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Boodman C, Lindsay LR, Dibernardo A, Kisil K, Coatsworth H, Huynh C, Heendeniya A, Schellenberg J, Keynan Y. Body Louse Pathogen Surveillance among Persons Experiencing Homelessness, Canada, 2020-2021. Emerg Infect Dis 2024; 30:1450-1453. [PMID: 38916637 PMCID: PMC11210640 DOI: 10.3201/eid3007.231660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
We analyzed body lice collected from persons experiencing homelessness in Winnipeg, Manitoba, Canada, during 2020-2021 to confirm vector species and ecotype and to identify louseborne pathogens. Of 556 lice analyzed from 7 persons, 17 louse pools (218 lice) from 1 person were positive for the louseborne bacterium Bartonella quintana.
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Tufa TB, Margos G, Fingerle V, Hartberger C, Poppert S, Birtles RJ, Kraiczy P, Kempf VAJ, Frickmann H, Feldt T. Evidence for Bartonella quintana in Lice Collected from the Clothes of Ethiopian Homeless Individuals. Pathogens 2023; 12:1299. [PMID: 38003765 PMCID: PMC10675803 DOI: 10.3390/pathogens12111299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/19/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Human lice, Pediculus humanus, can transmit various pathogens, including Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii. Xenosurveillance is an epidemiological approach to assessing human infection risks performed by screening vectors of infectious disease agents. In the proof-of-principle study reported herein, the DNA of 23 human lice was collected from the clothes of 30 homeless Ethiopian individuals. These samples were assessed using 16S rRNA gene-specific pan-eubacterial PCR for screening, followed by Bartonella genus 16S-23S internal transcribed spacer (ITS) sequence-specific PCR, Bartonella genus gltA gene-specific PCR, and 16S rRNA gene PCR with specificity for relapsing-fever-associated Borrelia spp. with subsequent sequencing of the amplicons. In one sample, the pan-eubacterial 16S rRNA gene-specific screening PCR, the Bartonella genus 16S-23S ITS sequence-specific PCR, and the Bartonella genus gltA gene-specific PCR allowed for the sequencing of B. quintana-specific amplicons. In two additional samples, Bartonella genus gltA gene-specific PCR also provided sequences showing 100% sequence identity with B. quintana. In total, 3/23 (13.0%) of the assessed lice were found to be positive for B. quintana. Correlating clinical data were not available; however, the assessment confirmed the presence of B. quintana in the local louse population and thus an associated infection pressure. Larger-sized cross-sectional studies seem advisable to more reliably quantify the infection risk of lice-infested local individuals. The need for prevention by providing opportunities to maintain standard hygiene for Ethiopian homeless individuals is stressed by the reported findings, especially in light of the ongoing migration of refugees.
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Affiliation(s)
- Tafese Beyene Tufa
- Asella Teaching and Referral Hospital, College of Health Sciences, Arsi University, Asella P.O. Box 04, Ethiopia;
- Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, Asella P.O. Box 04, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Medical Center Düsseldorf, 40225 Düsseldorf, Germany
| | - Gabriele Margos
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Volker Fingerle
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Christine Hartberger
- National Reference Center for Borrelia, Bavarian Health and Food Safety Authority (LGL), Branch Oberschleißheim, 85764 Oberschleißheim, Germany; (G.M.); (V.F.); (C.H.)
| | - Sven Poppert
- Diagnostic Department, Bernhard Nocht Institute for Tropical Medicine Hamburg, 20239 Hamburg, Germany;
| | - Richard J. Birtles
- School of Science, Engineering and Environment, University of Salford, Salford M5 4WT, UK;
| | - Peter Kraiczy
- Institute for Medical Microbiology and Infection Control and Consiliary Laboratory for Bartonella Infections (Appointed by the Robert Koch Institute), University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; (P.K.); (V.A.J.K.)
| | - Volkhard A. J. Kempf
- Institute for Medical Microbiology and Infection Control and Consiliary Laboratory for Bartonella Infections (Appointed by the Robert Koch Institute), University Hospital, Goethe University Frankfurt, 60596 Frankfurt am Main, Germany; (P.K.); (V.A.J.K.)
