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Boodman C, Gupta N, Nelson CA, van Griensven J. Bartonella quintana Endocarditis: A Systematic Review of Individual Cases. Clin Infect Dis 2024; 78:554-561. [PMID: 37976173 DOI: 10.1093/cid/ciad706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/30/2023] [Accepted: 11/15/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Bartonella quintana is a louse-borne bacterium that remains a neglected cause of endocarditis in low-resource settings. Our understanding of risk factors, clinical manifestations, and treatment of B. quintana endocarditis are biased by older studies from high-income countries. METHODS We searched Pubmed Central, Medline, Scopus, Embase, EBSCO (CABI) Global Health, Web of Science and international trial registers for articles published before March 2023 with terms related to Bartonella quintana endocarditis. We included articles containing case-level information on B. quintana endocarditis and extracted data related to patient demographics, clinical features, diagnostic testing, treatment, and outcome. RESULTS A total of 975 records were identified, of which 569 duplicates were removed prior to screening. In total, 84 articles were eligible for inclusion, describing a total of 167 cases. Infections were acquired in 40 different countries; 62 cases (37.1%) were acquired in low- and middle-income countries (LMICs). Disproportionately more female and pediatric patients were from LMICs. More patients presented with heart failure (n = 70/167 [41.9%]) than fever (n = 65/167 [38.9%]). Mean time from symptom onset to presentation was 5.1 months. Also, 25.7% of cases (n = 43/167) were associated with embolization, most commonly to the spleen and brain; 65.5% of antimicrobial regimens included doxycycline. The vast majority of cases underwent valve replacement surgery (n = 154/167, [98.0%]). Overall case fatality rate was 9.6% (n = 16/167). CONCLUSIONS B. quintana endocarditis has a global distribution, and long delays between symptom onset and presentation frequently occur. Improved clinician education and diagnostic capacity are needed to screen at-risk populations and identify infection before endocarditis develops.
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Affiliation(s)
- Carl Boodman
- Division of Infectious Diseases, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
- Unit of HIV and Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
| | - Nitin Gupta
- Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Christina A Nelson
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Johan van Griensven
- Unit of HIV and Neglected Tropical Diseases, Institute of Tropical Medicine, Antwerp, Belgium
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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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Marvasti TB, Philip R, Parikh H, Hazan E, Liu PJ, Saeed O, Billick MJ. Reviewing Your ABCs - Acute Kidney Injury, Bartonella Endocarditis, and C-ANCA Vasculitis. Am J Med 2024; 137:e22-e25. [PMID: 37918779 DOI: 10.1016/j.amjmed.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/20/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Tina B Marvasti
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Rohan Philip
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Harsh Parikh
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | - Elias Hazan
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
| | | | - Omar Saeed
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of General Internal Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Maxime J Billick
- Temerty Faculty of Medicine, University of Toronto, Ontario, Canada; Division of Infectious Diseases, University of Toronto, Ontario, Canada.
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Li J, Zhang C, Lu M, Wang Y, Wang W, Liu F, Wu S, Liu Y, Fan M, Li K. The diverse genetic genotypes of Bartonella species circulating in rodents from Inner Mongolia, Northern China. PLoS Negl Trop Dis 2023; 17:e0011462. [PMID: 37384796 DOI: 10.1371/journal.pntd.0011462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/14/2023] [Indexed: 07/01/2023] Open
Abstract
Bartonella are generally recognized as zoonotic pathogens of mammals, including many rodent species. However, data on the genetic diversity of Bartonella in some regions are still absent in China. In this study, we collected rodent samples (Meriones unguiculatus, Spermophilus dauricus, Eolagurus luteus, and Cricetulus barabensis) from Inner Mongolia located in Northern China. The Bartonella were detected and identified by sequencing the gltA, ftsZ, ITS, and groEL genes in them. An overall 47.27% (52/110) positive rate was observed. This may be the first report that M. unguiculatus and E. luteus harbor Bartonella. Phylogenetic and genetic analysis on gltA, ftsZ, ITS, and groEL genes indicated that the strains were divided into seven distinct clades, suggesting the diverse genetic genotypes of Bartonella species in this area. Of those, Clade 5 meets the criteria for identification as a novel species based on gene sequence dissimilarity to known Bartonella species and herein we name it "Candidatus Bartonella mongolica".
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Affiliation(s)
- Jianyun Li
- General Center for Disease Control and Prevention of Inner Mongolia Autonomous Region, Huhehot City, Inner Mongolia Autonomous Region, China
| | - Chenxi Zhang
- Inner Mongolia Medical University, Huhehot City, Inner Mongolia Autonomous Region, China
| | - Miao Lu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, China
| | - Yu Wang
- Inner Mongolia Agricultural University, Huhehot City, Inner Mongolia Autonomous Region, China
| | - Wen Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, China
| | - Fang Liu
- General Center for Disease Control and Prevention of Inner Mongolia Autonomous Region, Huhehot City, Inner Mongolia Autonomous Region, China
| | - Shaoqing Wu
- Ulanqab Center for Disease Control and Prevention, Ulanqab City, Inner Mongolia Autonomous Region, China
| | - Yang Liu
- Baotou Medical College, Baotou City, Inner Mongolia Autonomous Region, China
| | - Mengguang Fan
- General Center for Disease Control and Prevention of Inner Mongolia Autonomous Region, Huhehot City, Inner Mongolia Autonomous Region, China
| | - Kun Li
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing City, China
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Oh S, Park SH, Choi JH, Kim SL, Kim M, Lee S, Yi MH, Lee IY, Yong TS, Kim JY. The microbiota in feces of domestic pigeons in Seoul, Korea. Heliyon 2023; 9:e14997. [PMID: 37095944 PMCID: PMC10121612 DOI: 10.1016/j.heliyon.2023.e14997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
In Korea, feral pigeons pose significant public health risks because they carry various zoonotic pathogens. Human population density is a significant factor in zoonotic disease events. Seoul is one of the largest cities by population density among developed countries and where most of the homeless population in Korea exists. We designed this study to compare the microbiota of pigeon feces by regional characteristics and the presence of homeless individuals. Therefore, this study used 16S rRNA amplicon sequencing to detect possible pathogenic microbes and assess the current risk of zoonosis in Seoul, South Korea. Pigeon fecal samples (n = 144) obtained from 19 public sites (86 and 58 fecal samples from regions in and outside Seoul, respectively) were examined. Potentially pathogenic bacteria were also detected in the fecal samples; Campylobacter spp. was found in 19 samples from 13 regions, Listeriaceae was found in seven samples, and Chlamydia spp. was found in three samples from two regions. Principal coordinates analysis and permutational multivariate analysis of variance revealed a significant difference in bacterial composition between the regions in Seoul (n = 86) and outside Seoul (n = 58) and between the regions with (n = 81) and without (n = 63) homeless individuals. Overall, this study identified various potentially pathogenic microorganisms in pigeon feces at public sites in South Korea. Moreover, this study demonstrates that the microbial composition was influenced by regional characteristics and homelessness. Taken together, this study provides important information for public health strategic planning and disease control.
