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Bartonella (Rochalimaea) species as a cause of apparent "culture-negative" endocarditis.

Bartonella quintana (formerly Rochalimaea quintana) is a recently recognized cause of apparent "culture-negative" endocarditis. We describe a 39-year-old, homeless man who developed aortic valve endocarditis caused by B. quintana. He had a history of alcoholism and was seronegative for the human immunodeficiency virus. We established that B. quintana was the cause of the endocarditis on the basis of the isolation of B. quintana from blood cultures, the compatibility of histochemical stains of cardiac valve tissue, the reactivity of the polymerase chain reaction specific for B. quintana on cardiac valve tissue, and the failure to isolate an alternative causative organism despite extensive efforts. This is the second report of endocarditis caused by B. quintana and the fourth report of endocarditis caused by a Bartonella species. On the basis of the findings of this report and those of other recent reports, further study is warranted to determine the overall role of Bartonella species in apparent culture-negative endocarditis.

Adult↗

Bartonella birtlesii sp. nov., isolated from small mammals (Apodemus spp.).

Three strains isolated from Apodemus spp. were similar to Bartonella species on the basis of phenotypic characteristics. Futhermore, genotypic analysis based on sequence analysis of the 16S rRNA and gltA genes and on DNA-DNA hybridization showed that the three isolates represented a distinct and new species of Bartonella. The name Bartonella birtlesii is proposed for the new species. The type strain of B. birtlesii sp. nov. is IBS 325T (= CIP 106294T = CCUG 44360T).

Animals↗

Phylogenetic position of Bartonella vinsonii subsp. arupensis based on 16S rDNA and gltA gene sequences.

The nucleotide sequences of the genes encoding 16S rRNA and citrate synthase (gltA) from a recently described member of the genus Bartonella, Bartonella vinsonii subsp. arupensis, isolated from mice and from the blood of a patient suffering from bacteraemia, were determined and compared with sequences of the 16S rDNA and gltA genes of other members of the genus Bartonella in order to determine its relative phylogenetic position. B. vinsonii subsp. arupensis appeared to be closely related to B. vinsonii subsp. vinsonii, another rodent-associated taxon, and to B. vinsonii subsp. berkhoffii, which was described recently in dogs.

Animals↗

Involvement of host cell tyrosine phosphorylation in the invasion of HEp-2 cells by Bartonella bacilliformis.

We have provided evidence that exposure of human cells to protein kinase inhibitors results in decreased invasion of these cells by Bartonella bacilliformis in a dose-dependent manner. Preincubation of human laryngeal epithelial cells in the presence of genistein, a tyrosine protein kinase inhibitor, decreased the invasion of these cells by B. bacilliformis significantly. Further, exposure of normal human umbilical vein endothelial cells to staurosporine, a potent inhibitor of protein kinase C and some tyrosine protein kinases, resulted in a considerable reduction in the number of organisms internalized by these cells. Moreover, Bartonella infection of HEp-2 cells induced tyrosine phosphorylation of several Triton X-100 soluble proteins with approximate molecular masses of 243, 215 179, 172 (doublet), 160, 145 and 110 kDa that were absent or reduced in the presence of genistein in cells after 1 h of infection. Exposure of HEp-2 cell monolayers to anti-alpha 5 and anti-beta 1 chain integrin monoclonal antibodies resulted in a moderate decrease in the invasion of these cells, suggesting a possible role of alpha 5 beta 1 integrins in the uptake of Bartonella into nucleated cells.

Antibodies, Monoclonal↗

Species-specific monoclonal antibodies for rapid identification of Bartonella quintana.

Seven species-specific monoclonal antibodies (MAbs) to Bartonella quintana were produced and characterized. The MAbs were of the immunoglobulin G class and reacted only with 13 B. quintana strains in indirect microimmunofluorescence and Western immunoblotting assays. They did not react with eight other Bartonella spp., including Bartonella henselae, the most closely related species, and a selected MAb did also not react with nine other strains of gram-negative bacteria. The MAbs reacted mainly with a 34-kDa protein epitope of B. quintana which was shown to be species specific by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Four of five body lice experimentally infected with B. quintana were found to be positive for the organism in microimmunofluorescence assays with one MAb. These MAbs may provide a specific, simple, rapid, and low-cost tool for the identification of B. quintana and the diagnosis of infections due to the microorganism.

Animals↗

Characterization of Bartonella bacilliformis flagella and effect of antiflagellin antibodies on invasion of human erythrocytes.

