Bartonella infections in cats and dogs including zoonotic aspects

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

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.

Evaluation of the available animal models for Bartonella infections

The diseases caused by the Bartonella genus of bacteria are clinically diverse, and can be challenging to cure. The study of bartonellosis has been hampered by the lack of a suitable animal model. Preclinical studies for novel therapeutics and a competent host for vector transmission studies are needed to fill critical knowledge gaps. The studies included here are a representation of in vivo Bartonella research and the corresponding challenges. This review examines the current state of available animal models by assessing the success of various model species and strains in Bartonella infection. With a focus on the strengths and weaknesses of current animal models, the importance of these models for improvement of human health and veterinary care is emphasized.

Molecular evidence of Bartonella spp. in tropical wild birds from the Brazilian Pantanal, the largest wetland in South America

Despite the worldwide occurrence of bartonellae in a broad range of mammal species, in which they usually cause a long-lasting erythrocytic bacteremia, few studies reported Bartonella spp. in avian hosts. The present work aimed to investigate the occurrence and molecular identity of Bartonella spp. infecting birds in the Pantanal wetland, central-western Brazil using a multigene approach. For this purpose, blood samples were collected from 517 individuals from 13 avian orders in the states of Mato Grosso and Mato Groso do Sul. DNA was extracted from avian blood and 500/517 (96.7%) samples were positive in a conventional PCR targeting the avian β-actin gene. Nineteen (3.8%) out of 500 avian blood samples were positive in a qPCR assay for Bartonella spp. based on the nuoG gene. Among 19 avian blood DNA samples positive in the qPCR for Bartonella spp., 12 were also positive in the qPCR for Bartonella based on the 16S-23S RNA Intergenic region (ITS). In the PCR assays performed for molecular characterization, one 16S rRNA, three ribC, and one nuoG sequences were obtained. Based on BLASTn results, while 1 nuoG, 2 ribC, and 2 ITS sequences showed high identity to Bartonella henselae, one 16S rRNA and 2 ITS showed high similarity to Bartonella machadoae in the sampled birds. Bartonella spp. related to B. henselae and B. machadoae were detected, for the first time, in wild birds from the Brazilian Pantanal.

In silico identification of drug targets and vaccine candidates against Bartonella quintana: a subtractive proteomics approach

BACKGROUND

The availability of genes and protein sequences for parasites has provided valuable information for drug target identification and vaccine development. One such parasite is Bartonella quintana, a Gram-negative, intracellular pathogen that causes bartonellosis in mammalian hosts.

OBJECTIVE

Despite progress in understanding its pathogenesis, limited knowledge exists about the virulence factors and regulatory mechanisms specific to B. quintana.

METHODS AND FINDINGS

To explore these aspects, we have adopted a subtractive proteomics approach to analyse the proteome of B. quintana. By subtractive proteins between the host and parasite proteome, a set of proteins that are likely unique to the parasite but absent in the host were identified. This analysis revealed that out of the 1197 protein sequences of the parasite, 660 proteins are non-homologous to the human host. Further analysis using the Database of Essential Genes predicted 159 essential proteins, with 28 of these being unique to the pathogen and predicted as potential putative targets. Subcellular localisation of the predicted targets revealed 13 cytoplasmic, eight membranes, one periplasmic, and multiple location proteins. The three-dimensional structure and B cell epitopes of the six membrane antigenic protein were predicted. Four B cell epitopes in KdtA and mraY proteins, three in lpxB and BQ09550, whereas the ftsl and yidC proteins were located with eleven and six B cell epitopes, respectively.

MAINS CONCLUSIONS

This insight prioritises such proteins as novel putative targets for further investigations on their potential as drug and vaccine candidates.

Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases

Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. This study aimed to compare serum and synovial fluid antibodies to B. burgdorferi and Bartonella spp. in patients with rheumatic diseases. This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to B. burgdorferi (using CDC criteria) and Bartonella spp. via two indirect fluorescent antibody (IFA) assays was performed as part of routine patient care at the Institute for Specialized Medicine (San Diego, CA, USA). There were 30 participants (27%) with positive two-tier B. burgdorferi serology and 26 participants (24%) with IFA seroreactivity (≥1:256) to B. henselae and/or B. quintana. Both B. burgdorferi IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (P = 0.048). Conversely, B. henselae and B. quintana antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (P < 0.001). There were no significant associations between B. burgdorferi or Bartonella spp. seroreactivity with any of the clinical rheumatological diagnoses. This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to B. burgdorferi but not for documenting exposure to Bartonella spp.

IMPORTANCE

This study focuses on diagnostic testing for two common vector-borne diseases in an affected patient population. In it, we provide data showing that antibodies to B. burgdorferi, but not Bartonella spp., are more commonly found in synovial fluid than serum of patients with joint effusion. Since Lyme arthritis is a common-and sometimes difficult to diagnose-rheumatic disease, improving diagnostic capabilities is of utmost importance. While our findings are certainly not definitive for changes to practice, they do suggest that synovial fluid could be a useful sample for the clinical diagnosis of Lyme disease, and future prospective studies evaluating this claim are warranted.

Genomic detection and phylogenetic analysis of Bartonella quintana in pet cats from Urmia City, Northwest Iran

The aim of this study was to investigate the presence and genetic characteristics of Bartonella quintana in pet cats from Urmia City, located in the northwest of Iran. Blood samples were collected from 200 cats, and their age, gender, and breed were noted. Nested-PCR and sequencing were used to identify B. quintana in positive samples, and the ftsZ gene sequences were analyzed using BioEdit software. The gene sequence obtained in this study exhibited 100.00 % similarity to reference sequences in the GenBank® database, and a phylogenetic tree was constructed using MEGA11. The results revealed that 15 % of the cats (30 out of 200 blood samples) tested positive for the B. quintana gene, with a 95 % confidence interval of 10.71 % to 20.61 %.

Epidemiology of Bartonella henselae infection in pet and stray cats in Croatia with risk factors analysis

BACKGROUND

Cats are the primary reservoirs of the bacterium Bartonella henselae, the main cause of cat-scratch disease in humans. The main vector of the bacterium is the cat flea, Ctenocephalides felis. In southeastern Europe, data are lacking on the prevalence of B. henselae infection in cats, the strains of B. henselae involved and the risk factors associated with the infection.

METHODS

Blood samples collected in ethylenediaminetetraacetic acid-containing tubes from 189 domestic cats (156 pet cats and 33 stray cats) from Zagreb, the capital city of Croatia, and 10 counties throughout Croatia were cultured for Bartonella spp. Following culture, bacterial isolates were genotyped at eight loci after using PCR to amplify 16S ribosomal RNA (rRNA) and the internal transcribed spacer region between the 16S and 23S rRNA sequences. Univariate and multivariate logistic regression were used to identify risk factors for B. henselae infection in cats.

RESULTS

Bartonella spp. was detected in 31 cats (16.4%), and subsequent genotyping at the eight loci revealed B. henselae in all cases. Thirty complete multilocus sequence typing profiles were obtained, and the strains were identified as four sequence types that had been previously reported, namely ST5 (56.7%), ST6 (23.3%), ST1 (13.3%) and ST24 (3.3%), as well as a novel sequence type, ST33 (3.3%). The univariate analysis revealed a significantly higher risk of B. henselae infection in cats residing in coastal areas of Croatia (odds ratio [OR] 2.592, 95% confidence interval [CI] 1.150-5.838; P = 0.0191) and in cats with intestinal parasites (OR 3.207, 95% CI 1.088-9.457; P = 0.0279); a significantly lower risk was identified in cats aged > 1 year (OR 0.356, 95% CI 0.161-0.787; P = 0.0247) and in cats sampled between April and September (OR 0.325, 95% CI 0.147-0.715; P = 0.005). The multivariate analysis that controlled for age showed a positive association with the presence of intestinal parasites (OR 4.241, 95% CI 1.243-14.470; P = 0.0119) and coastal residence (OR 2.567, 95% CI 1.114-5.915; P = 0.0216) implying increased risk of infection, and a negative association with sampling between April and September (OR 0.379, 95% CI 0.169-0.848; P = 0.018) implying a decreased risk of infection. After controlling for the season, an increased risk of infection remained for the coastal region (OR 2.725, 95% CI 1.200-6.186; P = 0.012).

CONCLUSIONS

Bartonella henselae is prevalent throughout Croatia and is a public health threat. Environmental and host factors can significantly affect the risk of infection, and these should be explored in more detail. The presence of intestinal parasites highlights the need to eliminate the flea vector, Ctenocephalides felis, as the most effective approach to control infections in cats and humans.

