Cat-scratch disease

Cat-scratch disease (CSD) was first described by Debré in 1950, yet the causative bacterial agent of CSD remained obscure until 1992, when Bartonella (formerly Rochalimaea) henselae was implicated in CSD by serological and microbiologic studies. Bartonella henselae had initially been linked to bacillary angiomatosis (BA), a vascular proliferative disease most commonly associated with long-standing human immunodeficiency virus infection or other significant immunosuppression. Bartonella henselae has also been associated with bacillary peliosis, relapsing bacteraemia and endocarditis in humans. Cats are healthy carriers of B. henselae, and can be bacteraemic for months or years. Cat-to-cat transmission of the organism by the cat flea, with no direct contact transmission, has been demonstrated. Two new Bartonella species have been identified in the cat reservoir, namely: B. clarridgeiae and B. koehlerae. The role of these species in the aetiology of CSD still needs to be confirmed by isolation or DNA identification from lesions in humans. The author discusses the present state of knowledge on the aetiology, clinical features and epidemiological characteristics of CSD/BA, in addition to diagnosis, treatment and prevention.     

A serological survey of rural dogs and cats on the southwestern Canadian prairie for zoonotic pathogens

A survey for antibodies against agents of plague, tularemia, and Rocky Mountain spotted fever (RMSF), and against Sin Nombre hantavirus (SNV), Bartonella henselae and B. clarridgeiae was conducted in the summer of 1995 using serum from rural dogs and cats living in the vicinity of four public parks in southeastern Alberta and southwestern Saskatchewan. Antibodies to all pathogens were detected in all survey areas. Overall prevalence rates were 0.075 for Yersinia pestis, 0.089 for Francisella tularensis, 0.025 for Rickettsia rickettsii (dogs only), and 0.029, 0.178 and 0.186 for SNV, B. henselae and B. clarridgeiae, respectively (cats only). This serological survey of rural dogs and cats was more sensitive and efficient than previous surveys based on collection and culture of rodents and ectoparasites. All six pathogens appear endemic to the region. Surveillance for plague, tularemia, RMSF and SNV, and management of associated public risks should be done in endemic regions.     

Rodent-associated Bartonella febrile illness, Southwestern United States

Serum specimens from 114 patients hospitalized with a febrile illness were tested with an indirect immunofluorescence assay (IFA) using Bartonella antigens prepared from 6 species of sigmodontine rodents and 3 known human Bartonella pathogens: B. henselae, B. quintana, and B. elizabethae. Acute- and convalescent-phase serum samples from 5 of these patients showed seroconversion with an IFA titer >512 to rodent-associated Bartonella antigens. The highest titer was against antigen derived from the white-throated woodrat (Neotoma albigula), although this rodent is not necessarily implicated as the source of infection. Three of the 5 who seroconverted showed no cross-reaction to the 3 Bartonella human pathogens. Common clinical characteristics were fever, chills, myalgias, leukopenia, thrombocytopenia, and transaminasemia. Although antibodies to Bartonella are cross-reactive, high-titer seroconversions to rodent-associated Bartonella antigens in adults with common clinical characteristics should stimulate the search for additional Bartonella human pathogens.     

Bartonella spp. DNA associated with biting flies from California

Bartonella DNA was investigated in 104 horn flies (Haematobia spp.), 60 stable flies (Stomoxys spp.), 11 deer flies (Chrysops spp.), and 11 horse flies (Tabanus spp.) collected on cattle in California. Partial sequencing indicated B. bovis DNA in the horn fly pool and B. henselae type M DNA in one stable fly.     

Transmission of Bartonella henselae by Ixodes ricinus

Bartonella spp. are facultative intracellular bacteria associated with several emerging diseases in humans and animals. B. henselae causes cat-scratch disease and is increasingly associated with several other syndromes, particularly ocular infections and endocarditis. Cats are the main reservoir for B. henselae and the bacteria are transmitted to cats by cat fleas. However, new potential vectors are suspected of transmitting B. henselae, in particular, Ixodes ricinus, the most abundant ixodid tick that bites humans in western Europe. We used a membrane-feeding technique to infect I. ricinus with B. henselae and demonstrate transmission of B. henselae within I. ricinus across developmental stages, migration or multiplication of B. henselae in salivary glands after a second meal, and transmission of viable and infective B. henselae from ticks to blood. These results provide evidence that I. ricinus is a competent vector for B. henselae.     

