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Bartonella henselae in porpoise blood.

We report detection of Bartonella henselae DNA in blood samples from 2 harbor porpoises (Phocoena phocoena). By using real-time polymerase chain reaction, we directly amplified Bartonella species DNA from blood of a harbor porpoise stranded along the northern North Carolina coast and from a pre-enrichment blood culture from a second harbor porpoise. The second porpoise was captured out of habitat (in a low-salinity canal along the northern North Carolina coast) and relocated back into the ocean. Subsequently, DNA was amplified by conventional polymerase chain reaction for DNA sequencing. The 16S-23S intergenic transcribed spacer region obtained from each porpoise was 99.8% similar to that of B. henselae strain San Antonio 2 (SA2), whereas both heme-binding phage-associated pap31 gene sequences were 100% homologous to that of B. henselae SA2. Currently, the geographic distribution, mode of transmission, reservoir potential, and pathogenicity of bloodborne Bartonella species in porpoises have not been determined.

Animals↗

[Prevalence of Bartonella henselae antibodies in Chilean children, adolescents and veterinary workers].

BACKGROUND: Bartonella henselae is the causative agent of cat-scratch disease. AIM: To study the seroepidemiology of Bartonella henselae in healthy Chilean children and in a population with occupational risk. MATERIAL AND METHODS: Serum IgG antibodies were determined by indirect fluorescence technique in 181 children and adolescents and in 107 technical and professional workers involved in the care of cats. Samples with titers equal to or greater than 64 were considered positive. RESULTS: Twenty four (13.3%) children and 11 (10.3%) occupational risk subjects were seropositive. No significant differences by age and gender were observed. CONCLUSIONS: Assuming that seroprevalence indicates level of exposure to Bartonella henselae, these results suggest that this infection is endemic in Chile and, for this reason, the best antibody titer to diagnose acute cat-scratch disease should be higher than the figure recommended by the Centers for Disease Control in the in United States.

Adolescent↗

Bb65, a major immunoreactive protein of Bartonella bacilliformis.

A 65 kDa protein (Bb65) has been identified as one of the major specific antigens of Bartonella bacilliformis, the causative agent of bartonellosis which is a bacterial infectious disease of inhabitants of the Andes. The gene encoding this antigen (7B2) was isolated from an expression library made directly from randomly generated fragments of B. bacilliformis genomic DNA using Bartonella antibodies raised in rabbits and sera of bartonellosis patients. The Bartonella 7B2 gene was expressed in Escherichia coli and the recombinant Bb65 protein was purified by column chromatography. Using polyclonal antibodies raised in rabbits, the antigen was shown to be present in all of 13 B. bacilliformis isolates from different Peruvian regions. Immune electron microscopy demonstrated the probable cytoplasmatic localization of Bb65. When applied to enzyme immunoassays, Bb65 sensitively and specifically bound to IgG antibody of sera of bartonellosis patients, convalescents, and immunes from various Peruvian regions. IgM antibody was not recognized by Bb65, neither was IgG antibody circulating during the first 2 weeks of illness. The amino-terminal amino acid sequence of Bb65 was 53% homologous to the 65 kDa heat shock protein of Mycobacterium tuberculosis.

Amino Acid Sequence↗

First molecular evidence of new Bartonella spp. in fleas and a tick from Peru.

Fleas, lice, and ticks collected in Peru in a suburban area of Cusco in November 1998 were tested by polymerase chain reaction for the presence of Bartonella DNA using primers amplifying a fragment of the intergenic spacer region (ITS) gene. Three new Bartonella genotypes were detected in Pulex fleas self-collected from the beds and clothes of schoolchildren and adults. A fourth new genotype was also detected from a tick found on a sheep in the same area. One of the genotypes is closely related to B. vinsoni subsp. berkhoffii, and the others seem to originate from unknown Bartonella species, whose medical importance has yet to be clarified.

Animals↗

[Subacute infectious endocarditis due to the agent of cat scratch fever: Bartonella henselae].

The diagnosis of severe mitral stenosis with left atrial thrombus was rectified at valvular replacement in a 48-year old immuno-competent man who was a cat owner. The mass in the left atrium was, in fact, a large endocarditic vegetation. Pre- and postoperative blood cultures were negative as was culture of the excised mitral valve. The diagnosis of infectious endocarditis (IE) due to Bartonella Henselae was made from a positive serological test (1600) and identification of the germ by genetic amplification. Antibiotic therapy was continued for 6 months and the patient was cured with a follow-up of 4 years. Bartonella Henselae IE is very rare (14 reported cases) and affects mainly the aortic valve, often giving rise to very large vegetations which, in half the cases, are complicated by systemic emboli. Germs like Batonella are sensitive to most antibiotics, especially the aminosides and macrolides. In Bartonella Henselae IE, valve replacement is the rule (13 out of 14 cases) and the prognosis is usually good. Sero-diagnosis of Bartonellosis should be part of the systematic investigation of all blood culture negative IE.