Epidemiology of feline bartonellosis and molecular characteristics of Bartonella henselae in Bangladesh

Bartonellosis, a neglected vector-borne zoonotic disease transmitted from animals to humans, continues to threaten human and animal health significantly. This study aims to determine the epidemiology of feline bartonellosis and the molecular characteristics of Bartonella spp. in cats. From June 2018 to June 2020, 304 oral swabs were randomly collected from Bangladesh's Dhaka, Mymensingh, and Rajshahi districts. A pre-tested questionnaire was administered to collect data. Oral swabs were subjected to PCR targeting htrA gene to confirm Bartonella spp., which was subsequently validated through sequencing. Risk factors were identified using multivariable logistic regression analysis. The overall prevalence of feline bartonellosis was found to be 15.1 %. The following factors were significantly (p < 0.05) associated with Bartonella infection in risk factor analysis: cats aged ≥ 1 year (OR: 3.23, 95 % CI: 1.38-24.40), local breed cats (OR: 3.37, 95 % CI: 1.05-10.81), cats carrying fleas (OR: 2.33, 95 % CI: 1.93-13.45), antifleacidal drugs inconsistently administered cats (OR: 6.74, 95 % CI: 3.17-14.31), outdoor access cats (OR: 2.54, 95 % CI: 1.16-5.57). Notably, zoonotic B. henselae was confirmed through sequencing, establishing it as the causal agent of cat scratch disease. Phylogenetic analysis showed homology with B. henselae sequences from Brazil, Saint Kitts, and Nevis. We recommend consistent and appropriate flea control measures to curb its spread among Bangladeshi cats. Moreover, limiting outdoor exposure or implementing preventive measures for outdoor cats could reduce the disease burden. The associated human health risk can be decreased by effectively controlling this disease within the cat population.

Genetic characterization of Bartonella henselae samples isolated from stray cats by multi-locus sequence typing

BACKGROUND

Bartonella henselae is one of the most commonly identified Bartonella species associated with several human diseases. Although B. henselae was detected in humans and cats in Turkey, they have not been genotyped previously. Therefore, this study aimed to genotype B. henselae samples (n = 44) isolated from stray cats using the multi-locus sequence typing (MLST) method. For this aim, eight different housekeeping markers were amplified by nested PCR and then sequenced to reveal sequence types (STs) of B. henselae samples.

RESULTS

Allelic profiles obtained from 40 B. henselae isolates (90.9%) were compatible with available allelic profiles in the MLST online database. However, allelic profiles obtained from the remaining 4 B. henselae isolates (9.1%) were incompatible with the database. Among B. henselae isolates with compatible allelic profiles, 5 different STs including ST1, ST5, ST9, ST35 and ST36 were identified according to the B. henselae MLST online database. ST35 was the most prevalent ST with a prevalence rate of 29.5% (13/44), followed by ST36 with a prevalence rate of 22.7% (10/44). In addition, ST5 (16%, 7/44) and ST9 (18.2%, 8/44) were also among the prevalent STs. The prevalence of ST1 was 4.5% (2/44). For B. henselae isolates with incompatible allelic profiles, we recommended a new ST called ST38.

CONCLUSION

The present study genotyped B. henselae samples isolated from stray cats in Turkey for the first time and ST1, ST5, ST9, ST35, and ST36 as well as a new sequence type named ST38 were identified among these B. henselae isolates.

Hemophagocytic lymphohistiocytosis secondary to unrecognized Bartonella henselae infection: a case report

BACKGROUND

Bartonella henselae is a species of intracellular bacteria transmitted to humans through animal bites and scratches contaminated with the feces of arthropod vectors, and are most commonly associated with cat exposure although transmission from other mammals has been reported. Bartonella henselae infection has a spectrum of clinical manifestations and has rarely been reported as cause of hemophagocytic lymphohistiocytosis (HLH) in immunocompromised hosts.

CASE PRESENTATION

We present a report of Bartonella henselae infection progressing to HLH in an immunocompetent patient. The patient initially presented with regional lymphadenopathy but the diagnosis was not suspected as the patient reported no exposure to cats. On further history, he did report a scratch from a dog prior to development of symptoms. The patient was treated with methylprednisolone, intravenous immunoglobulin and anakinra for the HLH and three months of Doxycycline for Bartonella infection, with complete resolution of symptoms.

CONCLUSIONS

Although commonly associated with cat exposure, Bartonella henselae transmission can occur after exposure to other animals and vectors including dogs and clinicians need to maintain an index of suspicion for timely diagnosis. Bartonella henselae is associated with a spectrum of clinical manifestations which can include disseminated infection with severe complications such as hemophagocytic lymphohistiocytosis. Prompt initiation of Bartonella treatment is essential when thought to be the trigger for hemophagocytic lymphohistiocytosis although the optimal treatment regimen is unclear.

Bartonella infections are prevalent in rodents despite efficient immune responses

BACKGROUND

Pathogens face strong selection from host immune responses, yet many host populations support pervasive pathogen populations. We investigated this puzzle in a model system of Bartonella and rodents from Israel's northwestern Negev Desert. We chose to study this system because, in this region, 75-100% of rodents are infected with Bartonella at any given time, despite an efficient immunological response. In this region, Bartonella species circulate in three rodent species, and we tested the hypothesis that at least one of these hosts exhibits a waning immune response to Bartonella, which allows reinfections.

METHODS

We inoculated captive animals of all three rodent species with the same Bartonella strain, and we quantified the bacterial dynamics and Bartonella-specific immunoglobulin G antibody kinetics over a period of 139 days after the primary inoculation, and then for 60 days following reinoculation with the same strain.

RESULTS

Contrary to our hypothesis, we found a strong, long-lasting immunoglobulin G antibody response, with protective immunological memory in all three rodent species. That response prevented reinfection upon exposure of the rodents to the same Bartonella strain.

CONCLUSIONS

This study constitutes an initial step toward understanding how the interplay between traits of Bartonella and their hosts influences the epidemiological dynamics of these pathogens in nature.

Molecular detection of Bartonella and Borrelia in pet dogs in Metro Manila and Laguna, Philippines

Background and Aim

Bartonella and Borrelia are zoonotic vector-borne pathogens that can infect dogs and humans. Data on Bartonella and Borrelia in dogs in the Philippines are lacking. This study was conducted to validate previous reports and further investigate the occurrence of Bartonella and Borrelia spp. in cities of Metro Manila.

Materials and Methods

A total of 182 canine blood samples were acquired with DNA using a commercial extraction kit from selected veterinary clinics in the cities of Metro Manila and Laguna, Philippines. The mammalian actin was amplified through polymerase chain reaction (PCR), followed by PCR assays targeting Bartonella gltA and Borrelia flaB. Further PCR assays targeting 16S of Borrelia and ospA and ospC of Borrelia burgdorferi were performed for those that showed flaB bands.

Results

A positive band for gltA of Bartonella was observed in 9 (4.95%) samples, whereas a positive band for flaB of Borrelia was observed in 15 (8.24%) samples. Subsequent PCR assays for other genes of Borrelia were negative.

Conclusion

These results confirmed the presence of Bartonella and warranted further investigation for the possible presence of other Borrelia species.

Viability and Desiccation Resistance of Bartonella henselae in Biological and Non-Biological Fluids: Evidence for Pathogen Environmental Stability

Pathogen environmental stability is an often-neglected research priority for pathogens that are known to be vector-transmitted. Bartonella henselae, the etiologic agent of Cat Scratch Disease, has become a "pathogen of interest" in several serious human illnesses, which include neoplastic, cardiovascular, neurocognitive, and rheumatologic conditions. Survival in the flea gut and feces as well as the association with a biofilm in culture-negative endocarditis provides insight into this organism's ability to adjust to environmental extremes. The detection of B. henselae DNA in blood and tissues from marine mammals also raises questions about environmental stability and modes of pathogen transmission. We investigated the ability of B. henselae to survive in fluid matrices chosen to mimic potential environmental sources of infective materials. Feline whole blood, serum and urine, bovine milk, and physiologic saline inoculated with a laboratory strain of B. henselae San Antonio 2 were subsequently evaluated by culture and qPCR at specified time intervals. Bacterial viability was also assessed following desiccation and reconstitution of each inoculated fluid matrix. Bartonella henselae SA2 was cultured from feline urine up to 24 h after inoculation, and from blood, serum, cow's milk, and physiologic saline for up to 7 days after inoculation. Of potential medical importance, bacteria were cultured following air-desiccation of all fluid inoculates. The viability and stability of Bartonella within biological and non-biological fluids in the environment may represent a previously unrecognized source of infection for animals and human beings.

