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León-Sosa A, Orlando SA, Mora-Jaramillo N, Calderón J, Rodriguez-Pazmino AS, Carvajal E, Guizado-Herrera D, Narváez Y, Sánchez E, Arreaga A, Zevallos JC, Carrillo C, Garcia-Bereguiain MA. First report of Bartonella henselae and Bartonella clarridgeiae carriage in stray cats from Ecuador and its link to a cat scratch disease outbreak in 2022. Acta Trop 2024; 257:107278. [PMID: 38851625 DOI: 10.1016/j.actatropica.2024.107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/26/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
INTRODUCTION The genus Bartonella includes species and subspecies of fastidious, facultative intracellular Gram-negative bacilli that infect a wide variety of mammalian reservoirs including cats and humans. In 2022, the Ecuadorian Ministry of Health reported an outbreak of cat scratch disease caused by B. henselae in the city of Guayaquil. Therefore, we aimed to characterize the presence of Bartonella spp. in domestic and stray cats from the area of Guayaquil where the outbreak happened in 2022. METHODS Whole blood samples of 100 domestic and stray cats were collected. Riboflavin synthase (ribC) and 16S rRNA genes detection was performed by PCR using Bartonella spp. specific primers, followed by Sanger sequencing and phylogenetic analysis. RESULTS 14 cats were positive for Bartonella spp. carriage. Phylogenetic analysis confirmed the presence of 12 cats infected with B. henselae and 2 cats with B. clarridgeiae. CONCLUSIONS There is a high prevalence of Bartonella spp. carriage in cats in the city of Guayaquil within the area where a recent cat scratch disease outbreak happened. Considering the high presence of cats and other domestic and stray animals in the city of Guayaquil, a One Health approach for surveillance and prevention of zoonotic diseases like cat scratch disease is needed.
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Affiliation(s)
- Ariana León-Sosa
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | - Solon Alberto Orlando
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador; Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Naomi Mora-Jaramillo
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | - Joselyn Calderón
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | | | - Elsy Carvajal
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - David Guizado-Herrera
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | - Yolanda Narváez
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | - Eusebio Sánchez
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
| | - Alma Arreaga
- Instituto Nacional de Investigación en Salud Pública "Leopoldo Izquieta Pérez", Dirección Técnica de Investigación, Desarrollo e Innovación, Guayaquil, Ecuador
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Zarate-Sulca Y, Calvay-Sanchez KD, Jimenez-Vasquez V, Ruiz J, Acosta-Conchucos O, Mendoza-Mujica G. Single-nucleotide polymorphisms in ialB, gltA and rpoB genes of Bartonella bacilliformis isolated from patients in endemic Peruvian regions. PLoS Negl Trop Dis 2023; 17:e0011615. [PMID: 37815991 PMCID: PMC10564245 DOI: 10.1371/journal.pntd.0011615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/22/2023] [Indexed: 10/12/2023] Open
Abstract
Bartonella bacilliformis is a Gram-negative, aerobic bacterium and the known causal agent of Carrion's disease, still considered a neglected disease. There is limited information about the nucleotide sequences of this bacterium in international databases, and few studies have addressed the genetic diversity of B. bacilliformis. We analyzed a total of 20 isolates of B. bacilliformis from the Peruvian regions of Ancash and Cajamarca. Three genes (ialB, gltA, and rpoB) were sequenced in each isolate and nucleotide sequences retrieved from GenBank (16 B. bacilliformis genomes) were also included in the study. All this information was merged in order to obtain clearer evidence of the phylogenetic relationships of B. bacilliformis. In the phylogenetic analysis conducted with the concatenated markers, four isolates (B.b-1, B. b-3, B. b- 7, B.b-8) from the Ancash region were observed to form a subgroup different from B. bacilliformis type strain KC583, showing dissimilarity levels of 5.96% (ialB), 3.69% (gltA) and 3.04% (rpoB). Our results suggest that B. bacilliformis consists of two different subgroups. Future investigations are needed to establish the taxonomic status of these subgroups.