Bartonella bacilliformis is the etiologic agent of Oroya fever in humans. Flagellum-mediated motility has been postulated as a major virulence factor for invasion of host cells. To address this hypothesis, we purified and characterized flagella from strain KC584 and then assessed their role in human erythrocyte association and invasion. Electron microscopy of the flagellar preparation showed a high concentration of filaments with a mean wavelength of 800 nm. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis, immunoblot analysis, and KBr density gradient centrifugation indicated that the flagellar filament is composed of a polypeptide of 42 kDa. The flagellin is partially (ca. 50%) resistant to treatment with trypsin. The first 17 amino acid residues of the N terminus of the mature flagellin protein are GAAILTNDNAMDALQDL and show approximately 46% sequence identity to the residues of the N termini of two Caulobacter crescentus flagellin proteins. A monospecific polyclonal antibodies to the flagellin protein was generated, and its specificity was verified by both immunoblot and immunogold analyses. Human erythrocyte invasion assays performed with bartonellae exposed to the antiflagellin antiserum showed a significant decrease in bacterial association with and invasion of human erythrocytes in comparison with that in bartonellae exposed to preimmune rabbit serum or phosphate-buffered saline (PBS) controls. These results suggest that flagella are an important component in the invasiveness of B. bacilliformis.

Amino Acid Sequence↗

The 75-kilodalton antigen of Bartonella bacilliformis is a structural homolog of the cell division protein FtsZ.

A genomic library of Bartonella bacilliformis was constructed and screened with human anti-Bartonella serum from a patient with the chronic, verruga peruana phase of bartonellosis. An immunoreactive clone isolated from this library was found to code for a 591-amino-acid protein with a high degree of sequence similarity to the FtsZ family of proteins. The degree of amino acid identity between the B. bacilliformis protein (FtsZ[Bb]) and the other FtsZ proteins is especially pronounced over the N-terminal 321 amino acids (N-terminal domain) of the sequence, with values ranging from 45% identity for the homolog from Micrococcus luteus (FtsZ[Ml]) to 91% identity for the homolog from Rhizobium melliloti, (FtsZ[Rm1]). All of the functional domains required for FtsZ activity are conserved in FtsZ(Bb) and are located within the N-terminal domain of the protein. FtsZ(Bb) is approximately twice as large as most of the other FtsZ proteins previously reported, a property it shares with FtsZ(Rm1). Like the Rhizobium homolog, FtsZ(Bb) has a C-terminal region of approximately 256 amino acids that is absent in the other FtsZ proteins. Evidence is presented that implicates this region in the protein's antigenicity and suggests that, unlike most other FtsZ homologs, FtsZ(Bb) is at least partly exposed at the cell surface. PCR analysis revealed that an ftsZ gene similar in size to the B. bacilliformis gene is present in Bartonella henselae, a bacterium that is closely related to B. bacilliformis.

Amino Acid Sequence↗

[Diseases produced by Bartonella].

The genus Bartonella is cause of a broad number of emerging and re-emerging infectious diseases. Clinical manifestations depend on the implicated Bartonella sp. and the immunity of the host. Because there is not a universal therapy for this infection, treatment should be chosen individually. Bartonella sp. is responsible of potentially serious clinical pictures (endocarditis, chronic bacteremia, bacillary angiomatosis, Carrion's disease, etc.), so clinical suspicion, a quick diagnosis and an early treatment provide a better resolution.

Anti-Bacterial Agents↗

Prevalence of DNA of Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum,' Anaplasma phagocytophilum, and species of Bartonella, Neorickettsia, and Ehrlichia in cats used as blood donors in the United States.

OBJECTIVE: To identify the prevalence of DNA of Mycoplasma haemofelis; 'Candidatus Mycoplasma haemominutum'; Anaplasma phagocytophilum; and species of Bartonella, Neorickettsia, and Ehrlichia in blood of cats used as blood donors in the United States. DESIGN: Prospective study. ANIMALS: 146 cats that were active blood donors. PROCEDURES: Environmental history was requested for each blood-donor cat from which a blood sample (mixed with EDTA) was available. Polymerase chain reaction assays capable of amplifying the DNA of the microorganisms of interest following DNA extraction from blood were performed. RESULTS: Overall, DNA of one or more of the infectious agents was detected in blood samples from 16 of 146 (11%) feline blood donors. Twenty-eight laboratory-reared cats housed in a teaching hospital had negative results for DNA of all organisms investigated. The DNA of at least 1 infectious agent was amplified from blood samples collected from 16 of 118 (13.6%) community-source cats; assay results were positive for 'Candidatus M haemominutum,' M haemofelis, or Bartonella henselae alone or in various combinations. Of the community-source cats allowed outdoors (n = 61) or with known flea exposure (44), DNA for a hemoplasma or B henselae was detected in 21.3% and 22.7%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: When community-source cats, cats allowed outdoors, or cats exposed to fleas are to be used as blood donors, they should be regularly assessed for infection with M haemofelis, 'Candidatus M haemominutum,' and Bartonella spp, and flea-control treatment should be regularly provided.