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, 20359 Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, Germany
| | - Torsten Feldt
- Hirsch Institute of Tropical Medicine (HITM), Heinrich-Heine University, Asella P.O. Box 04, Ethiopia
- Department of Gastroenterology, Hepatology and Infectious Diseases, University Medical Center Düsseldorf, 40225 Düsseldorf, Germany
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Deng YP, Fu YT, Yao C, Shao R, Zhang XL, Duan DY, Liu GH. Emerging bacterial infectious diseases/pathogens vectored by human lice. Travel Med Infect Dis 2023; 55:102630. [PMID: 37567429 DOI: 10.1016/j.tmaid.2023.102630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/02/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
Human lice have always been a major public health concern due to their vector capacity for louse-borne infectious diseases, like trench fever, louse-borne relapsing fever, and epidemic fever, which are caused by Bartonella quintana, Borrelia recurrentis, and Rickettsia prowazekii, respectively. Those diseases are currently re-emerging in the regions of poor hygiene, social poverty, or wars with life-threatening consequences. These louse-borne diseases have also caused outbreaks among populations in jails and refugee camps. In addition, antibodies and DNAs to those pathogens have been steadily detected in homeless populations. Importantly, more bacterial pathogens have been detected in human lice, and some have been transmitted by human lice in laboratories. Here, we provide a comprehensive review and update on louse-borne infectious diseases/bacterial pathogens.
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Affiliation(s)
- Yuan-Ping Deng
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Yi-Tian Fu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China; Department of Parasitology, Xiangya School of Basic Medicine, Central South University, Changsha, Hunan, China
| | - Chaoqun Yao
- Department of Biomedical Sciences and One Health Center for Zoonoses and Tropical Veterinary Medicine, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis.
| | - Renfu Shao
- Centre for Bioinnovation, School of Science, Technology and Engineering, University of the Sunshine Coast, Sippy Downs, Australia
| | - Xue-Ling Zhang
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - De-Yong Duan
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China
| | - Guo-Hua Liu
- Research Center for Parasites & Vectors, College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan, China.
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Sarsiat L, Garrigos T, Houhamdi L, Dauwalder O, Kuli B, Braunberger E, Belmonte O, Fournier PE, Miltgen G. Case series of 12 Bartonella quintana endocarditis from the Southwest Indian Ocean. PLoS Negl Trop Dis 2023; 17:e0011606. [PMID: 37676863 PMCID: PMC10508605 DOI: 10.1371/journal.pntd.0011606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/19/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Bartonella spp. are fastidious bacteria frequently identified as the cause of blood culture-negative (BCN) endocarditis. However, Bartonella infections are difficult to diagnose in routine laboratory testing and their incidence is probably underestimated. We investigated the epidemiological and clinical features of Bartonella endocarditis cases diagnosed between 2009 and 2021 on Reunion Island (Southwest Indian Ocean). METHOD We retrospectively included all patients diagnosed with Bartonella endocarditis at Reunion Island University Hospital during this period. Endocarditis was diagnosed on the basis of microbiological findings, including serological tests (IFA) and PCR on cardiac valves, and the modified Duke criteria. We used then the multispacer typing (MST) method to genotype the available Bartonella strains. FINDINGS We report 12 cases of B. quintana endocarditis on Reunion Island (83.3% in men, median patient age: 32 years). All the patients originated from the Comoros archipelago. The traditional risk factors for B. quintana infection (homelessness, alcoholism, exposure to body lice) were absent in all but two of the patients, who reported head louse infestations in childhood. Previous heart disease leading to valve dysfunction was recorded in 50% of patients. All patients underwent cardiac valve surgery and antimicrobial therapy with a regimen including doxycycline. All patients presented high C-reactive protein concentrations, anemia and negative blood cultures. The titer of IgG antibodies against Bartonella sp. exceeded 1:800 in 42% of patients. Specific PCR on cardiac valves confirmed the diagnosis of B. quintana endocarditis in all patients. Genotyping by the MST method was performed on four strains detected in preserved excised valves and was contributive for three, which displayed the MST6 genotype. CONCLUSIONS Bartonella quintana is an important cause of infective endocarditis in the Comoros archipelago and should be suspected in patients with mitral valve dysfunction and BCN from this area.