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Affiliation(s)
- Yanina Zarate-Sulca
- Laboratorio de Referencia Nacional de Metaxénicas y Zoonosis Bacterianas, Centro Nacional de Salud Pública, Instituto Nacional de Salud Perú, Lima, Perú
| | - Karen Daphne Calvay-Sanchez
- Laboratorio de Referencia Nacional de Metaxénicas y Zoonosis Bacterianas, Centro Nacional de Salud Pública, Instituto Nacional de Salud Perú, Lima, Perú
| | - Víctor Jimenez-Vasquez
- Laboratorio de Referencia Nacional de Metaxénicas y Zoonosis Bacterianas, Centro Nacional de Salud Pública, Instituto Nacional de Salud Perú, Lima, Perú
| | - Joaquim Ruiz
- Grupo de Investigación en Enfermedades Infecciosas Emergentes, Universidad Científica del Sur, Lima, Perú
| | | | - Giovanna Mendoza-Mujica
- Laboratorio de Referencia Nacional de Metaxénicas y Zoonosis Bacterianas, Centro Nacional de Salud Pública, Instituto Nacional de Salud Perú, Lima, Perú
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Abstract
Bartonella bacilliformis causes Carrión's disease, an infectious disease present in rural Andean areas of Peru and Ecuador. The disease has an acute and a chronic phase called Oroya fever and Peruvian wart, respectively. Oroya fever is potentially fatal if treated inadequately. Female Lutzomyia verrucarum, a phlebotomine sand fly endemic to South America, is the major vector. B. bacilliformis exhibits high susceptibility levels to a variety of antibacterial agents. B. bacilliformis is difficult to culture. Most endemic areas are remote with fragile health systems and poor communication. Thus, the true burden of the disease is difficult to ascertain.
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Affiliation(s)
- Joaquim Ruiz
- Grupo de Enfermedades Emergentes y Reemergentes, Universidad Científica del Sur, Lima, Peru
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Lydy SL, Lascano MS, Garcia-Perez JE, Williams-Newkirk AJ, Grijalva MJ. Seroprevalence and risk factors for infection with Bartonella bacilliformis in Loja province, Ecuador. Emerg Microbes Infect 2018; 7:115. [PMID: 29941982 PMCID: PMC6018114 DOI: 10.1038/s41426-018-0110-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/28/2022]
Abstract
The seroprevalence and epidemiology of Bartonella bacilliformis infection in the Andean highlands of Ecuador is largely unknown. We conducted a sero-epidemiologic survey of 319 healthy children aged 1-15 years living in six rural, mountain communities in Loja Province, Ecuador. Blood was collected by finger stick onto filter paper and dried, and the eluted sera analyzed for antibodies to B. bacilliformis by rPap31 ELISA. Demographic, entomologic, and household variables were assessed to investigate associated risk factors for antibody seropositivity to B. bacilliformis. Seroprevalence of 28% was found among children in the study communities. Increased risk of seropositivity was associated with the presence of lumber piles near houses. Decreased risk of seropositivity was observed with the presence of animal waste and incremental 100 meter increases in elevation. Although investigation of clinical cases of Carrion's disease was not within the scope of this study, our serology data suggest that infection of children with B. bacilliformis is prevalent in this region of Ecuador and is largely unrecognized and undiagnosed. This study highlights the need to further investigate the prevalence, pathogenesis, epidemiology, and disease impact of this pathogen in Ecuador.
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Affiliation(s)
- Shari L Lydy
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Atlanta, GA, USA.