Eosinophilic pericardial effusion and pericarditis in a cat

Case summary

A 10-year-old domestic shorthair cat presented for lethargy, anorexia and labored breathing. Significant pleural and pericardial effusions prompted thoracocentesis and pericardiocentesis. Cytologic evaluation of the pericardial effusion revealed a highly cellular hemorrhagic, eosinophilic (12%) effusion, with many markedly atypical suspected mesothelial cells, interpreted as concerning for neoplasia. Thoracoscopic subtotal pericardiectomy and histology of the pericardium revealed predominantly eosinophilic inflammation with multifocal mesothelial hypertrophy and ulceration. A peripheral eosinophilia was not present on serial complete blood counts. Initial infectious disease testing was mostly negative. Toxoplasma gondii titers were most consistent with prior exposure, although reactivation could not be excluded. The owner's medical history included a prior diagnosis of bartonellosis. Owing to the challenges of definitive Bartonella species exclusion, the cat was treated empirically with pradofloxacin and doxycycline, and a subtotal pericardectomy. There was improvement at first but pleural effusion recurred approximately 3 months after discharge. The cat was euthanized and a necropsy was not performed. Subsequent pericardial effusion Piroplasma/Bartonella/Borrelia droplet digital PCR detected DNA of Bartonella vinsonii subspecies berkhoffii, and peripheral blood culture and sequencing revealed a rare apicomplexan organism (90% homology with Colpodella species) of unknown clinical significance. Testing for filamentous bacteria and fungal pathogens was not performed.

Relevance and novel information

This case offers several unique entities - eosinophilic pericardial effusion and eosinophilic pericarditis of unknown etiology - and illustrates the well-known marked atypia that may occur in reactive and hyperplastic mesothelial cells, particularly of infrequently sampled and cytologically described feline pericardial effusion, supporting a cautious interpretation of this cytology finding.

Risk Factors for Bartonella Seroreactivity Among Veterinary Workers in the Pacific Northwest

Background: Exposure to zoonotic diseases is a significant occupational risk in veterinary medicine. In this study, we characterized personal protective equipment use, injury frequency, and Bartonella seroreactivity in Washington State veterinary workers. Methods: Using a risk matrix developed to reflect occupational risk factors for exposure to Bartonella and multiple logistic regression, we explored determinants of risk for Bartonella seroreactivity. Results: Depending on the titer cutoff used, Bartonella seroreactivity was between 24.0% and 55.2%. No significant predictors of seroreactivity were found, although the relationship between high-risk status and increased seroreactivity for some Bartonella species approached significance. Serology for other zoonotic and vector borne pathogens did not identify consistent cross reactivity with Bartonella antibodies. Conclusion: The predictive power of the model was likely limited by the small sample size and high level of exposure to risk factors for most participants. Given the high proportion of veterinarians seroreactive to one or more of the three Bartonella spp. known to infect dogs and cats in the United States, as well as seroreactivity to other zoonoses, and the unclear relationship between occupational risk factors, seroreactivity, and disease expression, more research is needed in this area.

"Let the Cat Out of the Heart": Clinical Characteristics of Patients Presenting With Blood Culture-Negative Endocarditis Due to Bartonella Species

Patients with blood culture-negative endocarditis due to Bartonella infection frequently presented with fever, cytopenias, kidney failure, and positive PR3-ANCA. Bartonella IgG titers were variable. Patients commonly underwent surgery with overall low mortality.

Molecular detection of vector-borne pathogens in cats tested for FIV and FeLV

The aim of this study was to detect molecularly vector borne pathogens (VBPs) in domiciled cats tested for Feline immunodeficiency virus (FIV) and Feline leukemia virus (FeLV). Blood samples (n = 119) were analyzed microscopically and molecularly through PCR and sequenced for the detection of the following pathogens: piroplasmids., Bartonella henselae, Cytauxzoon felis, Ehrlichia canis, Leishmania spp., hemotropic Mycoplasma spp., Trypanosoma spp., and Ricketssia spp. Animals were also serological assessed for detection of antibodies against FIV and FeLV. Out of all animals, 20.16% (24/119) tested positive for at least one VBPs at molecular examination. Conversely, no animal resulted positive at microscopic analysis. The most prevalent pathogen was hemotropic Mycoplasma haemofelis (8.40%; 10/119), followed by Candidatus Mycoplasma haemominutum (5.88%; 7/119), E. canis (5.04%; 6/119), C. felis (0.84%; 1/119) and B. henselae (0.84%; 1/119). One animal (0.84%; 1/119) was co-infected with. E. canis and B. henselae. A total of 5.88% (7/119) and 1.68% (2/119) tested positive for FIV and FeLV, respectively. Data of this study demonstrate that owned cats can be at risk of hemotropic Mycoplasma spp., E. canis, C. felis and B. henselae. Therefore, preventive measures against vectors of these pathogens should be implemented in order to reduce the risk of exposition and consequently infection. Additionally, aggressive behaviors among cats should be avoided, especially because hemotropic Mycoplasma spp. may be transmitted through the bite of animals.

Infective endocarditis in dogs in the UK: 77 cases (2009-2019)

OBJECTIVES

To determine the causative organisms, clinical features and outcome of canine infective endocarditis in the UK.

MATERIALS AND METHODS

Medical records of three veterinary referral hospitals were searched for dogs with infective endocarditis between December 2009 and December 2019. Signalment, clinical signs, causative organism, valve affected, treatment and survival data were recorded.

RESULTS

Seventy-seven cases with possible or definite infective endocarditis (according to the modified Duke criteria) were included. The majority were large breed (40/77 - 51.9%). There were 47 of 77 (61%) male dogs and the mean age was 7.3 ±3 years. A causative organism was identified in 26 of 77 (33.8%) cases. The most common organisms were Escherichia coli (7/27 - 25.9%), Pasteurella spp. (5/27 - 18.5%), Staphylococcus spp. (4/27 - 14.8%) and Corynebacterium spp. (4/27 - 14.8%). Bartonella spp. were not detected in any patients. The mitral valve was most commonly affected (48/77 - 62.3%). Clinical features were non-specific, with lethargy being the most common clinical sign observed (53/77 - 68.8%). Fifty-three dogs (68.8%) survived to discharge. The median survival time post discharge was 425 days (2 to 3650 days). The development of congestive heart failure was associated with a poorer outcome. Cardiac troponin concentration, antithrombotic use and the development of thromboembolism or arrhythmias were not significantly associated with outcome.

CLINICAL SIGNIFICANCE

Some dogs with infective endocarditis that survive to discharge can have a long lifespan. The inability to detect an underlying organism is common and Bartonella spp. may be a less prevalent cause of canine infective endocarditis in the UK than in the USA.

Advanced approaches for the diagnosis and chemoprevention of canine vector-borne pathogens and parasites-Implications for the Asia-Pacific region and beyond

Vector-borne pathogens (VBPs) of canines are a diverse range of infectious agents, including viruses, bacteria, protozoa and multicellular parasites, that are pernicious and potentially lethal to their hosts. Dogs across the globe are afflicted by canine VBPs, but the range of different ectoparasites and the VBPs that they transmit predominate in tropical regions. Countries within the Asia-Pacific have had limited prior research dedicated to exploring the epidemiology of canine VBPs, whilst the few studies that have been conducted show VBP prevalence to be high, with significant impacts on dog health. Moreover, such impacts are not restricted to dogs, as some canine VBPs are zoonotic. We reviewed the status of canine VBPs in the Asia-Pacific, with particular focus on nations in the tropics, whilst also investigating the history of VBP diagnosis and examining recent progress in the field, including advanced molecular methods, such as next-generation sequencing (NGS). These tools are rapidly changing the way parasites are detected and discovered, demonstrating a sensitivity equal to, or exceeding that of, conventional molecular diagnostics. We also provide a background to the armoury of chemopreventive products available for protecting dogs from VBP. Here, field-based research within high VBP pressure environments has underscored the importance of ectoparasiticide mode of action on their overall efficacy. The future of canine VBP diagnosis and prevention at a global level is also explored, highlighting how evolving portable sequencing technologies may permit diagnosis at point-of-care, whilst further research into chemopreventives will be essential if VBP transmission is to be effectively controlled.