Bartonella henselae in Ixodes ricinus ticks (Acari: Ixodida) removed from humans,Belluno province,Italy

The potential role of ticks as vectors of Bartonella species has recently been suggested. In this study, we investigated the presence of Bartonella species in 271 ticks removed from humans in Belluno Province, Italy. By using primers derived from the 60-kDa heat shock protein gene sequences, Bartonella DNA was amplified and sequenced from four Ixodes ricinus ticks (1.48%). To confirm this finding, we performed amplification and partial sequencing of the pap31 protein and the cell division protein ftsZ encoding genes. This process allowed us to definitively identify B. henselae (genotype Houston-1) DNA in the four ticks. Detection of B. henselae in these ticks might represent a highly sensitive form of xenodiagnosis. B. henselae is the first human-infecting Bartonella identified from Ixodes ricinus, a common European tick and the vector of various tickborne pathogens. The role of ticks in the transmission of bartonellosis should be further investigated.     

Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease-endemic region

Bartonella spp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies against Bartonella henselae, B. koehlerae, or B. vinsonii subsp. berkhoffii (185 [62%]) and Bartonella spp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%). B. henselae bacteremia was significantly associated with prior referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereas B. koehlerae bacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link between Bartonella spp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution of Bartonella spp. infection, if any, to these symptoms should be systematically investigated.     

Bartonella DNA in dog saliva

Bartonella species, transmitted by arthropods or animal bites and scratches, are emerging pathogens in human and veterinary medicine. PCR and DNA sequencing were used to test oral swabs collected from dogs. Results indicated the presence of 4 Bartonella species: B. bovis, B. henselae, B. quintana, and B. vinsonii subspecies berkhoffii.     

Seroprevalence of Bartonella henselae and Bartonella quintana infections in Poland in 1998-2001

Bartonella henselae and Bartonella quintana infections result in illnesses with symptoms of severity ranging from mild lymphadenopathy (CSD) to systemic disease. The aim of the study was to estimate a prevalence of B. henselae and B. quintana infections in human in Poland. Serum samples collected from 265 patients in 1998-2001 were tested for the presence of antibodies specific to B. henselae and B. quintana. Levels of serum IgM and IgG antibodies to Bartonella henselae and Bartonella quintana were measured with indirect microimmunofluorescence test (MRL Diagnostic, USA). Cats' sera were assessed with indirect microimmunofluorescence test (MRL Diagnostic, USA) and goat immune serum anti-cat IgG FITC conjugate (Sigma, USA). Bartonella henselae specific antibodies were detected in 146 (57.0%) patients with lymphadenopathy. From that number 11.3% have shown specific Bartonella henselae IgM serum antibodies. Bartonella quintana infection was detected with serological methods in 4 patients. It has been found that CSD is a seasonal infection, with most cases occurring in autumn. Most cases of the disease have been recognized in children 8-16 years old. Most of CSD cases (30.1%) were detected in Mazowieckie voivodeship. There were no cases of CSD in Pomorskie, Podkarpackie, Lubuskie and Opolskie voivodeship. The seroprevalence of Bartonella sp. infections in cats was estimated on 86% (31/36). The highest titer of specific Bartonella henselae antibodies detected in cats was 1024. The number of detected Bartonella henselae infections in Poland is very low. It is very probable that the number of cases is underestimated in our country. Cat scratch disease is the most frequently clinically and serologically identified bartonellosis.     

Persistent infection of pets within a household with three Bartonella species.

We monitored by blood culture and immunofluorescence assay (IFA) bartonella infection in one dog and eight cats in a household to determine the prevalence and persistence of the infection as well as its transmissibility to humans. Ectoparasite control was rigorously exercised. During a 3-year period, Bartonella clarridgeiae was recovered from one cat on two occasions, and B. henselae was isolated from another cat on four occasions. During a 16-month period, B. vinsonii subsp. berkhoffii was isolated from the dog on 8 of 10 culture attempts. Despite extensive household contact, the pet owner was seronegative to all three species by IFA for Bartonella-specific immunoglobulin G.     

