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Boodman C, Gupta N, van Griensven J, Van Bortel W. Bartonella quintana detection among arthropods and their hosts: a systematic review and meta-analysis. Parasit Vectors 2024; 17:328. [PMID: 39095833 PMCID: PMC11295871 DOI: 10.1186/s13071-024-06413-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Bartonella quintana is a body louse-borne bacterium causing bacteremia and infective endocarditis. We aimed to describe B. quintana detection among arthropods and their hosts. METHODS We searched databases in PubMed Central/MEDLINE, Scopus, Embase, and Web of Science from January 1, 1915 (the year of B. quintana discovery) to January 1, 2024, to identify publications containing specific search terms relating to B. quintana detection among arthropods. Descriptive statistics and meta-analysis of pooled prevalence using random-effects models were performed for all arthropods and body and head lice. RESULTS Of 1265 records, 62 articles were included, describing 8839 body lice, 4962 head lice, and 1692 other arthropods, such as different species of fleas, bedbugs, mites, and ticks. Arthropods were collected from 37 countries, of which 28 had arthropods with B. quintana DNA. Among articles that reported B. quintana detection among individual arthropods, 1445 of 14,088 (0.1026, 95% CI [0.0976; 0.1077]) arthropods tested positive for B. quintana DNA, generating a random-effects model global prevalence of 0.0666 (95% CI [0.0426; 0.1026]). Fifty-six studies tested 8839 body lice, of which 1679 had B. quintana DNA (0.1899, 95% CI [0.1818; 0.1983]), generating a random-effects model pooled prevalence of 0.2312 (95% CI [0.1784; 0.2843]). Forty-two studies tested 4962 head lice, of which 390 head lice from 20 studies originating from 11 different countries had B. quintana DNA (0.0786, 95% CI [0.0713; 0.0864]). Eight studies detected B. quintana DNA exclusively on head lice. Five studies reported greater B. quintana detection on head lice than body lice; all originated from low-resource environments. CONCLUSIONS Bartonella quintana is a vector-borne bacterium with a global distribution, disproportionately affecting marginalized populations. Bartonella quintana DNA has been detected in many different arthropod species, though not all of these arthropods meet criteria to be considered vectors for B. quintana transmission. Body lice have long been known to transmit B. quintana. A limited number of studies suggest that head lice may also act as possible vectors for B. quintana in specific low-resource contexts.
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Affiliation(s)
- Carl Boodman
- University of Manitoba, Winnipeg, MB, Canada.
- Institute of Tropical Medicine, Antwerp, Belgium.
- University of Antwerp, Antwerp, Belgium.
| | - Nitin Gupta
- Institute of Tropical Medicine, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
- Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
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Boodman C, Garcia OF, Kabbani D, Villalobos APC, Beeson A, Marx GE, van Griensven J, Doucette K. Donor-Derived Bartonella quintana Infection in Solid Organ Transplantation: An Emerging Public Health Issue With Diagnostic Challenges. Open Forum Infect Dis 2024; 11:ofae381. [PMID: 39192995 PMCID: PMC11348938 DOI: 10.1093/ofid/ofae381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/04/2024] [Indexed: 08/29/2024] Open
Abstract
Bartonella quintana is a louse-borne intracellular bacterium that remains a neglected cause of bacteremia, bacillary angiomatosis, and infective endocarditis among individuals experiencing poverty. In October 2023, Health Canada notified Canadian organ transplantation programs of an outbreak of donor-derived B quintana infection. From March to August 2023, 5 cases of donor-derived B quintana disease were acquired in Alberta, Canada, from 3 deceased donors who had experienced homelessness. Similar cases recently occurred in the United States. In this article, we discuss strategies to screen organ donors and monitor transplant recipients for B quintana infection using epidemiologic risk factors, physical examination signs, and laboratory diagnostic tests. We review the limitations of existing diagnostic tests for B quintana and describe how these problems may be magnified in the organ transplantation context.
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Affiliation(s)
- Carl Boodman
- Division of Infectious Diseases, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Unit of Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
| | - Oscar Fernandez Garcia
- Department of Infectious Disease, Faculty of Medicine and Dentistry Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Dima Kabbani
- Department of Infectious Disease, Faculty of Medicine and Dentistry Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Amy Beeson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Grace E Marx
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Johan van Griensven
- Unit of Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
| | - Karen Doucette
- Department of Infectious Disease, Faculty of Medicine and Dentistry Medicine, University of Alberta, Edmonton, Alberta, Canada
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Bullard RL, Olsen EL, Cheslock MA, Embers ME. Evaluation of the available animal models for Bartonella infections. One Health 2024; 18:100665. [PMID: 38223332 PMCID: PMC10784307 DOI: 10.1016/j.onehlt.2023.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/12/2023] [Indexed: 01/16/2024] Open
Abstract
The diseases caused by the Bartonella genus of bacteria are clinically diverse, and can be challenging to cure. The study of bartonellosis has been hampered by the lack of a suitable animal model. Preclinical studies for novel therapeutics and a competent host for vector transmission studies are needed to fill critical knowledge gaps. The studies included here are a representation of in vivo Bartonella research and the corresponding challenges. This review examines the current state of available animal models by assessing the success of various model species and strains in Bartonella infection. With a focus on the strengths and weaknesses of current animal models, the importance of these models for improvement of human health and veterinary care is emphasized.
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Affiliation(s)
- Rebekah L. Bullard
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
| | - Emily L. Olsen
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
| | - Mercedes A. Cheslock
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
| | - Monica E. Embers
- Division of Immunology, Tulane National Primate Research Center, Tulane University Health Sciences, Covington, LA, USA
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Yang J, Wang Y, Yang H, Zhang X, Zheng X, Huang X. Infection status and molecular detection of pathogens carried by ectoparasites of Miniopterus fuliginosus bats in Yunnan, China. Parasitol Int 2024; 98:102823. [PMID: 37967717 DOI: 10.1016/j.parint.2023.102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/24/2023] [Accepted: 11/08/2023] [Indexed: 11/17/2023]
Abstract
Bats serve as natural hosts for various infectious agents that can affect both humans and animals, and they are geographically widespread. In recent years, the prevalence of bat-associated pathogens has surged on a global scale, consequently generating significant interest in bats and their ectoparasites. In this study, we specifically selected the Miniopterus fuliginosus as the host and conducted bat captures in Nanjian Yi Autonomous County, Dali Bai Autonomous Prefecture, and the other in Mouding Township, Chuxiong Yi Autonomous Prefecture, located in Yunnan Province, China. Ectoparasites were meticulously collected from the bat body surface, alongside blood samples for subsequent analyses. Following collection, the ectoparasites were methodically identified and subjected to comprehensive ecological analysis. Additionally, DNA was extracted from both the bat blood and bat flies, with conventional PCR techniques utilized for molecular screening of four pathogens: Anaplasma sp., Babesia sp., Hepatozoon sp., and Bartonella sp. The capture efforts yielded a total of 37 M. fuliginosus, from which 388 ectoparasites were recovered, including 197 gamasid mites (Cr = 50.77%, PM = 94.59%, MA = 5.32, MI = 5.63) and 191 bat flies (Cr = 49.23%, PM = 75.68%, MA = 5.16, MI = 6.82). Notably, Steatonyssus nyctali (Y = 0.28, m*/m = 2.44) and Nycteribia allotopa (Y = 0.23,m*/m = 1.54) predominated among different individuals of M. fuliginosus, exhibiting an aggregated distribution pattern. The infection rates of Bartonella sp. were identified to be 18.92% (7/37) among bats and 37.17% (71/191) among bat flies, based on the testing of 37 bats and 191 bat flies. Phylogenetic analysis demonstrated that the Bartonella sequences exhibited similarity to those found in bats and bat flies within China and South Korea. This study not only contributes to our comprehension of ectoparasite infection in M. fuliginosus but also establishes a foundation for potential exploration of their role as vectors.
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Affiliation(s)
- Jinting Yang
- Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, 22 Wanhua St, Dali 671000, China
| | - Yujian Wang
- Jilin Provincial Key Laboratory of Animal Resource Conservation and Utilization, Northeast Normal University, 5268 Renmin St, Changchun 130000, China
| | - Huijuan Yang
- Department of Pathogen Biology, Institute of Tropical Medicine, School of Public Health, Southern Medical University, Shatai South Road, Guangzhou 510000, China
| | - Xianzheng Zhang
- Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, 22 Wanhua St, Dali 671000, China
| | - Xiaoyan Zheng
- Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, 22 Wanhua St, Dali 671000, China
| | - Xiaobin Huang
- Institute of Pathogens and Vectors, Yunnan Provincial Key Laboratory for Zoonosis Control and Prevention, Dali University, 22 Wanhua St, Dali 671000, China.
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Boodman C, Fongwen N, Pecoraro AJ, Mihret A, Abayneh H, Fournier PE, Gupta N, van Griensven J. Hidden Burden of Bartonella quintana on the African Continent: Should the Bacterial Infection Be Considered a Neglected Tropical Disease? Open Forum Infect Dis 2024; 11:ofad672. [PMID: 38370291 PMCID: PMC10873695 DOI: 10.1093/ofid/ofad672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/19/2023] [Indexed: 02/20/2024] Open
Abstract
Bartonella quintana is a louse-borne gram-negative bacillus that remains a poorly characterized cause of bacteremia, fever, and infective endocarditis. Due to the link with pediculosis, B quintana transmission is tied to poverty, conflict, overcrowding, and inadequate water access to maintain personal hygiene. Although these risk factors may be present globally, we argue that a substantial burden of undocumented B quintana infection occurs in Africa due to the high prevalence of these risk factors. Here, we describe the neglected burden of B quintana infection, endocarditis, and vector positivity in Africa and evaluate whether B quintana meets criteria to be considered a neglected tropical disease according to the World Health Organization.