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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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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: 0] [Impact Index Per Article: 0] [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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Robert M, Lecomte R, Michel M, Guimbretiere G, Croizier G, Corvec S, Leroy A. Bartonella quintana infective endocarditis in a homeless man with unexpected positive blood culture. IDCases 2022; 30:e01647. [DOI: 10.1016/j.idcr.2022.e01647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022] Open
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Mai BHA. Seroprevalence of Bartonella quintana infection: A systematic review. J Glob Infect Dis 2022; 14:50-56. [PMID: 35910824 PMCID: PMC9336607 DOI: 10.4103/jgid.jgid_220_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/20/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction: Bartonella quintana is an anaerobic bacillus whose main target is the erythrocyte. This bacterium transmitted by the body louse notably infected the soldiers of the First World War from where the name of this disease: fever of the trenches. The 90s marked the return of this bacterial infection. B. quintana infection in the homeless was reported in the literature with a high incidence in these populations worldwide. This upsurge of cases justified this study for a better understanding of B. quintana infections. Methods: We conducted a systematic review to evaluate the seroprevalence of B. quintana infection by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to collect scientific papers from PubMed and Google Scholar based on combining keywords. Results: The review included 45 articles published from April 1996 to March 2020 with 84 subpopulations of 21 countries from 4 continents; among them, 61 subpopulations had a positive rate from 0.2% to 65%. These subpopulations were divided into four main groups: homeless people, healthy people, blood donors, and symptoms/diseases. Homeless people were the main target of this infection, and three factors related to susceptibility were homeless period, age, and alcoholism. 6/11, 12/20, and 32/41 subpopulations of healthy people, blood donors, symptoms/diseases, respectively, had a positive percentage. However, factors of exposure in these three groups were not mentioned. Other reservoirs, vectors, and transmitted routes were identified to partially explain the worldwide spread of the infection, and it is important to have more further investigations to identify potential risk factors. This will help to limit contamination and prevent effectively. Conclusions: This serological overview indicated the importance of B. quintana infection that has emerged in multiple regions, touched worldwide populations.
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Bartonella infections diagnosed in the French reference center, 2014-2019, and focus on infections in the immunocompromised. Eur J Clin Microbiol Infect Dis 2021; 40:2407-2410. [PMID: 33846874 DOI: 10.1007/s10096-021-04244-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
We studied retrospectively 651 PCR-confirmed Bartonella infections diagnosed at the French reference center for bartonellosis from 2014 to 2019. The most common form was cat-scratch disease (89%) followed by endocarditis (9%). Disseminated forms (2%) mainly presented as bacillary angiomatosis or peliosis hepatis in solid organ transplant recipients.
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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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Unusual subdural empyema in a homeless patient diagnosed by molecular approach: a case report. BMC Infect Dis 2020; 20:357. [PMID: 32429864 PMCID: PMC7236200 DOI: 10.1186/s12879-020-05088-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/13/2020] [Indexed: 01/06/2023] Open
Abstract
Background We report a case of subdural empyema in a homeless patient caused by Bartonella quintana. B. quintana is a facultative intracellular bacteria for which bacterial growth is fastidious. The molecular biology approach has been a real help in establishing the diagnosis. Case report A 59-years old homeless patient, with a history of chronic alcohol abuse, was brought to the emergency department with a massive subdural empyema. Extensive microbiological evaluation didn’t reveal any pathogen in the pus collected before antibiotic treatment. B. quintana was detected in the pus from the empyema using a 16S rRNA-based PCR. Histology of intraoperative samples was consistent with the diagnosis and a serological assay was positive. The patient responded well to a treatment that included craniectomy with drainage of the loculated pus, total removal of the infected capsule and a combination of antibiotics. Conclusion This unique case of B. quintana-related empyema illustrates the risk of secondary infection of subdural hematoma with B. quintana since such infections have recently reemerged, predominantly among the homeless populations. Patients with subdural empyema in at-risk populations should be systematically evaluated for B. quintana with an appropriate diagnostic approach involving molecular biology.
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Amanzougaghene N, Mediannikov O, Ly TDA, Gautret P, Davoust B, Fenollar F, Izri A. Molecular investigation and genetic diversity of Pediculus and Pthirus lice in France. Parasit Vectors 2020; 13:177. [PMID: 32264930 PMCID: PMC7140345 DOI: 10.1186/s13071-020-04036-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/25/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Humans are parasitized by three types of lice: body, head and pubic lice. As their common names imply, each type colonizes a specific region of the body. The body louse is the only recognized disease vector. However, an increasing awareness of head lice as a vector has emerged recently whereas the status of pubic lice as a vector is not known since it has received little attention. METHODS Here, we assessed the occurrence of bacterial pathogens in 107 body lice, 33 head lice and 63 pubic lice from Marseille and Bobigny (France) using molecular methods. RESULTS Results show that all body lice samples belonged to the cytb Clade A whereas head lice samples belonged to Clades A and B. DNA of Bartonella quintana was detected in 7.5% of body lice samples and, for the first time to our knowledge, in 3.1% of pubic lice samples. Coxiella burnetii, which is not usually associated with transmission by louse, was detected in 3.7% of body lice samples and 3% of head lice samples. To the best of our knowledge, this is the first report of C. burnetii in Pediculus lice infesting humans in France. Acinetobacter DNA was detected in 21.5% of body lice samples, 6% of head lice samples and 9.5% of pubic lice samples. Five species were identified with A. baumannii being the most prevalent. CONCLUSIONS Our study is the first to report the presence of B. quintana in pubic lice. This is also the first report of the presence of DNA of C. burnetii in body lice and head lice in France. Further efforts on the vectorial role of human lice are needed, most importantly the role of pubic lice as a disease vector should be further investigated.
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Affiliation(s)
- Nadia Amanzougaghene
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France. .,IHU-Méditerranée Infection, Marseille, France.
| | - Oleg Mediannikov
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France. .,IHU-Méditerranée Infection, Marseille, France.
| | - Tran Duc Anh Ly
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Bernard Davoust
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Florence Fenollar
- IHU-Méditerranée Infection, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, MEPHI, Marseille, France
| | - Arezki Izri
- Department of Parasitology-Mycology, AP-HP, Hôpital Avicenne, Bobigny, France.,UMR "Émergence des Pathologies Virales" (EPV, Aix-Marseille University-IRD, 190-Inserm 1207 EHESP-IHU Méditerranée Infection), Marseille, France
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14
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Lam JC, Fonseca K, Pabbaraju K, Meatherall BL. Case Report: Bartonella quintana Endocarditis Outside of the Europe-African Gradient: Comprehensive Review of Cases within North America. Am J Trop Med Hyg 2020; 100:1125-1129. [PMID: 30793686 DOI: 10.4269/ajtmh.18-0929] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Clinical syndromes associated with Bartonella quintana infection can be insidious and difficult to diagnose for multiple reasons. Clinically, B. quintana can manifest as asymptomatic bacteremia or with subtle subacute constitutional symptoms. Second, it is a fastidious organism that is difficult to identify using traditional culture methods. Last, the body lice vector of B. quintana transmission is likely not uncommon in most patients affected, who are homeless and of low socioeconomic status. Therefore, barriers in seeking medical care and financial constraints for medications are important considerations. The mainstay of literature surrounding B. quintana endocarditis is from Europe and the developing nations. Herein, we describe a case of native valve endocarditis secondary to B. quintana in a homeless male with preexisting valvular disease and undertake a comprehensive literature review of documented B. quintana endocarditis in North America.
