Survey of Bartonella spp. in U.S. bed bugs detects Burkholderia multivorans but not Bartonella

Cimicids of Medical and Veterinary Importance

Members of the Cimicidae family are significant pests for mammals and birds, and they have attracted medical and veterinary interest. A number of recent studies have investigated bed bugs, due to their dramatic resurgence all over the world. Indeed, bed bugs are of significant public health and socioeconomic importance since they lead to financial burdens and dermatological complications and may have mental and psychological consequences. It is important to note that certain cimicids with a preference for specific hosts (birds and bats) use humans as an alternative host, and some cimicids have been reported to willingly feed on human blood. In addition, members of the Cimicidae family can lead to economic burdens and certain species are the vectors for pathogens responsible for diseases. Therefore, in this review, we aim to provide an update on the species within the Cimicidae family that have varying medical and veterinary impacts, including their distribution and their associated microorganisms. Various microbes have been documented in bed bugs and certain important pathogens have been experimentally documented to be passively transmitted by bed bugs, although no conclusive evidence has yet associated them with epidemiological outbreaks. Additionally, among the studied cimicids (bat bugs, chicken bugs, and swallow bugs), only the American swallow bug has been considered to be a vector of several arboviruses, although there is no proven evidence of transmission to humans or animals. Further studies are needed to elucidate the reason that certain species in the Cimicidae family cannot be biologically involved in transmission to humans or animals. Additional investigations are also required to better understand the roles of Cimicidae family members in the transmission of human pathogens in the field.

Investigating the association of bed bugs with infectious diseases: A retrospective case-control study

Bed bugs are common urban pests. Unlike many other blood-feeding human ectoparasites, bed bugs are not known to be vectors of human infectious diseases, but clinical and epidemiological studies to directly interrogate this link have been limited. Here, we aimed to determine whether bed bugs were associated with infectious diseases in a set of infested patients presenting to emergency departments (ED) in the greater Cleveland, OH area. We performed a retrospective case-control study involving 332 ED patients with bed bugs and 4,952 control patients, seen from February 1, 2011, through February 1, 2017. Cases and controls were matched by age, sex, and the presenting ED. Additionally, data were adjusted for ≥20 sociodemographic variables, triage data, and comorbidities in multivariable regression analyses. Seventeen laboratory values, ten different ED and inpatient diagnoses, chest radiographs, infectious disease consults, and blood cultures were examined. The odds of bed bug infestation were significantly higher for patients that had positive blood cultures, had blood cultures growing coagulase-negative Staphylococcus, were diagnosed with pneumonia, were diagnosed with cellulitis, received an infectious disease consult, received a chest radiograph, and had higher percentages of eosinophils in the blood (P < .05 for all). Additional investigations are needed to determine whether bed bugs directly contribute to disease by transmitting causative agents, whether bed bug exposure contributes secondarily contributes to infections, or whether these associations are better explained by other environmental and social determinants of health.

Experimental infection of bed bugs (Cimex lectularius L.) with Burkholderia multivorans

The bacterium Burkholderia multivorans is an opportunistic nosocomial pathogen of humans. A previous study reported molecular detection of this bacterium in several specimens of the common bed bug (Cimex lectularius L.) collected from an elderly care facility in the U.S.A., raising questions about the possibility of vector-borne transmission. However, the ability of B. multivorans to colonize bed bugs and the ability of bed bugs to transmit the bacteria both remained untested. To resolve this knowledge gap, here we performed a set of experiments to examine the persistence and shedding of B. multivorans following ingestion by bed bugs in a blood meal. We isolated viable B. multivorans from the bodies of bed bugs for up to 13 days post-ingestion, but bacterial load substantially diminished over time. By 16 days post-ingestion, the bacteria could not be isolated. Further, B. multivorans was not shed in the saliva of infected bugs during feeding nor was it transmitted vertically from infected insects to their progeny. Based on these results, significant biological or mechanical transmission of B. multivorans to humans by bed bugs appears unlikely. Nonetheless, some viable bacteria were passively shed into the environment through defecation, a process which could potentially contribute to transmission through indirect contamination under rare circumstances.