Azithromycin↗

Aortic valve endocarditis caused by Bartonella henselae: a rare surgical entity.

We report a case of aortic valve endocarditis caused by Bartonella henselae. The patient initially presented to a regional hospital with generalized symptoms including lethargy, malaise and decreased appetite. Transthoracic echocardiogram revealed a large vegetation on the aortic valve and he was treated empirically with broad spectrum intravenous antibiotics. Several blood cultures were obtained which all returned negative results and the white blood cell count was normal. He was transferred to our hospital, with persistence of his initial symptoms and additional low-grade fevers. In light of his negative culture results, serological testing for Bartonella and Chlamydia was performed, which gave a positive result for Bartonella henselae. In view of this result and following development of severe aortic valve insufficiency, he underwent an aortic valve replacement and made a good recovery.

Angiomatosis, Bacillary↗

Rheumatic manifestations of Bartonella infection in 2 children.

We describe 2 patients with very unusual rheumatological presentations presumably caused by Bartonella infection: one had myositis of proximal thigh muscles bilaterally, and the other had arthritis and skin nodules. Both patients had very high levels of antibody to Bartonella that decreased in association with clinical improvement. Bartonella infection should be considered in the differential diagnosis of unusual myositis or arthritis in children.

Anti-Bacterial Agents↗

Isolation of Bartonella henselae from domestic cats in an Italian urban area.

Bartonella henselae is the causative agent of Cat Scratch Disease (CSD) in humans. Cat is considered the reservoir of the bacterium. Identification of bacteriemic cats is the basic tool in the prophylaxis of CSD. Blood samples were collected between January 1999-December 2000 from 248 domestic cats living in an urban area (Reggio Emilia) in Northern Italy and tested for Bartonella henselae bacteriemia. Cultural and PCR methods were used. PCR was used directly on cat blood as well as to identify the Bartonella strain growth in culture. 24 (9.7 %) cats were found bacteriemic, most of which aged <1 year. A higher sensitivity was demonstrated by cultural method compared with PCR.

Animals↗

Molecular detection of Bartonella spp. in the dental pulp of stray cats buried for a year.

Bartonella henselae causes chronic bacteremia in cats. To test if B. henselae DNA can be recovered from the dental pulp of cats buried a year previously, we used PCR with primers for a sequence of the conserved groEL to test 104 teeth from 11 cats. Seven of the cats were found positive; canine teeth were more frequently positive than molar teeth. Where PCR sequences could be determined, they were identical to those of B. henselae Marseille (four cats), B. henselae Houston (one cat) or similar to those of B. grahamii (one cat). Our study indicates that dental pulp from the teeth of cats, especially the canine teeth, may be used for the PCR detection of Bartonella in animals buried for a year.

Animals↗

Low seroprevalence of bartonella species in danish elite orienteers.

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.

Adult↗

Multispacer typing to study the genotypic distribution of Bartonella henselae populations.

Bartonella henselae, a worldwide fastidious bacterium, has a feline reservoir and is pathogenic for humans. However, the relationship between human and cat isolates of B. henselae, as well as its population dynamics and geographic heterogeneity, is not fully understood, in part because of the absence of appropriate typing methods. Multilocus sequence typing (MLST), the most discriminatory genotyping method for B. henselae, identified seven genotypes and suggested that human isolates arose from a limited number of cat isolates. Herein, we estimated the discriminatory power of multispacer typing (MST) by studying 126 B. henselae cat isolates from various areas of Europe, Asia, and the United States. We identified the nine most variable intergenic spacers conserved by both B. henselae and Bartonella quintana genomes. By comparing the sequences obtained from these nine spacers for each studied isolate, we identified 39 MST genotypes. The distribution of isolates into MST genotypes matched their phylogenetic organization into four clusters. MST showed that European and Asian isolates were different, in contrast with American isolates, but failed to identify pandemic strains. Our study demonstrated that MST is a powerful method for genotyping B. henselae at the strain level and may serve in studying the population dynamics of this bacterium and understanding the relationships between cat and human isolates. Finally, we provide a free-access MST-Rick online software program (http://ifr48.timone.univ-mrs.fr/MST_BHenselae/mst) that investigators may use to compare their own MST sequences to our database.

Animals↗

Culture-negative endocarditis: contribution of bartonella infections.