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Affiliation(s)
- Carl Boodman
- Section of Infectious Diseases, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Unit of Neglected Tropical Diseases, Clinical Sciences Department, Institute of Tropical Medicine, Antwerp, Belgium
| | - Noah Fongwen
- Diagnostics Access, Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Alfonso J Pecoraro
- Division of Cardiology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - Adane Mihret
- Microbiology Department, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Hiwot Abayneh
- Microbiology Department, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Pierre-Edouard Fournier
- French Reference Center for Rickettsioses, Q Fever and Bartonelloses, Institut Hospitalier Universitaire, Marseille, France
| | - Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal, India
| | - Johan van Griensven
- Unit of Neglected Tropical Diseases, Clinical Sciences Department, Institute of Tropical Medicine, Antwerp, Belgium
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Motzer AR, Mudroch S, Schultz S, Sullivan KV, Altneu E. The Brief Case: Bartonella quintana aortic and mitral valve endocarditis identified through 16S rRNA sequencing. J Clin Microbiol 2024; 62:e0040223. [PMID: 38230945 PMCID: PMC10793333 DOI: 10.1128/jcm.00402-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Affiliation(s)
- Andrew R. Motzer
- Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Steven Mudroch
- Section of Infectious Diseases, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Sara Schultz
- Section of Infectious Diseases, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Kaede V. Sullivan
- Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
| | - Eric Altneu
- Section of Infectious Diseases, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
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Tufa TB, Margos G, Fingerle V, Hartberger C, Poppert S, Birtles RJ, Kraiczy P, Kempf VAJ, Frickmann H, Feldt T. Evidence for Bartonella quintana in Lice Collected from the Clothes of Ethiopian Homeless Individuals. Pathogens 2023; 12:1299. [PMID: 38003765 PMCID: PMC10675803 DOI: 10.3390/pathogens12111299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/19/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Human lice, Pediculus humanus, can transmit various pathogens, including Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii. Xenosurveillance is an epidemiological approach to assessing human infection risks performed by screening vectors of infectious disease agents. In the proof-of-principle study reported herein, the DNA of 23 human lice was collected from the clothes of 30 homeless Ethiopian individuals. These samples were assessed using 16S rRNA gene-specific pan-eubacterial PCR for screening, followed by Bartonella genus 16S-23S internal transcribed spacer (ITS) sequence-specific PCR, Bartonella genus gltA gene-specific PCR, and 16S rRNA gene PCR with specificity for relapsing-fever-associated Borrelia spp. with subsequent sequencing of the amplicons. In one sample, the pan-eubacterial 16S rRNA gene-specific screening PCR, the Bartonella genus 16S-23S ITS sequence-specific PCR, and the Bartonella genus gltA gene-specific PCR allowed for the sequencing of B. quintana-specific amplicons. In two additional samples, Bartonella genus gltA gene-specific PCR also provided sequences showing 100% sequence identity with B. quintana. In total, 3/23 (13.0%) of the assessed lice were found to be positive for B. quintana. Correlating clinical data were not available; however, the assessment confirmed the presence of B. quintana in the local louse population and thus an associated infection pressure. Larger-sized cross-sectional studies seem advisable to more reliably quantify the infection risk of lice-infested local individuals. The need for prevention by providing opportunities to maintain standard hygiene for Ethiopian homeless individuals is stressed by the reported findings, especially in light of the ongoing migration of refugees.
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Affiliation(s)
- Tafese Beyene Tufa
- Asella Teaching and Referral Hospital, College of Health Sciences, Arsi University, Asella P.O. Box 04, Ethiopia;
- Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, Asella P.O. Box 04, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Medical Center Düsseldorf, 40225 Düsseldorf, Germany
| | - Gabriele Margos
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Volker Fingerle
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Christine Hartberger
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Sven Poppert
- Diagnostic Department, Bernhard Nocht Institute for Tropical Medicine Hamburg, 20239 Hamburg, Germany;
| | - Richard J. Birtles
- School of Science, Engineering and Environment, University of Salford, Salford M5 4WT, UK;
| | - Peter Kraiczy
- Institute for Medical Microbiology and Infection Control and Consiliary Laboratory for Bartonella Infections (Appointed by the Robert Koch Institute), University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; (P.K.); (V.A.J.K.)
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control and Consiliary Laboratory for Bartonella Infections (Appointed by the Robert Koch Institute), University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; (P.K.); (V.A.J.K.)
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany
| | - Torsten Feldt
- Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, Asella P.O. Box 04, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Medical Center Düsseldorf, 40225 Düsseldorf, Germany
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Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
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Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
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Lionello FCP, Rotundo S, Bruno G, Marino G, Morrone HL, Fusco P, Costa C, Russo A, Trecarichi EM, Beltrame A, Torti C. Touching Base with Some Mediterranean Diseases of Interest from Paradigmatic Cases at the "Magna Graecia" University Unit of Infectious Diseases: A Didascalic Review. Diagnostics (Basel) 2023; 13:2832. [PMID: 37685370 PMCID: PMC10486464 DOI: 10.3390/diagnostics13172832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Among infectious diseases, zoonoses are increasing in importance worldwide, especially in the Mediterranean region. We report herein some clinical cases from a third-level hospital in Calabria region (Southern Italy) and provide a narrative review of the most relevant features of these diseases from epidemiological and clinical perspectives. Further, the pathogenic mechanisms involved in zoonotic diseases are reviewed, focusing on the mechanisms used by pathogens to elude the immune system of the host. These topics are of particular concern for individuals with primary or acquired immunodeficiency (e.g., people living with HIV, transplant recipients, patients taking immunosuppressive drugs). From the present review, it appears that diagnostic innovations and the availability of more accurate methods, together with better monitoring of the incidence and prevalence of these infections, are urgently needed to improve interventions for better preparedness and response.
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Affiliation(s)
- Ferdinando Carmelo Pio Lionello
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Salvatore Rotundo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriele Bruno
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Gabriella Marino
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Helen Linda Morrone
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
| | - Paolo Fusco
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Chiara Costa
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Alessandro Russo
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Enrico Maria Trecarichi
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
| | - Anna Beltrame
- College of Public Health, University of South Florida, Gainesville, FL 33620, USA;
| | - Carlo Torti
- Department of Medical and Surgical Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy; (F.C.P.L.); (S.R.); (G.B.); (G.M.); (H.L.M.); (A.R.); (E.M.T.); (C.T.)
- Unit of Infectious and Tropical Diseases, “Mater Domini” Teaching Hospital, 88100 Catanzaro, Italy;
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10
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Sarsiat L, Garrigos T, Houhamdi L, Dauwalder O, Kuli B, Braunberger E, Belmonte O, Fournier PE, Miltgen G. Case series of 12 Bartonella quintana endocarditis from the Southwest Indian Ocean. PLoS Negl Trop Dis 2023; 17:e0011606. [PMID: 37676863 PMCID: PMC10508605 DOI: 10.1371/journal.pntd.0011606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/19/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Bartonella spp. are fastidious bacteria frequently identified as the cause of blood culture-negative (BCN) endocarditis. However, Bartonella infections are difficult to diagnose in routine laboratory testing and their incidence is probably underestimated. We investigated the epidemiological and clinical features of Bartonella endocarditis cases diagnosed between 2009 and 2021 on Reunion Island (Southwest Indian Ocean). METHOD We retrospectively included all patients diagnosed with Bartonella endocarditis at Reunion Island University Hospital during this period. Endocarditis was diagnosed on the basis of microbiological findings, including serological tests (IFA) and PCR on cardiac valves, and the modified Duke criteria. We used then the multispacer typing (MST) method to genotype the available Bartonella strains. FINDINGS We report 12 cases of B. quintana endocarditis on Reunion Island (83.3% in men, median patient age: 32 years). All the patients originated from the Comoros archipelago. The traditional risk factors for B. quintana infection (homelessness, alcoholism, exposure to body lice) were absent in all but two of the patients, who reported head louse infestations in childhood. Previous heart disease leading to valve dysfunction was recorded in 50% of patients. All patients underwent cardiac valve surgery and antimicrobial therapy with a regimen including doxycycline. All patients presented high C-reactive protein concentrations, anemia and negative blood cultures. The titer of IgG antibodies against Bartonella sp. exceeded 1:800 in 42% of patients. Specific PCR on cardiac valves confirmed the diagnosis of B. quintana endocarditis in all patients. Genotyping by the MST method was performed on four strains detected in preserved excised valves and was contributive for three, which displayed the MST6 genotype. CONCLUSIONS Bartonella quintana is an important cause of infective endocarditis in the Comoros archipelago and should be suspected in patients with mitral valve dysfunction and BCN from this area.