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Affiliation(s)
- Ludivine Sarsiat
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
| | - Linda Houhamdi
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
| | - Olivier Dauwalder
- Plateau de Microbiologie Moléculaire Spécialisé et de Séquençage, Institut des Agents Infectieux, Centre de Biologie et Pathologie Nord, Hospices Civils de Lyon, Lyon, France
| | - Barbara Kuli
- Service de Maladies Infectieuses, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Eric Braunberger
- Service de Chirurgie Cardio-thoracique, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Pierre-Edouard Fournier
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
- UMR Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), Université d’Aix-Marseille, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Marseille, France
| | - Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
- Centre Régional en Antibiothérapie (CRAtb) de La Réunion, France
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McHugh J, Saleh OA. Updates in Culture-Negative Endocarditis. Pathogens 2023; 12:1027. [PMID: 37623987 PMCID: PMC10459830 DOI: 10.3390/pathogens12081027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Blood culture-negative infective endocarditis (BCNE) is a challenging condition associated with significant morbidity and mortality. This review discusses the epidemiology, microbiology, diagnosis, and treatment of BCNE considering advancements in molecular diagnostics and increased access to cardiac surgery. BCNE can be categorized into bacterial endocarditis with sterilized blood cultures due to previous antibiotic treatment, endocarditis caused by fastidious microorganisms, and true BCNE caused by intracellular organisms that cannot be cultured using traditional techniques. Non-infectious causes such as nonbacterial thrombotic endocarditis should also be considered. Diagnostic approaches involve thorough patient history; blood and serum testing, including appropriate handling of blood cultures; serological testing; and molecular techniques such as targeted and shotgun metagenomic sequencing. Where available, evaluation of explanted cardiac tissue through histopathology and molecular techniques is crucial. The therapy for BCNE depends on the likely causative agent and the presence of prosthetic material, with surgical intervention often required.
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Affiliation(s)
- Jack McHugh
- Division of Public Health, Infectious Diseases, Occupational Medicine, Mayo Clinic, Rochester, MN 55901, USA;
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Choat J, Yockey B, Sheldon SW, Pappert R, Petersen J, Dietrich EA. Development and validation of a real-time PCR test to detect Bartonella quintana in clinical samples. Diagn Microbiol Infect Dis 2023; 106:116000. [PMID: 37295184 PMCID: PMC10860707 DOI: 10.1016/j.diagmicrobio.2023.116000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/19/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
This study reports on the validation of a real-time polymerase chain reaction test targeting the vomp region of Bartonella quintana. The assay displayed 100% sensitivity and specificity for the 52 bloods and 159 cultures tested. Molecular diagnosis of Bartonella quintana can aid clinical treatment during acute infection.
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Affiliation(s)
- Jamie Choat
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Brook Yockey
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Sarah W Sheldon
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Ryan Pappert
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Jeannine Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Elizabeth A Dietrich
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA.
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Boodman C, MacDougall W, Hawkes M, Tyrrell G, Fanella S. Bartonella quintana endocarditis in a child from Northern Manitoba, Canada. PLoS Negl Trop Dis 2022; 16:e0010399. [PMID: 35617170 PMCID: PMC9135198 DOI: 10.1371/journal.pntd.0010399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a case of Bartonella quintana endocarditis in an 11-year-old child from Northern Manitoba, Canada. This case demonstrates the neglected endemicity of B. quintana in Northern Canada and highlights the need for improved case finding and elucidation of specific risk factors for B. quintana infection in the Canadian North. Considering B. quintana’s predominant transmission via body lice ectoparasitosis, we hypothesize that B. quintana’s endemicity in Northern Canada is linked to inadequate access to suitable housing and running water among remote communities in the Canadian North.