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Affiliation(s)
- John C Lam
- Department of Medicine, University of Calgary, Calgary, Canada
| | - Kevin Fonseca
- Provincial Laboratory for Public Health, Calgary, Canada.,Department of Microbiology, Immunology, and Infectious Diseases, University of Calgary, Calgary, Canada
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15
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Vasconcelos EJR, Billeter SA, Jett LA, Meinersmann RJ, Barr MC, Diniz PPVP, Oakley BB. Assessing Cat Flea Microbiomes in Northern and Southern California by 16S rRNA Next-Generation Sequencing. Vector Borne Zoonotic Dis 2018; 18:491-499. [PMID: 29893631 DOI: 10.1089/vbz.2018.2282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Flea-borne diseases (FBDs) impact both human and animal health worldwide. Because adult fleas are obligately hematophagous and can harbor potential pathogens, fleas act as ectoparasites of vertebrates, as well as zoonotic disease vectors. Cat fleas (Ctenocephalides felis) are important vectors of two zoonotic bacterial genera listed as priority pathogens by the National Institute of Allergy and Infectious Diseases (NIAID-USA): Bartonella spp. and Rickettsia spp., causative agents of bartonelloses and rickettsioses, respectively. In this study, we introduce the first microbiome analysis of C. felis samples from California, determining the presence and abundance of relevant pathogenic genera by characterizing the cat flea microbiome through 16S rRNA next-generation sequencing (16S-NGS). Samples from both northern (NoCal) and southern (SoCal) California were assessed to expand current knowledge regarding FBDs in the state. We identified Rickettsia and Bartonella, as well as the endosymbiont Wolbachia, as the most abundant genera, followed by less abundant taxa. In comparison to our previous study screening Californian cat fleas for rickettsiae using PCR/digestion/sequencing of the ompB gene, the 16S-NGS approach applied herein showed a 95% level of agreement in detecting Rickettsia spp. There was no overall difference in microbiome diversity between NoCal and SoCal samples. Bacterial taxa identified by 16S-NGS in this study may help to improve epidemiological investigations, pathogen surveillance efforts, and clinical diagnostics of FBDs in California and elsewhere.
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Affiliation(s)
- Elton J R Vasconcelos
- 1 College of Veterinary Medicine, Western University of Health Sciences , Pomona, California
| | - Sarah A Billeter
- 2 Vector-Borne Disease Section, California Department of Public Health , Ontario, California
| | - Lindsey A Jett
- 1 College of Veterinary Medicine, Western University of Health Sciences , Pomona, California
| | - Richard J Meinersmann
- 3 USDA Agricultural Research Service, U.S. National Poultry Research Center , Athens, Georgia
| | - Margaret C Barr
- 1 College of Veterinary Medicine, Western University of Health Sciences , Pomona, California
| | - Pedro P V P Diniz
- 1 College of Veterinary Medicine, Western University of Health Sciences , Pomona, California
| | - Brian B Oakley
- 1 College of Veterinary Medicine, Western University of Health Sciences , Pomona, California
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16
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Mullins KE, Hang J, Clifford RJ, Onmus-Leone F, Yang Y, Jiang J, Leguia M, Kasper MR, Maguina C, Lesho EP, Jarman RG, Richards A, Blazes D. Whole-Genome Analysis of Bartonella ancashensis, a Novel Pathogen Causing Verruga Peruana, Rural Ancash Region, Peru. Emerg Infect Dis 2018; 23:430-438. [PMID: 28221130 PMCID: PMC5382735 DOI: 10.3201/eid2303.161476] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The genus Bartonella contains >40 species, and an increasing number of these Bartonella species are being implicated in human disease. One such pathogen is Bartonella ancashensis, which was isolated in blood samples from 2 patients living in Caraz, Peru, during a clinical trial of treatment for bartonellosis. Three B. ancashensis strains were analyzed by using whole-genome restriction mapping and high-throughput pyrosequencing. Genome-wide comparative analysis of Bartonella species showed that B. ancashensis has features seen in modern and ancient lineages of Bartonella species and is more related to B. bacilliformis. The divergence between B. ancashensis and B. bacilliformis is much greater than what is seen between known Bartonella genetic lineages. In addition, B. ancashensis contains type IV secretion system proteins, which are not present in B. bacilliformis. Whole-genome analysis indicates that B. ancashensis might represent a distinct Bartonella lineage phylogenetically related to B. bacilliformis.
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17
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Malgorzata-Miller G, Heinbockel L, Brandenburg K, van der Meer JWM, Netea MG, Joosten LAB. Bartonella quintana lipopolysaccharide (LPS): structure and characteristics of a potent TLR4 antagonist for in-vitro and in-vivo applications. Sci Rep 2016; 6:34221. [PMID: 27670746 PMCID: PMC5037446 DOI: 10.1038/srep34221] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/06/2016] [Indexed: 12/12/2022] Open
Abstract
The pattern recognition receptor TLR4 is well known as a crucial receptor during infection and inflammation. Several TLR4 antagonists have been reported to inhibit the function of TLR4. Both natural occurring antagonists, lipopolysaccharide (LPS) from Gram-negative bacteria as well as synthetic compounds based on the lipid A structure of LPS have been described as potent inhibitors of TLR4. Here, we have examined the characteristics of a natural TLR4 antagonist, isolated from Bartonella quintana bacterium by elucidating its chemical primary structure. We have found that this TLR4 antagonist is actually a lipooligosaccharide (LOS) instead of a LPS, and that it acts very effective, with a high inhibitory activity against triggering by the LPS-TLR4 system in the presence of a potent TLR4 agonist (E. coli LPS). Furthermore, we demonstrate that B. quintana LPS is not inactivated by polymyxin B, a classical cyclic cationic polypeptide antibiotic that bind the lipid A part of LPS, such as E. coli LPS. Using a murine LPS/D-galactosamine endotoxaemia model we showed that treatment with B. quintana LPS could improve the survival rate significantly. Since endogenous TLR4 ligands have been associated with several inflammatory- and immune-diseases, B. quintana LPS might be a novel therapeutic strategy for TLR4-driven pathologies.