Two cases of bartonella endocarditis are described: one in a 55 year old homeless alcoholic man, caused by Bartonella quintana; the other in a 41 year old male with a history of exposure to cat fleas, caused by B henselae. Serological testing and polymerase chain reaction of the excised valves were used to identify the organisms. False positive serology for chlamydia was detected in one case.

Adult↗

Prevalence of Bartonella species causing bacteraemia in domesticated and companion animals in the United Kingdom.

Between October 1999 and February 2000, 691 blood samples examined routinely for either haematological or virological assessment were screened by culture for the presence of Bartonella species. They came from 615 animals: 360 cats, 211 dogs, 27 horses, 16 cattle and a gorilla. The samples were incubated for long periods on 10 per cent horse blood agar at 37 degrees C in an atmosphere containing 5 per cent carbon dioxide. Isolates were obtained from 35 samples from 34 (9.4 per cent) of the cats, but not from any of the other animals. Comparison of citrate synthase gene sequences from the isolates indicated that they were all Bartonella henselae. Analysis of 16S rRNA gene fragments indicated that 30 of the cats were infected solely with B henselae genotype II, two were infected solely with B henselae genotype I and two were infected with both genotypes.

Animals↗

[Clinical evaluation of commercial serological test for Bartonella infection].

We evaluated the usefulness of a serological diagnostic kit (Bartonella IFA IgG, IgM; MRL Diagnostics) for Bartonella henselae infection. Of the 110 healthy individuals, 107 (97.3%) were with titers being less than 1:64 for IgG antibody to B. henselae, 2 were with titers being 1:64 and 1 with 1:128, IgM antibody to B. henselae was negative in all individuals. Serological diagnosis of cat scratch disease (CSD) using indirect fluorescence antibody (IFA) methods (in-house and diagnostic kit) was made in either elevated titers of IgM (> or = 1:20) or IgG (> or = 1:256) antibodies, or a four-fold rise in IgG titer between acute and convalescent sera. Of the 18 individuals with serological diagnosis of CSD by in-house IFA method in 26 CSD clinical diagnosed patients, 15 (83%) were compatible with the results of the diagnostic kit, whereas 3 (17%) were not compatible. Of the 8 without serological diagnosis, 1 (13%) was serologically diagnosed as CSD, and the others were negative. Overall, the serological diagnosis was made in 16 of 26 (62%). The specificity and sensitivity of this kit were 100% and 62%, respectively. The cross-reaction between B. henselae and Bartonella quintana was observed in sera from controls and patients. Our results show that the diagnostic kit as well as in-house method is an useful tool for the serological diagnosis of cat scratch disease.

Adolescent↗

Bartonella infections: diagnostic and management issues.

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.

Journal Article↗

Aortic valve endocarditis with Bartonella quintana - a rare entity.

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.

Adult↗

Sternal abscess due to Bartonella (Rochalimaea) henselae in a renal transplant patient.

Bartonella henselae, previously called Rochalimaea henselae, is the causative agent of cat scratch disease (CSD) in immunocompetent subjects and bacillary angiomatosis in immunocompromised ones. Bone lesions are common in bacillary angiomatosis, but not in CSD. We present the case of a patient with a renal transplant treated by immunosuppressive therapy who developed a sternal abscess with a histological pattern of CSD. The CT pattern was that of a lytic bone lesion with adjacent fluid collection. The diagnosis was made on the basis of a polymerase chain reaction amplification performed on bone material. Bartonella henselae is a newly described bacteria that causes CSD in a normal host and bacillary angiomatosis in immunocompromised patients. We report a case of an osteolytic lesions of the sternum with adjacent fluid collection related to CSD, which occurred in a patient with a renal transplant.

Abscess↗

The 16S-23S rRNA intergenic spacer region of Bartonella (Rochalimaea) species is longer than usually described in other bacteria.

We amplified by polymerase chain reaction (PCR) and sequenced using an automated laser fluorescent DNA sequencer (Pharmacia) the intergenic spacer region (ITS) between the 16S and 23S rRNAs of the four species of Rochalimaea which were recently renamed Bartonella sp. We obtained DNA fragments of 1211, 1262, 1258 and 1529 bp for the reference species of B. quintana, B. henselae, B. vinsonii and B. elizabethae, respectively. The ITS of the four species are longer than previously reported in prokaryotes and contained the genes encoding isoleucine-tRNA (tRNA(Ile)) and alanine-tRNA (tRNA(Ala)). The sequences of the tRNA(Ala) genes are identical for the four Bartonella species, but the tRNA(Ile) gene sequence of B. quintana presents one mutation in comparison with the other species.

Bartonella↗