 1 elite orienteer, 1 handball player and 1 blood donor. B. elizabethae antibodies were detected in 1 handball player and 1 basketball player. We found no association between elite orienteers and the prevalence of Bartonella antibody positivity. This is in contrast to the Swedish study, and might be explained by the use of different serological methods in the 2 studies; to determine whether it is a true difference, a new study is needed.

PMID: 15370673 [PubMed - indexed for MEDLINE]

196. Proc Natl Acad Sci U S A. 2004 Sep 14;101(37):13630-5. Epub 2004 Sep 3.

A family of variably expressed outer-membrane proteins (Vomp) mediates adhesion and autoaggregation in Bartonella quintana.

Zhang P, Chomel BB, Schau MK, Goo JS, Droz S, Kelminson KL, George SS, Lerche NW, Koehler JE.

Division of Infectious Diseases, Department of Medicine, University of California-San Francisco, 521 Parnassus Avenue, San Francisco, CA 94143-0654.

Bartonella species are fastidious, Gram-negative human pathogens that can persist in the host bloodstream for years and bind to and invade several types of host cells. For many pathogens, adhesion to host cells and extracellular matrix (ECM) components is a critical virulence determinant. Bacteria often vary expression of surface adhesins by phase or antigenic variation to subvert the host immune response and permit adaptive interaction with different host structures. We developed a macaque animal model for Bartonella quintana infection to detect changes in bacterial outer-membrane proteins (OMP) during prolonged bloodstream infection. We identified a gene family encoding four highly conserved, 100-kDa, variably expressed OMP (Vomp), two of which function as adhesins. The variable expression of Vomp family members appears to be mediated by deletion of one or more vomp genes during chronic bloodstream infection. vomp deletion was observed also in isolates from humans with chronic B. quintana infection. The Vomp are closely related to the afimbrial adhesin, YadA, a virulence factor of Yersinia enterocolitica. The surface-expressed Vomp contain conserved structural features of YadA, including collagen-binding motifs. We demonstrate that the B. quintana Vomp are multifunctional OMP involved in binding to collagen and autoaggregation: VompC confers the ability to bind collagen IV, and VompA is necessary and sufficient for autoaggregation. The B. quintana Vomp are members of the newly recognized family of YadA-like trimeric autotransporters; the Vomp constitute a multigene family, they are variably expressed, and different virulence properties are attributable to individual Vomp family members.

PMCID: PMC518805 PMID: 15347808 [PubMed - indexed for MEDLINE]

197. Vet Microbiol. 2004 Sep 8;102(3-4):183-8.

Pathogen carriage by the cat flea Ctenocephalides felis (Bouché) in the United Kingdom.

Shaw SE, Kenny MJ, Tasker S, Birtles RJ.

Department of Clinical Veterinary Science, University of Bristol, Langford House, Langford, North Somerset BS40 5DU, UK. susan.e.shaw@bristol.ac.uk

The carriage of Bartonella, Rickettsia felis and haemoplasma species was investigated in cat fleas (Ctenocephalides felis) collected from 121 cats and dogs in the United Kingdom. DNA extracted from fleas was analysed using genus and species-specific PCR and amplicons were characterised using DNA sequencing. Fifty percent of flea samples were PCR positive for at least one pathogen. Twenty one percent were positive for R. felis, 17% for Bartonella henselae, 40% for haemoplasma species and 20% were infected with more than one of the pathogen species studied. It is clear from the results in this study that companion cats and dogs are commonly infested with Ct. felis carrying bacterial pathogens of significance to human and animal health. These findings raise the possibility that Ct. felis found on dogs and cats are a potential source of infection with such pathogens for humans.

PMID: 15327793 [PubMed - indexed for MEDLINE]

198. Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Jul;25(7):602-6.

[Study on Bartonella infection using molecular biological diagnostic techniques from China].

[Article in Chinese]

Li DM, Yu DZ, Liu QY, Hai R, Guo BH.

Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

OBJECTIVE: To establish polymerase chain reaction (PCR) technique for the detection of specific genes related to species of genus Bartonella, and for diagnosing clinically suspected cat-scratch disease (CSD) case complicated with pneumonia on both lungs. The appearance of Bartonella infectious diseases calls for genus and species detection and tools for identification in order to make clinical diagnosis and carry on epidemiological studies.

METHODS: One pair of primer TIle.455p-TAla.885n was designed based on the fact that tRNA(Ile)-tRNA(Ala) intergenic spacer region in 16S-23S rRNA intergenic spacer (ITS) of genus Bartonella were high variable sequences flanked by completely conserved tRNA-encoding genes. 16S-23S rRNA was longer than that which had been described in other bacteria. Two published pairs of primers were used to directly detect the specific gene fragments of Bartonella species DNA extracts from human blood, followed by PCR product Sequencing and nucleotide base sequence analysis.

RESULTS: Amplification products of the three pairs of primers had the same predicted size of those in Bartonella spp. According to the different length of electrophoresis bank, the sample was identified as a species of genus Bartonella other than the positive control. Sequence analysis showed that the nuleotide sequence from the PCR product of primer TIle.455p-TAla.885n was identical to the Bartonella isolated from Yunnan in China.

CONCLUSIONS: PCR-based assay provided a simple and rapid means to detect pathogenic Bartonella species in humans and mammalian hosts as well as in arthropod vecters. This study suggested that this pathogenic Bartonella species existed in patients in northern and southern parts of China.

PMID: 15308042 [PubMed - indexed for MEDLINE]

199. Clin Infect Dis. 2004 Aug 1;39(3):e21-4. Epub 2004 Jul 9.

Disseminated infection with Bartonella henselae as a cause of spontaneous splenic rupture.

Daybell D, Paddock CD, Zaki SR, Comer JA, Woodruff D, Hansen KJ, Peacock JE Jr.

Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.

A 65-year-old man developed massive hemoperitoneum secondary to spontaneous splenic rupture. Histopathological analysis of the spleen demonstrated necrotizing granulomas. Results of serological tests indicated infection with a species of Bartonella, and immunohistochemical staining established Bartonella henselae as the cause of splenitis. To our knowledge, this represents the first reported case of spontaneous splenic rupture caused by infection with a species of Bartonella.

PMID: 15307019 [PubMed - indexed for MEDLINE]

200. Nat Rev Microbiol. 2004 Aug;2(8):616-7.

Genomes beyond compare.

Crossman L, Holden M, Pain A, Parkhill J.

PMID: 15303267 [PubMed - indexed for MEDLINE]

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Bartonella Species in Humans and Human Petsand Other Insect Carrying AnimalsExplode in Variety All Over the Globe

Bartonella is Ahead of Labs and Clearly Proven Treatments

Bartonella Species in Humans and Human Pets
and Other Insect Carrying Animals
Explode in Variety All Over the Globe