| | - Mauricio S Lascano
- Department of Biomedical Sciences, Ohio University, Heritage College of Osteopathic Medicine, Infectious and Tropical Disease Institute, Athens, OH, USA
- Pontificia Universidad Católica del Ecuador, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Quito, Ecuador
- Organization for Tropical Studies-North American Branch, Tropical Diseases, Environmental Change and Human Health Program, Durham, NC, USA
| | - Josselyn E Garcia-Perez
- Pontificia Universidad Católica del Ecuador, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Quito, Ecuador
- School of Medicine, Department of Microbiology and Immunology, University of Colorado, Denver, CO, USA
| | - Amanda J Williams-Newkirk
- Centers for Disease Control and Prevention, Division of Vector-Borne Diseases, Rickettsial Zoonoses Branch, Atlanta, GA, USA
- Centers for Disease Control and Prevention, Division of Foodborne, Waterborne, and Environmental Diseases, Enteric Disease Laboratory Branch, Atlanta, GA, USA
| | - Mario J Grijalva
- Department of Biomedical Sciences, Ohio University, Heritage College of Osteopathic Medicine, Infectious and Tropical Disease Institute, Athens, OH, USA
- Pontificia Universidad Católica del Ecuador, Centro de Investigación para la Salud en América Latina, Escuela de Ciencias Biológicas, Quito, Ecuador
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Abstract
Carrion's disease (CD) is a neglected biphasic vector-borne illness related to Bartonella bacilliformis. It is found in the Andean valleys and is transmitted mainly by members of the Lutzomyia genus but also by blood transfusions and from mother to child. The acute phase, Oroya fever, presents severe anemia and fever. The lethality is high in the absence of adequate treatment, despite the organism being susceptible to most antibiotics. Partial immunity is developed after infection by B. bacilliformis, resulting in high numbers of asymptomatic carriers. Following infection there is the chronic phase, Peruvian warts, involving abnormal proliferation of the endothelial cells. Despite potentially being eradicable, CD has been expanded due to human migration and geographical expansion of the vector. Moreover, in vitro studies have demonstrated the risk of the development of antimicrobial resistance. These findings, together with the description of new Bartonella species producing CD-like infections, the presence of undescribed potential vectors in new areas, the lack of adequate diagnostic tools and knowledge of the immunology and bacterial pathogenesis of CD, and poor international visibility, have led to the risk of increasing the potential expansion of resistant strains which will challenge current treatment schemes as well as the possible appearance of CD in areas where it is not endemic.
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Affiliation(s)
- Cláudia Gomes
- Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Joaquim Ruiz
- Institute for Global Health, Barcelona Centre for International Health Research, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Gutiérrez R, Vayssier-Taussat M, Buffet JP, Harrus S. Guidelines for the Isolation, Molecular Detection, and Characterization of Bartonella Species. Vector Borne Zoonotic Dis 2017; 17:42-50. [PMID: 28055575 DOI: 10.1089/vbz.2016.1956] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Bartonellae are fastidious, facultative, intracellular vector-borne bacteria distributed among mammalian reservoirs worldwide. The pathogenic potential of many Bartonella spp. has increased the interest in these bacteria and advanced their research. Isolation of Bartonella spp. is laborious using classical bacteriological methods and requires specific conditions and prolonged incubation periods. In contrast, molecular methods for detection of Bartonella DNA are considered as more practical and sensitive than the former. Among the molecular methods, the use of real-time PCR assays for primary screening of Bartonella spp., followed by several molecular confirmatory assays, using either conventional or real-time PCR, is recommended. Although primary isolation of Bartonella is a laborious task, we encourage its application to all PCR-positive samples as this is the most reliable proof for the presence of live bacteria. Moreover, a successful trial will enable a broader molecular characterization and speciation of isolated colonies. The present guideline gathers and summarizes recommendations, including advantages and limitations of isolation and molecular detection of Bartonella from mammalian and arthropod samples.