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Affiliation(s)
- Ludivine Sarsiat
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
| | - Linda Houhamdi
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
| | - Olivier Dauwalder
- Plateau de Microbiologie Moléculaire Spécialisé et de Séquençage, Institut des Agents Infectieux, Centre de Biologie et Pathologie Nord, Hospices Civils de Lyon, Lyon, France
| | - Barbara Kuli
- Service de Maladies Infectieuses, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Eric Braunberger
- Service de Chirurgie Cardio-thoracique, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Pierre-Edouard Fournier
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
- UMR Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), Université d’Aix-Marseille, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Marseille, France
| | - Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
- Centre Régional en Antibiothérapie (CRAtb) de La Réunion, France
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11
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Suzuki N, Kumadaki K, Tatematsu K, Doi Y, Tsukamoto K. The autotransporter BafA contributes to the proangiogenic potential of Bartonella elizabethae. Microbiol Immunol 2023; 67:248-257. [PMID: 36810719 DOI: 10.1111/1348-0421.13057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023]
Abstract
Bartonella elizabethae is a rat-borne zoonotic bacterium that causes human infectious endocarditis or neuroretinitis. Recently, a case of bacillary angiomatosis (BA) resulting from this organism was reported, leading to speculation that B. elizabethae may also trigger vasoproliferation. However, there are no reports of B. elizabethae promoting human vascular endothelial cell (EC) proliferation or angiogenesis, and to date, the effects of this bacterium on ECs are unknown. We recently identified a proangiogenic autotransporter, BafA, secreted from B. henselae and B. quintana, which are recognized as Bartonella spp. responsible for BA in humans. Here, we hypothesized that B. elizabethae also harbored a functional bafA gene and examined the proangiogenic activity of recombinant B. elizabethae-derived BafA. The bafA gene of B. elizabethae, which was found to share a 51.1% amino acid sequence identity with BafA of B. henselae and 52.5% with that of B. quintana in the passenger domain, was located in a syntenic region of the genome. The recombinant protein of the N-terminal passenger domain of B. elizabethae-BafA facilitated EC proliferation and capillary structure formation. Furthermore, it upregulated the receptor signaling pathway of vascular endothelial growth factor, as observed in B. henselae-BafA. Taken together, B. elizabethae-derived BafA stimulates human EC proliferation and may contribute to the proangiogenic potential of this bacterium. So far, functional bafA genes have been found in all BA-causing Bartonella spp., supporting the key role BafA may play in BA pathogenesis.
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Affiliation(s)
- Natsumi Suzuki
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kayo Kumadaki
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kaoru Tatematsu
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Yohei Doi
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan.,Department of Infectious Diseases, Fujita Health University School of Medicine, Toyoake, Japan.,Division of Infectious Diseases, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Kentaro Tsukamoto
- Department of Microbiology, Fujita Health University School of Medicine, Toyoake, Japan
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12
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Marshall KE, Martinez HE, Woodall T, Guerrero A, Mechtenberg J, Herlihy R, House J. Body Lice among People Experiencing Homelessness and Access to Hygiene Services during the COVID-19 Pandemic-Preventing Trench Fever in Denver, Colorado, 2020. Am J Trop Med Hyg 2022; 107:427-432. [PMID: 35895412 PMCID: PMC9393458 DOI: 10.4269/ajtmh.22-0118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Eight people with human body louse-borne Bartonella quintana infections were detected among people experiencing homelessness (PEH) in Denver during January-September 2020, prompting a public health investigation and community outreach. Public health officials conducted in-person interviews with PEH to more fully quantify body lice prevalence, transmission risk factors, access to PEH resources, and how the COVID-19 pandemic has affected resource access. Recent body lice exposure was reported by 35% of 153 interview participants. In total, 75% of participants reported reduced access to PEH services, including essential hygiene activities to prevent body lice, during Colorado's COVID-19 stay-at-home orders. Future pandemic planning should consider hygiene resource allocation for PEH populations to prevent emerging and reemerging infections such as B. quintana.
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Affiliation(s)
- Kristen E. Marshall
- Colorado Department of Public Health and Environment, Denver, Colorado
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Heather E. Martinez
- Colorado Department of Public Health and Environment, Denver, Colorado
- Council of State and Territorial Epidemiologists, Atlanta, Georgia
| | - Tracy Woodall
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Andrés Guerrero
- Colorado Department of Public Health and Environment, Denver, Colorado
| | | | - Rachel Herlihy
- Colorado Department of Public Health and Environment, Denver, Colorado
| | - Jennifer House
- Colorado Department of Public Health and Environment, Denver, Colorado
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13
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Boodman C, MacDougall W, Hawkes M, Tyrrell G, Fanella S. Bartonella quintana endocarditis in a child from Northern Manitoba, Canada. PLoS Negl Trop Dis 2022; 16:e0010399. [PMID: 35617170 PMCID: PMC9135198 DOI: 10.1371/journal.pntd.0010399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a case of Bartonella quintana endocarditis in an 11-year-old child from Northern Manitoba, Canada. This case demonstrates the neglected endemicity of B. quintana in Northern Canada and highlights the need for improved case finding and elucidation of specific risk factors for B. quintana infection in the Canadian North. Considering B. quintana's predominant transmission via body lice ectoparasitosis, we hypothesize that B. quintana's endemicity in Northern Canada is linked to inadequate access to suitable housing and running water among remote communities in the Canadian North.
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Affiliation(s)
- Carl Boodman
- University of Manitoba, Winnipeg, Manitoba, Canada
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14
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Boodman C, Wuerz T, Lagacé-Wiens P, Lindsay R, Dibernardo A, Bullard J, Stein DR, Keynan Y. Serologic testing for Bartonella in Manitoba, Canada, 2010-2020: a retrospective case series. CMAJ Open 2022; 10:E476-E482. [PMID: 35640989 PMCID: PMC9177198 DOI: 10.9778/cmajo.20210180] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bartonella are gram-negative bacilli not identified by routine bacterial culture. The objectives of this study were to review the results of all serologic testing for Bartonella ordered in Manitoba, Canada, and to review cases with positive test results among adults to assess species identification, risk factors, clinical manifestations and outcomes. METHODS This retrospective study included all Bartonella serologic tests ordered in Manitoba and performed at the National Microbiology Laboratory, Winnipeg, from Jan. 1, 2010, until Dec. 31, 2020. We analyzed the aggregate data for all serologic tests for Bartonella for patients of all ages. We reviewed the charts of adult (age ≥ 18 yr) patients with serologic positivity for Bartonella who had a medical chart at 1 of Winnipeg's 2 largest hospitals (Health Sciences Centre and St. Boniface Hospital) to extract clinical and demographic data and create a case series. Descriptive statistics were performed. RESULTS During the study period, 1014 Bartonella serologic tests were ordered in adult and pediatric patients, of which 24 (2.4%) gave a positive result. Sixteen adults (12 men and 4 women; mean age 48 yr) seen at a participating hospital had a positive result. Molecular species-level identification occurred on explanted cardiac valves in 5 (31%) of the 16 cases; B. quintana was identified in all 5. Six patients (38%) were diagnosed with probable B. quintana infection, for a total of 11 B. quintana cases (69%); 8 (73%) of the 11 had endocarditis. Four cases of B. quintana infection (36%) were associated with rural residence. Four cases (25%) of probable B. henselae were identified; 2 patients had fever and lymphadenopathy, and 2 had endocarditis. The remaining patient was deemed to have a false-positive result as his B. henselae titre was at the threshold for positivity, his B. quintana serologic test gave a negative result, and his clinical syndrome was not suggestive of Bartonella infection. Two patients died; both had multivalvular B. quintana endocarditis with ruptured intracranial mycotic aneurysms. INTERPRETATION Bartonella quintana was a common cause of Bartonella serologic positivity among adults in Manitoba in 2010-2020 and was associated with endocarditis and systemic embolization. As B. quintana is transmitted by body lice, active case finding for people who lack suitable housing, both in urban and rural settings, should prioritize those with elevated Bartonella titres to receive echocardiography and detect endocarditis before systemic embolization occurs.
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Affiliation(s)
- Carl Boodman
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man.
| | - Terence Wuerz
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Philippe Lagacé-Wiens
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Robbin Lindsay
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Antonia Dibernardo
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Jared Bullard
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Derek R Stein
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Yoav Keynan
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man.
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15
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Boodman C, Wuerz T, Lagacé-Wiens P. Endocarditis due to Bartonella quintana, the etiological agent of trench fever. CMAJ 2021; 192:E1723-E1726. [PMID: 33288506 DOI: 10.1503/cmaj.201170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Carl Boodman
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man
| | - Terence Wuerz
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man
| | - Philippe Lagacé-Wiens
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man.
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16
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Abstract
Since the early 1900s, Bartonella species were known only to cause human disease resulting from very restricted geographic (bartonellosis) or environmental influences ("trench fever"). In the 1990s, and in parallel, cat scratch disease and bacillary angiomatosis were definitively linked to Bartonella species. Subsequently, widespread use of modern diagnostic methods revealed the broad ecologic niche of this organism and greatly expanded our knowledge of the epidemiology and clinical presentations associated with this genus. A large number of reservoirs and vectors involved with Bartonella propagation and transmission to humans have been identified; cats and various arthropods remain the most well-studied to date. Though not completely understood, it appears that specific immune-modulated interactions between the infecting species and host-related factors play a major role in the observed breadth of human clinical syndromes associated with Bartonellae, the large differences in immunopathologic features of tissue samples among different syndromes and potentially the varied responses to antimicrobial therapy. Further, the clinical management for cat scratch disease in particular is quite variable among clinicians, reflecting a poor evidence base. No preventive measures have been developed beyond suggestions to avoid at-risk behavior with known vectors.