Anaplasma phagocytophilum↗

Persistent infection of pets within a household with three Bartonella species.

We monitored by blood culture and immunofluorescence assay (IFA) bartonella infection in one dog and eight cats in a household to determine the prevalence and persistence of the infection as well as its transmissibility to humans. Ectoparasite control was rigorously exercised. During a 3-year period, Bartonella clarridgeiae was recovered from one cat on two occasions, and B. henselae was isolated from another cat on four occasions. During a 16-month period, B. vinsonii subsp. berkhoffii was isolated from the dog on 8 of 10 culture attempts. Despite extensive household contact, the pet owner was seronegative to all three species by IFA for Bartonella-specific immunoglobulin G.

Animals↗

Cutting edge: antibody-mediated cessation of hemotropic infection by the intraerythrocytic mouse pathogen Bartonella grahamii.

The genus Bartonella includes important human-specific and zoonotic pathogens which cause intraerythrocytic bacteremia in their mammalian reservoir host(s). It is accepted that cellular immunity plays a decisive role in the host's defense against most intracellular bacteria. Bartonella sp. infection in the immunocompetent host typically leads to immunity against homologous challenge. The basis of this immunity, be it cellular or humoral, is unclear. In this study, the course of Bartonella grahamii bacteremia in immunocompetent and immunocompromised mice was compared. In immunocompetent hosts, the bacteremia is transient and induces a strong humoral immune response. In contrast, bacteremia persists in immunocompromised B and T cell-deficient mice. Immune serum transfer beginning with day 6 postinfection to B cell-deficient mice unable to produce Igs converted the persistent bacteremia to a transient course indistinguishable from that of immunocompetent animals. These data demonstrate an essential role for specific Abs in abrogating the intraerythrocytic bacteremia of B. grahamii in mice.

Adoptive Transfer↗

Cat scratch disease. Survey on the presence of Bartonella henselae among cats of Tuscany.

To verify the presence of Bartonella henselae-infection in cats living in Tuscany (central Italy) serological and bacteriological surveys were carried out. The blood serum samples of 427 cats, 254 living in private houses and gardens and 173 in public or private catteries, were tested for anti-B. henselae antibodies by indirect immunofluorescence assay (IFA). Among these samples, 35 were examined by IFA to detect antibodies against Bartonella quintana. Bacteriological examinations were performed on the blood samples, collected in EDTA (ethylene diaminetetraacetic acid), of 18 cats (10 seropositive to B. henselae and 8 negative). From each of the same 18 specimens DNA was extracted and used as template in polymerase chain reaction (PCR). The primers p24E and p12B were employed in the PCR assay to amplify a 296 bp fragment of the Bartonella 16S rRNA gene. IFA detected 98 (22.95%) B. henselae-positive serum samples (40-40.82% from cats living in houses and gardens and 58-59.18% from cats of catteries) at different antibody titers (70 at 1:64 titer, 4 at 1:128, 22 at 1:256, 2 at 1:512). Among the 35 sera tested to detect antibodies against B. quintana, 9 (25.71%) resulted positive at 1:64 titer; all these samples showed higher antibody titers to B. henselae. Out of the 26 negative sera, 20 were negative to B. henselae too and 6 had antibodies against B. henselae at 1:64. Hemocultures gave negative results. PCR scored positive with DNA of 4 B. henselae-seropositive cats, two of which belonged to two children with cat scratch disease (CSD).

Animals↗

[Bartonella and bartonellosis--emerging and re-emerging infections. Taxonomy, bacteriology, pathogenesis and genetics].

The review updates knowledge on the taxonomy, bacteriology and genetics of Bartonella as well as pathogenesis of bartonellosis. The role of Bartonella in human pathology, formerly considered to be rather modest, causes now growing anxiety. In this connection Bartonella are now believed to be the causative agents of so-called emerging and re-emerging diseases, i.e. diseases, formerly unknown to man, and diseases, believed to be eradicated and playing at present no important role in human pathology. These microorganisms are a bright example of successes of molecular biology in the detection of microorganisms, as well as in their phylogenetics and systematics.

Animals↗

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

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.