The association of host and vector characteristics with Ctenocephalides felis pathogen and endosymbiont infection

Surveillance of the fleas and flea-borne pathogens infecting cats is important for both human and animal health. Multiple zoonotic Bartonella and Rickettsia species are known to infect the most common flea infesting cats and dogs worldwide: Ctenocephalides felis, the cat flea. The ability of other flea species to transmit pathogens is relatively unexplored. We aimed to determine cat host and flea factors independently associated with flea Bartonella and Rickettsia infection. We also assessed flea and cat infection by flea-host pair and location. To accomplish these aims, we performed qPCR for the detection of Bartonella, hemotropic Mycoplasma, Rickettsia, and Wolbachia DNA using paired cat and flea samples obtained from free-roaming cats presenting for spay or neuter across four locations in the United States. A logistic regression model was employed to identify the effect of cat (sex, body weight, geographic location, and Bartonella, hemotropic Mycoplasma, and Rickettsia spp., infection) and flea (clade and Rickettsia and Wolbachia infection) factors on C. felis Bartonella clarridgeiae infection. From 189 free roaming cats, we collected 84 fleas: Ctenocephalides felis (78/84), Cediopsylla simplex (4/84), Orchopeas howardi (1/84), and Nosopsyllus fasciatus (1/84). Ctenocephalides felis were phylogenetically assigned to Clades 1, 4, and 6 by cox1 gene amplification. Rickettsia asembonensis (52/84) and B. clarridgeiae (16/84) were the most common pathogenic bacteria detected in fleas. Our model identified host cat sex and weight as independently associated with B. clarridgeiae infection in fleas. Rickettsia asembonensis (52/84), Rickettsia felis (7/84) and Bartonella henselae (7/84) were detected in specific clades: R. felis was detected only in Clades 1 and 6 while B. henselae and R. asembonensis were detected only in Clade 4. Wolbachia spp., also displayed clade specificity with strains other than Wolbachia wCfeT only infecting fleas from Clade 6. There was poor flea and host agreement for Bartonella spp., infection; however, there was agreement in the Bartonella species detected in cats and fleas by geographic location. These findings reinforce the importance of considering reservoir host attributes and vector phylogenetic diversity in epidemiological studies of flea-borne pathogens. Widespread sampling is necessary to identify the factors driving flea-borne pathogen presence and transmission.

Cat scratch disease: What to do with the cat?

Purpose

Cat scratch disease (CSD) frequently has ophthalmologic manifestations. The ophthalmologist's approach to treating neuroretinitis is familiar, but few eye care providers are comfortable answering the next question of “what do I do with my cat?” Published guidelines are often vague in answering the complexities of real-life conundrums that can lead patients and their doctors to believe that risk mitigation should involve removal of the animal. Here, we present demonstrative scenarios informed by clinical practice and provide updated recommendations.

Observations

A 10-year-old boy presented with reduced vision in the right eye. Funduscopic examination identified optic nerve head edema with subretinal fluid, and a macular star developed one week later, consistent with the diagnosis of neuroretinitis. Serology confirmed Bartonella henselae antibodies and a diagnosis of CSD. The father disclosed that the family has recently adopted three kittens, who have scratched the boy and the patient's younger sister. The physician and patient's family find themselves at a loss regarding best practices for what should be done with the kittens.

Conclusions and Importance

B. henselae has been detected in a variety of mammals and can be transmitted via vectors such as fleas. Even well-appearing animals can transmit the bacteria, months to years after their initial infection. Symptoms, clinical and laboratory findings will depend on bacterial load and strain virulence, as well as the physiological/immunological status of the host, with people at the extremes of age and the immunocompromised being at greater disease risk. Flea control is crucial to minimize transmission risk. Our veterinary expert (EBB) recommends testing (with serology and PCR) and treating infected animals (with doxycycline and a quinolone). Patients should be counseled to speak with their pets’ veterinarian. When addressing the concerns of our CSD patients in clinical practice, ophthalmologists should be aware of the strategies for minimizing Bartonella transmission risk, and cognizant of the One Health approach for managing zoonoses.

Vector-borne and other pathogens of potential relevance disseminated by relocated cats

Large populations of unowned cats constitute an animal welfare, ecological, societal and public health issue worldwide. Their relocation and homing are currently carried out in many parts of the world with the intention of relieving suffering and social problems, while contributing to ethical and humane population control in these cat populations. An understanding of an individual cat’s lifestyle and disease status by veterinary team professionals and those working with cat charities can help to prevent severe cat stress and the spread of feline pathogens, especially vector-borne pathogens, which can be overlooked in cats. In this article, we discuss the issue of relocation and homing of unowned cats from a global perspective. We also review zoonotic and non-zoonotic infectious agents of cats and give a list of practical recommendations for veterinary team professionals dealing with homing cats. Finally, we present a consensus statement consolidated at the 15th Symposium of the Companion Vector-Borne Diseases (CVBD) World Forum in 2020, ultimately to help veterinary team professionals understand the problem and the role they have in helping to prevent and manage vector-borne and other pathogens in relocated cats.

Graphical Abstract

Epidemiological Survey of the Main Tick-Borne Pathogens Infecting Dogs from the Republic of Moldova

Despite the significant burden of tick-borne diseases (TBDs), epidemiologic studies are missing, and TBD awareness is low in the Republic of Moldova. Our study is the first to assess the prevalence of the main tick-borne pathogens (TBPs) infecting dogs in this country and associated risk factors. In this cross-sectional, multi-centre study (June 2018-July 2019), blood samples were collected from dogs presenting in veterinary clinics (Chişinău: N = 30) and hosted in public dog shelters (Cahul: N = 42; Chişinău: N = 48). TBPs were assessed by molecular techniques and risk factors by the logistic regression model. Hepatozoon canis was the most prevalent TBP (15.8% [19/120]), followed by Babesia canis (11.7% [14/120]), Anaplasma phagocytophilum (5.8% [7/120]), and Bartonella spp. (0.8% [1/120]). Blood samples tested negative for Borrelia spp., Rickettsia spp., Francisella tularensis, Anaplasma platys, and Ehrlichia canis. Dogs originating from the veterinary clinics had a higher prevalence of A. phagocytophilum infection than those from the shelters (16.6% versus 2.2%, respectively, p = 0.0292; OR: 27.0 [95%CI: 1.4-521.9]). Dogs from Chișinău had a higher prevalence of Hepatozoon canis infection versus those from Cahul (19.2% versus 9.5%, respectively, p = 0.0295; OR: 3.9 [95%CI: 1.1-13.4]). We recommend routine use of acaricides and deworming of dogs to prevent or/and limit TBD spread. Further TBD surveillance studies are needed.

Risk factors of Bartonella spp. infection and the association between Bartonella spp. and T-lymphocyte subset alteration in asymptomatic retrovirus-infected cats in Bangkok Metropolitan, Thailand

Background and Aim: Cats are a reservoir for Bartonella spp. infection in humans. Human bartonellosis causes disseminated inflammation to develop in immunocompromised patients, such as those infected with human immunodeficiency virus. However, the associated risks of Bartonella spp. infection in immunocompromised retroviral-infected cats have been inconclusive. This study aimed to evaluate the associated risks of Bartonella spp. infection with the alteration of T-lymphocyte subsets of retroviral-infected cats. Materials and Methods: We collected blood samples from 161 client-owned cats at veterinary clinics and hospitals throughout the Bangkok Metropolitan area from 2017 to 2020. The samples underwent hematological biochemical tests, feline retroviral status evaluation, Bartonella spp. polymerase chain reaction assay, immunofluorescence assay, and CD4+ and CD8+ lymphocyte counts. Risk factors associated with Bartonella spp. infection were determined by odds ratio (OR). Hematological and biochemical parameters were compared using independent t-tests. CD4+ and CD8+ lymphocyte counts and the CD4+/CD8+ ratio were compared among groups classified according to their retroviral and Bartonella spp. infection status. Results: The prevalence of Bartonella spp. in our study cohort was 16.1%, and the seroprevalence was 94.9%. Cats aged >1 year were at a higher risk of seropositivity than cats aged <1 year (OR: 4.296, 95% confidence interval: 1.010–18.275). The CD8+ percentage was significantly higher in seropositive cats (p = 0.026). There was a significant reduction in the CD4+/CD8+ ratio between cats negative for both retrovirus and Bartonella spp. infection and cats with concurrent retrovirus and Bartonella spp. infection (p = 0.041). Conclusion: In endemic countries or areas, cat owners must be made aware of the risk of exposure to Bartonella spp. due to the high rate of bacteremia and seroprevalence. Retrovirus-infected cats with concurrent Bartonella spp. infection also showed a significant, inverted CD4+/CD8+ ratio, which may be used as a novel marker in bartonellosis. Similar studies focusing on the different stages of retrovirus infection should be undertaken further to elucidate the effect of retrovirus infection on Bartonella spp. infection.

Combining deep sequencing and conventional molecular approaches reveals broad diversity and distribution of fleas and Bartonella in rodents and shrews from Arctic and Subarctic ecosystems

BACKGROUND

Bartonella are intracellular bacteria that are transmitted via animal scratches, bites and hematophagous arthropods. Rodents and their associated fleas play a key role in the maintenance of Bartonella worldwide, with > 22 species identified in rodent hosts. No studies have addressed the occurrence and diversity of Bartonella species and vectors for small mammals in Arctic and Subarctic ecosystems, which are increasingly impacted by invasive species and climate change.