Bartonella henselae in porpoise blood

We report detection of Bartonella henselae DNA in blood samples from 2 harbor porpoises (Phocoena phocoena). By using real-time polymerase chain reaction, we directly amplified Bartonella species DNA from blood of a harbor porpoise stranded along the northern North Carolina coast and from a pre-enrichment blood culture from a second harbor porpoise. The second porpoise was captured out of habitat (in a low-salinity canal along the northern North Carolina coast) and relocated back into the ocean. Subsequently, DNA was amplified by conventional polymerase chain reaction for DNA sequencing. The 16S-23S intergenic transcribed spacer region obtained from each porpoise was 99.8% similar to that of B. henselae strain San Antonio 2 (SA2), whereas both heme-binding phage-associated pap31 gene sequences were 100% homologous to that of B. henselae SA2. Currently, the geographic distribution, mode of transmission, reservoir potential, and pathogenicity of bloodborne Bartonella species in porpoises have not been determined.     

Ocular bartonellosis in an HIV-HVC coinfected patient

Bartonella henselae is the etiologic agent of the cat scratch disease and in immunocompromised patients, of bacillary angiomatosis and peliosis hepatis. Less often, ocular complications associated with B. henselae infection have been reported in immunocompetent patients and five times in HIV-infected patients. We report the case of a 42-year-old woman, coinfected by HIV-HCV, presenting with cirrhosis, who owned a cat and was hospitalized for bilateral loss of visual acuity. Ophthalmologic examination revealed bilateral papillitis with hyalitis. Nuclear magnetic resonance revealed a retrobulbar neuritis. Confirmation was given by blood tests positive for B. henselae and the exclusion of other causes of neuroretinitis with biological data. Doxycycline cured the disease rapidly.     

Infections dues to Bartonella spp.

The genus Bartonella now includes four species which may infect humans : B. bacilliformis, B. quintana, B. henselae, and B. elizabethae. B. bacilliformis, the agent of Carrion's disease, was the only species of the genus since 1993 when Rochalimaea species were removed from the genus Rochalimaea and included in the genus Bartonella, within the family Bartonellaceae. B. quintana is the etiologic agent of trench fever, bacillary angiomatosis, septicemia, endocarditis, and chronic lymphadenopathy. B. henselae is responsible for bacillary angiomatosis, peliosis of the liver or the spleen, septicemia, endocarditis, and cat scratch disease. There is a single isolate of B. elizabethae, which was recovered from the blood of a patient involved with endocarditis. The spectrum of clinical manifestations related to Bartonella species has extended since 1990, partly because of newly available molecular biological techniques. However, some aspects of Bartonella-related diseases remain unsettled, including epidemiology, physiopathology, and optimum therapy to be administered.     

Multispacer typing of Bartonella henselae isolates from humans and cats, Japan

To determine genotypic distribution of and relationship between human and cat strains of Bartonella henselae,we characterized 56 specimens using multispacer typing (MST). Of 13 MST genotypes identified, 12 were grouped into cluster 1. In Japan, human infections can be caused by B. henselae strains in cluster 1.     

从山东省家犬血液中分离出致病性巴尔通体——文森巴尔通体伯格霍夫亚种

目的调查家犬巴尔通体的带菌状况,分离培养并鉴定菌种.方法将采获的家犬血标本抗凝血接种于含5%去纤维兔血的脑心浸液培养基上,置于37℃含5%CO2培养箱中分离巴尔通体.然后挑选巴尔通体疑似菌落染色镜检,应用聚合酶链反应技术（PCR）在属分类水平鉴定巴尔通体,通过PCR产物限制性片段长度多态性分析（PCR-RFLP）方法在分离菌株及与阳性对照菌株之间鉴别.选择16S rRNA、gltA和16S～23S rRNAITS的PCR产物测序,将所测核酸序列进行同源性比较及系统发育分析确定巴尔通体种或基因型.结果从山东省采获的71份犬血液中分离培养出2株巴尔通体疑似菌株,光镜下观察为革兰染色阴性、微弯曲的细小杆菌,3对巴尔通体属特异性引物扩增结果阳性,PCR-RFLP分析2株分离菌株相同,与阳性对照不同,16S rRNA、gltA和16S～23SrRNA ITS序列分析结果表明2株巴尔通体分离株与文森巴尔通体伯格霍夫亚种的同源性分别为100.0%、99.7%和97.2%.结论山东省家犬中存在巴尔通体感染,分离培养出的菌株经鉴定为文森巴尔通体伯格霍夫亚种,该亚种属于致病性巴尔通体.     