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Affiliation(s)
- Gosia Malgorzata-Miller
- Department of Internal Radboud University Medical Center, Nijmegen, 6500HB, The Netherlands.,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lena Heinbockel
- Division of Biophysics, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Borstel, Germany
| | - Klaus Brandenburg
- Division of Biophysics, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Borstel, Germany
| | - Jos W M van der Meer
- Department of Internal Radboud University Medical Center, Nijmegen, 6500HB, The Netherlands
| | - Mihai G Netea
- Department of Internal Radboud University Medical Center, Nijmegen, 6500HB, The Netherlands.,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Leo A B Joosten
- Department of Internal Radboud University Medical Center, Nijmegen, 6500HB, The Netherlands.,Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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18
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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: 9] [Impact Index Per Article: 1.1] [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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19
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Bonilla DL, Cole-Porse C, Kjemtrup A, Osikowicz L, Kosoy M. Risk factors for human lice and bartonellosis among the homeless, San Francisco, California, USA. Emerg Infect Dis 2015; 20:1645-51. [PMID: 25280380 PMCID: PMC4193271 DOI: 10.3201/eid2010.131655] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Results suggest that body lice disproportionately affect certain demographic groups and those who sleep outdoors. Homeless persons in San Francisco, California, USA, have been shown to have head and body lice infestations and Bartonella quintana infections. We surveyed a self-selected population of homeless persons in San Francisco to assess infestations of head and body lice, risks of having body lice, and presence of B. quintana in lice. A total of 203 persons who reported itching were surveyed during 2008–2010 and 2012: 60 (30%) had body lice, 10 (4.9%) had head lice, and 6 (3.0%) had both. B. quintana was detected in 10 (15.9%) of 63 body lice pools and in 6 (37.5%) of 16 head lice pools. Variables significantly associated (p<0.05) with having body lice in this homeless population included male sex, African–American ethnicity, and sleeping outdoors. Our study findings suggest that specific segments of the homeless population would benefit from information on preventing body lice infestations and louseborne diseases.
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20
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Abstract
We present 3 children affected by B. quintana infection treated at the IRCCS Burlo Garofolo of Trieste between March and April 2013. B. quintana infection is rare but it should be suspected in patients with fever and lymphadenopathy who do not respond to conventional antibiotic treatment. All patients had a complete recovery without sequelae or relapses.
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21
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Pitassi LHU, de Paiva Diniz PPV, Scorpio DG, Drummond MR, Lania BG, Barjas-Castro ML, Gilioli R, Colombo S, Sowy S, Breitschwerdt EB, Nicholson WL, Velho PENF. Bartonella spp. bacteremia in blood donors from Campinas, Brazil. PLoS Negl Trop Dis 2015; 9:e0003467. [PMID: 25590435 PMCID: PMC4295888 DOI: 10.1371/journal.pntd.0003467] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 12/10/2014] [Indexed: 12/05/2022] Open
Abstract
Bartonella species are blood-borne, re-emerging organisms, capable of causing prolonged infection with diverse disease manifestations, from asymptomatic bacteremia to chronic debilitating disease and death. This pathogen can survive for over a month in stored blood. However, its prevalence among blood donors is unknown, and screening of blood supplies for this pathogen is not routinely performed. We investigated Bartonella spp. prevalence in 500 blood donors from Campinas, Brazil, based on a cross-sectional design. Blood samples were inoculated into an enrichment liquid growth medium and sub-inoculated onto blood agar. Liquid culture samples and Gram-negative isolates were tested using a genus specific ITS PCR with amplicons sequenced for species identification. Bartonella henselae and Bartonella quintana antibodies were assayed by indirect immunofluorescence. B. henselae was isolated from six donors (1.2%). Sixteen donors (3.2%) were Bartonella-PCR positive after culture in liquid or on solid media, with 15 donors infected with B. henselae and one donor infected with Bartonella clarridgeiae. Antibodies against B. henselae or B. quintana were found in 16% and 32% of 500 blood donors, respectively. Serology was not associated with infection, with only three of 16 Bartonella-infected subjects seropositive for B. henselae or B. quintana. Bartonella DNA was present in the bloodstream of approximately one out of 30 donors from a major blood bank in South America. Negative serology does not rule out Bartonella spp. infection in healthy subjects. Using a combination of liquid and solid cultures, PCR, and DNA sequencing, this study documents for the first time that Bartonella spp. bacteremia occurs in asymptomatic blood donors. Our findings support further evaluation of Bartonella spp. transmission which can occur through blood transfusions. Bartonella is a genus of small bacteria with worldwide distribution, transmitted by blood-sucking insects, and is capable of causing disease in humans and animals. Some of the clinical presentations of Bartonella spp., such as cat scratch disease, trench fever, and bacillary angiomatosis are well documented; however, novel presentations have been described in the last two decades, ranging from cyclic flu-like syndrome to neurologic disease and life-threatening endocarditis. Asymptomatic human infection is possible and accidental blood transmission has been reported. Bacterium isolation is very difficult because they grow slowly and require special culture media and procedures. Serology testing poorly predicts active Bartonella infection, except in infection of cardiac valves. Therefore, diagnosis is generally challenging. However, when molecular detection techniques are coupled with special culture protocols, enhanced sensitivity and specificity can be achieved. We investigated Bartonella spp. infection prevalence in a large blood donor population and confirmed bacteremia in 1.2% of the subjects. Bloodstream infection was detected with at least three different molecular methods in 3.2% of donors. These results indicate that Bartonella is a genus of importance for transfusion medicine.