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Affiliation(s)
- Ricardo Gutiérrez
- 1 Koret School of Veterinary Medicine, The Hebrew University of Jerusalem , Rehovot, Israel
| | | | - Jean-Philippe Buffet
- 2 INRA , UMR BIPAR INRA, Anses, ENVA 14 rue Pierre et Marie Curie, Maisons-Alfort, France
| | - Shimon Harrus
- 1 Koret School of Veterinary Medicine, The Hebrew University of Jerusalem , Rehovot, Israel
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Pons MJ, Gomes C, Aguilar R, Barrios D, Aguilar-Luis MA, Ruiz J, Dobaño C, del Valle-Mendoza J, Moncunill G. Immunosuppressive and angiogenic cytokine profile associated with Bartonella bacilliformis infection in post-outbreak and endemic areas of Carrion's disease in Peru. PLoS Negl Trop Dis 2017. [PMID: 28628613 PMCID: PMC5491314 DOI: 10.1371/journal.pntd.0005684] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Analysis of immune responses in Bartonella bacilliformis carriers are needed to understand acquisition of immunity to Carrion's disease and may allow identifying biomarkers associated with bacterial infection and disease phases. Serum samples from 144 healthy subjects from 5 villages in the North of Peru collected in 2014 were analyzed. Four villages had a Carrion's disease outbreak in 2013, and the other is a traditionally endemic area. Thirty cytokines, chemokines and growth factors were determined in sera by fluorescent bead-based quantitative suspension array technology, and analyzed in relation to available data on bacteremia quantified by RT-PCR, and IgM and IgG levels measured by ELISA against B. bacilliformis lysates. The presence of bacteremia was associated with low concentrations of HGF (p = 0.005), IL-15 (p = 0.002), IL-6 (p = 0.05), IP-10 (p = 0.008), MIG (p = 0.03) and MIP-1α (p = 0.03). In multi-marker analysis, the same and further TH1-related and pro-inflammatory biomarkers were inversely associated with infection, whereas angiogenic chemokines and IL-10 were positively associated. Only EGF and eotaxin showed a moderate positive correlation with bacteremia. IgM seropositivity, which reflects a recent acute infection, was associated with lower levels of eotaxin (p = 0.05), IL-6 (p = 0.001), and VEGF (p = 0.03). Only GM-CSF and IL-10 concentrations were positively associated with higher levels of IgM (p = 0.01 and p = 0.007). Additionally, IgG seropositivity and levels were associated with high levels of angiogenic markers VEGF (p = 0.047) and eotaxin (p = 0.006), respectively. Our findings suggest that B. bacilliformis infection causes immunosuppression, led in part by overproduction of IL-10. This immunosuppression probably contributes to the chronicity of asymptomatic infections favoring B. bacilliformis persistence in the host, allowing the subsequent transmission to the vector. In addition, angiogenic markers associated with bacteremia and IgG levels may be related to the induction of endothelial cell proliferation in cutaneous lesions during chronic infections, being possible candidate biomarkers of asymptomatic infections.
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Affiliation(s)
- Maria J. Pons
- Centro de Investigación e Innovación de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Instituto de Investigación Nutricional, Lima, Perú
| | - Cláudia Gomes
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
| | - Ruth Aguilar
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
| | - Diana Barrios
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
| | - Miguel Angel Aguilar-Luis
- Centro de Investigación e Innovación de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Instituto de Investigación Nutricional, Lima, Perú
| | - Joaquim Ruiz
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
| | - Carlota Dobaño
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
| | - Juana del Valle-Mendoza
- Centro de Investigación e Innovación de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Lima, Perú
- Instituto de Investigación Nutricional, Lima, Perú
- * E-mail: (GM); (JdV)
| | - Gemma Moncunill
- ISGlobal, Barcelona Centre for International Health Research, Hospital Clínic - Universitat de Barcelona, Catalonia, Spain
- * E-mail: (GM); (JdV)
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Gomes C, Pons MJ, del Valle Mendoza J, Ruiz J. Carrion's disease: an eradicable illness? Infect Dis Poverty 2016; 5:105. [PMID: 27903286 PMCID: PMC5131403 DOI: 10.1186/s40249-016-0197-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 09/29/2016] [Indexed: 12/21/2022] Open
Abstract
Carrion's disease is a neglected tropical disease caused by Bartonella bacilliformis, a vector-borne pathogen restricted to the Andean valleys of Peru, Ecuador and Colombia. Carrion's disease is a biphasic illness; in the acute phase the case-fatality rate can be as high as 88 %, related to high parasitemia, arriving to almost all erythrocytes, and secondary bacterial infections close related with the development of transient immunosuppression in the earlier illness phases. In addition, there are an undefined number of asymptomatic carriers that are reservoirs of the etiological agent of Carrion's disease in endemic areas, they make take into account due to they are the perpetuators of this disease. The actual scenario of Carrion's disease, in which the illness is arriving to new areas, due to the expansion of the vector's distribution, suggests that now may be a crucial time to design a strategy focusing on its elimination.