间接酶联免疫吸附试验检测北京市昌平地区体检人群中汉赛巴尔通体抗体

目的调查北京市昌平地区健康体检人群血清汉赛巴尔通体抗体阳性情况。方法用间接酶联免疫吸附试验（ELISA）和免疫荧光抗体（IFA）试剂盒检测体检人群血清汉赛巴尔通体抗体情况。结果以IFA为参考标准，间接ELISA方法的灵敏度为70．6％，特异度为91．6％；阳性预测值为82．2％（60／73），阴性预测值为84．9％。ELISA共检测了357份健康体检人群血清，汉赛巴尔通体抗体阳性率为34．5％，IFA共检测了239份体检血清，其汉赛巴尔通体抗体阳性率为35．6％。结论间接ELISA方法对于检测汉赛巴尔通体感染是一种快速、敏感、特异的方法，昌平地区健康体检人群中存在汉赛巴尔通体抗体阳性的情况。     

A Preliminary Parasitological Survey of Hepatozoon Spp. Infection in Dogs in Mashhad,Iran

Background

We attempted to determine the prevalence of Hepatozoon spp. infection in Mashhad, northeast of Iran, via blood smear parasitology.

Methods

The prevalence was investigated by examination of blood smear parasitology, using blood samples collected from 254 dogs (51 strays and 203 privately owned-dogs).

Results

Two stray dogs (2/51; 3.92%) and two privately-owned dogs (2/203; 0.98%) were infected with Hepatozoon spp. Therefore, as per blood smear parasitology, the prevalence of Hepatozoon spp. infection was 1.57% (4/254). Sixteen out of 254 dogs (6.29%) were infested with ticks; all of which were Rhipicephalus sanguineus. One of the dogs infected with Hepatozoon spp. exhibited ticks at the time of examination. Concurrent infection with Ehrlichia canis and Leishmania infantum was not detected in the four Hepatozoon spp. infected dogs.

Conclusion

This is the first epidemiological study on the prevalence of Hepatozoon spp. infection in dogs in Iran.     

实时荧光定量PCR检测汉赛巴通体

目的采用新型TaqMan-MGB探针建立检测汉赛巴通体的实时荧光定量PCR方法。方法根据汉赛巴通体特异的16S-23S rRNA间隔区序列设计引物和探针,以克隆的16S～23S rRNA间隔区基因片段作DNA模板,在荧光定量PCR检测仪(ABI 7900HT)上建立实时荧光定量检测方法,对所建立的方法分别进行敏感性、特异性及重复性分析,并且对模拟标本进行检测。结果建立的定量标准曲线的循环阈值(C_(?))与模板拷贝数呈良好的线性关系(r=0.997);与普通PCR相比较,荧光定量PCR检测的灵敏度是其1000倍。用荧光定量PCR检测其他相关立克次体和细菌DNA样本,除军团菌检出微弱信号(2个拷贝)外,其余检出结果均为0;对重复性进行了评价,批内和批间的变异系数在0.2%～1.9%之间。用荧光定量PCR检测汉赛巴通体感染的小鼠血标本,在感染后第2天、第3天、第5天,检出少量的汉赛巴通体,在感染后的第1天和第2天从脾脏样本中检出大量的汉赛巴通体。结论检测汉赛巴通体实时荧光定量PCR方法具有高度特异性和高敏感性以及良好的重复性,可用于快速检测各种样本中的微量汉赛巴通体以及作为汉赛巴通体感染的实验室诊断。     

浙江省家猫中汉赛巴尔通体感染的流行病学调查

目的查明浙江省家猫汉赛巴尔通体感染情况。方法采集家猫股静脉血，一半留全血，一半分离血清，用分离培养和聚合酶链反应检测全血，用ELISA检测血清，计算感染情况。结果浙江省各地家猫汉赛巴尔通体抗体阳性率平均为34．5％，江山、龙游、安吉、淳安、建德和上虞市（县）的阳性率分别为37．5％、30．0％、33．3％、40．0％、50．0％和28．6％，各地之间阳性率差异无统计学意义；雌性猫阳性率为36．0％，雄性为33．3％，二者间的阳性率差异亦无统计学意义。结论浙江省各地家猫汉赛巴尔通体抗体阳性率均较高，存在传播给人的风险，必须采取措施加以控制。