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Affiliation(s)
- Carl Boodman
- University of Manitoba, Winnipeg, Manitoba, Canada
- * E-mail:
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Boodman C, Wuerz T, Lagacé-Wiens P, Lindsay R, Dibernardo A, Bullard J, Stein DR, Keynan Y. Serologic testing for Bartonella in Manitoba, Canada, 2010-2020: a retrospective case series. CMAJ Open 2022; 10:E476-E482. [PMID: 35640989 PMCID: PMC9177198 DOI: 10.9778/cmajo.20210180] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Bartonella are gram-negative bacilli not identified by routine bacterial culture. The objectives of this study were to review the results of all serologic testing for Bartonella ordered in Manitoba, Canada, and to review cases with positive test results among adults to assess species identification, risk factors, clinical manifestations and outcomes. METHODS This retrospective study included all Bartonella serologic tests ordered in Manitoba and performed at the National Microbiology Laboratory, Winnipeg, from Jan. 1, 2010, until Dec. 31, 2020. We analyzed the aggregate data for all serologic tests for Bartonella for patients of all ages. We reviewed the charts of adult (age ≥ 18 yr) patients with serologic positivity for Bartonella who had a medical chart at 1 of Winnipeg's 2 largest hospitals (Health Sciences Centre and St. Boniface Hospital) to extract clinical and demographic data and create a case series. Descriptive statistics were performed. RESULTS During the study period, 1014 Bartonella serologic tests were ordered in adult and pediatric patients, of which 24 (2.4%) gave a positive result. Sixteen adults (12 men and 4 women; mean age 48 yr) seen at a participating hospital had a positive result. Molecular species-level identification occurred on explanted cardiac valves in 5 (31%) of the 16 cases; B. quintana was identified in all 5. Six patients (38%) were diagnosed with probable B. quintana infection, for a total of 11 B. quintana cases (69%); 8 (73%) of the 11 had endocarditis. Four cases of B. quintana infection (36%) were associated with rural residence. Four cases (25%) of probable B. henselae were identified; 2 patients had fever and lymphadenopathy, and 2 had endocarditis. The remaining patient was deemed to have a false-positive result as his B. henselae titre was at the threshold for positivity, his B. quintana serologic test gave a negative result, and his clinical syndrome was not suggestive of Bartonella infection. Two patients died; both had multivalvular B. quintana endocarditis with ruptured intracranial mycotic aneurysms. INTERPRETATION Bartonella quintana was a common cause of Bartonella serologic positivity among adults in Manitoba in 2010-2020 and was associated with endocarditis and systemic embolization. As B. quintana is transmitted by body lice, active case finding for people who lack suitable housing, both in urban and rural settings, should prioritize those with elevated Bartonella titres to receive echocardiography and detect endocarditis before systemic embolization occurs.
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Affiliation(s)
- Carl Boodman
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man.
| | - Terence Wuerz
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Philippe Lagacé-Wiens
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Robbin Lindsay
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Antonia Dibernardo
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Jared Bullard
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Derek R Stein
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man
| | - Yoav Keynan
- Section of Infectious Diseases (Boodman, Wuerz, Keynan), Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba; Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens, Bullard, Stein, Keynan) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens); National Microbiology Laboratory (Lindsay, Dibernardo); Cadham Provincial Laboratory (Bullard, Stein), Winnipeg, Man.