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Affiliation(s)
- Cláudia Gomes
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
| | - Maria J. Pons
- Centro de Investigación e Innovación de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Avda. San Marcos cuadra 2, Chorrillos, Lima Peru
| | - Juana del Valle Mendoza
- Centro de Investigación e Innovación de la Facultad de Ciencias de la Salud de la Universidad Peruana de Ciencias Aplicadas, Avda. San Marcos cuadra 2, Chorrillos, Lima Peru
| | - Joaquim Ruiz
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic – Universitat de Barcelona, Barcelona, Spain
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Gomes C, Palma N, Pons MJ, Magallón-Tejada A, Sandoval I, Tinco-Valdez C, Gutarra C, del Valle-Mendoza J, Ruiz J, Matsuoka M. Succinyl-CoA Synthetase: New Antigen Candidate of Bartonella bacilliformis. PLoS Negl Trop Dis 2016; 10:e0004989. [PMID: 27627803 PMCID: PMC5023120 DOI: 10.1371/journal.pntd.0004989] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/19/2016] [Indexed: 11/29/2022] Open
Abstract
Background Bartonella bacilliformis is the causative agent of Carrion’s disease, a neglected illness with mortality rates of 40–85% in the absence of treatment. The lack of a diagnostic technique to overcome misdiagnosis and treat asymptomatic carriers is of note. This study aimed to identify new B. bacilliformis antigenic candidates that could lead to a new diagnostic tool able to be implemented in endemic rural areas. Methodology/Principal Findings Blood (n = 198) and serum (n = 177) samples were collected in northern Peru. Clinical data were recorded. Specific 16S rRNA amplification by RT-PCR, IFA and ELISA for IgM/IgG with whole cells as antigens was done. Western blot analysis and N-terminal amino acid sequencing detected seroreactive proteins. ELISAs for IgM/IgG for the antigenic candidates were performed. Of the population 33.3% reported at least one symptom compatible with Carrion’s disease; 25.4% (IFA), 27.1% (ELISA-IgG), 33.9% (ELISA-IgM) and 38.9% (RT-PCR) of samples were positive. Four proteins were considered potential antigenic candidates, including two new antigenic candidates, succinyl-CoA synthetase subunit α (SCS-α) and succinyl-CoA synthetase subunit β (SCS-β). On Western blot both Pap31 and SCS-α interacted with IgM, while GroEL and SCS-β interacted with IgG. The presence of specific antibodies against the antigenic candidates varied from 34.5% (IgG against SCS-α) to 97.2% (IgM against Pap31). Conclusions/Significance RT-PCR and the high levels of positivity for specific ELISAs demonstrate high levels of B. bacilliformis exposure and asymptomatic carriers among inhabitants. The new antigens identified might be used as a new rapid diagnostic tool to diagnose acute Carrion’s disease and identify asymptomatic carriers. B. bacilliformis is a neglected pathogen causing Carrion’s disease, a febrile illness with two distinct phases, the acute so-called Oroya fever that can be life-threatening, and the chronic so-called Peruvian wart. This illness is currently limited to poor inhabitants of Andean valleys of Ecuador, Colombia and Peru and for this reason is understudied. One of the most significant limitations is the lack of an adequate diagnostic tool able to be implemented in rural areas. It is imperative to unequivocally detect cases of Carrion’s disease as well as identify asymptomatic carriers who perpetuate the illness. The present study describes the identification of 4 antigenic candidates potentially useful in the future development of a rapid diagnostic test. Moreover, 2 of these candidates have not been described in the literature. Additionally, four post-outbreak and one endemic community were studied and characterized. The identification of new antigens is essential for the development of a cheap, sensitive diagnostic tool, able to be implemented in low-income areas.