METHODS

In this study, we characterized the diversity of rodent fleas using conventional PCR targeting the mitochondrial cytochrome c oxidase II gene (COII) and Bartonella species in rodents and shrews (n = 505) from northern Canada using conventional PCR targeting the ITS (intergenic transcribed spacer) region and gltA (citrate synthase) gene. Metagenomic sequencing of a portion of the gltA gene was completed on a subset of 42 rodents and four rodent flea pools.

RESULTS

Year, total summer precipitation the year prior to sampling, average minimum spring temperature and small mammal species were significant factors in predicting Bartonella positivity. Occurrence based on the ITS region was more than double that of the gltA gene and was 34% (n = 349) in northern red-backed voles, 35% (n = 20) in meadow voles, 37% (n = 68) in deer mice and 31% (n = 59) in shrews. Six species of Bartonella were identified with the ITS region, including B. grahamii, B. elizabethae, B. washoensis, Candidatus B. rudakovii, B. doshiae, B. vinsonii subsp. berkhoffii and subsp. arupensis. In addition, 47% (n = 49/105) of ITS amplicons had < 97% identity to sequences in GenBank, possibly due to a limited reference library or previously unreported species. An additional Bartonella species (B. heixiaziensis) was detected during metagenomic sequencing of the gltA gene in 6/11 rodents that had ITS sequences with < 97% identity in GenBank, highlighting that a limited reference library for the ITS marker likely accounted for low sequence similarity in our specimens. In addition, one flea pool from a northern red-backed vole contained multiple species (B. grahamii and B. heixiaziensis).

CONCLUSION

Our study calls attention to the usefulness of a combined approach to determine the occurrence and diversity of Bartonella communities in hosts and vectors.

Molecular detection and identification of Bartonella species in cats from Hamedan and Kermanshah, Western Iran

Bartonella species are emerging vector-borne zoonotic pathogens which infect a wide range of domestic and wild animals as well as humans. Cats are the primary reservoir hosts for several zoonotic Bartonella spp., the most common being B. henselae the causative agent of cat scratch disease. Despite the important role of cats in the epidemiology of bartonellosis, there is limited information about the prevalence and species infecting cats in Iran. The aim of present study was molecular detection and identification of Bartonella species in cats from two western provinces Hamedan and Kermanshah. From December 2018 to February 2021, 87 cats (n = 26 from Hamedan, n = 61 from Kermanshah) were examined clinically, their bodies were searched for collection of ectoparasites, and cephalic or saphenous blood specimens were collected. Genomic DNA was extracted from blood specimens and conventional PCRs targeting the rpoB, and ITS regions of Bartonella spp. were performed. Positive samples were sequenced and analysed phylogenetically. Bartonella DNA was detected in 11/87 cats (12.64 %). Sequencing results revealed the presence of B. henselae in cats from Hamedan, and B. clarridgeiae and B. henselae in cats from Kermanshah. A statistical association between cat origin and the prevalence of Bartonella spp. was observed in the studied population. This study confirms for the first time the circulation of Bartonella spp. in cats in two western Iranian provinces. Prevention strategies e.g. ectoparasites control, and regular examination of pet and urban cats are suggested for minimising Bartonella infection in cats and subsequently in humans.

Serological evidence of exposure to Bartonella sp. in dogs with suspected vector-borne diseases, toxoplasmosis and neosporosis

Bartonellosis is a vector-borne zoonotic disease with worldwide distribution that infect a broad spectrum of mammalian species. Despite the recent studies carried out in Brazil, information regarding Bartonella in dogs are scarce. Therefore, we performed a retrospective study to investigate the exposure to Bartonella sp. in dogs by indirect immunofluorescence assay (IFA). Three hundred and thirty-five archived serum samples from dogs previously tested for vector-borne pathogens, Toxoplasma gondii, and Neospora caninum were screened for the presence of IgG antibodies to Bartonella sp. All dogs originated from the Metropolitan region of Ribeirão Preto, northeast of the State of São Paulo. Twenty-eight samples (8.3%) were positive for Bartonella sp. at the cut-off of 64. Among the 28 seropositive samples for Bartonella sp., 16 (57.1%) were also seropositive for Ehrlichia canis, 12 (42.8%) for Babesia vogeli, five (17.8%) for T. gondii and three (10.7%) for L. infantum and N. caninum. Our results demonstrated that dogs sampled were exposed to Bartonella sp. Since all the animals sampled in the present study were from private owners, our findings demonstrate that these people may also be exposed to Bartonella sp. Further studies designed to assess whether the infection by other arthropod-borne pathogens such as B. vogeli and E. canis are risk factors for Bartonella infection are needed.

Molecular prevalence and genetic diversity of Bartonella spp. in stray cats of İzmir, Turkey

Background

Bartonella spp. are vector-borne pathogens that cause zoonotic infections in humans. One of the most well-known of these is cat-scratch disease caused by Bartonella henselae and Bartonella clarridgeiae, with cats being the major reservoir for these two bacteria. Izmir, Turkey is home to many stray cats, but their potential role as a reservoir for the transmission of Bartonella to humans has not been investigated yet. Therefore, the aim of this study was to investigate the prevalence of Bartonella species and their genetic diversity in stray cats living in Izmir.

Methods

Molecular prevalence of Bartonella spp. in stray cats (n = 1012) was investigated using a PCR method targeting the 16S-23S internal transcribed spacer gene (ITS), species identification was performed by sequencing and genetic diversity was evaluated by haplotype analysis.

Results

Analysis of the DNA extracted from 1012 blood samples collected from stray cats revealed that 122 samples were Bartonella-positive, which is a molecular prevalence of 12.05% (122/1012; 95% confidence interval [CI] 10.1–14.2%). Among the Bartonella-positive specimens, 100 (100/122; 81.96%) were successfully sequenced, and B. henselae (45/100; 45%), B. clarridgeiae (29/100; 29%) and Bartonella koehlerae (26/100; 26%) were identified by BLAST and phylogenetic analyses. High genetic diversity was detected in B. clarridgeiae with 19 haplotypes, followed by B. henselae (14 haplotypes) and B. koehlerae (8 haplotypes).

Conclusions

This comprehensive study analyzing a large number of samples collected from stray cats showed that Bartonella species are an important source of infection to humans living in Izmir. In addition, high genetic diversity was detected within each Bartonella species.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-022-05431-3.

CAT-SCRATCH DISEASE: 9 YEARS OF EXPERIENCE AT A PEDIATRIC CENTER

Background

A more complete understanding of the epidemiology, risk factors, and clinical features of cat scratch disease (CSD) in children could help guide patient care.

Methods

We conducted a retrospective analysis of children presenting to a tertiary pediatric hospital system in Atlanta, Georgia between January 1, 2010, and December 31, 2018 who had serology, PCR and/or cytopathological results consistent with a Bartonella henselae infection. We also retrospectively reviewed veterinary diagnostic results performed at the University of Georgia (UGA) from 2018-2020 to ascertain the burden of bartonellosis in companion animals within the state.

Results

We identified 304 children with CSD over 9 years with the largest proportion of diagnoses made during August (41/304, 13.5%) and September (47/304, 15.5%). The median age of child cases was 8.1 years (interquartile range (IQR) 5.4-12.1]; 156 (51.3%) were female; 242/262 (92.4%) reported feline exposure, while 55/250 (22%) reported canine exposure of those with exposure histories documented in the medical record. Although lymphadenopathy was present on physical examination in the majority of cases (78.8%), atypical presentations lacking lymphadenopathy were also common (63/304, 20.7%). Among children with radiographic imaging, 20/55 (36.4%) had splenomegaly and 21/55 (38.1%) had splenic and/or hepatic microabscesses. Among veterinary data, Bartonella seroprevalence was 12/146 (8.2%), all among canines, with a geographic distribution that spanned the state of Georgia.

Conclusion

Distinguishing clinical features of CSD included subacute regional lymphadenopathy in school-aged children in the late summer, almost all of whom had cat exposure. Atypical clinical manifestations of CSD were also commonly identified.

A Review of Bartonella Infections in California-Implications for Public and Veterinary Health

Bartonella are vector-transmitted, intracellular bacteria that infect a wide variety of blood-feeding arthropods and their vertebrate hosts. In California, more than 13 species of Bartonella have been described from companion animals, livestock, and wildlife, of which four have been associated with human disease. Infections in humans cause a range of symptoms from relatively mild to severe, especially in immunocompromised individuals. Exposure to infected domestic animals and wildlife, and their ectoparasites, may increase the risk of cross-species transmission. The objective of this review was to compile and summarize published materials on human and animal Bartonella infections in California. Medical and veterinary case reports of bartonellosis were highlighted in an effort to increase the awareness of this poorly understood and potentially under-recognized disease among healthcare professionals and veterinarians.