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Affiliation(s)
- Luiza Helena Urso Pitassi
- Division of Dermatology, Department of Medicine, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | | | - Diana Gerardi Scorpio
- Department of Molecular & Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Marina Rovani Drummond
- Division of Dermatology, Department of Medicine, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Bruno Grosselli Lania
- Division of Dermatology, Department of Medicine, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Maria Lourdes Barjas-Castro
- Centro de Hematologia e Hemoterapia (HEMOCENTRO), Department of Medicine, State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Rovilson Gilioli
- Laboratory of Animal Quality Control, Multidisciplinary Center of Biological Investigation (CEMIB), State University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Silvia Colombo
- Department of Virology, Adolfo Lutz Institute (IAL), Secretaria de Estado de Saúde de São Paulo, São Paulo, Brazil
| | - Stanley Sowy
- College of Veterinary Medicine, Western University of Health Sciences, Pomona California, United States of America
| | - Edward B. Breitschwerdt
- Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - William L. Nicholson
- Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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22
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Angelakis E, Raoult D. Pathogenicity and treatment of Bartonella infections. Int J Antimicrob Agents 2014; 44:16-25. [DOI: 10.1016/j.ijantimicag.2014.04.006] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/30/2014] [Indexed: 10/25/2022]
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23
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Kernif T, Leulmi H, Socolovschi C, Berenger JM, Lepidi H, Bitam I, Rolain JM, Raoult D, Parola P. Acquisition and excretion ofBartonella quintanaby the cat flea,Ctenocephalides felis felis. Mol Ecol 2014; 23:1204-12. [DOI: 10.1111/mec.12663] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 12/02/2013] [Accepted: 12/10/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Tahar Kernif
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
- Institut Pasteur d'Algérie; Algiers 16015 Algeria
| | - Hamza Leulmi
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Cristina Socolovschi
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Jean-Michel Berenger
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Hubert Lepidi
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Idir Bitam
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
- Département de Biologie; Faculté des sciences; Université M'hamed Bougara Boumerdes; Boumerdes 35000 Algérie
| | - Jean-Marc Rolain
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Didier Raoult
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
| | - Philippe Parola
- Aix Marseille Université; URMITE; UM63; CNRS 7278; IRD 198; Inserm 1095; Marseille 13005 France
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24
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Prutsky G, Domecq JP, Mori L, Bebko S, Matzumura M, Sabouni A, Shahrour A, Erwin PJ, Boyce TG, Montori VM, Malaga G, Murad MH. Treatment outcomes of human bartonellosis: a systematic review and meta-analysis. Int J Infect Dis 2013; 17:e811-9. [DOI: 10.1016/j.ijid.2013.02.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 11/27/2022] Open
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25
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Abromaitis S, Nelson CS, Previte D, Yoon KS, Clark JM, DeRisi JL, Koehler JE. Bartonella quintana deploys host and vector temperature-specific transcriptomes. PLoS One 2013; 8:e58773. [PMID: 23554923 PMCID: PMC3595295 DOI: 10.1371/journal.pone.0058773] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 02/06/2013] [Indexed: 11/20/2022] Open
Abstract
The bacterial pathogen Bartonella quintana is passed between humans by body lice. B. quintana has adapted to both the human host and body louse vector niches, producing persistent infection with high titer bacterial loads in both the host (up to 105 colony-forming units [CFU]/ml) and vector (more than 108 CFU/ml). Using a novel custom microarray platform, we analyzed bacterial transcription at temperatures corresponding to the host (37°C) and vector (28°C), to probe for temperature-specific and growth phase-specific transcriptomes. We observed that transcription of 7% (93 genes) of the B. quintana genome is modified in response to change in growth phase, and that 5% (68 genes) of the genome is temperature-responsive. Among these transcriptional changes in response to temperature shift and growth phase was the induction of known B. quintana virulence genes and several previously unannotated genes. Hemin binding proteins, secretion systems, response regulators, and genes for invasion and cell attachment were prominent among the differentially-regulated B. quintana genes. This study represents the first analysis of global transcriptional responses by B. quintana. In addition, the in vivo experiments provide novel insight into the B. quintana transcriptional program within the body louse environment. These data and approaches will facilitate study of the adaptation mechanisms employed by Bartonella during the transition between human host and arthropod vector.
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Affiliation(s)
- Stephanie Abromaitis
- Microbial Pathogenesis and Host Defense Program, University of California San Francisco, San Francisco, California, United States of America
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Christopher S. Nelson
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, United States of America
- Biomedical Sciences Graduate Program, University of California San Francisco, San Francisco, California, United States of America
| | - Domenic Previte
- Department of Veterinary and Animal Science, University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
| | - Kyong S. Yoon
- Department of Veterinary and Animal Science, University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
| | - J. Marshall Clark
- Department of Veterinary and Animal Science, University of Massachusetts at Amherst, Amherst, Massachusetts, United States of America
| | - Joseph L. DeRisi
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, California, United States of America
- Howard Hughes Medical Institute, University of California San Francisco, San Francisco, California, United States of America
| | - Jane E. Koehler
- Microbial Pathogenesis and Host Defense Program, University of California San Francisco, San Francisco, California, United States of America
- Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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26
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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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27
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Pulliainen AT, Dehio C. Persistence of Bartonella spp. stealth pathogens: from subclinical infections to vasoproliferative tumor formation. FEMS Microbiol Rev 2012; 36:563-99. [PMID: 22229763 DOI: 10.1111/j.1574-6976.2012.00324.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 12/13/2011] [Accepted: 12/13/2011] [Indexed: 01/11/2023] Open
Abstract
Bartonella spp. are facultative intracellular bacteria that typically cause a long-lasting intraerythrocytic bacteremia in their mammalian reservoir hosts, thereby favoring transmission by blood-sucking arthropods. In most cases, natural reservoir host infections are subclinical and the relapsing intraerythrocytic bacteremia may last weeks, months, or even years. In this review, we will follow the infection cycle of Bartonella spp. in a reservoir host, which typically starts with an intradermal inoculation of bacteria that are superficially scratched into the skin from arthropod feces and terminates with the pathogen exit by the blood-sucking arthropod. The current knowledge of bacterial countermeasures against mammalian immune response will be presented for each critical step of the pathogenesis. The prevailing models of the still-enigmatic primary niche and the anatomical location where bacteria reside, persist, and are periodically seeded into the bloodstream to cause the typical relapsing Bartonella spp. bacteremia will also be critically discussed. The review will end up with a discussion of the ability of Bartonella spp., namely Bartonella henselae, Bartonella quintana, and Bartonella bacilliformis, to induce tumor-like vascular deformations in humans having compromised immune response such as in patients with AIDS.
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Desenclos JC, Laporte A, Brouqui P. Les infections humaines transmises par les poux. Med Mal Infect 2011; 41:295-300. [DOI: 10.1016/j.medmal.2011.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 12/13/2010] [Accepted: 02/07/2011] [Indexed: 11/28/2022]
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Bartonella species and their ectoparasites: selective host adaptation or strain selection between the vector and the mammalian host? Comp Immunol Microbiol Infect Dis 2011; 34:299-314. [PMID: 21616536 DOI: 10.1016/j.cimid.2011.04.005] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/16/2011] [Accepted: 04/21/2011] [Indexed: 11/22/2022]
Abstract
A wide range of blood-sucking arthropods have either been confirmed or are suspected as important vectors in Bartonella transmission to mammals, including humans. Overall, it appears that the diversity of Bartonella species DNA identified in ectoparasites is much broader than the species detected in their mammalian hosts, suggesting a mechanism of adaptation of Bartonella species to their host-vector ecosystem. However, these mechanisms leading to the fitness between the vectors and their hosts still need to be investigated.
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30
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Biswas S, Rolain JM. Bartonella infection: treatment and drug resistance. Future Microbiol 2011; 5:1719-31. [PMID: 21133691 DOI: 10.2217/fmb.10.133] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Bartonella species, which belong to the α-2 subgroup of Proteobacteria, are fastidious Gram-negative bacteria that are highly adapted to their mammalian host reservoirs. Bartonella species are responsible for different clinical conditions affecting humans, including Carrion's disease, cat scratch disease, trench fever, bacillary angiomatosis, endocarditis and peliosis hepatis. While some of these diseases can resolve spontaneously without treatment, in other cases, the disease is fatal without antibiotic treatment. In this article, we discuss the antibiotic susceptibility patterns of Bartonella species, detected using several methods. We also provide an overview of Bartonella infection in humans and animals and discuss the antibiotic treatment recommendations for the different infections, treatment failure and the molecular mechanism of antibiotic resistance in these bacteria.