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Affiliation(s)
- Kenneth M Zangwill
- From the Division of Pediatric Infectious Diseases, Harbor-UCLA Medical Center, Los Angeles, California
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17
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Boodman C, Wuerz T, Lagacé-Wiens P. Endocardite provoquée par Bartonella quintana, l’agent causal de la fièvre des tranchées. CMAJ 2021; 193:E296-E299. [PMID: 33619074 PMCID: PMC8034350 DOI: 10.1503/cmaj.201170-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Carl Boodman
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
| | - Terence Wuerz
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
| | - Philippe Lagacé-Wiens
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
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18
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Abstract
During the two World Wars, Bartonella quintana was responsible for trench fever and is now recognised as an agent of re-emerging infection. Many reports have indicated widespread B. quintana exposure since the 1990s. In order to evaluate its prevalence in ancient populations, we used real-time PCR to detect B. quintana DNA in 400 teeth collected from 145 individuals dating from the 1st to 19th centuries in nine archaeological sites, with the presence of negative controls. Fisher’s exact test was used to compare the prevalence of B. quintana in civil and military populations. B. quintana DNA was confirmed in a total of 28/145 (19.3%) individuals, comprising 78 citizens and 67 soldiers, 20.1% and 17.9% of which were positive for B. quintana bacteraemia, respectively. This study analysed previous studies on these ancient samples and showed that the presence of B. quintana infection followed the course of time in human history; a total of 14/15 sites from five European countries had a positive prevalence. The positive rate in soldiers was higher than those of civilians, with 20% and 18.8%, respectively, in the 18th and 19th centuries, but the difference in frequency was not significant. These results confirmed the role of dental pulp in diagnosing B. quintana bacteraemia in ancient populations and showed the incidence of B. quintana in both civilians and soldiers.
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19
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Ectoparasites. J Am Acad Dermatol 2020; 82:551-569. [DOI: 10.1016/j.jaad.2019.05.110] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/16/2019] [Accepted: 05/31/2019] [Indexed: 12/18/2022]
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20
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Meher-Homji Z, Graves SR, Trubiano J, Holmes NE. Bartonella Quintana prosthetic aortitis successfully treated with doxycycline. BMJ Case Rep 2019; 12:12/7/e229877. [PMID: 31296621 DOI: 10.1136/bcr-2019-229877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Bartonella quintana is a rare cause of culture-negative endovascular infection, characterised by intracellular persistence. We describe a case of ascending aortic prosthetic graft infection due to B. quintana, in a patient with past unrecognised necrotising aortitis, which was successfully treated with doxycycline monotherapy.
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Affiliation(s)
- Zaal Meher-Homji
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Stephen R Graves
- Australian Rickettsial Reference Laboratory, University Hospital Geelong, Geelong, Victoria, Australia
| | - Jason Trubiano
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
| | - Natasha E Holmes
- Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
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21
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Tasher D, Raucher-Sternfeld A, Tamir A, Giladi M, Somekh E. Bartonella quintana, an Unrecognized Cause of Infective Endocarditis in Children in Ethiopia. Emerg Infect Dis 2018; 23. [PMID: 28730981 PMCID: PMC5547792 DOI: 10.3201/eid2308.161037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Bartonella quintana endocarditis, a common cause of culture-negative endocarditis in adults, has rarely been reported in children. We describe 5 patients 7-16 years of age from Ethiopia with heart defects and endocarditis; 4 cases were caused by infection with B. quintana and 1 by Bartonella of undetermined species. All 5 patients were afebrile and oligosymptomatic, although 3 had heart failure. C-reactive protein was normal or slightly elevated, and erythrocyte sedimentation rate was high. The diagnosis was confirmed by echocardiographic demonstration of vegetations, the presence of high Bartonella IgG titers, and identification of B. quintana DNA in excised vegetations. Embolic events were diagnosed in 2 patients. Our data suggest that B. quintana is not an uncommon cause of native valve endocarditis in children in Ethiopia with heart defects and that possible B. quintana infection should be suspected and pursued among residents of and immigrants from East Africa, including Ethiopia, with culture-negative endocarditis.
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22
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Scherler A, Jacquier N, Greub G. Chlamydiales, Anaplasma and Bartonella: persistence and immune escape of intracellular bacteria. Microbes Infect 2017; 20:416-423. [PMID: 29162422 DOI: 10.1016/j.micinf.2017.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
Intracellular bacteria, such as Chlamydiales, Anaplasma or Bartonella, need to persist inside their host in order to complete their developmental cycle and to infect new hosts. In order to escape from the host immune system, intracellular bacteria have developed diverse mechanisms of persistence, which can directly impact the health of their host.
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Affiliation(s)
- Aurélie Scherler
- Centre for Research on Intracellular Bacteria, Institute of Microbiology, University Hospital Centre and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Jacquier
- Centre for Research on Intracellular Bacteria, Institute of Microbiology, University Hospital Centre and University of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Centre for Research on Intracellular Bacteria, Institute of Microbiology, University Hospital Centre and University of Lausanne, Lausanne, Switzerland.
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23
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Abstract
Since the reclassification of the genus Bartonella in 1993, the number of species has grown from 1 to 45 currently designated members. Likewise, the association of different Bartonella species with human disease continues to grow, as does the range of clinical presentations associated with these bacteria. Among these, blood-culture-negative endocarditis stands out as a common, often undiagnosed, clinical presentation of infection with several different Bartonella species. The limitations of laboratory tests resulting in this underdiagnosis of Bartonella endocarditis are discussed. The varied clinical picture of Bartonella infection and a review of clinical aspects of endocarditis caused by Bartonella are presented. We also summarize the current knowledge of the molecular basis of Bartonella pathogenesis, focusing on surface adhesins in the two Bartonella species that most commonly cause endocarditis, B. henselae and B. quintana. We discuss evidence that surface adhesins are important factors for autoaggregation and biofilm formation by Bartonella species. Finally, we propose that biofilm formation is a critical step in the formation of vegetative masses during Bartonella-mediated endocarditis and represents a potential reservoir for persistence by these bacteria.
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24
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Sullivan KE, Bassiri H, Bousfiha AA, Costa-Carvalho BT, Freeman AF, Hagin D, Lau YL, Lionakis MS, Moreira I, Pinto JA, de Moraes-Pinto MI, Rawat A, Reda SM, Reyes SOL, Seppänen M, Tang MLK. Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies. J Clin Immunol 2017; 37:650-692. [PMID: 28786026 PMCID: PMC5693703 DOI: 10.1007/s10875-017-0426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/21/2017] [Indexed: 12/18/2022]
Abstract
In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.
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Affiliation(s)
- Kathleen E Sullivan
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Hamid Bassiri
- Division of Infectious Diseases and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Ahmed A Bousfiha
- Clinical Immunology Unit, Infectious Department, Hopital d'Enfant Abderrahim Harouchi, CHU Ibn Rochd, Laboratoire d'Immunologie Clinique, d'Inflammation et d'Allergie LICIA, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - Beatriz T Costa-Carvalho
- Department of Pediatrics, Federal University of São Paulo, Rua dos Otonis, 725, São Paulo, SP, 04025-002, Brazil
| | - Alexandra F Freeman
- NIAID, NIH, Building 10 Room 12C103, 9000 Rockville, Pike, Bethesda, MD, 20892, USA
| | - David Hagin
- Division of Allergy and Immunology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizmann St, 64239, Tel Aviv, Israel
| | - Yu L Lau
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Rm 106, 1/F New Clinical Building, Pok Fu Lam, Hong Kong.,Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy & Infectious Diseases (NIAID), National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 11C102, Bethesda, MD, 20892, USA
| | - Ileana Moreira
- Immunology Unit, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, 1425, Buenos Aires, Argentina
| | - Jorge A Pinto
- Division of Immunology, Department of Pediatrics, Federal University of Minas Gerais, Av. Alfredo Balena 190, room # 161, Belo Horizonte, MG, 30130-100, Brazil
| | - M Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of São Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil
| | - Amit Rawat
- Pediatric Allergy and Immunology, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shereen M Reda
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Saul Oswaldo Lugo Reyes
- Immunodeficiencies Research Unit, National Institute of Pediatrics, Av Iman 1, Torre de Investigacion, Piso 9, Coyoacan, 04530, Mexico City, Mexico
| | - Mikko Seppänen
- Harvinaissairauksien yksikkö (HAKE), Rare Disease Center, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Mimi L K Tang
- Murdoch Children's Research Institute, The Royal Children's Hospital, University of Melbourne, Melbourne, Australia
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Ghidey FY, Igbinosa O, Mills K, Lai L, Woods C, Ruiz ME, Fishbein D, Sampath R, Lowery R, Wortmann G. Case series of Bartonella quintana blood culture-negative endocarditis in Washington, DC. JMM Case Rep 2016; 3:e005049. [PMID: 28348772 PMCID: PMC5330240 DOI: 10.1099/jmmcr.0.005049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 05/17/2016] [Indexed: 11/27/2022] Open
Abstract
Introduction: Prior studies (predominantly from Europe) have demonstrated blood culture-negative endocarditis due to Bartonella. Our objective was to describe three cases of Bartonella quintana endocarditis identified within one year at a large hospital in Washington, DC, USA. Case presentation: We constructed a descriptive case series from a retrospective review of medical records from April to December 2013 at an 800-bed urban hospital. All three patients (ages: 52, 55 and 57 years) were undomiciled/homeless men with a history of alcoholism. Although they had negative blood cultures, echocardiography demonstrated aortic/mitral valve perforation and regurgitation in one patient, aortic/mitral valve vegetation with mitral regurgitation in the second patient, and aortic valve vegetation with regurgitation in the third patient. The patients had positive Bartonella quintana serum immunoglobulin G (IgG) with negative immunoglobulin M (IgM). PCR on DNA extracted from cardiac valves was positive for Bartonella, and DNA sequencing of PCR amplicons identified Bartonella quintana. Patients received treatment with doxycycline/rifampin or doxycycline/gentamicin. Conclusion: Clinicians should consider Bartonella endocarditis as a differential diagnosis in patients who fit elements of the Duke Criteria, as well as having a history of homelessness and alcoholism.