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Affiliation(s)
- Cláudia Gomes
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | - Noemí Palma
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Maria J. Pons
- Centro de Investigación e Innovación, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Ariel Magallón-Tejada
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | | | - Carmen Tinco-Valdez
- Centro de Investigación e Innovación, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | | | - Juana del Valle-Mendoza
- Centro de Investigación e Innovación, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Instituto de Investigación Nutricional, Lima, Peru
| | - Joaquim Ruiz
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Minnick MF, Anderson BE, Lima A, Battisti JM, Lawyer PG, Birtles RJ. Oroya fever and verruga peruana: bartonelloses unique to South America. PLoS Negl Trop Dis 2014; 8:e2919. [PMID: 25032975 PMCID: PMC4102455 DOI: 10.1371/journal.pntd.0002919] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Bartonella bacilliformis is the bacterial agent of Carrión's disease and is presumed to be transmitted between humans by phlebotomine sand flies. Carrión's disease is endemic to high-altitude valleys of the South American Andes, and the first reported outbreak (1871) resulted in over 4,000 casualties. Since then, numerous outbreaks have been documented in endemic regions, and over the last two decades, outbreaks have occurred at atypical elevations, strongly suggesting that the area of endemicity is expanding. Approximately 1.7 million South Americans are estimated to be at risk in an area covering roughly 145,000 km2 of Ecuador, Colombia, and Peru. Although disease manifestations vary, two disparate syndromes can occur independently or sequentially. The first, Oroya fever, occurs approximately 60 days following the bite of an infected sand fly, in which infection of nearly all erythrocytes results in an acute hemolytic anemia with attendant symptoms of fever, jaundice, and myalgia. This phase of Carrión's disease often includes secondary infections and is fatal in up to 88% of patients without antimicrobial intervention. The second syndrome, referred to as verruga peruana, describes the endothelial cell-derived, blood-filled tumors that develop on the surface of the skin. Verrugae are rarely fatal, but can bleed and scar the patient. Moreover, these persistently infected humans provide a reservoir for infecting sand flies and thus maintaining B. bacilliformis in nature. Here, we discuss the current state of knowledge regarding this life-threatening, neglected bacterial pathogen and review its host-cell parasitism, molecular pathogenesis, phylogeny, sand fly vectors, diagnostics, and prospects for control.
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Affiliation(s)
- Michael F. Minnick
- Division of Biological Sciences, University of Montana, Missoula, Montana, United States of America
| | - Burt E. Anderson
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States of America
| | - Amorce Lima
- Department of Molecular Medicine, Morsani College of Medicine, University of South Florida, Tampa, Florida, United States of America
| | - James M. Battisti
- Division of Biological Sciences, University of Montana, Missoula, Montana, United States of America
| | - Phillip G. Lawyer
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Richard J. Birtles
- School of Environment and Life Sciences, University of Salford, Salford, United Kingdom
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Angkasekwinai N, Atkins EH, Romero S, Grieco J, Chao CC, Ching WM. An evaluation study of enzyme-linked immunosorbent assay (ELISA) using recombinant protein Pap31 for detection of antibody against Bartonella bacilliformis infection among the Peruvian population. Am J Trop Med Hyg 2014; 90:690-6. [PMID: 24515944 DOI: 10.4269/ajtmh.13-0131] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Reliable laboratory testing is of great importance to detect Bartonella bacilliformis infection. We evaluated the sensitivity and specificity of the enzyme-linked immunosorbent assay (ELISA) using recombinant protein Pap31 (rPap31) for the detection of antibodies against B. bacilliformis as compared with immunofluorescent assay (IFA). Of the 302 sera collected between 1997 and 2000 among an at-risk Peruvian population, 103 and 34 samples tested positive for IFA-immunoglobulin G (IgG) and IFA-IgM, respectively. By using Youden's index, the cutoff values of ELISA-IgG at 0.915 gave a sensitivity of 84.5% and specificity of 94%. The cutoff values of ELISA-IgM at 0.634 gave a sensitivity of 88.2% and specificity of 85.1%. Using latent class analysis, estimates of sensitivity and specificity of almost all the assays were slightly higher than those of a conventional method of calculation. The test is proved beneficial for discriminating between infected and non-infected individuals with the advantage of low-cost and high-throughput capability.
