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Bartonella quintana and Bartonella vinsonii subsp. vinsonii bloodstream co-infection in a girl from North Carolina, USA

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Abstract

The genus Bartonella consists of globally distributed and highly diverse alpha-proteobacteria that infect a wide-range of mammals. Medically, Bartonella spp. constitute emerging, vector-borne, zoonotic, intravascular organisms that induce long-lasting bacteremia in reservoir-adapted (passive carrier of a microorganism) hosts. At times, these bacteria are accidentally transmitted by animal scratches, bites, needles sticks or vectors to animal or human hosts. We report the first documented human case of blood stream infection with Bartonella vinsonii subsp. vinsonii in a girl from North Carolina, USA, who was co-infected with Bartonella quintana. Limitations of Bartonella spp. serology and the challenges of microbiological culture and molecular diagnostic confirmation of co-infection with more than one Bartonella spp. are discussed. When and where these infections were acquired is unknown; however, exposure to rodents, fleas and cats in the peri-equestrian environment was a suspected source for transmission of both organisms.

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References

  1. Iannino F, Salucci S, Di Provvido A, Paolini A, Ruggieri E (2018) Bartonella infections in humans dogs and cats. Vet Ital 54:63–72

    PubMed  Google Scholar 

  2. Regier Y, O Rourke F, Kempf VA (2016) Bartonella spp.—a chance to establish One Health concepts in veterinary and human medicine. Parasit Vectors 9:261

    Article  PubMed  PubMed Central  Google Scholar 

  3. Breitschwerdt EB. Bartonellosis (2014) One health perspectives for an emerging infectious disease. ILAR J 55:46–58

    Article  PubMed  CAS  Google Scholar 

  4. Baker JA A rickettsia1 infection in Canadian voles. J. Exp. Med. 1946; 84;37–51

  5. Kordick DL, Swaminathan B, Greene CE, Wilson KH, Whitney AM, O’Connor S, Hollis DG, Matar GM, Steigerwalt AG, Malcolm GB, Hayes PS, Hadfield TL, Breitschwerdt EB, Brenner DJ (1996) Bartonella vinsonii subsp. berkhoffii subsp. nov., isolated from dogs; Bartonella vinsonii subsp. vinsonii; and emended description of Bartonella vinsonii. Int J Syst Bacteriol 46:704–709

    Article  PubMed  CAS  Google Scholar 

  6. Hofmeister EK, Kolbert CP, Abdulkarim AS, Magera JM, Hopkins MK, Uhl JR, Ambyaye A, Telford SR 3rd, Cockerill FR 3rd, Persing DH (1998) Cosegregation of a novel Bartonella species with Borrelia burgdorferi and Babesia microti in Peromyscus leucopus. J Infect Dis 177:409–416

    Article  PubMed  CAS  Google Scholar 

  7. Schulte Fischedick FB, Stuckey MJ, Aguilar-Setién A, Moreno-Sandoval H, Galvez-Romero G, Salas-Rojas M, Arechiga-Ceballos N, Overgaauw PA, Kasten RW, Chomel BB (2016) Identification of Bartonella Species Isolated from Rodents from Yucatan, Mexico, and Isolation of Bartonella vinsonii subsp. yucatanensis subsp. nov. Vector Borne Zoonotic Dis 16:636–642

    Article  PubMed  Google Scholar 

  8. Roux V, Eykyn SJ, Wyllie S, Raoult D (2000) Bartonella vinsonii subsp. berkhoffii as an agent of afebrile blood culture-negative endocarditis in a human. J Clin Microbiol 38:1698–1700

    PubMed  CAS  PubMed Central  Google Scholar 

  9. Fenollar F, Sire S, Raoult D (2005) Bartonella vinsonii subsp. arupensis as an agent of blood culture-negative endocarditis in a human. J Clin Microbiol 43:945–947

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Oteo JA, Maggi R, Portillo A, Bradley J, García-Álvarez L, San-Martín M, Roura X, Breitschwerdt E (2017) Prevalence of Bartonella spp. by culture, PCR and serology, in veterinary personnel from Spain. Parasit Vectors 10:553

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Lantos PM, Maggi RG, Ferguson B, Varkey J, Park LP, Breitschwerdt EB, Woods CW (2014) Detection of Bartonella species in the blood of veterinarians and veterinary technicians: a newly recognized occupational hazard? Vector Borne Zoonotic Dis 14:563–570

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hegarty BC, Bradley JM, Lappin MR, Balakrishnan N, Mascarelli PE, Breitschwerdt EB (2014) Analysis of seroreactivity against cell culture-derived Bartonella spp. antigens in dogs. J Vet Intern Med 28:38–41

    Article  PubMed  CAS  Google Scholar 

  13. Tamura K, Nei M (1993) Estimation of the number of nucleotide substitutions in the control region of mitochondrial DNA in humans and chimpanzees. Mol Biol Evol 10:512–526