Bed bugs shape the indoor microbial community composition of infested homes

Indoor pests, and the allergens they produce, adversely affect human health. Surprisingly, however, their effects on indoor microbial communities have not been assessed. Bed bug (Cimex lectularius) infestations pose severe challenges in elderly and low-income housing. They void large amounts of liquid feces into the home environment, which might alter the indoor microbial community composition. In this study, using bed bug-infested and uninfested homes, we showed a strong impact of bed bug infestations on the indoor microbial diversity. Floor dust samples were collected from uninfested and bed bug-infested homes and their microbiomes were analyzed before and after heat interventions that eliminated bed bugs. The microbial communities of bed bug-infested homes were radically different from those of uninfested homes, and the bed bug endosymbiont Wolbachia was the major driver of this difference. After bed bugs were eliminated, the microbial community gradually shifted toward the community composition of uninfested homes, strongly implicating bed bugs in shaping the dust-associated environmental microbiome. Further studies are needed to understand the viability of these microbial communities and the potential risks that bed bug-associated microbes and their metabolites pose to human health.

Case not Closed: Arguments for New Studies of the Interactions between Bed Bugs and Human Pathogens

Bed bugs (Cimex spp.) are common ectoparasites of humans. Their ubiquity across diverse human environments combined with their blood-feeding behavior creates an ideal interface for the transmission of pathogenic microbes. Despite this potential, the current dogma is that bed bugs are not vectors of any known infectious agents. However, this conclusion is based largely on the results of studies conducted before the advent of modern molecular biology and the resurgence of bed bugs on a global scale. More importantly, a small but compelling body of modern research suggesting that bed bugs can potentially vector some human pathogens exists but is often overlooked. This article critically examines the current classification of the bed bug as an insect that does not transmit disease agents. In doing so, it highlights key knowledge gaps that still exist in understanding the potential of bed bugs as pathogen vectors and outlines several arguments for why new research on the topic is necessary.

Lack of influence by endosymbiont Wolbachia on virus titer in the common bed bug, Cimex lectularius

BACKGROUND

The common bed bug, Cimex lectularius, is an obligatory blood-feeding ectoparasite that requires a blood meal to molt and produce eggs. Their frequent biting to obtain blood meals and intimate association with humans increase the potential for disease transmission. However, despite more than 100 years of inquiry into bed bugs as potential disease vectors, they still have not been conclusively linked to any pathogen or disease. This ecological niche is extraordinarily rare, given that nearly every other blood-feeding arthropod is associated with some type of human or zoonotic disease. Bed bugs rely on the bacteria Wolbachia as an obligate endosymbiont to biosynthesize B vitamins, since they acquire a nutritionally deficient diet, but it is unknown if Wolbachia confers additional benefits to its bed bug host. In some insects, Wolbachia induces resistance to viruses such as Dengue, Chikungunya, West Nile, Drosophila C and Zika, and primes the insect immune system in other blood-feeding insects. Wolbachia might have evolved a similar role in its mutualistic association with the bed bug. In this study, we evaluated the influence of Wolbachia on virus replication within C. lectularius.

METHODS

We used feline calicivirus as a model pathogen. We fed 40 bed bugs from an established line of Wolbachia-cured and a line of Wolbachia-positive C. lectularius a virus-laden blood meal, and quantified the amount of virus over five time intervals post-feeding. The antibiotic rifampicin was used to cure bed bugs of Wolbachia.

RESULTS

There was a significant effect of time post-feeding, as the amount of virus declined by ~90% over 10 days in both groups, but no significant difference in virus titer was observed between the Wolbachia-positive and Wolbachia-cured groups.

CONCLUSIONS

These findings suggest that other mechanisms are involved in virus suppression within bed bugs, independent of the influence of Wolbachia, and our conclusions underscore the need for future research.