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Affiliation(s)
- Silpak Biswas
- CNRS-IRD, UMR 6236, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine et de Pharmacie, Université de la Méditerranée, 27 boulevard Jean-Moulin, Marseille cedex 05, France
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31
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Brouqui P. Arthropod-borne diseases associated with political and social disorder. ANNUAL REVIEW OF ENTOMOLOGY 2011; 56:357-374. [PMID: 20822446 DOI: 10.1146/annurev-ento-120709-144739] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The living conditions and the crowded situations of the homeless, war refugees, or victims of a natural disaster provide ideal conditions for the spread of lice, fleas, ticks, flies and mites. The consequence of arthropod infestation in these situations is underestimated. Along with louse-borne infections such as typhus, trench fever, and relapsing fever, the relationship between Acinetobacter spp.-infected lice and bacteremia in the homeless is not clear. Murine typhus, tungiasis, and myiasis are likely underestimated, and there has been a reemergence of bed bugs. Attempted eradication of the body louse, despite specific measures, has been disappointing, and infections with Bartonella quintana continue to be reported. The efficacy of ivermectin in eradicating the human body louse, although the effect is not sustained, might provide new therapeutic approaches. Arthropod-borne diseases continue to emerge within the deprived population. Public health programs should be engaged rapidly to control these pests and reduce the incidence of these transmissible diseases.
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Affiliation(s)
- Philippe Brouqui
- Faculté de Médecine, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, CNRS-IRD UMR 6236/198, 13385 Marseille cedex 5, France.
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32
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Fleas and flea-borne diseases. Int J Infect Dis 2010; 14:e667-76. [DOI: 10.1016/j.ijid.2009.11.011] [Citation(s) in RCA: 196] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 06/02/2009] [Accepted: 11/04/2009] [Indexed: 01/14/2023] Open
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33
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George JG, Bradley JC, Kimbrough RC, Shami MJ. Bartonella quintana associated neuroretinitis. ACTA ACUST UNITED AC 2009; 38:127-8. [PMID: 16449005 DOI: 10.1080/00365540500372929] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report an observational case of Bartonella quintana-associated neuroretinitis. The patient had a positive IgM IFA titer for Bartonella quintana early in the disease. After treatment, the neuroretinitis and IgM resolved. Given the patient's history, symptoms, response to treatment, and IgM course, we believe his neuroretinitis was secondary to Bartonella quintana.
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Affiliation(s)
- Joel G George
- Department of Ophthalmology and Visual Sciences, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
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34
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Elston D. Treatment of infestations, vector-borne, and zoonotic diseases. Dermatol Ther 2009; 22:271-2. [PMID: 19580573 DOI: 10.1111/j.1529-8019.2009.01241.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dirk Elston
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
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35
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Ehrenborg C, Byström R, Hjelm E, Friman G, Holmberg M. High Bartonella spp. seroprevalence in a Swedish homeless population but no evidence of trench fever. ACTA ACUST UNITED AC 2009; 40:208-15. [PMID: 17852922 DOI: 10.1080/00365540701632972] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Blood samples and epidemiological data were collected from 50 homeless patients in central Stockholm, Sweden. Sera were analysed for antibodies to B. henselae, B. quintana, B. elizabethae and B. grahamii. Whole blood was cultured and used as substrate for a newly developed quantitative real time polymerase chain reaction (QPCR) specifically targeting Bartonella spp. DNA. 61 matched blood donor sera were used as controls. Homeless patients were significantly more often seropositive to Bartonella spp. than controls (OR 7.58 (3.30-17.39), p<0.05). Reactivity to the B. elizabethae antigen was dominating, although the difference between patients and controls was most significant in seroreactivity to the B. henselae antigen. There was no evidence of an ongoing B. quintana epidemic. The absence of louse infestation could explain the lack of B. quintana bacteraemia and the failure to amplify Bartonella DNA.
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Affiliation(s)
- Christian Ehrenborg
- Infectious Diseases, Care Centre for homeless people, Beroendecentrum, Stockholm, Sweden.
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36
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Isolation and characterization of Bartonella quintana from the parotid gland of an immunocompetent man. J Clin Microbiol 2009; 47:862-4. [PMID: 19129406 DOI: 10.1128/jcm.01012-08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe a case of the isolation of Bartonella quintana from the parotid gland of an apparently healthy man. Pathological examination showed intraparotid granulomatous abscessual lymphadenitis. Diagnosis was made on the basis of high titers of immunoglobulin G (IgG) and IgM antibodies and of culture isolation of a causative agent from parotid aspirate.
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37
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Vorou RM, Papavassiliou VG, Tsiodras S. Emerging zoonoses and vector-borne infections affecting humans in Europe. Epidemiol Infect 2007; 135:1231-47. [PMID: 17445320 PMCID: PMC2870710 DOI: 10.1017/s0950268807008527] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The purpose of this study was to assess and describe the current spectrum of emerging zoonoses between 2000 and 2006 in European countries. A computerized search of the Medline database from January 1966 to August 2006 for all zoonotic agents in European countries was performed using specific criteria for emergence. Fifteen pathogens were identified as emerging in Europe from 2000 to August 2006: Rickettsiae spp., Anaplasma phagocytophilum, Borrelia burgdorferi, Bartonella spp., Francisella tularensis, Crimean Congo Haemorrhagic Fever Virus, Hantavirus, Toscana virus, Tick-borne encephalitis virus group, West Nile virus, Sindbis virus, Highly Pathogenic Avian influenza, variant Creutzfeldt-Jakob disease, Trichinella spp., and Echinococus multilocularis. Main risk factors included climatic variations, certain human activities as well as movements of animals, people or goods. Multi-disciplinary preventive strategies addressing these pathogens are of public health importance. Uniform harmonized case definitions should be introduced throughout Europe as true prevalence and incidence estimates are otherwise impossible.
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Affiliation(s)
- R M Vorou
- Hellenic Center for Disease Control and Prevention, Athens, Greece.
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38
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Woolley MW, Gordon DL, Wetherall BL. Analysis of the first Australian strains of Bartonella quintana reveals unique genotypes. J Clin Microbiol 2007; 45:2040-3. [PMID: 17428928 PMCID: PMC1933027 DOI: 10.1128/jcm.00175-07] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bartonella quintana is increasingly recognized as a cause of clinical disease in various geographical locations. We characterized three Australian strains associated with endocarditis, using established molecular-typing techniques, the 16S/23S rRNA intergenic spacer (ITS) region, and multispacer typing (MST). All strains examined demonstrated novel ITS and/or MST genotypes. Further characterization of Australian strains is required to determine whether there is an association between genotype and geographical location.
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Affiliation(s)
- Mark W Woolley
- Department of Microbiology and Infectious Diseases, School of Medicine,Flinders University and Flinders Medical Centre, South Australia, Australia 5042.
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39
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dos Santos RP, Cartell A, Goldani LZ. An HIV-positive patient with cervical lymphadenopathy and skin lesions. Clin Infect Dis 2007; 44:849, 884-5. [PMID: 17304465 DOI: 10.1086/511887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Rodrigo Pires dos Santos
- Infectious Diseases Section, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil.