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Affiliation(s)
- Fisseha Y Ghidey
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Osamuyimen Igbinosa
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Kristin Mills
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Leon Lai
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Christian Woods
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Maria E Ruiz
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Dawn Fishbein
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | | | - Robert Lowery
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
| | - Glenn Wortmann
- Infectious Disease Section, MedStar Washington Hospital Center , Washington , USA
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Sangaré AK, Doumbo OK, Raoult D. Management and Treatment of Human Lice. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8962685. [PMID: 27529073 PMCID: PMC4978820 DOI: 10.1155/2016/8962685] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 04/17/2016] [Accepted: 06/16/2016] [Indexed: 12/18/2022]
Abstract
Of the three lice (head, body, and pubic louse) that infest humans, the body louse is the species involved in epidemics of louse-borne typhus, trench fever, and relapsing fever, but all the three cause pediculosis. Their infestations occur today in many countries despite great efforts to maintain high standards of public health. In this review, literature searches were performed through PubMed, Medline, Google Scholar, and EBSCOhost, with key search words of "Pediculus humanus", "lice infestation", "pediculosis", and "treatment"; and controlled clinical trials were viewed with great interest. Removing lice by hand or with a lice comb, heating infested clothing, and shaving the scalp were some of the oldest methods of controlling human lice. Despite the introduction of other resources including cresol, naphthalene, sulfur, mercury, vinegar, petroleum, and insecticides, the numbers of lice infestation cases and resistance have increased. To date, viable alternative treatments to replace insecticides have been developed experimentally in vitro. Today, the development of new treatment strategies such as symbiotic treatment and synergistic treatment (antibiotics + ivermectin) in vitro has proved effective and is promising. Here, we present an overview on managing and treating human lice and highlight new strategies to more effectively fight pediculosis and prevent resistance.
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Affiliation(s)
- Abdoul Karim Sangaré
- Research Unit on Emerging Infectious and Tropical Diseases (URMITE), UMR CNRS 7278, IRD 198, INSERM 1095, Faculty of Medicine, Aix-Marseille University, 27 boulevard Jean Moulin, 13005 Marseille, France
- Epidemiology Department of Parasitic Diseases, Faculty of Medicine and Odonto-Stomatology, Faculty of Pharmacy (MRTC/DEAP/FMOS-FAPH) UMI3189, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Ogobara K. Doumbo
- Epidemiology Department of Parasitic Diseases, Faculty of Medicine and Odonto-Stomatology, Faculty of Pharmacy (MRTC/DEAP/FMOS-FAPH) UMI3189, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali
| | - Didier Raoult
- Research Unit on Emerging Infectious and Tropical Diseases (URMITE), UMR CNRS 7278, IRD 198, INSERM 1095, Faculty of Medicine, Aix-Marseille University, 27 boulevard Jean Moulin, 13005 Marseille, France
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Leibler JH, Zakhour CM, Gadhoke P, Gaeta JM. Zoonotic and Vector-Borne Infections Among Urban Homeless and Marginalized People in the United States and Europe, 1990-2014. Vector Borne Zoonotic Dis 2016; 16:435-44. [PMID: 27159039 DOI: 10.1089/vbz.2015.1863] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION In high-income countries, homeless individuals in urban areas often live in crowded conditions with limited sanitation and personal hygiene. The environment of homelessness in high-income countries may result in intensified exposure to ectoparasites and urban wildlife, which can transmit infections. To date, there have been no systematic evaluations of the published literature to assess vector-borne and zoonotic disease risk to these populations. OBJECTIVES The primary objectives of this study were to identify diversity, prevalence, and risk factors for vector-borne and zoonotic infections among people experiencing homelessness and extreme poverty in urban areas of high-income countries. METHODS We conducted a systematic review and narrative synthesis of published epidemiologic studies of zoonotic and vector-borne infections among urban homeless and very poor people in the United States and Europe from 1990 to 2014. RESULTS Thirty-one observational studies and 14 case studies were identified (n = 45). Seroprevalence to the human louse-borne pathogen Bartonella quintana (seroprevalence range: 0-37.5%) was identified most frequently, with clinical disease specifically observed among HIV-positive individuals. Seropositivity to Bartonella henselae (range: 0-10.3%) and Rickettsia akari (range: 0-16.2%) was noted in multiple studies. Serological evidence of exposure to Rickettsia typhi, Rickettsia prowazekii, Bartonella elizabethae, West Nile virus, Borellia recurrentis, lymphocytic choriomeningitis virus, Wohlfartiimonas chitiniclastica, Seoul hantavirus (SEOV), and Leptospira species was also identified in published studies, with SEOV associated with chronic renal disease later in life. HIV infection, injection drug use, and heavy drinking were noted across multiple studies as risk factors for infection with vector-borne and zoonotic pathogens. CONCLUSIONS B. quintana was the most frequently reported vector-borne infection identified in our article. Delousing efforts and active surveillance among HIV-positive individuals, who are at elevated risk of complication from B. quintana infection, are advised to reduce morbidity. Given documented exposure to rodent-borne zoonoses among urban homeless and marginalized people, reducing human contact with rodents remains an important public health priority.
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Affiliation(s)
- Jessica H Leibler
- 1 Department of Environmental Health, Boston University School of Public Health , Boston, Massachusetts
| | - Christine M Zakhour
- 2 Department of Epidemiology, Boston University School of Public Health , Boston, Massachusetts
| | - Preety Gadhoke
- 3 College of Pharmacy and Health Sciences, St. Johns University , Queens, New York
| | - Jessie M Gaeta
- 4 Boston Health Care for the Homeless Program, Boston, Massachusetts.,5 Department of Medicine, Boston University School of Medicine, Boston, Massachusetts
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Torreggiani S, Filocamo G, Esposito S. Recurrent Fever in Children. Int J Mol Sci 2016; 17:448. [PMID: 27023528 PMCID: PMC4848904 DOI: 10.3390/ijms17040448] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 03/13/2016] [Accepted: 03/21/2016] [Indexed: 12/16/2022] Open
Abstract
Children presenting with recurrent fever may represent a diagnostic challenge. After excluding the most common etiologies, which include the consecutive occurrence of independent uncomplicated infections, a wide range of possible causes are considered. This article summarizes infectious and noninfectious causes of recurrent fever in pediatric patients. We highlight that, when investigating recurrent fever, it is important to consider age at onset, family history, duration of febrile episodes, length of interval between episodes, associated symptoms and response to treatment. Additionally, information regarding travel history and exposure to animals is helpful, especially with regard to infections. With the exclusion of repeated independent uncomplicated infections, many infective causes of recurrent fever are relatively rare in Western countries; therefore, clinicians should be attuned to suggestive case history data. It is important to rule out the possibility of an infectious process or a malignancy, in particular, if steroid therapy is being considered. After excluding an infectious or neoplastic etiology, immune-mediated and autoinflammatory diseases should be taken into consideration. Together with case history data, a careful physical exam during and between febrile episodes may give useful clues and guide laboratory investigations. However, despite a thorough evaluation, a recurrent fever may remain unexplained. A watchful follow-up is thus mandatory because new signs and symptoms may appear over time.
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Affiliation(s)
- Sofia Torreggiani
- Pediatric Medium Intensive Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Giovanni Filocamo
- Pediatric Medium Intensive Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
| | - Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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Synergistic activity of antibiotics combined with ivermectin to kill body lice. Int J Antimicrob Agents 2016; 47:217-23. [DOI: 10.1016/j.ijantimicag.2016.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/20/2015] [Indexed: 01/25/2023]
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Samanta AK, Jayaram C, Jayapal N, Sondhi N, Kolte AP, Senani S, Sridhar M, Dhali A. Assessment of Fecal Microflora Changes in Pigs Supplemented with Herbal Residue and Prebiotic. PLoS One 2015; 10:e0132961. [PMID: 26176779 PMCID: PMC4503616 DOI: 10.1371/journal.pone.0132961] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/20/2015] [Indexed: 11/24/2022] Open
Abstract
Antibiotic usage in animals as a growth promoter is considered as public health issue due to its negative impact on consumer health and environment. The present study aimed to evaluate effectiveness of herbal residue (ginger, Zingiber officinale, dried rhizome powder) and prebiotic (inulin) as an alternative to antibiotics by comparing fecal microflora composition using terminal restriction fragment length polymorphism. The grower pigs were offered feed containing antibiotic (tetracycline), ginger and inulin separately and un-supplemented group served as control. The study revealed significant changes in the microbial abundance based on operational taxonomic units (OTUs) among the groups. Presumptive identification of organisms was established based on the fragment length of OTUs generated with three restriction enzymes (MspI, Sau3AI and BsuRI). The abundance of OTUs representing Bacteroides intestinalis, Eubacterium oxidoreducens, Selonomonas sp., Methylobacterium sp. and Denitrobacter sp. was found significantly greater in inulin supplemented pigs. Similarly, the abundance of OTUs representing Bacteroides intestinalis, Selonomonas sp., and Phascolarcobacterium faecium was found significantly greater in ginger supplemented pigs. In contrast, the abundance of OTUs representing pathogenic microorganisms Atopostipes suicloacalis and Bartonella quintana str. Toulouse was significantly reduced in ginger and inulin supplemented pigs. The OTUs were found to be clustered under two major phylotypes; ginger-inulin and control-tetracycline. Additionally, the abundance of OTUs was similar in ginger and inulin supplemented pigs. The results suggest the potential of ginger and prebioticsto replace antibiotics in the diet of grower pig.