Epidemiology and Genetic Diversity of Bartonella in Rodents in Urban Areas of Guangzhou, Southern China

Bartonella spp. are gram-negative bacteria that can infect a wide spectrum of mammals. Rodents are considered to be the natural reservoir of many Bartonella species that are transmitted by various blood-sucking arthropods. The close contact between rodents and humans in urban areas increased the chance of transmitting rodent-borne Bartonella to humans. Investigation of the epidemiological characteristics of Bartonella infection in rodents is of great significance for the prevention and control of human Bartonellosis. In this study, rodents were captured to monitor the prevalence of Bartonella in urban areas of Guangzhou city. Six official or candidate species of Bartonella, including two confirmed zoonotic species, were detected with an overall prevalence of 6.4% in rodents captured herein. In addition, Rattus norvegicus was the predominant host species for Bartonella infection, and B. queenslandensis was the dominant species circulating in rodents in these areas. These results provide insights into the prevalence and genetic diversity of Bartonella species circulating in rodents in the urban areas of Guangzhou, and also urged the surveillance of rodent-associated Bartonella species in these areas.

Prevalence and Risk Factors for Bartonella spp. and Haemoplasma Infections in Cats from Greece

Simple Summary

Bartonellosis and haemoplasmosis are diseases with global impact on the health of domestic cats and of zoonotic importance. This is the first study investigating the risk factors for Bartonella spp. and haemoplasma species infections in cats from Greece. In addition, this study determined the serologic and molecular prevalence of Bartonella spp. and haemoplasma species infections in different populations of cats living in different regions of Greece. A total of 452 cats were enrolled into the study. Blood was collected from each cat for the serological detection of Bartonella henselae antibodies and the molecular detection of Bartonella spp. and haemoplasma species infections. Overall, the seroprevalence of B. henselae was 35.4%, while the molecular prevalence of Bartonella spp. and haemoplasma species was 2.9% and 19%, respectively. The results of this study indicate that cats with partial or exclusive outdoor access and cats with flea infestation are at the greatest risk for B. henselae seropositivity. Furthermore, cats living in warmer regions such as Attica and Crete are at the greatest risk. Lack of ectoparasiticide use was identified as a risk factor for haemoplasma species infection. This suggests that the use of ectoparasiticides in cats may be an effective means of preventing haemoplasma species infection in cats.

Abstract

Bartonellosis and haemoplasmosis are vector-borne diseases with global impact on the health of domestic cats and of zoonotic importance. The aim of this study was to describe the epidemiological aspects of various populations of cats infected with Bartonella spp. or haemoplasma species. The populations evaluated included client-owned cats, stray cats and cats that live in breeding catteries in Greece. A total of 452 cats were prospectively enrolled into the study. A commercially available indirect immunofluorescence antibody testkit was used for the detection of Bartonella henselae IgG antibodies in serum. PCRs for the detection of Bartonella spp. and haemoplasma species DNA in the blood were also performed in a subgroup of 242 of the 452 cats. Risk factors for B. henselae seropositivity and infection with the haemoplasma species were determined using multivariable analysis. Overall, 160 (35.4%) of the 452 cats were seropositive for B. henselae. Seven (2.9%) and 46 (19%) of the 242 cats were PCR-positive for Bartonella spp. and haemoplasma species, respectively. The factors associated with B. henselae seropositivity, based on multivariate analysis, included older age, outdoor access, living region and flea infestation. Non-administration of ectoparasiticides was associated with haemoplasma species infection. This study shows a high prevalence of seropositivity for B. henselae and a relatively high prevalence of infection with haemoplasma species. Therefore, it is necessary to establish optimal strategies for the prevention of Bartonella spp. and haemoplasma species infections, considering the high-risk groups of cats identified in this study.

Osteomyelitis associated with Bartonella henselae infection in a young cat

Case summary

A 1-year-old male intact domestic shorthair cat was evaluated for acute onset non-weightbearing left forelimb lameness and generalized peripheral lymphadenopathy. CT identified a monostotic aggressive bone lesion with an incomplete fracture of the left radial metaphysis. Bone aspirates yielded osteoblasts with minimal nuclear atypia. Abdominal ultrasound revealed a nodular spleen and lymphadenopathy; cytologically, both contained lymphoid hyperplasia. A urine histoplasma antigen test was negative. Bartonella henselae and Mycoplasma haemominutum DNA was amplified by PCR from peripheral blood. Indirect immunofluorescence documented strong B henselae immunoreactivity, with lower Bartonella vinsonii subspecies berkhoffii and Bartonella koehlerae antibody titers. After the administration of doxycycline and pradofloxacin for suspected Bartonella-induced osteomyelitis, lameness resolved rapidly. Six-week post-treatment radiographs identified healing of the affected bone, and Bartonella species enrichment blood culture was negative. B henselae antibody titers decreased four-fold over a year, supporting seroreversion.

Relevance and novel information

B henselae is a flea-transmitted, host-adapted species, not previously implicated as a cause of osteomyelitis in cats. B henselae subclinical bacteremia is highly prevalent among cats; however, bacteremia has been associated with lymphadenopathy and febrile illness in cats. This report describes a unique clinical presentation in association with B henselae infection in a cat.

Histoplasma capsulatum, Toxoplasma gondii, Bartonella henselae and Bartonella clarridgeiae coinfections in an indoor-only Siamese cat

Case summary

A 6-year-old male castrated Siamese cat was referred for acute-onset blindness and mydriasis. Physical examination revealed serous retinal detachment with panuveitis and systemic hypertension. Abdominal ultrasound showed suspected dilation of the cisterna chyli and abdominal lymphadenopathy. Aspirates of mesenteric lymph nodes revealed intrahistiocytic yeast organisms with mild-to-moderate pyogranulomatous inflammation. Fungal culture and ITS1 sequencing of the lymph node aspirates confirmed infection with Histoplasma capsulatum. PCR performed on whole blood was positive for Bartonella henselae and Bartonella clarridgeiae, and Toxoplasma gondii IgG and IgM antibodies were detected in serum. The cat was prescribed prednisolone (0.5 mg/kg PO q24h), itraconazole (10 mg/kg PO q24h), clindamycin (13 mg/kg PO q12h), amlodipine (0.625 mg PO q24h), prednisolone acetate 1% drops (q6h) and ophthalmic lubricant for both eyes (q6h). The cat was doing well at home after 2 weeks of prednisolone, itraconazole and clindamycin administration, and no abnormalities were detected on repeat abdominal ultrasound 3 months later. The retinal detachment showed mild-to-moderate improvement at that time, but vision was not regained.

Relevance and novel information

This is the first report of coinfection of H capsulatum, T gondii, B henselae and B clarridgeiae in an indoor-only cat living in a H capsulatum non-enzootic area with no known travel history.

Molecular Survey of Bartonella Species in Stray Cats and Dogs, Humans, and Questing Ticks from Portugal

Bartonella spp. comprises emergent and re-emergent fastidious Gram-negative bacteria with worldwide distribution. Cats are the main reservoir hosts for Bartonella henselae and dogs represent opportunistic hosts for the bacteria. Even though ticks may also play a role in transmission, their competence as vectors for Bartonella spp. has not been totally understood. Considering only a few studies had a focus on screening Bartonella in animals, humans and ectoparasites in Portugal, this study aimed to address the molecular occurrence of Bartonella sp. in 123 stray cats, 25 stray dogs, 30 humans from Lisbon and 236 questing ticks within the country. Using a qPCR targeting the nuoG gene, it was possible to detect Bartonella sp. DNA on 20.32% of cat samples (25/123). From these positive samples, 13 sequences were characterized as B. henselae, 11 as B. clarridgeiae and 1 presented co-infection with both species. The absolute quantification of nuoGBartonella DNA in sampled cats ranged from 2.78 × 10 to 1.03 × 10⁵ copies/µL. The sampled dogs, humans and ticks were negative. These results showed that B. henselae and B. clarridgeiae are circulating in stray cats from Lisbon. Additional and more extended studies should be conducted to determine the impact of such infections on humans, particularly those in constant and direct contact with cats.