Bacterial symbionts in human blood-feeding arthropods: Patterns, general mechanisms and effects of global ecological changes

Due to their high impact on public health, human blood-feeding arthropods are one of the most relevant animal groups. Bacterial symbionts have been long known to play a role in the metabolism, and reproduction of these arthropod vectors. Nowadays, we have a more complete picture of their functions, acknowledging the wide influence of bacterial symbionts on processes ranging from the immune response of the arthropod host to the possible establishment of pathogens and parasites. One or two primary symbiont species have been found to co-evolve along with their host in each taxon (being ticks an exception), leading to various kinds of symbiosis, mostly mutualistic in nature. Moreover, several secondary symbiont species are shared by all arthropod groups. With respect to gut microbiota, several bacterial symbionts genera are hosted in common, indicating that these bacterial groups are prone to invade several hematophagous arthropod species feeding on humans. The main mechanisms underlying bacterium-arthropod symbiosis are discussed, highlighting that even primary symbionts elicit an immune response from the host. Bacterial groups in the gut microbiota play a key role in immune homeostasis, and in some cases symbiont bacteria could be competing directly or indirectly with pathogens and parasites. Finally, the effects climate change, great human migrations, and the increasingly frequent interactions of wild and domestic animal species are analyzed, along with their implications on microbiota alteration and their possible impacts on public health and the control of pathogens and parasites harbored in arthropod vectors of human parasites and pathogens.

Genetic Diversity and Phylogenetic Relationships of Cytochrome C Oxidase Subunit I in Cimex hemipterus (Hemiptera: Cimicidae) Populations in Malaysia

The tropical bed bug is scientifically recognized as a significant public health problem. While there is an increased awareness about their resurgence by medical and life science committees, efficient bed bug management still remains unresolved. The solution may soon arise, as information about bed bugs' infestation dynamics and systematics are becoming more distinguishable. Recent developments in studies about bed bugs are based on molecular intervention by determining their genetic variation and phylogeography. The aim of this study is to assess the phylogenetic relationships and genetic diversity among the populations of tropical bed bugs inhabiting Malaysia. A molecular genotyping study was conducted with 22 tropical bed bug populations composed of three individuals per population. The mitochondrial (COI) gene was used as a marker. The data obtained were analyzed using the T-Coffee, ClustalX, MEGA 6.0, and PAUP software. The results showed one main monophyletic clade that consisted of two groups: Ch01 and Ch02. Ch02 consists of samples from the Bandar Hilir population, differing from the other populations studied by one singleton base. However, as there were no changes in the amino acid, this singleton genetic variation was considered to have no effect on genetic differentiation. Ch01 shows similarity with some sequence of Cimex hemipterus (F.) from Thailand, suggesting an international diversity connection. The disparity index apparently suggests that all isolates are homogeneous populations and are supported by the low value of the mean pairwise distance between isolates. This study will increase the knowledge about phylogeographic diversity of tropical bed bug in Malaysia.

Bed bugs and possible transmission of human pathogens: a systematic review

The global population of bed bugs (Cimex lectularius and Cimex hemipterus, family Cimicidae) has undergone a significant resurgence since the late 1990s. This is likely due to an increase in global travel, trade, and the number of insecticide-resistant bed bugs. The global bed bug population is estimated to be increasing by 100-500 % annually. The worldwide spread of bed bugs is concerning, because they are a significant socioeconomic burden and a major concern to public health. According to the United States Environmental Protection Agency, bed bugs are "a pest of significant health importance." Additionally, 68 % of U.S. pest professionals reported that bed bugs are the most challenging pest to treat. Upwards of 45 disease pathogens have been reported in bed bugs. Recent studies report that bed bugs may be competent vectors for pathogens, such as Bartonella quintana and Trypanosoma cruzi. However, public health reports have thus far failed to produce evidence that major infectious disease outbreaks have been associated with bed bugs. Since many disease pathogens have previously been reported in bed bugs and the worldwide bed bug population is now drastically increasing, it stands to reason to wonder if bed bugs might transmit human pathogens. This review includes a literature search on recently published clinical and laboratory studies (1990-2016) investigating bed bugs as potential vectors of infectious disease, and reports the significant findings and limitations of the reviewed studies. To date, no published study has demonstrated a causal relationship between bed bugs and infectious disease transmission in humans. Also, we present and propose to expand on previous hypotheses as to why bed bugs do not transmit human pathogens. Bed bugs may contain "neutralizing factors" that attenuate pathogen virulence and, thereby, decrease the ability of bed bugs to transmit infectious disease.