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A Pain in the Flank. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2022. [DOI: 10.1097/ipc.0000000000001120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Robert M, Lecomte R, Michel M, Guimbretiere G, Croizier G, Corvec S, Leroy A. Bartonella quintana infective endocarditis in a homeless man with unexpected positive blood culture. IDCases 2022; 30:e01647. [DOI: 10.1016/j.idcr.2022.e01647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/22/2022] [Indexed: 11/26/2022] Open
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Lashnits E, Neupane P, Bradley JM, Richardson T, Maggi RG, Breitschwerdt EB. Comparison of Serological and Molecular Assays for Bartonella Species in Dogs with Hemangiosarcoma. Pathogens 2021; 10:pathogens10070794. [PMID: 34201572 PMCID: PMC8308881 DOI: 10.3390/pathogens10070794] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 11/23/2022] Open
Abstract
Currently, a gold standard diagnostic test for Bartonella infection in dogs is lacking. This represents a critical limitation for the development and evaluation of new diagnostic tests, as well as for the diagnosis of, and research on, bartonellosis in dogs. This retrospective observational study aims to compare the results of commonly performed and newly-reported Bartonella spp. diagnostic tests in banked clinical specimens from 90 dogs with hemangiosarcoma (HSA) using composite reference standard (CRS) and random effects latent class analysis (RE-LCA) techniques. Samples from each dog were tested using six serological or molecular diagnostic assays, including indirect fluorescent antibody (IFA) and Western blot (WB) for the detection of antibodies in serum, and qPCR and droplet digital PCR (ddPCR) in blood and fresh frozen tissue biopsy samples (mainly splenic HSA tumors and histopathologically normal spleen or skin/adipose tissue). Bartonella infection prevalence was estimated to be 78% based on the CRS (parallel testing with all six assays), and 64% based on the RE-LCA model. The assay with the highest diagnostic accuracy was qPCR performed on fresh frozen tissue biopsy samples (sensitivity: 94% by RE-LCA and 80% by CRS; specificity: 100%). When comparing newly-reported to traditional Bartonella diagnostic assays, ddPCR was more sensitive for the detection of Bartonella DNA than qPCR when testing blood samples (36% vs. 0%, p < 0.0001). Dogs that were positive on serological assays alone with negative molecular assays were highly unlikely (<3%) to be classified as infected by the RE-LCA model. These data indicate that Bartonella spp. DNA can be PCR amplified from fresh frozen tissues from a majority of dogs with HSA using both qPCR and ddPCR, supporting the use of these methods for future controlled studies comparing the prevalence of Bartonella spp. DNA in the tissue of dogs with HSA to that of unaffected controls.
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Affiliation(s)
- Erin Lashnits
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53713, USA;
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Pradeep Neupane
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Julie M. Bradley
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Toni Richardson
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
| | - Ricardo G. Maggi
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
| | - Edward B. Breitschwerdt
- Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA; (P.N.); (J.M.B.); (T.R.); (R.G.M.)
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA
- Correspondence:
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12
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Boodman C, Wuerz T, Lagacé-Wiens P. Endocarditis due to Bartonella quintana, the etiological agent of trench fever. CMAJ 2021; 192:E1723-E1726. [PMID: 33288506 DOI: 10.1503/cmaj.201170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Carl Boodman
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man
| | - Terence Wuerz
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man
| | - Philippe Lagacé-Wiens
- Section of Infectious Diseases (Boodman, Wuerz), Department of Internal Medicine and Departments of Medical Microbiology and Infectious Diseases (Boodman, Lagacé-Wiens) and Community Health Sciences (Wuerz), Max Rady College of Medicine, University of Manitoba; Shared Health (Lagacé-Wiens), Winnipeg, Man.
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Sricharern W, Kaewchot S, Saengsawang P, Kaewmongkol S, Inpankaew T. Molecular Detection of Bartonella quintana among Long-Tailed Macaques ( Macaca fascicularis) in Thailand. Pathogens 2021; 10:629. [PMID: 34069707 PMCID: PMC8160695 DOI: 10.3390/pathogens10050629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/15/2021] [Accepted: 05/18/2021] [Indexed: 11/16/2022] Open
Abstract
Bartonella quintana is a zoonotic pathogen with a worldwide distribution. Humans and non-human primates are considered to be natural reservoir hosts for B. quintana. However, information on the molecular epidemiology of this organism is very limited in regard to long-tailed macaques (Macaca fascicularis) in Thailand. Therefore, this study aimed to investigate the occurrence and genetic diversity of Bartonella spp. among long-tailed macaques in Thailand. In total, 856 blood samples were collected from long-tailed macaques in Thailand. All specimens were screened for Bartonella spp. using a polymerase chain reaction (PCR) assay targeting the 16S rRNA, gltA and ftsZ genes. All positive samples were further analyzed based on nucleotide sequencing, phylogenetic analysis and multiple sequence alignment analysis. Only one macaque showed a positive result in the PCR assays based on the 16S rRNA, gltA and ftsZ genes. Nucleotide sequencing and phylogenetic analysis revealed that the obtained sequences were closely related to B. quintana previously detected in non-human primates. Single-nucleotide polymorphisms (SNPs) were detected in the gltA and ftsZ gene sequences. This study revealed that long-tailed macaques in Thailand carried B. quintana. Despite the low infection rate detected, long-tailed macaques may be a reservoir of B. quintana.