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Affiliation(s)
- Ashis Kumar Samanta
- Feed Additives and Nutraceuticals Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - C. Jayaram
- Feed Additives and Nutraceuticals Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - N. Jayapal
- Feed Additives and Nutraceuticals Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - N. Sondhi
- Feed Additives and Nutraceuticals Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - A. P. Kolte
- Omics Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - S. Senani
- Feed Additives and Nutraceuticals Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - M. Sridhar
- Fermentation Technology Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
| | - A. Dhali
- Omics Laboratory, National Institute of Animal Nutrition and Physiology, Adugodi, Hosur Road, Bangalore, 560030, India
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Bartonella clarridgeiae bacteremia detected in an asymptomatic blood donor. J Clin Microbiol 2014; 53:352-6. [PMID: 25392353 DOI: 10.1128/jcm.00934-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Human exposure to Bartonella clarridgeiae has been reported only on the basis of antibody detection. We report for the first time an asymptomatic human blood donor infected with B. clarridgeiae, as documented by enrichment blood culture, PCR, and DNA sequencing.
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Zapata HJ, Villanueva M, Shenoi S. Initial diagnosis of HIV/AIDS in a 56-year-old man with non-healing forearm lesion. BMJ Case Rep 2013; 2013:bcr-2013-201184. [PMID: 24248316 DOI: 10.1136/bcr-2013-201184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 56-year-old Hispanic man with no significant medical problems presented with a 2-month history of a non-healing right forearm lesion that progressed despite several courses of empiric antibiotics. The patient underwent incision and drainage. Warthin-Starry stain with immunohistochemistry testing diagnosed bacillary angiomatosis secondary to Bartonella quintana. Subsequently, the patient was diagnosed with HIV, with a CD4 count of 68 cells/mm(3), and a HIV viral load of 47, 914 copies/mL. The patient was treated with doxycycline and started on antiretroviral therapy. The lesion has resolved and he has had no recurrence after 16 months of treatment.
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Affiliation(s)
- Heidi J Zapata
- Department of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut, USA
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Ben-Tekaya H, Gorvel JP, Dehio C. Bartonella and Brucella--weapons and strategies for stealth attack. Cold Spring Harb Perspect Med 2013; 3:3/8/a010231. [PMID: 23906880 DOI: 10.1101/cshperspect.a010231] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Bartonella spp. and Brucella spp. are closely related α-proteobacterial pathogens that by distinct stealth-attack strategies cause chronic infections in mammals including humans. Human infections manifest by a broad spectrum of clinical symptoms, ranging from mild to fatal disease. Both pathogens establish intracellular replication niches and subvert diverse pathways of the host's immune system. Several virulence factors allow them to adhere to, invade, proliferate, and persist within various host-cell types. In particular, type IV secretion systems (T4SS) represent essential virulence factors that transfer effector proteins tailored to recruit host components and modulate cellular processes to the benefit of the bacterial intruders. This article puts the remarkable features of these two pathogens into perspective, highlighting the mechanisms they use to hijack signaling and trafficking pathways of the host as the basis for their stealthy infection strategies.
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Affiliation(s)
- Houchaima Ben-Tekaya
- Focal Area Infection Biology, Biozentrum, University of Basel, 4052 Basel, Switzerland
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Maggi RG, Ericson M, Mascarelli PE, Bradley JM, Breitschwerdt EB. Bartonella henselae bacteremia in a mother and son potentially associated with tick exposure. Parasit Vectors 2013; 6:101. [PMID: 23587194 PMCID: PMC3637281 DOI: 10.1186/1756-3305-6-101] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 03/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bartonella henselae is a zoonotic, alpha Proteobacterium, historically associated with cat scratch disease (CSD), but more recently associated with persistent bacteremia, fever of unknown origin, arthritic and neurological disorders, and bacillary angiomatosis, and peliosis hepatis in immunocompromised patients. A family from the Netherlands contacted our laboratory requesting to be included in a research study (NCSU-IRB#1960), designed to characterize Bartonella spp. bacteremia in people with extensive arthropod or animal exposure. All four family members had been exposed to tick bites in Zeeland, southwestern Netherlands. The mother and son were exhibiting symptoms including fatigue, headaches, memory loss, disorientation, peripheral neuropathic pain, striae (son only), and loss of coordination, whereas the father and daughter were healthy. METHODS Each family member was tested for serological evidence of Bartonella exposure using B. vinsonii subsp. berkhoffii genotypes I-III, B. henselae and B. koehlerae indirect fluorescent antibody assays and for bacteremia using the BAPGM enrichment blood culture platform. RESULTS The mother was seroreactive to multiple Bartonella spp. antigens and bacteremia was confirmed by PCR amplification of B. henselae DNA from blood, and from a BAPGM blood agar plate subculture isolate. The son was not seroreactive to any Bartonella sp. antigen, but B. henselae DNA was amplified from several blood and serum samples, from BAPGM enrichment blood culture, and from a cutaneous striae biopsy. The father and daughter were seronegative to all Bartonella spp. antigens, and negative for Bartonella DNA amplification. CONCLUSIONS Historically, persistent B. henselae bacteremia was not thought to occur in immunocompetent humans. To our knowledge, this study provides preliminary evidence supporting the possibility of persistent B. henselae bacteremia in immunocompetent persons from Europe. Cat or flea contact was considered an unlikely source of transmission and the mother, a physician, reported that clinical symptoms developed following tick exposure. To our knowledge, this is the first time that a B. henselae organism has been visualized in and amplified from a striae lesion. As the tick bites occurred three years prior to documentation of B. henselae bacteremia, the mode of transmission could not be determined.
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Affiliation(s)
- Ricardo G Maggi
- Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
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Li H, Bai JY, Wang LY, Zeng L, Shi YS, Qiu ZL, Ye HH, Zhang XF, Lu QB, Kosoy M, Liu W, Cao WC. Genetic diversity of Bartonella quintana in macaques suggests zoonotic origin of trench fever. Mol Ecol 2013; 22:2118-27. [PMID: 23517327 DOI: 10.1111/mec.12261] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 01/13/2013] [Accepted: 01/15/2013] [Indexed: 11/27/2022]
Abstract
Bartonella quintana is a bacterium that causes a broad spectrum of diseases in humans including trench fever. Humans were previously considered to be the primary, if not the only, reservoir hosts for B. quintana. To identify the animal reservoir and extend our understanding of the ecological and evolutionary history of B. quintana, we examined blood samples from macaques and performed multilocus sequence typing (MLST) analysis. We demonstrated the prevalence of B. quintana infection was common in macaques from main primate centres in mainland China. Overall, 18.0% (59/328) of rhesus macaques and 12.7% (39/308) of cynomolgus macaques were found to be infected with B. quintana by blood culture and/or polymerase chain reaction. The infection was more frequently identified in juvenile and young monkeys compared with adult animals. In contrast with the relatively low level of sequence divergence of B. quintana reported in humans, our investigation revealed much higher genetic diversity in nonhuman primates. We identified 44 new nucleotide variable sites and 14 novel sequence types (STs) among the B. quintana isolates by MLST analysis. Some STs were found only in cynomolgus macaques, while some others were detected only in rhesus macaques, suggesting evidence of host-cospeciation, which were further confirmed by phylogenetic analysis and Splits decomposition analysis. Our findings suggest that trench fever may primarily be a zoonotic disease with macaques as the natural hosts.
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Affiliation(s)
- Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
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Hemin-binding proteins as potent markers for serological diagnosis of infections with Bartonella quintana. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:620-6. [PMID: 23408526 DOI: 10.1128/cvi.00717-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
It is difficult to distinguish infections with different Bartonella species using commercially available immunofluorescence (indirect immunofluorescent antibody [IFA]) assay kits. To identify appropriate proteins for serodiagnosis of Bartonella quintana infections, we investigated the antigenicity of B. quintana proteins using sera from homeless people with high B. quintana IgG titers in IFA assay. These sera reacted strongly to an outer membrane protein, hemin-binding protein D (HbpD). Further, serum from an endocarditis patient infected with B. quintana reacted to HbpB and HbpD. To locate the antigenic sites within the proteins, we generated deletion mutants of HbpB and HbpD. Amino acid residues 89 to 220 of HbpB and 151 to 200 of HbpD were identified as the minimum regions required for recognition by these sera. Several oligopeptides comprising parts of the minimum regions of HbpB and HbpD were synthesized, and their immunoreactivity with the above-mentioned sera was tested by enzyme-linked immunosorbent assay (ELISA). Serum from the endocarditis patient reacted similarly to synthetic peptides HbpB2 (amino acid residues 144 to 173 of HbpB) and HbpD3 (151 to 200 residues of HbpD), while sera from the other subjects reacted to HbpD3. These results indicate that synthetic peptides HbpB2 and HbpD3 might be suitable for developing serological tools for differential diagnosis of B. quintana infections from other Bartonella infections.