Molecular characterization of Wolbachia infection in bed bugs (Cimex lectularius) collected from several localities in France

Wolbachia symbionts are maternally inherited intracellular bacteria that have been detected in numerous insects including bed bugs. The objective of this study, the first epidemiological study in Europe, was to screen Wolbachia infection among Cimex lectularius collected in the field, using PCR targeting the surface protein gene (wsp), and to compare obtained Wolbachia strains with those reported from laboratory colonies of C. lectularius as well as other Wolbachia groups. For this purpose, 284 bed bug specimens were caught and studied from eight different regions of France including the suburbs of Paris, Bouches-du-Rhône, Lot-et-Garonne, and five localities in Alpes-Maritimes. Among the samples, 166 were adults and the remaining 118 were considered nymphs. In all, 47 out of 118 nymphs (40%) and 61 out of 166 adults (37%) were found positive on wsp screening. Among the positive cases, 10 samples were selected randomly for sequencing. The sequences had 100% homology with wsp sequences belonging to the F-supergroup strains of Wolbachia. Therefore, we confirm the similarity of Wolbachia strains detected in this epidemiological study to Wolbachia spp. reported from laboratory colonies of C. lectularius.

Insecticide Resistance and Management Strategies in Urban Ecosystems

The increased urbanization of a growing global population makes imperative the development of sustainable integrated pest management (IPM) strategies for urban pest control. This emphasizes pests that are closely associated with the health and wellbeing of humans and domesticated animals. Concurrently there are regulatory requirements enforced to minimize inadvertent exposures to insecticides in the urban environment. Development of insecticide resistance management (IRM) strategies in urban ecosystems involves understanding the status and mechanisms of insecticide resistance and reducing insecticide selection pressure by combining multiple chemical and non-chemical approaches. In this review, we will focus on the commonly used insecticides and molecular and physiological mechanisms underlying insecticide resistance in six major urban insect pests: house fly, German cockroach, mosquitoes, red flour beetle, bed bugs and head louse. We will also discuss several strategies that may prove promising for future urban IPM programs.

Bats and Buildings: The Conservation of Synanthropic Bats

Humans have shared buildings with bats for thousands of years, probably as early as first humans built primitive huts. Indeed, many bat species can be defined as synanthropic, i.e., they have a strong ecological association with humans. Bats have been observed using buildings as roosting and foraging sites, temporary shelters, for reproduction and hibernation. A synanthropic lifestyle may result in direct fitness benefits owing to energetic advantages in warmer roosts, which may ultimately lead to more rapid gestation and faster development of juveniles, or by being less exposed to natural predators in urban environments. All these benefits may allow bats to use buildings as stepping stones to exploit habitats otherwise devoid of roosting structures and may even lead to the expansion of geographic ranges. Yet, the coexistence with humans also comes with some risks. Bats may be exposed to chemical pollutants, particularly preservation chemicals used on lumber or during pest control measures. Bats may also be at risk of direct persecution or they may die accidently if trapped within buildings. In general, eviction of bats from buildings should follow the general rule of avoidance–mitigation–compensation. When considering conservation measures for synanthropic bats, it is most important to assess the role of the building for different life stages of bats. Construction work at buildings should be conducted in a manner that minimizes disturbance of bats. Artificial roosts can replace lost roosts, yet bats will often not accept alternative roosts. Demographic changes in human populations may lead to the abandonment of buildings, for example, in rural areas and to increased conflicts in urban areas when old buildings are replaced by new buildings or when previously unoccupied space in buildings is renovated. We advocate maintenance and enhancement of roosts for synanthropic bats, in addition to outreach and education campaigns, to improve the tolerance of humans for synanthropic bats.