Bartonella vinsonii subsp. arupensis as an agent of blood culture-negative endocarditis in a human

Exotic small mammals as potential reservoirs of zoonotic Bartonella spp

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.

Isolation of Candidatus Bartonella melophagi from human blood

Candidatus Bartonella melophagi was isolated by blood culture from 2 women, 1 of whom was co-infected with B. henselae. Partial 16S rRNA, RNA polymerase B, and citrate synthase genes and 16S-23S internal transcribed spacer sequences indicated that human isolates were similar to Candidatus B. melophagi.

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

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.

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

Culture-negative infectious endocarditis caused by Bartonella spp.: 2 case reports and a review of the literature

Bartonella spp. are rare pathogens in humans and were recently recognized as important causative agents of culture-negative endocarditis. Here, we describe the 1st 2 documented cases of culture-negative endocarditis due to Bartonella henselae and Bartonella quintana encountered in a single hospital in Germany. Infection of the heart valve tissue was detected by broad-range polymerase chain reaction (PCR) and further confirmed by serologic testing. In particular, acute B. henselae infection with an impressive bacterial colonization of the infected cardiac valve was illustrated by transmission electron microscopy. B. henselae was further characterized by PCR assays targeting genotype-specific regions. Disease progression was initially monitored over the entire infection episode through inflammatory markers. In addition, a short overview of published detailed cases of Bartonella endocarditis in Europe within the last 7 years is given.

Evaluation of an internally controlled real-time polymerase chain reaction assay targeting the groEL gene for the detection of Bartonella spp. DNA in patients with suspected cat-scratch disease

Bartonella (B.) henselae is the causative agent of cat-scratch disease (CSD), which usually presents as a self-limiting lymphadenopathy. This study reports the development and evaluation of an internally controlled real-time polymerase chain reaction targeting the groEL gene for detection of Bartonella spp. DNA was extracted using the MagNA Pure system. The lower detection limit was 10-100 fg DNA and the in vitro sensitivity of the assay was not affected by duplexing with an internal control PCR. The real-time PCR assay detected DNA from all five B. henselae strains tested, and from B. birtlesii, B. vinsonii subsp. vinsonii, B. vinsonii subsp. arupensis and B. doshiae. The assay generated negative results with a selection of other bacteria, including several Mycobacterium spp., Streptococcus pyogenes and Staphylococcus aureus. Results of real-time PCR in clinical samples were compared with those of a conventional 16S rDNA-based PCR assay. During the period described in the Material and methods section, real-time PCR and conventional 16S PCR were performed on 73 clinical samples. Of these samples, 29 (40%) were found to give positive results and 44 (60%) gave negative results, both by real-time PCR and by conventional PCR, with a 100% agreement between the two tests. The PCR developed in this study is a rapid, sensitive, and simple method for the detection of Bartonella spp. in CSD and is suitable for implementation in the diagnostic laboratory.

From cat scratch disease to endocarditis, the possible natural history of Bartonella henselae infection

Background

Most patients with infectious endocarditis (IE) due to Bartonella henselae have a history of exposure to cats and pre-existing heart valve lesions. To date, none of the reported patients have had a history of typical cat scratch disease (CSD) which is also a manifestation of infection with B. henselae.

Case presentation

Here we report the case of a patient who had CSD and six months later developed IE of the mitral valve caused by B. henselae.

Conclusion

Based on this unique case, we speculate that CSD represents the primary-infection of B. henselae and that IE follows in patients with heart valve lesions.

First isolation of Bartonella alsatica from a valve of a patient with endocarditis

We report the first documented case of endocarditis in a man infected with Bartonella alsatica, which causes bacteremia in healthy wild rabbits. B. alsatica was identified by serology and culture and by PCR of an aortic valve specimen. B. alsatica should be added to the list of zoonotic agents of blood culture-negative endocarditis.