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Wassef MA, Rahman EMA. Chromogenic Cica-β Testing for Detection of Extended-Spectrum and AmpC β-Lactamases Among Cefoxitin-Resistant Isolates. Lab Med 2013. [DOI: 10.1309/lm67ni1uulijnjkd] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Zangwill KM. Cat Scratch Disease and Other Bartonella Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2013; 764:159-66. [DOI: 10.1007/978-1-4614-4726-9_13] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Esposito S, Esposito I, Leone S. Considerations of antibiotic therapy duration in community- and hospital-acquired bacterial infections. J Antimicrob Chemother 2012; 67:2570-5. [PMID: 22833640 DOI: 10.1093/jac/dks277] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Despite the large number of suggestions available in the literature, the optimal duration of antibiotic treatment remains an individual decision mainly based on clinical criteria. Shorter but equally effective regimens would reduce the side effect rates, including both antibiotic resistance and drug expenses. Although several prospective, randomized trials and meta-analyses with the aim of comparing a standard duration with a shorter one for most bacterial infections have been published, to date most current recommendations carry little weight, as they are based on expert opinions or practical experience. This review will briefly touch upon the clinical evidence of short-course versus long-course antibiotic therapy for the most common community- and hospital-acquired bacterial infections.
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Affiliation(s)
- Silvano Esposito
- Department of Infectious Diseases, Azienda Universitaria San Giovanni di Dio e Ruggi d'Aragona, Largo Città di Ippocrate, 84131 Salerno, Italy.
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Abstract
SUMMARYBartonellaspp. are increasingly implicated in infectious endocarditis cases in the UK. Herein, we attempted to quantify their role in this syndrome and explored the epidemiology ofBartonella-associated endocarditis in the UK. Between November 2005 and October 2010, samples from 685 endocarditis patients were submitted to the Health Protection Agency forBartonellaserology. Serological evidence of infection was obtained for 57 (8·3%) patients. PCR-based evidence of infection was obtained from 13 out of 14 patients for whom heart valve tissue was available, withBartonella quintanaimplicated in 12 cases andB. henselaein one. Six patients withB. quintanaendocarditis were recent immigrants into the UK, of whom four lived in poor socioeconomic conditions. These results indicate thatBartonellais a not uncommon cause of endocarditis in the UK and should be considered particularly in patients raised in eastern Europe and/or with a history of homelessness or alcoholism.
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Abstract
Bartonella spp. are facultative intracellular pathogens that employ a unique stealth infection strategy comprising immune evasion and modulation, intimate interaction with nucleated cells, and intraerythrocytic persistence. Infections with Bartonella are ubiquitous among mammals, and many species can infect humans either as their natural host or incidentally as zoonotic pathogens. Upon inoculation into a naive host, the bartonellae first colonize a primary niche that is widely accepted to involve the manipulation of nucleated host cells, e.g., in the microvasculature. Consistently, in vitro research showed that Bartonella harbors an ample arsenal of virulence factors to modulate the response of such cells, gain entrance, and establish an intracellular niche. Subsequently, the bacteria are seeded into the bloodstream where they invade erythrocytes and give rise to a typically asymptomatic intraerythrocytic bacteremia. While this course of infection is characteristic for natural hosts, zoonotic infections or the infection of immunocompromised patients may alter the path of Bartonella and result in considerable morbidity. In this review we compile current knowledge on the molecular processes underlying both the infection strategy and pathogenesis of Bartonella and discuss their connection to the clinical presentation of human patients, which ranges from minor complaints to life-threatening disease.
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Affiliation(s)
- Alexander Harms
- Focal Area Infection Biology, Biozentrum, University of Basel, Switzerland
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In vivo efficacy of the novel aminoglycoside ACHN-490 in murine infection models. Antimicrob Agents Chemother 2011; 55:1728-33. [PMID: 21282439 DOI: 10.1128/aac.00862-10] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aminoglycosides are broad-spectrum antibiotics with particular clinical utility against life-threatening infections. As resistance to antibiotics, including aminoglycosides, continues to grow, there is a need for new and effective antimicrobial agents. ACHN-490 is a novel aminoglycoside in clinical development with activity against multidrug-resistant Gram-negative and select Gram-positive pathogens. Here we assess the in vivo efficacy of ACHN-490 against a variety of common pathogens in two murine models: the septicemia and neutropenic thigh models. When its activity against a gentamicin-susceptible strain of Escherichia coli was tested in the septicemia model, ACHN-490 improved 7-day survival with a dose-response profile similar to that of gentamicin, with 100% survival seen at doses of 1.6 mg/kg of body weight and above. In animals infected with a gentamicin-susceptible strain of Pseudomonas aeruginosa, treatment with either ACHN-490 or gentamicin led to 100% survival at doses of 16 mg/kg and above in the septicemia model. ACHN-490 was also effective in the neutropenic thigh model, reducing multidrug-resistant Enterobacteriaceae family and methicillin-resistant Staphylococcus aureus strains, as well as broadly susceptible strains, to static levels with dose-dependent activity. Against gentamicin-sensitive Enterobacteriaceae and methicillin-resistant S. aureus, the efficacy of ACHN-490 was comparable to that of gentamicin. However, gentamicin-resistant Enterobacteriaceae strains and those harboring the Klebsiella pneumoniae carbapenemase responded to ACHN-490 but not gentamicin, with static doses ranging from 12 mg/kg to 64 mg/kg for ACHN-490. These results suggest that ACHN-490 has the potential to become a clinically useful agent against drug-resistant pathogens, including Enterobacteriaceae, P. aeruginosa, and methicillin-resistant S. aureus, and support further development of this promising novel aminoglycoside.
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Influence of empiric therapy with a beta-lactam alone or combined with an aminoglycoside on prognosis of bacteremia due to gram-negative microorganisms. Antimicrob Agents Chemother 2010; 54:3590-6. [PMID: 20585123 DOI: 10.1128/aac.00115-10] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Evidence supporting the combination of aminoglycosides with beta-lactams for gram-negative bacteremia is inconclusive. We have explored the influence on survival of empirical therapy with a beta-lactam alone versus that with a beta-lactam-aminoglycoside combination by retrospectively analyzing a series of bacteremic episodes due to aerobic or facultative gram-negative microorganisms treated with single or combination therapy. The outcome variable was a 30-day mortality. Prognostic factors were selected by regression logistic analysis. A total of 4,863 episodes were assessed, of which 678 (14%) received combination therapy and 467 (10%) were fatal. Factors independently associated with mortality included age greater than 65 (odds ratio [OR], 2; 95% confidence interval [CI], 1.6 to 2.6), hospital acquisition (OR, 1.5; 95% CI, 1.2 to 1.9), a rapidly or ultimately fatal underlying disease (OR, 2.5; 95% CI, 2 to 3.2), cirrhosis (OR, 1.9; 95% CI, 1.4 to 2.6), prior corticosteroids (OR, 1.5; 95% CI, 1.1 to 2), shock on presentation (OR, 8.8; 95% CI, 7 to 11), pneumonia (OR, 2.8; 95% CI, 1.9 to 4), and inappropriate empirical therapy (OR, 1.8; 95% CI, 1.3 to 2.5). Subgroup analysis revealed that combination therapy was an independent protective factor in episodes presenting shock (OR, 0.6; 95% CI, 0.4 to 0.9) or neutropenia (OR, 0.5; 95% CI, 0.3 to 0.9). Combination therapy improved the appropriateness of empirical therapy in episodes due to extended-spectrum beta-lactamase (ESBL)- or AmpC-producing Enterobacteriaceae and Pseudomonas aeruginosa. In patients with gram-negative bacteremia, we could not find an overall association between empirical beta-lactam-aminoglycoside combination therapy and prognosis. However, a survival advantage cannot be discarded for episodes presenting shock or neutropenia, hence in these situations the use of combination therapy may still be justified. Combination therapy also should be considered for patients at risk of being infected with resistant organisms, if only to increase the appropriateness of empirical therapy.
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Pharmacokinetic-pharmacodynamic-model-guided doripenem dosing in critically ill patients. Antimicrob Agents Chemother 2010; 54:2360-4. [PMID: 20385857 DOI: 10.1128/aac.01843-09] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The growing number of infections caused by multidrug-resistant pathogens has prompted a more rational use of available antibiotics given the paucity of new, effective agents. Monte Carlo simulations were utilized to determine the appropriateness of several doripenem dosing regimens based on the probability of attaining the critical drug exposure metric of time that drug concentrations remain above the drug MIC (T>MIC) for 35% (and lower thresholds) of the dosing interval in >80 to 90% of the population (T>MIC 35% target). This exposure level generally correlates with in vivo efficacy for carbapenems. In patients with creatinine clearance of >50 ml/min, a 500-mg dose of doripenem infused over 1 h every 8 h is expected to be effective against bacilli with doripenem MICs of < or =1 microg/ml based on a T>MIC 35% target and MICs of < or =2 microg/ml based on lower targets. A longer, 4-hour infusion time improved target attainment in most cases, such that the T>MIC was adequate for pathogens with doripenem MICs as high as 4 microg/ml. Efficacy is expected for infections caused by pathogens with doripenem MICs of < or =2 microg/ml in patients with moderate renal impairment (creatinine clearance, 30 to 50 ml/min) who receive doripenem at 250 mg infused over 1 h every 8 h and in patients with severe impairment (creatinine clearance between 10 and 29 ml/min) who receive doripenem at 250 mg, infused over 1 h or 4 h, every 12 h. Results of pharmacokinetics/pharmacodynamics (PK/PD) modeling can guide dose optimization, thereby potentially increasing the clinical efficacy of doripenem against serious Gram-negative bacterial infections.