Afghanistan↗

Molecular detection of Rickettsia felis, Rickettsia typhi and two genotypes closely related to Bartonella elizabethae.

A total of 56 fleas were collected from mice, rats, and one hedgehog in national parks of mainland Portugal and the Madeira Island. All fleas were tested for the presence of bacteria of the genera Rickettsia and Bartonella using PCR assays. In fleas from mainland Portugal, we detected Rickettsia felis in one Archaeopsylla erinacei maura flea and in one Ctenophtalmus sp. In five Leptopsylla segnis fleas taken from rats in the Madeira Island, we identified Rickettsia typhi. In addition, in four fleas from the genera Ornithophaga and Stenoponia collect from mice and a rat in mainland Portugal, we detected the presence of two new Bartonella genotypes closely related to Bartonella elizabethae. Our findings emphasize the potential risk of flea-transmitted infections in mainland Portugal and the Madeira archipelago, and extend our knowledge of the potential flea vectors of human pathogens.

Animals↗

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

Bartonella henselae, the causative agent of cat-scratch disease, was identified recently by DNA amplification techniques. Several other Bartonellae (most of which were called Rochalimaea before) cause disease in humans: B. bacilliformis (Carrion's disease), B. elizabethae (endocarditis) and B. quintana (bacillary angiomatosis and peliosis, chronic bacteraemia and endocarditis, trench fever). B. henselae is transmitted to humans by scratch or bite of a bacteraemic, but asymptomatic, cat, which event may be followed by regional lymphadenitis (classical cat-scratch disease), bacillary angiomatosis or peliosis of liver and spleen (in immune compromised, e.g. HIV-infected individuals) or chronic bacteraemia and endocarditis (in elderly individuals). The incidence in the Netherlands of cat-scratch disease is > 2/100,000/year. If a Bartonella infection is suspected, specific immuno-assays and polymerase chain reaction assay may be applied for diagnosis. Culture of the organism is difficult. Macrolides and tetracyclines have been shown to be effective in treatment of disseminated infections. The natural (self-limiting) course of regional lymphadenitis however is not affected by antibiotic treatment.

Aged↗

Survey of veterinary professionals and other veterinary conference attendees for antibodies to Bartonella henselae and B quintana.

OBJECTIVE: To determine serologic and epidemiologic characteristics of an occupational group potentially at risk for Bartonella sp infection. DESIGN: Epidemiologic survey. SAMPLE POPULATION: 351 veterinarians, veterinary technicians, and other individuals attending a veterinary conference in Ohio. PROCEDURE: A serum sample was obtained from each individual and tested for antibodies to Bartonella henselae or B quintana. A 24-question survey also was administered regarding demographic, occupational, and exposure information. RESULTS: 25 (7.1%) individuals were seropositive for B henselae or B quintana. Forty-seven, of whom 5 were seropositive, reported a history of illness consistent with cat-scratch disease and 18, of whom 3 were seropositive, reported a previous diagnosis of cat-scratch disease. Of the variables analyzed, only years of experience with cats was correlated with seropositivity. CLINICAL IMPLICATIONS: The overall seroprevalence for 2 species of Bartonella in this occupational group was only slightly higher than that reported from other surveys. Seroprevalences among veterinarians, veterinary technicians, hospital staff, and others were essentially identical. Small sample groups, high percentage of cat ownership among participants, unknown duration of seropositivity, and unknown prevalence of infection among cats were potential confounders.

Adult↗

[Bartonella endocarditis on native valves. Apropos of 2 cases].

The authors report two cases of Bartonella endocarditis in native valves. The first case was a 15 year old North African Girl who lived in poor social conditions and was admitted to hospital with pyrexia and congestive heart failure. Investigations revealed massive mitral regurgitation due to ruptured chordae tendinae, vegetations on the pulmonary valve with severe pulmonary hypertension due to persistent ductus arteriosus. After antibiotic therapy, the patient underwent surgery for mitral valve replacement, pulmonary valvuloplasty and closure of the patent ductus arteriosus. The second case was a 39 year old man with no fixed abode with a history of alcoholism who presented with a recurrent ischaemic stroke in a context of infection with a murmur of aortic regurgitation. Echocardiography showed a vegetation on the aortic valve with grade III/IV regurgitation requiring aortic valve replacement with a homograft after antibiotic therapy. The aetiological diagnosis was made a posteriori by the finding of high antibody titres and specific genetic amplification of Bartonella. In patients with negative blood cultures, Bartonella infection should be looked for systematically especially in those living under poor social conditions. The practical diagnostic investigation of endocarditis with negative blood cultures is reviewed.

Adolescent↗