    PubMed  CAS  Google Scholar 

  14. Kumar S, Stecher G, Tamura K (2016) MEGA7: Molecular Evolutionary Genetics Analysis version 7.0 for bigger datasets. Mol Biol Evol 33:1870–1874

    Article  PubMed  CAS  Google Scholar 

  15. Mozayeni BR, Maggi RG, Bradley JM, Breitschwerdt EB (2018) Rheumatological presentation of Bartonella koehlerae and Bartonella henselae bacteremias: a case report. Medicine (Baltimore) 97:e0465

    Article  Google Scholar 

  16. Maggi RG, Mascarelli PE, Pultorak EL, Hegarty BC, Bradley JM, Mozayeni BR, Breitschwerdt EB (2011) Bartonella spp. bacteremia in high-risk immunocompetent patients. Diagn Microbiol Infect Dis 71:430–437

    Article  PubMed  Google Scholar 

  17. Vayssier-Taussat M, Moutailler S, Féménia F, Raymond P, Croce O, La Scola B, Fournier PE, Raoult D (2016) Identification of Novel Zoonotic Activity of Bartonella spp., France. Emerg Infect Dis 22:457–462

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  18. Kwon HY, Park YK, Lee SM, Baek JH, Kang JS, Chung MH, Kim EJ, Lee JS (2018) Characterization of clinical isolates of Bartonella henselae Strains, South Korea. Emerg Infect Dis 24:912–915

    Article  PubMed  PubMed Central  Google Scholar 

  19. Duncan AW, Maggi RG, Breitschwerdt EB (2007) A combined approach for the enhanced detection and isolation of Bartonella species in dog blood samples: pre-enrichment culture followed by PCR and subculture onto agar plates. J Microbiol Meth 69:273–281

    Article  CAS  Google Scholar 

  20. Riess T, Dietrich F, Schmidt KV, Kaiser PO, Schwarz H, Schäfer A, Kempf VA (2008) Analysis of a novel insect cell culture medium-based growth medium for Bartonella species. Appl Environ Microbiol 74:5224–5227

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. La Scola B, Raoult D (1999) Culture of Bartonella quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998). J Clin Microbiol 37:1899–1905

    PubMed  PubMed Central  Google Scholar 

  22. Lynch T, Iverson J, Kosoy M (2011) Combining culture techniques for Bartonella: the best of both worlds. J Clin Microbiol 49:1363–1368

    Article  PubMed  PubMed Central  Google Scholar 

  23. Pultorak EL, Maggi RG, Mascarelli PE, Breitschwerdt EB (2013) Serial testing from a 3-day collection period by use of the Bartonella Alphaproteobacteria growth medium platform may enhance the sensitivity of Bartonella species detection in bacteremic human patients. J Clin Microbiol 51:1673–1677

    Article  PubMed  PubMed Central  Google Scholar 

  24. Varanat M, Maggi RG, Linder KE, Breitschwerdt EB (2011) Molecular prevalence of Bartonella, Babesia, and hemotropic Mycoplasma sp. in dogs with splenic disease. J Vet Intern Med 25:1284–1291

    Article  PubMed  CAS  Google Scholar 

  25. Donovan TA, Balakrishnan N, Carvalho Barbosa I, McCoy T, Breitschwerdt EB, Fox PR (2018) Bartonella spp. as a possible cause or cofactor of feline endomyocarditis-Left ventricular endocardial fibrosis complex. J Comp Path 162:29–42

    Article  PubMed  CAS  Google Scholar 

  26. Viezens J, Arvand M (2008) Simultaneous presence of two different copies of the 16S rRNA gene in Bartonella henselae. Microbiology 154:2881–2886

    Article  PubMed  CAS  Google Scholar 

  27. Kosoy M, McKee C, Albayrak L, Fofanov Y (2018) Genotyping of Bartonella bacteria and their animal hosts: current status and perspectives. Parasitology 145:543–562

    Article  PubMed  CAS  Google Scholar 

  28. Okaro U, Addisu A, Casanas B, Anderson B (2017) Bartonella species, an emerging cause of blood-culture-negative endocarditis. Clin Microbiol Rev 30:709–746

    Article  PubMed  PubMed Central  Google Scholar 

  29. Pitassi LH, de Paiva Diniz PP, Scorpio DG, Drummond MR, Lania BG, Barjas-Castro ML, Gilioli R, Colombo S, Sowy S, Breitschwerdt EB, Nicholson WL, Velho PE (2015) Bartonella spp. bacteremia in blood donors from Campinas, Brazil. PLoS Negl Trop Dis 9:e0003467

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  30. Diniz PP, Velho PE, Pitassi LH, Drummond MR, Lania BG, Barjas-Castro ML, Sowy S, Breitschwerdt EB, Scorpio DG (2016) Risk factors for bartonella species infection in blood donors from Southeast Brazil. PLoS Negl Trop Dis 10:e0004509

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  31. Breitschwerdt EB, Maggi RG, Nicholson WL, Cherry NA, Woods CW (2008) Bartonella sp. bacteremia in patients with neurological and neurocognitive dysfunction. J Clin Microbiol 46:2856–2861