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40
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Boonjakuakul JK, Gerns HL, Chen YT, Hicks LD, Minnick MF, Dixon SE, Hall SC, Koehler JE. Proteomic and immunoblot analyses of Bartonella quintana total membrane proteins identify antigens recognized by sera from infected patients. Infect Immun 2007; 75:2548-61. [PMID: 17307937 PMCID: PMC1865797 DOI: 10.1128/iai.01974-06] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Bartonella quintana is a fastidious, gram-negative, rod-shaped bacterium that causes prolonged bacteremia in immunocompetent humans and severe infections in immunocompromised individuals. We sought to define the outer membrane subproteome of B. quintana in order to obtain insight into the biology and pathogenesis of this emerging pathogen and to identify the predominant B. quintana antigens targeted by the human immune system during infection. We isolated the total membrane proteins of B. quintana and identified 60 proteins by two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis and peptide mass fingerprinting. Using the newly constructed proteome map, we then utilized two-dimensional immunoblotting with sera from 21 B. quintana-infected patients to identify 24 consistently recognized, immunoreactive B. quintana antigens that have potential relevance for pathogenesis and diagnosis. Among the outer membrane proteins, the variably expressed outer membrane protein adhesins (VompA and VompB), peptidyl-prolyl cis-trans-isomerase (PpI), and hemin-binding protein E (HbpE) were recognized most frequently by sera from patients, which is consistent with surface expression of these virulence factors during human infection.
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Affiliation(s)
- Jenni K Boonjakuakul
- Division of Infectious Diseases, 521 Parnassus Ave., Room C-443, University of California at San Francisco, San Francisco, CA 94143-0654, USA
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41
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Abstract
Homeless people are particularly exposed to ectoparasite. The living conditions and the crowded shelters provide ideal conditions for the spread of lice, fleas, ticks, and mites. Body lice have long been recognized as human parasites and although typically prevalent in rural communities in upland areas of countries close to the equator, it is now increasingly encountered in developed countries especially in homeless people or inner city economically deprived population. Fleas are widespread but are not adapted to a specific host and may occasionally bite humans. Most common fleas that parasite humans are the cat, the rat, and the human fleas, Ctenocephalides felis, Xenopsylla cheopis, and Pulex irritans, respectively. Ticks belonging to the family Ixodidae, in particular, the genera Dermacentor, Rhipicephalus, and Ixodes, are frequent parasites in humans. Sarcoptes scabiei var. hominis is a mite (Arachnida class) responsible for scabies. It is an obligate parasite of human skin. The hematophagic-biting mite, Liponyssoides sanguineus, is a mite of the rat, mouse, and other domestic rodents but can also bite humans. Finally, the incidence of skin disease secondary to infestation with the human bedbug, Cimex lectularius, has increased recently. Bacteria, such as Wolbacchia spp. have been detected in bedbug. The threat posed by the ectoparasite in homeless is not the ectoparasite themselves but the associated infectious diseases that they may transmit to humans. Except for scabies all these ectoparasites are potential vectors for infectious agents. Three louse-borne diseases are known at this time. Trench fever caused by Bartonella quintana (B. quintana), epidemic typhus caused by Rickettsia prowazekii, and relapsing fever caused by the spirochete Borrelia recurrentis. Fleas transmit plague (Xenopsylla cheopis and Pulex irritans), murine typhus (Xenopsylla cheopis), flea-borne spotted rickettsiosis on account of the recently described species Rickettsia felis (C. felis), and occasionally cat scratch disease on account of Bartonella henselae (C. felis). The role of fleas as potential vector of B. quintana has recently been suggested. Among the hematophagic-biting mites, L. sanguineus, is responsible for the transmission of Rickettsia akari, the etiologic agent of rickettsialpox. Virtually, no data are available on tick-borne disease in this population. This article will deal with epidemiology, diagnosis, prevention, and treatment of these ectoparasite and the infectious diseases they transmit to the homeless people.
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Affiliation(s)
- Philippe Brouqui
- Unité des rickettsies, CNRS UMR 6020, IFR 48, Faculté de médecine, 27 bd, J Moulin, 13385 Marseille, cedex 5, France.
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42
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Abstract
The pathogen is reemerging in the United States and Europe and is responsible for a number of clinical conditions. Bartonella quintana, a pathogen that is restricted to human hosts and louse vectors, was first characterized as the agent of trench fever. The disease was described in 1915 on the basis of natural and experimental infections in soldiers. It is now recognized as a reemerging pathogen among homeless populations in cities in the United States and Europe and is responsible for a wide spectrum of conditions, including chronic bacteremia, endocarditis, and bacillary angiomatosis. Diagnosis is based on serologic analysis, culture, and molecular biology. Recent characterization of its genome allowed the development of modern diagnosis and typing methods. Guidelines for the treatment of B. quintana infections are presented.
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43
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O'Rourke LG, Pitulle C, Hegarty BC, Kraycirik S, Killary KA, Grosenstein P, Brown JW, Breitschwerdt EB. Bartonella quintana in cynomolgus monkey (Macaca fascicularis). Emerg Infect Dis 2006; 11:1931-4. [PMID: 16485482 PMCID: PMC3367614 DOI: 10.3201/eid1112.030045] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We identified a Bartonella quintana strain by polymerase chain reaction amplification, cloning, and sequencing of DNA extracted from lysed erythrocytes and cultured colonies grown from peripheral blood collected from a captive-bred cynomolgus monkey (Macaca fascicularis). This report describes naturally acquired B. quintana infection in a nonhuman primate.
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Affiliation(s)
| | | | | | - Sharon Kraycirik
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Karen A. Killary
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - Paul Grosenstein
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | - James W. Brown
- North Carolina State University, Raleigh, North Carolina, USA
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44
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García-García JA, Baquerizo R, Vargas J, Mira JA, Merchante N, Macías J, Pineda JA. Prevalencia de anticuerpos séricos frente a Bartonella spp. en una polación sana del área sur de la provincia de Sevilla. Rev Clin Esp 2005; 205:541-4. [PMID: 16381097 DOI: 10.1016/s0014-2565(05)72634-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To know the prevalence of serum antibodies against Bartonella spp. in a healthy population from south of Spain. PATIENTS AND METHODS A clinical-epidemiological survey was conducted among 146 healthy individuals. An indirect immunofluorescence commercial technique was used in a sample of serum from each individual to detect the present of IgG type serum antibodies against Bartonella spp., considering a result equal to or greater than 1:128 as positive. RESULTS Thirty six (24.7%) of all the subjects studied were asymptomatic carriers of antibodies against Bartonella spp. No crossed reactions against Chlamydia trachomatis, C. pneumoniae or Coxiella burnetti were observed. No significant association was found between the presence of seropositivity for Bartonella spp. and other factors. CONCLUSION There is an elevated frequency of asymptomatic carriers of antibodies against Bartonella spp. among the healthy population of our area. This suggests that most of the infections by Bartonella are subclinical.