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Affiliation(s)
- Nasikarn Angkasekwinai
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Viral and Rickettsial Diseases Department, Infectious Disease Directorate, Naval Medical Research Center, Silver Spring, Maryland; Naval Medical Research Institute Detachment, Lima, Peru
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13
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Abstract
Bartonella spp. are facultative intracellular pathogens that employ a unique stealth infection strategy comprising immune evasion and modulation, intimate interaction with nucleated cells, and intraerythrocytic persistence. Infections with Bartonella are ubiquitous among mammals, and many species can infect humans either as their natural host or incidentally as zoonotic pathogens. Upon inoculation into a naive host, the bartonellae first colonize a primary niche that is widely accepted to involve the manipulation of nucleated host cells, e.g., in the microvasculature. Consistently, in vitro research showed that Bartonella harbors an ample arsenal of virulence factors to modulate the response of such cells, gain entrance, and establish an intracellular niche. Subsequently, the bacteria are seeded into the bloodstream where they invade erythrocytes and give rise to a typically asymptomatic intraerythrocytic bacteremia. While this course of infection is characteristic for natural hosts, zoonotic infections or the infection of immunocompromised patients may alter the path of Bartonella and result in considerable morbidity. In this review we compile current knowledge on the molecular processes underlying both the infection strategy and pathogenesis of Bartonella and discuss their connection to the clinical presentation of human patients, which ranges from minor complaints to life-threatening disease.
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Affiliation(s)
- Alexander Harms
- Focal Area Infection Biology, Biozentrum, University of Basel, Switzerland
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14
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Chaloner GL, Palmira Ventosilla, Birtles RJ. Multi-locus sequence analysis reveals profound genetic diversity among isolates of the human pathogen Bartonella bacilliformis. PLoS Negl Trop Dis 2011; 5:e1248. [PMID: 21811647 PMCID: PMC3139668 DOI: 10.1371/journal.pntd.0001248] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 06/07/2011] [Indexed: 11/18/2022] Open
Abstract
Bartonella bacilliformis is the aetiological agent of human bartonellosis, a potentially life threatening infection of significant public health concern in the Andean region of South America. Human bartonellosis has long been recognised in the region but a recent upsurge in the number of cases of the disease and an apparent expansion of its geographical distribution have re-emphasized its contemporary medical importance. Here, we describe the development of a multi-locus sequence typing (MLST) scheme for B. bacilliformis and its application to an archive of 43 isolates collected from patients across Peru. MLST identified eight sequence types among these isolates and the delineation of these was generally congruent with those of the previously described typing scheme. Phylogenetic analysis based on concatenated sequence data derived from MLST loci revealed that seven of the eight sequence types were closely related to one another; however, one sequence type, ST8, exhibited profound evolutionary divergence from the others. The extent of this divergence was akin to that observed between other members of the Bartonella genus, suggesting that ST8 strains may be better considered as members of a novel Bartonella genospecies.
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Affiliation(s)
- Gemma L Chaloner
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.