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Affiliation(s)
- Wanat Sricharern
- Center for Agricultural Biotechnology, Kamphaengsaen Campus, Kasetsart University, Nakhonpathom 73140, Thailand;
- Center of Excellence on Agricultural Biotechnology, Science and Technology Postgraduate Education and Research Development Office, Commission on Higher Education, Ministry of Education, Science, Research Innovation (AG-BIO/PERDO-CHE), Bangkok 10900, Thailand
- Department of Veterinary Technology, Faculty of Veterinary Technology, Kasetsart University, Bangkok 10900, Thailand;
| | - Supakarn Kaewchot
- Department of National Parks, Wildlife and Plant Conservation, Bangkok 10900, Thailand;
| | - Phirabhat Saengsawang
- Akkhraratchakumari Veterinary College, Walailak University, Nakhon Si Thammarat 80161, Thailand;
| | - Sarawan Kaewmongkol
- Department of Veterinary Technology, Faculty of Veterinary Technology, Kasetsart University, Bangkok 10900, Thailand;
| | - Tawin Inpankaew
- Center for Agricultural Biotechnology, Kamphaengsaen Campus, Kasetsart University, Nakhonpathom 73140, Thailand;
- Center of Excellence on Agricultural Biotechnology, Science and Technology Postgraduate Education and Research Development Office, Commission on Higher Education, Ministry of Education, Science, Research Innovation (AG-BIO/PERDO-CHE), Bangkok 10900, Thailand
- Department of Parasitology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok 10900, Thailand
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14
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Laboratory Diagnosis of 37 Cases of Bartonella Endocarditis Based on Enzyme Immunoassay and Real-Time PCR. J Clin Microbiol 2021; 59:JCM.02217-20. [PMID: 33731411 DOI: 10.1128/jcm.02217-20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/08/2021] [Indexed: 12/15/2022] Open
Abstract
Bartonella spp., mostly Bartonella quintana and B. henselae, are a common cause of culture-negative endocarditis. Serology using immunofluorescence assay (IFA) and PCR performed on cardiac tissues are the mainstays of diagnosis. We developed an enzyme immunoassay (EIA) and a novel multiplex real-time PCR assay, utilizing Bartonella genus-specific, B. henselae-specific, and B. quintana-specific SimpleProbe probes, for diagnosis of Bartonella endocarditis. We aimed to evaluate the performance of these assays. Thirty-seven patients with definite endocarditis, 18 with B. henselae, 18 with B. quintana, and 1 with B. koehlerae, were studied. Diagnosis was confirmed by conventional PCR and DNA sequencing of surgical cardiac specimens. Similar to the case with IFA, anti-Bartonella IgG titers of ≥1:800 were found in 94% of patients by EIA; cross-reactivity between B. henselae and B. quintana precluded species-specific serodiagnosis, and frequent (41%) but low-titer cross-reactivity between Coxiella burnetii antibodies and B. henselae antigen was found in patients with Q fever endocarditis. Low-titer (1:100) cross-reactivity was uncommonly found also in patients with brucellosis and culture-positive endocarditis, particularly Enterococcus faecalis endocarditis. Real-time PCR performed on explanted heart valves/vegetations was in complete agreement with results of sequence-based diagnosis with characteristic melting curves. The genus-specific probe identified five additional endocarditis-associated Bartonella spp. at the genus level. In conclusion, EIA coupled with a novel real-time PCR assay can play an important role in Bartonella endocarditis diagnosis and expand the diagnostic arsenal at the disposal of the clinical microbiologist. Since serology remains a major diagnostic tool, recognizing its pitfalls is essential to avoid incorrect diagnosis.