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Affiliation(s)
- J A García-García
- Servicio de Medicina Interna, Hospital Universitario de Valme, Sevilla
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45
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Blanco JR, Raoult D. Enfermedades producidas por Bartonella spp. Enferm Infecc Microbiol Clin 2005; 23:313-9; quiz 320. [PMID: 15899181 DOI: 10.1157/13074971] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The genus Bartonella is cause of a broad number of emerging and re-emerging infectious diseases. Clinical manifestations depend on the implicated Bartonella sp. and the immunity of the host. Because there is not a universal therapy for this infection, treatment should be chosen individually. Bartonella sp. is responsible of potentially serious clinical pictures (endocarditis, chronic bacteremia, bacillary angiomatosis, Carrion's disease, etc.), so clinical suspicion, a quick diagnosis and an early treatment provide a better resolution.
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Affiliation(s)
- José Ramón Blanco
- Area de Gestión en Enfermedades Infecciosas, Complejo San Millán San Pedro de La Rioja, Hospital de La Rioja, Avda. del Viana 1, 26001 Logroño, Spain.
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46
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Aboudharam G, Fournier PE, Drancourt M, Raoult D, Foucault C, Brouqui P. Molecular detection of Bartonella quintana DNA in the dental pulp of a homeless patient. Eur J Clin Microbiol Infect Dis 2005; 23:920-2. [PMID: 15558347 DOI: 10.1007/s10096-004-1244-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dental pulp has been proposed as a suitable tissue sample for the identification of pathogenic organisms. Using PCR with two specific gene targets, Bartonella quintana DNA was detected in the dental pulp extracted from the tooth of a homeless patient. The patient had been bacteremic 6 months previously but was not when the tooth was sampled.
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Affiliation(s)
- G Aboudharam
- Unité des Rickettsies, CNRS UMR 6020 IFR 48, Faculté de Médecine, Université de la Méditerranée, 27, Boulevard Jean Moulin, 13385, Marseille Cedex 5, France
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47
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Foucault C, La Scola B, Lindroos H, Andersson SGE, Raoult D. Multispacer typing technique for sequence-based typing of Bartonella quintana. J Clin Microbiol 2005; 43:41-8. [PMID: 15634949 PMCID: PMC540158 DOI: 10.1128/jcm.43.1.41-48.2005] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bartonella quintana is a worldwide fastidious bacterium of the Alphaproteobacteria responsible for bacillary angiomatosis, trench fever, chronic lymphadenopathy, and culture-negative endocarditis. The recent genome sequencing of a B. quintana isolate allowed us to propose a genome-wide sequence-based typing method. To ensure sequence discrimination based on highly polymorphic areas, we amplified and sequenced 34 spacers in a large collection of B. quintana isolates. Six of these exhibited polymorphisms and allowed the characterization of 4 genotypes. However, the strain variants suggested by the noncoding sequences did not correlate with the results of pulsed-field gel electrophoresis (PFGE), which suggested a higher degree of variability. Modification of the PFGE profile of one isolate after nine subcultures confirmed that rearrangement frequencies are high in this species, making PFGE unreliable for epidemiological purposes. The low extent of sequence heterogeneity in the species suggests a recent emergence of this bacterium as a human pathogen. Direct typing of natural samples allowed the identification of a fifth genotype in the DNA extracted from a human body louse collected in Burundi. We have named the typing technique herein described multispacer typing.
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Affiliation(s)
- C Foucault
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine de Marseille, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 05, France
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48
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Brouqui P, Stein A, Dupont HT, Gallian P, Badiaga S, Rolain JM, Mege JL, La Scola B, Berbis P, Raoult D. Ectoparasitism and vector-borne diseases in 930 homeless people from Marseilles. Medicine (Baltimore) 2005; 84:61-68. [PMID: 15643300 DOI: 10.1097/01.md.0000152373.07500.6e] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Homeless people are particularly exposed to ectoparasites, but their exposure to arthropod-borne diseases has not been evaluated systematically. A medical team of 27 persons (7 nurses, 6 infectious disease residents or fellows, 2 dermatologists, and 12 infectious disease specialists) visited the 2 shelters in Marseilles, France, for 4 consecutive years. Homeless volunteers were interviewed, examined, and received care; and blood was sampled for cell counts and detection of bacteremia, antibodies to louse-borne (Rickettsia prowazekii, Bartonella quintana, and Borrelia recurrentis), flea-borne (R. typhi, R. felis), mite-borne (R. akari), and tick-borne (R. conorii) bacterial agents. We selected sex- and age-adjusted controls among healthy blood donors. Over 4 years, 930 homeless people were enrolled. Lice were found in 22% and were associated with hypereosinophilia (odds ratio, 5.7; 95% confidence intervals, 1.46-22.15). Twenty-seven patients (3%) with scabies were treated with ivermectin. Bartonella quintana was isolated from blood culture in 50 patients (5.3%), 36 of whom were treated effectively. The number of bacteremic patient increased from 3.4% to 8.4% (p = 0.02) over the 4 years of the study. We detected a higher seroprevalence to Borrelia recurrentis, R. conorii, and R. prowazekii antibodies in the homeless. Our study shows a high prevalence of louse-borne infections in the homeless and a high degree of exposure to tick-borne diseases and scabies. Despite effective treatment for Bartonella quintana bacteremia and the efforts made to delouse this population, Bartonella quintana remains endemic, and we found hallmarks of epidemic typhus and relapsing fever. The uncontrolled louse infestation of this population should alert the community to the possibility of severe re-emerging louse-borne infections.
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Affiliation(s)
- Philippe Brouqui
- From Maladies Infectieuses et Tropicales (P Brouqui), Service des Urgences (SB), Service de Dermatologie (P Berbis), CHU Nord, AP-HM; Unité des Rickettsies (P Brouqui, AS, HTD, JMR, JLM, BLS, DR), CNRS UMR 6020, IFR 48, Faculté de Médecine; Service des Maladies Infectieuses (AS, HTD), CHU Conception, AP-HM; Centre National de Transfusion Sanguine (PG); Marseilles, France
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49
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Foucault C, Rolain JM, Raoult D, Brouqui P. Detection of Bartonella quintana by direct immunofluorescence examination of blood smears of a patient with acute trench fever. J Clin Microbiol 2004; 42:4904-6. [PMID: 15472378 PMCID: PMC522292 DOI: 10.1128/jcm.42.10.4904-4906.2004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report a case of Bartonella quintana acute symptomatic infection in a homeless man, presenting as a typical trench fever. B. quintana has been retrieved in erythrocytes in large clusters and in erythroblasts. Direct immunofluorescence of blood smears allows a rapid diagnosis.
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Affiliation(s)
- C Foucault
- Unité des Rickettsies, CNRS UMR 6020, IFR48, Faculté de Médecine, Université de la Méditerranée, Marseille, France.
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50
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Abstract
Arthropods of medical importance include vespids, ticks, mosquitoes, mites, flies, and fleas. They spread illness as disease vectors, are associated with lethal allergic reactions, and produce potentially deadly toxins. Strategies for prevention of illness include avoidance, vector reduction programs, chemoprophylaxis, and repellents. Strategies must be tailored to regional risks.
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Affiliation(s)
- Dirk M Elston
- Department of Dermatology, Geisinger Medical Center, Danville, Pennsylvania, USA
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