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15
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Engel P, Salzburger W, Liesch M, Chang CC, Maruyama S, Lanz C, Calteau A, Lajus A, Médigue C, Schuster SC, Dehio C. Parallel evolution of a type IV secretion system in radiating lineages of the host-restricted bacterial pathogen Bartonella. PLoS Genet 2011; 7:e1001296. [PMID: 21347280 PMCID: PMC3037411 DOI: 10.1371/journal.pgen.1001296] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 01/07/2011] [Indexed: 12/03/2022] Open
Abstract
Adaptive radiation is the rapid origination of multiple species from a single ancestor as the result of concurrent adaptation to disparate environments. This fundamental evolutionary process is considered to be responsible for the genesis of a great portion of the diversity of life. Bacteria have evolved enormous biological diversity by exploiting an exceptional range of environments, yet diversification of bacteria via adaptive radiation has been documented in a few cases only and the underlying molecular mechanisms are largely unknown. Here we show a compelling example of adaptive radiation in pathogenic bacteria and reveal their genetic basis. Our evolutionary genomic analyses of the α-proteobacterial genus Bartonella uncover two parallel adaptive radiations within these host-restricted mammalian pathogens. We identify a horizontally-acquired protein secretion system, which has evolved to target specific bacterial effector proteins into host cells as the evolutionary key innovation triggering these parallel adaptive radiations. We show that the functional versatility and adaptive potential of the VirB type IV secretion system (T4SS), and thereby translocated Bartonella effector proteins (Beps), evolved in parallel in the two lineages prior to their radiations. Independent chromosomal fixation of the virB operon and consecutive rounds of lineage-specific bep gene duplications followed by their functional diversification characterize these parallel evolutionary trajectories. Whereas most Beps maintained their ancestral domain constitution, strikingly, a novel type of effector protein emerged convergently in both lineages. This resulted in similar arrays of host cell-targeted effector proteins in the two lineages of Bartonella as the basis of their independent radiation. The parallel molecular evolution of the VirB/Bep system displays a striking example of a key innovation involved in independent adaptive processes and the emergence of bacterial pathogens. Furthermore, our study highlights the remarkable evolvability of T4SSs and their effector proteins, explaining their broad application in bacterial interactions with the environment. Adaptive radiation is the rapid origination of an array of species by the divergent colonization of disparate ecological niches. In the case of pathogenic bacteria, radiations can lead to the emergence of novel human pathogens. Being divergently adapted to a range of different mammalian hosts, including humans as reservoir or incidental hosts, the genus Bartonella represents a suitable model to study genomic mechanisms underpinning divergent adaptation of pathogens. Here we show that two distinct lineages of Bartonella have radiated in parallel, resulting in two arrays of evolutionary distinct species adapted to overlapping sets of mammalian hosts. Such parallelisms display excellent models to reveal insights into the genetic mechanisms underlying these independent evolutionary processes. Our genome-wide analysis identifies a striking evolutionary parallelism in a horizontally-acquired protein secretion system in the two lineages. The parallel evolutionary trajectory of this system in the two lineages is characterized by the convergent origination of a wide array of adaptive functions dedicated to the cellular interaction within the mammalian hosts. The parallel evolution of the two radiating lineages on the ecological as well as on the molecular level suggests that the horizontal acquisition and the functional diversification of the secretion system display an evolutionary key innovation underlying adaptive evolution.
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Affiliation(s)
- Philipp Engel
- Focal Area Infection Biology, Biozentrum, University of Basel, Basel, Switzerland
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16
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del Valle LJ, Flores L, Vargas M, García-de-la-Guarda R, Quispe RL, Ibañez ZB, Alvarado D, Ramírez P, Ruiz J. Bartonella bacilliformis, endemic pathogen of the Andean region, is intrinsically resistant to quinolones. Int J Infect Dis 2010; 14:e506-10. [DOI: 10.1016/j.ijid.2009.07.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2009] [Revised: 07/07/2009] [Accepted: 07/29/2009] [Indexed: 10/20/2022] Open
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17
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Jensenius M, Davis X, von Sonnenburg F, Schwartz E, Keystone JS, Leder K, Lopéz-Véléz R, Caumes E, Cramer JP, Chen L, Parola P. Multicenter GeoSentinel analysis of rickettsial diseases in international travelers, 1996-2008. Emerg Infect Dis 2010; 15:1791-8. [PMID: 19891867 PMCID: PMC2857242 DOI: 10.3201/eid1511.090677] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Spotted fever group rickettsiosis acquired in sub-Saharan Africa was the most common rickettsial disease observed.
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Affiliation(s)
- Mogens Jensenius
- Department of Infectious Diseases, Oslo University Hospital, Ullevål, NO-0407 Oslo, Norway.
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