Distribution of Tick-Borne Pathogens in Domestic Animals and Their Ticks in the Countries of the Mediterranean Basin between 2000 and 2021: A Systematic Review

Tick-borne pathogens (TBPs) include a wide range of bacteria, parasites and viruses that cause a large spectrum of animal, human and zoonotic tick-borne diseases (TBDs). The object of this review was to establish an inventory and an analysis of TBPs found in domestic animals in the countries of the Mediterranean Basin. This geographic area occupies a central position between several continents and is an area of movement for animals, humans and pathogens of interest and their vectors, which is important in terms of animal and human health. In this systematic review, we included a total of 271 publications produced between 2000–2021 concerning TBPs in domestic animals. Among this literature, we found a total of 90 pathogen species (known as TBPs) reported in the 20 countries of the area; these were detected in tick species from domestic animals and were also directly detected in domestic animals. In all, 31 tick species were recorded and 12 domestic animal species, the latter comprising nine livestock and three pet species. More than 50% of the publications were from Western Europe. Island data were extracted and assessed, as islands of the Mediterranean Basin were represented in 16% of the publications and 77.8% of the TBPs reported. Our results show the importance of islands in the monitoring of TBPs, despite the low percentage of publications.

Occurrence and bacterial loads of Bartonella and haemotropic Mycoplasma species in privately owned cats and dogs and their fleas from East and Southeast Asia

Bartonella spp. and haemoplasmas are pathogens of veterinary and medical interest with ectoparasites mainly involved in their transmission. This study aimed at molecular detection of Bartonella spp. and haemoplasmas in cats (n = 93) and dogs (n = 96), and their related fleas (n = 189) from countries in East and Southeast Asia. Ctenocephalides felis was the dominant flea species infesting both cats (97.85%) and dogs (75%) followed by Ctenocephalides orientis in dogs (18.75%) and rarely in cats (5.2%). Bartonella spp. DNA was only detected in blood samples of flea‐infested cats (21.51%) (p < .0001, OR = 27.70) with Bartonella henselae more frequently detected than Bartonella clarridgeiae in cat hosts (15.05%, 6.45%) and their associated fleas (17.24%, 13.79%). Out of three Bartonella‐positive fleas from dogs, two Ct. orientis fleas carried Bartonella vinsonii subsp. berkhoffii and Bartonella clarridgeiae, while the 3rd flea (Ct. felis) carried Candidatus Bartonella merieuxii. Felines represented a risk factor for Bartonella spp. infections, where fleas collected from cats (32.25%) presented an increased likelihood for Bartonella spp. occurrence (p < .0001, OR = 14.76) than those from dogs (3.13%). Moreover, when analysing infectious status, higher Bartonella spp. DNA loads were detected in fleas from bacteraemic cats compared to those from non‐bacteraemic ones (p < .05). The haemoplasma occurrence was 16.13% (15/93) and 4.17% (4/96) in cat and dog blood samples from different countries (i.e. Indonesia, Malaysia, the Philippines, Taiwan and Thailand), with cats more at risk of infection (p < .01, OR = 5.96) than dogs. Unlike Bartonella spp., there was no evidence for flea involvement in the hemoplasmas' transmission cycle, thus supporting the hypothesis of non‐vectorial transmission for these pathogens. In conclusion, client‐owned cats and dogs living in East and Southeast Asia countries are exposed to vector‐borne pathogens with fleas from cats playing a key role in Bartonella spp. transmission, thus posing a high risk of infection for humans sharing the same environment.

Detection and genetic diversity of Bartonella species in small mammals from the central region of the Qinghai-Tibetan Plateau, China

In this study, we aimed to investigate the prevalence and molecular characteristics of Bartonella infections in small mammals from the central region of the Qinghai-Tibetan Plateau. Toward this, small mammals were captured using snap traps in Yushu City and Nangqian County, West China, and the spleen tissue was used for Bartonella culture. The suspected positive colonies were evaluated using polymerase chain reaction (PCR) amplification and by sequencing the citrate synthase (gltA) gene. We discovered that 31 out of the 103 small mammals tested positive for Bartonella, with an infection rate of 30.10%. Sex differences between the mammals did not result in a significant difference in infection rate (χ² = 0.018, P = 0.892). However, there was a significant difference in infection rates in different small mammals (Fisher’s exact probability method, P = 0.017) and habitats (χ² = 7.157, P = 0.028). Additionally, 31 Bartonella strains belonging to three species were identified, including B. grahamii (25), B. japonica (4) and B. heixiaziensis (2), among which B. grahamii was the dominant epidemic strain (accounting for 80.65%). Phylogenetic analyses showed that most of the B. grahamii isolates identified in this study may be closely related to the strains isolated from Japan and China. Genetic diversity analyses revealed that B. grahamii strains had high genetic diversity, which showed a certain host and geographical specificity. The results of Tajima’s test suggested that the B. grahamii followed the progressions simulated by a neutral evolutionary model in the process of evolution. Overall, a high prevalence and genetic diversity of Bartonella infection were observed in small mammals in the central region of the Qinghai-Tibetan Plateau. B. grahamii as the dominant epidemic strain may cause diseases in humans, and the corresponding prevention and control measures should be taken into consideration in this area.

Treatment of a cat with presumed Bartonella henselae-associated immune-mediated hemolytic anemia, fever, and lymphadenitis

A 2.5‐year‐old castrated male cat presented with fever and marked generalized lymphadenopathy of 4‐months duration, despite treatment with amoxicillin‐clavulanate/marbofloxacin. Abnormalities were not detected on complete blood count, serum chemistry, and FIV/FeLV test apart from a borderline, non‐regenerative anemia. Peripheral lymph node fine needle aspirations revealed a marked increase in the percentage of intermediate‐ and lymphoblastic‐lymphocytes in addition to reactive macrophages. Three weeks after presentation, the cat developed a severe, regenerative, immune‐mediated hemolytic anemia (IMHA) which responded to immunosuppressive therapy. Fever and lymphadenopathy persisted. Peripheral lymph nodes tested positive for Bartonella henselae DNA in real‐time PCR assay and sequencing. Treatment with pradofloxacin and doxycycline resulted in resolution of clinical signs, and negative PCR tests. Despite its reported low pathogenicity, B. henselae infection should also be considered in cats with protracted unexplained fever, lymphadenitis, and IMHA. Furthermore, a combination of pradofloxacin and doxycycline might be considered in cats with bartonellosis given its apparent clinical efficacy.

Associations between presence of Bartonella species deoxyribonucleic acid and complete blood cell count and serum biochemical changes in client-owned cats

Background

Infection with Bartonella species is common in cats but reported effects of bacteremia on laboratory variables differ.

Objectives

Evaluate for associations between Bartonella bacteremia and CBC and serum biochemical changes in sick and healthy cats throughout the United States.

Animals

A total of 3964 client‐owned cats.

Methods

Retrospective cohort study using submissions to a commercial laboratory between 2011 and 2017. Serum biochemistry and CBC abnormalities (categorized as above or below reference intervals), age, and location (high‐ or low‐risk state for Ctenocephalides felis) in presumed healthy and sick cats were evaluated for associations with presence of Bartonella spp. DNA, detected by PCR. Univariate and multivariable logistic regression analyses were performed.

Results

Bartonella spp. DNA was amplified from 127 (3.2%) of 3964 cats; 126 (99.2%) of 127 were from high flea risk states and 121 (95.3%) of 127 were presumed sick. Fever of unknown origin was the most common PCR panel requested. In the multivariable analysis, neutrophilia, decreased ALP activity, clinical status (presumed sick), and young age (≤2 years) each were positively associated whereas neutropenia and hyperproteinemia both were negatively associated with Bartonella spp. bacteremia. Presence of Bartonella spp. DNA had no association with test results for other infectious disease agents.

Conclusions and Clinical Importance

In both healthy and sick cats, active Bartonella infections had minimal association with clinically relevant laboratory abnormalities. However, based on these results, in areas considered high risk for C. felis, active infection with Bartonella spp. is a reasonable differential diagnosis for cats presented with unexplained fever and neutrophilia, particularly if the cat is young.

The Clinical Profile of Cat-Scratch Disease’s Neuro-Ophthalmological Effects

Cat-scratch disease is an illness caused by Bartonella henselae that occurs as a result of contact with an infected kitten or dog, such as a bite or scratch. It is more prevalent in children and young adults, as well as immunocompromised individuals. There are limited publications examining the features of CSD in patients. As such, the purpose of this research was to assess the clinical neuro-ophthalmological consequences of CSD reported in the literature. Among the ophthalmologic disorders caused by cat-scratch disease in humans, Parinaud oculoglandular syndrome, uveitis, vitritis, retinitis, retinochoroiditis and optic neuritis are the most prevalent. The neurological disorders caused by cat-scratch disease in humans include encephalopathy, transverse myelitis, radiculitis, and cerebellar ataxia. The current review addresses the neuro-ophthalmological clinical manifestations of cat-scratch disease, as described in papers published over the last four decades (1980–2022). All the data gathered were obtained from PubMed, Medline and Google Scholar. The current descriptive review summarizes the most-often-encountered clinical symptomatology in instances of cat-scratch disease with neurological and ocular invasion. Thus, the purpose of this review is to increase knowledge of cat-scratch disease’s neuro-ophthalmological manifestations.