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  32. Kaufman DL, Kogelnik AM, Mozayeni RB, Cherry NA, Breitschwerdt EB (2017) Neurological and immunological dysfunction in two patients with Bartonella henselae bacteremia. Clin Case Rep 5:931–935

    Article  PubMed  PubMed Central  Google Scholar 

  33. Breitschwerdt EB, Linder KL, Day MJ, Maggi RG, Chomel BB, Kempf VA (2013) Koch’s postulates and the pathogenesis of comparative infectious disease causation associated with Bartonella species. J Comp Pathol 148:115–125

    Article  PubMed  CAS  Google Scholar 

  34. Kosoy M, Bai Y, Sheff K, Morway C, Baggett H, Maloney SA, Boonmar S, Bhengsri S, Dowell SF, Sitdhirasdr A, Lerdthusnee K, Richardson J, Peruski LF (2010) Identification of Bartonella infections in febrile human patients from Thailand and their potential animal reservoirs. Am J Trop Med Hyg 82(6):1140–1145

    Article  PubMed  PubMed Central  Google Scholar 

  35. McVea DA, Himsworth CG, Patrick DM, Lindsay LR, Kosoy M, Kerr T (2018) Exposure to rats and rat-associated leptospira and bartonella species among people who use drugs in an impoverished, inner-city neighborhood of Vancouver, Canada. Vector Borne Zoonotic Dis 18:82–88

    Article  PubMed  PubMed Central  Google Scholar 

  36. Fernández-González AM, Kosoy MY, Rubio AV, Graham CB, Montenieri JA, Osikowicz LM, Bai Y, Acosta-Gutiérrez R, Ávila-Flores R, Gage KL, Suzán G (2016) Molecular survey of Bartonella species and yersinia pestis in rodent fleas (Siphonaptera) from Chihuahua, Mexico. J Med Entomol 53:199–205

    Article  PubMed  CAS  Google Scholar 

  37. Kamani J, Morick D, Mumcuoglu KY, Harrus S (2013) Prevalence and diversity of Bartonella species in commensal rodents and ectoparasites from Nigeria, West Africa. PLoS Negl Trop Dis 7:e2246

    Article  PubMed  PubMed Central  Google Scholar 

  38. Lei BR, Olival KJ (2014) Contrasting patterns in mammal–bacteria coevolution: bartonella and leptospira in bats and rodents. PLoS Negl Trop Dis 8:e2738

    Article  PubMed  PubMed Central  Google Scholar 

  39. Breitschwerdt EB, Maggi RG, Sigmon B, Nicholson WL (2007) Isolation of Bartonella quintana from a woman and a cat following putative bite transmission. J Clin Microbiol 45:270–272

    Article  PubMed  CAS  Google Scholar 

  40. Breitschwerdt EB, Mascarelli PE, Schweickert LA, Maggi RG, Hegarty BC, Bradley JM, Woods CW (2011) Hallucinations, sensory neuropathy, and peripheral visual deficits in a young woman infected with Bartonella koehlerae. J Clin Microbiol 49:3415–3417

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  41. Pappalardo BL, Correa MT, York CC, Peat CY, Breitschwerdt EB (1997) Epidemiologic evaluation of the risk factors associated with exposure and seroreactivity to Bartonella vinsonii in dogs. Am J Vet Res 58:467–471

    PubMed  CAS  Google Scholar 

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Acknowledgements

This study was supported in part by the state of North Carolina and donations to the North Carolina State University College of Veterinary Medicine Foundation fund for Bartonella/Vector Borne Disease Research. The authors thank Julie M. Bradley, Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, for technical assistance.

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  1. Intracellular Pathogens Research Laboratory, Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, NC, 27607, USA

    Edward B. Breitschwerdt & Ricardo G. Maggi

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  1. Edward B. Breitschwerdt
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  2. Ricardo G. Maggi
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Correspondence to Edward B. Breitschwerdt.

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Conflict of interest

E.B.B., in conjunction with Sushama Sontakke and North Carolina State University, holds US Patent No. 7,115,385, Media and Methods for Cultivation of Microorganisms, which was issued October 3, 2006. E.B.B. is a founder, shareholder and the chief scientific officer for Galaxy Diagnostics, a company that provides diagnostic testing for the detection of Bartonella species and other vector borne pathogens in animals and human patients. R.G. Maggi has lead research efforts to optimize the BAPGM platform and is the scientific technical advisor for Galaxy Diagnostics.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. North Carolina State University (NCSU) Institutional Review Board provided (IRB 1960) ethical approval for this study.

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Informed consent was obtained from the parents of the participant included in this study.

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Breitschwerdt, E.B., Maggi, R.G. Bartonella quintana and Bartonella vinsonii subsp. vinsonii bloodstream co-infection in a girl from North Carolina, USA. Med Microbiol Immunol 208, 101–107 (2019). https://doi.org/10.1007/s00430-018-0563-0

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  • DOI: https://doi.org/10.1007/s00430-018-0563-0

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