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Minnick MF, Battisti JM. Pestilence, persistence and pathogenicity: infection strategies of Bartonella. Future Microbiol 2009; 4:743-58. [PMID: 19659429 DOI: 10.2217/fmb.09.41] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
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.
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Affiliation(s)
- Michael F Minnick
- The University of Montana, Division of Biological Sciences, Missoula, MT 59812, USA.
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Prospective observational study of the impact of VIM-1 metallo-beta-lactamase on the outcome of patients with Klebsiella pneumoniae bloodstream infections. Antimicrob Agents Chemother 2009; 53:1868-73. [PMID: 19223638 DOI: 10.1128/aac.00782-08] [Citation(s) in RCA: 171] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
VIM-1-producing Klebsiella pneumoniae (VPKP) is an emerging pathogen. A prospective observational study was conducted to evaluate the importance of VIM production on outcome of patients with K. pneumoniae bloodstream infections (BSIs). Consecutive patients with K. pneumoniae BSIs were identified and followed up until patient discharge or death. A total of 162 patients were included in the analysis; 67 (41.4%) were infected with VPKP, and 95 were infected with non-VPKP. Fourteen of the patients infected with VPKP were carbapenem resistant (Carb(r)) (MIC > 4 mug/ml), whereas none of the non-VPKP exhibited carbapenem resistance. The patients infected with a Carb(r) organism were more likely (odds ratio, 4.08; 95% confidence interval [CI], 1.29 to 12.85; P = 0.02) to receive inappropriate empirical therapy. The all-cause 14-day mortality rates were 15.8% (15 of 95) for patients infected with VIM-negative organisms, 18.9% (10 of 53) for those infected with VIM-positive carbapenem-susceptible organisms, and 42.9% (6 of 14) for those infected with VIM-positive Carb(r) organisms (P = 0.044). In Cox regression analysis, age (hazard ratio [HR], 1.03; 95% CI, 1.01 to 1.06; P = 0.021), rapidly fatal underlying disease (HR, 2.84; 95% CI, 1.26 to 6.39; P = 0.012), and carbapenem resistance (HR, 2.83; 95% CI, 1.08 to 7.41; P = 0.035) were independent predictors of death. After adjustment for inappropriate empirical or definitive therapy, the effect of carbapenem resistance on outcome was reduced to a level of nonsignificance. In patients with K. pneumoniae BSIs, carbapenem resistance, advanced, age, and severity of underlying disease were independent predictors of outcome, whereas VIM production had no effect on mortality. The higher mortality associated with carbapenem resistance was probably mediated by the failure to provide effective therapy.
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Parrow NL, Abbott J, Lockwood AR, Battisti JM, Minnick MF. Function, regulation, and transcriptional organization of the hemin utilization locus of Bartonella quintana. Infect Immun 2009; 77:307-16. [PMID: 18981245 PMCID: PMC2612243 DOI: 10.1128/iai.01194-08] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 10/21/2008] [Accepted: 10/27/2008] [Indexed: 01/03/2023] Open
Abstract
Bartonella quintana is a gram-negative agent of trench fever, chronic bacteremia, endocarditis, and bacillary angiomatosis in humans. B. quintana has the highest known hemin requirement among bacteria, but the mechanisms of hemin acquisition are poorly defined. Genomic analyses revealed a potential locus dedicated to hemin utilization (hut) encoding a putative hemin receptor, HutA; a TonB-like energy transducer; an ABC transport system comprised of three proteins, HutB, HutC, and HmuV; and a hemin degradation/storage enzyme, HemS. Complementation analyses with Escherichia coli hemA show that HutA functions as a hemin receptor, and complementation analyses with E. coli hemA tonB indicate that HutA is TonB dependent. Quantitative reverse transcriptase PCR analyses show that hut locus transcription is subject to hemin-responsive regulation, which is mediated primarily by the iron response regulator (Irr). Irr functions as a transcriptional repressor of the hut locus at all hemin concentrations tested. Overexpression of the ferric uptake regulator (fur) represses transcription of tonB in the presence of excess hemin, whereas overexpression of the rhizobial iron regulator (rirA) has no effect on hut locus transcription. Reverse transcriptase PCR analyses show that hutA and tonB are divergently transcribed and that the remaining hut genes are expressed as a polycistronic mRNA. Examination of the promoter regions of hutA, tonB, and hemS reveals consensus sequence promoters that encompass an H-box element previously shown to interact with B. quintana Irr.
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Affiliation(s)
- Nermi L Parrow
- Division of Biological Sciences, The University of Montana, 32 Campus Drive, Missoula, MT 59812, USA
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Abstract
Trench fever is the common name for the acute febrile syndrome associated with a Bartonella quintana bacterial infection. The focus of this unit is to describe reliable methods for cultivation and cryopreservation of B. quintana and can be applied to cultivation and preservation of all Bartonella. Detailed recipes for preparation of three types of semisolid media are also included.
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Affiliation(s)
- James M Battisti
- Division of Biological Sciences, The University of Montana, Missoula, Montana, USA
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Pharmacoeconomic analysis of microbiologic techniques for differentiating staphylococci directly from blood culture bottles. J Clin Microbiol 2008; 46:2924-9. [PMID: 18614649 DOI: 10.1128/jcm.00623-08] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Differentiating staphylococci in blood cultures is a critical issue, particularly when only one of two cultures is positive by Gram staining for staphylococci. New tests for the identification of Staphylococcus aureus allow faster results and definitive treatment compared to the tube coagulase test interpreted at 24 h (TCT24). These newer tests, peptide nucleic acid fluorescence in situ hybridization (PNA-FISH) and real-time PCR (RT-PCR), offer improved sensitivity at higher cost. Data suggest that the tube coagulase test may be interpreted at 4 h (TCT4) with little loss of sensitivity. The impact of variability in turnaround time, sensitivity, specificity, and cost on comparative cost-effectiveness is unknown. Our aim was to establish the cost-effectiveness of TCT24, PNA-FISH, RT-PCR, and TCT4 for direct identification of staphylococci in blood cultures. Decision analysis comparing these strategies was done from the institutional perspective. Besides test variables, other variables included patient risk factors, empirical treatment, and follow-up cultures. Probability and cost estimates came from the literature and institutional data. Base case estimates were derived from institutional rates of 73% contamination when coagulase-negative staphylococci were identified, 67.6% prevalence of risk factors, and 12.4% prevalence of S. aureus when one of two cultures yielded staphylococci. Sensitivity analysis was done across a range of probabilities and costs. In the base case, TCT4 and TCT24 were more cost-effective than RT-PCR and PNA-FISH ($78 versus $120 versus $165 per patient, respectively). The advantage of TCT4 and TCT24 remained robust upon sensitivity analysis. TCT4 should be further evaluated as a rapid, cost-effective means for identification of S. aureus in blood cultures.
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Bloodstream infections caused by extended-spectrum-beta-lactamase- producing Escherichia coli: risk factors for inadequate initial antimicrobial therapy. Antimicrob Agents Chemother 2008; 52:3244-52. [PMID: 18591273 DOI: 10.1128/aac.00063-08] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Extended-spectrum-beta-lactamase (ESBL)-producing strains of Escherichia coli are a significant cause of bloodstream infections (BSI) in hospitalized and nonhospitalized patients. We previously showed that delaying effective antimicrobial therapy in BSI caused by ESBL producers significantly increases mortality. The aim of this retrospective 7-year analysis was to identify risk factors for inadequate initial antimicrobial therapy (IIAT) (i.e., empirical treatment based on a drug to which the isolate had displayed in vitro resistance) for inpatients with BSI caused by ESBL-producing E. coli. Of the 129 patients considered, 56 (43.4%) received IIAT for 48 to 120 h (mean, 72 h). Independent risk factors for IIAT include an unknown BSI source (odds ratios [OR], 4.86; 95% confidence interval [CI], 1.98 to 11.91; P = 0.001), isolate coresistance to >or=3 antimicrobials (OR, 3.73; 95% CI, 1.58 to 8.83; P = 0.003), hospitalization during the 12 months preceding BSI onset (OR, 3.33; 95% CI, 1.42 to 7.79; P = 0.005), and antimicrobial therapy during the 3 months preceding BSI onset (OR, 2.65; 95% CI, 1.11 to 6.29; P = 0.02). IIAT was the strongest risk factor for 21-day mortality and significantly increased the length of hospitalization after BSI onset. Our results underscore the need for a systematic approach to the management of patients with serious infections by ESBL-producing E. coli. Such an approach should be based on sound, updated knowledge of local infectious-disease epidemiology, detailed analysis of the patient's history with emphasis on recent contact with the health care system, and aggressive attempts to identify the infectious focus that has given rise to the BSI.
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