Bartonella henselae Recombinant Pap31 for the Diagnosis of Canine and Human Bartonelloses

Bartonella spp. comprise a genus of Gram-negative alphaproteobacteria that are slow growing, fastidious, and facultative intracellular pathogens with zoonotic potential. Immunofluorescent antibody assays (IFAs), Western blot (WB), and enzyme-linked immunosorbent assays (ELISAs), the frequently used modalities for the serological diagnosis of canine and human Bartonelloses, generate numerous false negative results. Therefore, the development of a reliable serodiagnostic assay for Bartonelloses is of clinical and epidemiological importance. Pap31, a heme binding surface protein of B. henselae, is associated with bacterial adhesion and related to bacterial colonization. To our knowledge, B. henselae Pap31 and its fragments (N-terminal (NTD), middle (MD), and C-terminal (CTD) domains) have not been investigated for the serodiagnosis of canine and human Bartonelloses. In this study, we evaluate the diagnostic utility of B. henselae recombinant whole Pap31 (rPap31) and Pap31 fragments by ELISA using sera from 70 dogs (36 Bartonella spp. IFA-positive (naturally infected), and 34 Bartonella spp. IFA- and PCR-negative (control dogs)) and 36 humans (18 Bartonella spp. IFA-positive (naturally infected) and 18 controls)). In the dogs, the area under the curve (AUC) score of recombinant whole Pap31 was 0.714 with a sensitivity of 42% and specificity of 94% at an OD cutoff value of 0.8955. Among the evaluated recombinant Pap31 proteins for the diagnosis of canine Bartonelloses, rPap31-NTD yielded the highest AUC score of 0.792 (95% CI 0.688–0.895) with a sensitivity of 44% and specificity of 100% at a cutoff value of 1.198. In concordance with this finding, rPap31-NTD also had the highest AUC score of 0.747 (95% CI 0.581–0.913) among the Pap31 recombinant proteins for the diagnosis of human Bartonelloses, with 39% sensitivity and 94% specificity at a cutoff value of 1.366. Recombinant whole Pap31 (rPap31) resulted in 72% sensitivity and 61% specificity at a cutoff value of 0.215 for human Bartonelloses. Due to either low sensitivity or questionable specificity, our findings indicate that recombinant Pap31 and the selected fragments may not be appropriate diagnostic targets in detecting anti-Bartonella antibodies in Bartonella-infected dogs and humans. The findings from this study can be used to further assess the antigenicity and immunogenicity of B. henselae Pap31 as a diagnostic target.

Prospective serological and molecular cross-sectional study focusing on Bartonella and other blood-borne organisms in cats from Catalonia (Spain)

Background

There is limited clinical or epidemiological knowledge regarding Bartonella infection in cats, and no serological studies have compared the presence of antibodies against different Bartonella species. Moreover, there are limited feline Bartonella studies investigating co-infections with other vector-borne pathogens and the associated risk factors. Therefore, the objective of this study was to investigate Bartonella spp. infections and co-infections with other pathogens in cats from Barcelona (Spain) based on serological and/or molecular techniques and to determine associated risk factors.

Methods

We studied colony and owned cats (n = 135). Sera were tested for Bartonella henselae-, Bartonella quintana-, and Bartonella koehlerae-specific antibodies using endpoint in-house immunofluorescence antibody assays. Bartonella real-time PCR (qPCR) and conventional PCR (cPCR) were performed. In addition, cPCR followed by DNA sequencing was performed for other pathogenic organisms (Anaplasma, Babesia, Cytauxzoon, Ehrlichia, Hepatozoon, hemotropic Mycoplasma, and Theileria spp.).

Results

From 135 cats studied, 80.7% were seroreactive against at least one Bartonella species. Bartonella quintana, B. koehlerae, and B. henselae seroreactivity was 67.4, 77.0, and 80.7%, respectively. Substantial to almost perfect serological agreement was found between the three Bartonella species. Colony cats were more likely to be Bartonella spp.-seroreactive than owned cats. Moreover, cats aged ≤ 2 years were more likely to be Bartonella spp.-seroreactive. Bartonella spp. DNA was detected in the blood of 11.9% (n = 16) of cats. Cats were infected with B. henselae (n = 12), B. clarridgeiae (n = 3), and B. koehlerae (n = 1). Mycoplasma spp. DNA was amplified from 14% (n = 19) of cat blood specimens. Cats were infected with Mycoplasma haemofelis (n = 8), Candidatus M. haemominutum (n = 6), Candidatus Mycoplasma turicensis (n = 4), and Mycoplasma wenyonii (n = 1). Anaplasma, Babesia, Cytauxzoon, Ehrlichia spp., Hepatozoon, and Theileria spp. DNA was not amplified from any blood sample. Of the 16 Bartonella spp.-infected cats based on PCR results, six (37%) were co-infected with Mycoplasma spp.

Conclusions

Bartonella spp. and hemoplasma infections are prevalent in cats from the Barcelona area, whereas infection with Anaplasma spp., Babesia, Cytauxzoon, Ehrlichia spp., Hepatozoon, and Theileria infections were not detected. Co-infection with hemotropic Mycoplasma appears to be common in Bartonella-infected cats. To our knowledge, this study is the first to document M. wenyonii is infection in cats.

Graphical Abstract

Molecular Detection of Bartonella Species in Rodents Residing in Urban and Suburban Areas of Central Thailand

Bartonella spp. are Gram-negative zoonotic bacteria transmitted to humans via various blood-sucking arthropods. Rodents have been identified as reservoir hosts of several zoonotic pathogens, including Bartonella spp. In Thailand, studies of Bartonella spp. in rodents from urban areas are limited; thus, a study in this area is necessary. The objectives of this study were to detect Bartonella spp. in rodents in Thailand and to compare the species’ distribution across different areas. In total, 70 blood samples from rodents in urban and suburban areas were tested for Bartonella spp. using a conventional polymerase chain reaction that targeted the citrate synthase (gltA) gene. All Bartonella-positive sequences were analyzed using polymorphism in order to build a phylogenetic tree. Approximately 38% of the rodents studied contained Bartonella DNA. Both Rattus exulans (Pacific rat) and R. tanezumi (Asian house rat) contained Bartonella spp. Four species of Bartonella were detected in blood samples: B. tribocorum, B. phoceensis, B. grahamii, and B. rattimassiliensis. In addition, eight Pacific rats contained the B. kosoyi–B. tribocorum complex. Bartonella phoceensis and B. tribocorum–B. kosoyi complexes were found in a specific habitat (p < 0.05). Interestingly, only seven haplotypes were identified in the sequences analyzed, and only haplotype A was found in both rodent species. Finally, a monitoring program for zoonotic Bartonella infection, especially the B. kosoyi–B. tribocorum complex, B. phoceensis, B. grahamii, and B. rattimassiliensis should be established, especially in high-risk areas.

Canine and Feline Parasitology: Analogies, Differences, and Relevance for Human Health

Cats and dogs are treated as family members by most pet owners. Therefore, a high quality of veterinary care and preventive medicine is imperative for animal health and welfare and for the protection of humans from zoonotic pathogens. There is a general perception of cats being treated as "small dogs," especially in the field of clinical parasitology. As a result, several important differences between the two animal species are not taken into proper consideration and are often overlooked. Dogs and cats are profoundly different under evolutionary, biological, ethological, behavioral, and immunological standpoints. These differences impact clinical features, diagnosis, and control of canine and feline parasites and transmission risk for humans. This review outlines the most common parasitoses and vector-borne diseases of dogs and cats, with a focus on major convergences and divergences, and discusses parasites that have (i) evolved based on different preys for dogs and cats, (ii) adapted due to different immunological or behavioral animal profiles, and (iii) developed more similarities than differences in canine and feline infections and associated diseases. Differences, similarities, and peculiarities of canine and feline parasitology are herein reviewed in three macrosections: (i) carnivorism, vegetarianism, anatomy, genetics, and parasites, (ii) evolutionary adaptation of nematodes, including veterinary reconsideration and zoonotic importance, and (iii) behavior and immune system driving ectoparasites and transmitted diseases. Emphasis is given to provide further steps toward a more accurate evaluation of canine and feline parasitology in a changing world in terms of public health relevance and One Health approach.