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Bartonella species as a cause of culture-negative endocarditis in South Africa. Eur J Clin Microbiol Infect Dis 2021; 40:1873-1879. [PMID: 33829350 DOI: 10.1007/s10096-021-04239-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
Previous reports have highlighted the high prevalence of blood culture negative endocarditis (BCNE) in South Africa. The Tygerberg Endocarditis Cohort (TEC) study is an ongoing prospective cohort study of patients with confirmed or suspected IE presenting to Tygerberg Academic Hospital, Cape Town, South Africa. Current analysis includes patients that presented between November 2019 and August 2020. Forty four (44) patients have been included in this ongoing study. Fourteen of the 44 patients (31.8%) had BCNE. Further analysis of the patients with BCNE identified Bartonella species as the most common causative organism (n=6; 43%). Other causes included Mycoplasma species (n=2). No cause could be identified in 4 of the 44 patients (9%). Bartonella quintana was identified with PCR of valvular tissue as the causative organism in 4 of the 5 patients that underwent urgent surgery. The patients with Bartonella IE (n=6) had an average age of 39 years with equal gender distribution. The common clinical features were clubbing (n=5; 83%), anemia (n=4; 66.6%), haematuria (n=3; 50%), acute on chronic severe regurgitant lesion (n=3; 50%) and acute severe regurgitant lesion (n=2; 33.3%).The aortic valve was involved in 5 of 6 patients. During a mean follow-up period of 251 days after diagnosis, no major adverse events occurred. Bartonella-associated IE is an important cause of BCNE in the Western Cape of South Africa. Imaging findings (in patients with BCNE) of significant valvular destruction with large vegetations on the aortic valve not affected by congenital or rheumatic valve disease should raise the suspicion of Bartonella-associated IE.
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Boodman C, Wuerz T, Lagacé-Wiens P. Endocardite provoquée par Bartonella quintana, l’agent causal de la fièvre des tranchées. CMAJ 2021; 193:E296-E299. [PMID: 33619074 PMCID: PMC8034350 DOI: 10.1503/cmaj.201170-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Carl Boodman
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
| | - Terence Wuerz
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
| | - Philippe Lagacé-Wiens
- Section des maladies infectieuses (Boodman, Wuerz), Département de médecine interne et Département de microbiologie médicale et des maladies infectieuses (Boodman, Lagacé-Wiens), et Département de sciences de la santé communautaire (Wuerz), Collège de médecine Max Rady, Université du Manitoba; Soins communs Manitoba (Lagacé-Wiens), Winnipeg (Manitoba)
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17
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Kleinman DR, Lam JC, Bacani J, Tyrrell G, Turvey SL. Bartonella quintana infective endocarditis in northern Alberta: A case report. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2020; 5:256-260. [PMID: 36340060 PMCID: PMC9602878 DOI: 10.3138/jammi-2020-0013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 08/26/2020] [Indexed: 06/16/2023]
Abstract
We present a case of Bartonella quintana infective endocarditis requiring valvular surgery in an Indigenous patient from northern Alberta that was identified months after initial presentation to hospital with undifferentiated laboratory abnormalities. Syndromes caused by B. quintana are often challenging to diagnose due to their non-specific presentation and the difficulty in detecting this organism using traditional culture methods. Additionally, risk factors for B. quintana include marginal housing and alcohol use disorder, which often impede access to health care. Indigenous patients in northern Canada often face worse health outcomes compared with other regions owing to poor economic conditions, substandard housing, and limited access to health care resources. Given that risk factors for B. quintana are prevalent throughout northern Canada and that this infection is difficult to diagnose, we surmise that the prevalence of B. quintana infection is underestimated in northern Canada.
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Affiliation(s)
- David Ryan Kleinman
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - John C Lam
- Division of Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Julinor Bacani
- Division of Anatomical Pathology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Gregory Tyrrell
- Division of Diagnostic and Applied Microbiology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
| | - Shannon Lee Turvey
- Division of Infectious Diseases, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
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