Bartonella
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B. alsatica |
- This article is about the bacteria. For the disease, see Bartonellosis.
Bartonella (formerly known as Rochalimaea) is a genus of Gram-negative bacteria. Facultative intracellular parasites, Bartonella species can infect healthy people but are considered especially important as opportunistic pathogens.[1] Bartonella are transmitted by insect vectors such as ticks, fleas, sand flies and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.[2] In June 2007, a new species under the genus, called Bartonella rochalimae, was discovered.[3] This is the sixth species known to infect humans, and the ninth species and subspecies, overall, known to infect humans.
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[edit] History
Bartonella species have been infecting humans for thousands of years, as demonstrated by Bartonella quintana DNA in a 4000 year old tooth.[4] The genus is named after Alberto Leonardo Barton Thompson, a Peruvian scientist born in Argentina.
Bartonella was detected in ticks in 1999.[5] Several species are a human pathogens carried on rats.[6]
In 2001 doctors treating Lyme disease first reported that their patients were co-infected with Bartonella.[5] Multiple reports of this finding seem to indicate that Bartonella is not only a tick borne but a tick-transmitted pathogen;[7].
[edit] Infection cycle
The currently accepted model explaining the infection cycle holds that the transmitting vectors are blood-sucking arthropods and the reservoir hosts are mammals. Immediately after infection, the bacteria colonize a primary niche, the endothelial cells. Every five days, a part of the Bartonella in the endothelial cells are released in the blood stream where they infect erythrocytes. The bacteria then invade and replicate within a phagosomal membrane inside the erythrocytes. Inside the erythrocytes, bacteria multiply until they reach a critical population density. At this point, the Bartonella has simply to wait until it is taken with the erythrocytes by a blood-sucking arthropod.
[edit] Pathophysiology
Bartonella infections are remarkable in the wide range of symptoms an infection can produce: the time course (acute or chronic) as well as the underlying pathology are highly variable.[8]
| Bartonella pathophysiology in humans | ||||
| Species | Human reservoir or incidental host? |
Animal reservoir |
Pathophysiology | Distribution |
|---|---|---|---|---|
| B. bacilliformis | Reservoir | Causes Carrion's disease (Oroya fever, Verruga peruana) | Peru, Ecuador, and Colombia | |
| B. quintana | Reservoir | Causes Trench fever, Bacillary angiomatosis, and endocarditis | Worldwide | |
| B. clarridgeiae | Incidental | Domestic cat | Cat-scratch Disease | |
| B .elizabethae | Incidental | Rat | Endocarditis | |
| B. grahamii | Incidental | Mouse | Endocarditis and Neuroretinitis | |
| B. henselae | Incidental | Domestic cat | Cat-scratch Disease, Bacillary angiomatosis, Peliosis hepatis, Endocarditis, Bacteremia with fever and Neuroretinitis | Worldwide |
| B. koehlerae | Incidental | Domestic cat | ||
| B. vinsonii | Incidental | Mouse, Dog | ||
| B. washoensis | Incidental | Squirrel | Myocarditis | |
| B. rochalimae | Incidental | Unknown | Carrion´s disease like symptoms | |
| References: [9][10][11] | ||||
[edit] Treatment
Treatment is dependent on which strain of Bartonella is found in a given patient. While Bartonella species are susceptible to a number of standard antibiotics in vitro—macrolides and tetracycline, for example—the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.[8] Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and rifampin; B. henselae is generally resistant to penicillin, amoxicillin, and nafcillin.[8]
[edit] Epidemiology
Whether because rodent associated, IV transmitted or because tick borne disease is higher risk for the homeless, homeless IV drug users are at high risk for Bartonella infections, particularly B. elizabethae. B. elizabethae seropositivity rates in this population range from 12.5% in Los Angeles,[12] to 33% in Baltimore, Maryland,[13] 46% in New York,[14] and in Sweden 39%.[15]
[edit] see also
[edit] References
- ^ Walker DH (1996). Rickettsiae. In: Barron's Medical Microbiology (Barron S et al, eds.), 4th ed., Univ of Texas Medical Branch. ISBN 0-9631172-1-1.
- ^ Chomel BB, Boulouis HJ (2005). "[Zoonotic diseases caused by bacteria of the genus Bartonella genus: new reservoirs ? New vectors?]" (in French). Bull. Acad. Natl. Med. 189 (3): 465-77; discussion 477-80. PMID 16149211.
- ^ Eremeeva ME, Gerns HL, Lydy SL, et al (2007). "Bacteremia, Fever, and Splenomegaly Caused by a Newly Recognized Bartonella Species". N Engl J Med 356: 2381–7. doi:.
- ^ Drancourt M, Tran-Hung L, Courtin J, Lumley H, Raoult D (2005). "Bartonella quintana in a 4000-year-old human tooth". J. Infect. Dis. 191 (4): 607-11. doi:. PMID 15655785.
- ^ a b Schouls LM, Van De Pol I, Rijpkema SG, Schot CS (1999). "Detection and identification of Ehrlichia, Borrelia burgdorferi sensu lato, and Bartonella species in Dutch Ixodes ricinus ticks". J. Clin. Microbiol. 37 (7): 2215-22. PMID 10364588.
- ^ RatBehavior.org
- ^ Stricker RB, Brewer JH, Burrascano JJ, et al (2006). "Possible role of tick-borne infection in "cat-scratch disease": comment on the article by Giladi et al". Arthritis Rheum. 54 (7): 2347-8. doi:. PMID 16802385.
- ^ a b c Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D (2004). "Recommendations for treatment of human infections caused by Bartonella species". Antimicrob. Agents Chemother. 48 (6): 1921-33. doi:. PMID 15155180.
- ^ Zeaiter Z, Liang Z, Raoult D (2002). "Genetic classification and differentiation of Bartonella species based on comparison of partial ftsZ gene sequences". J. Clin. Microbiol. 40 (10): 3641-7. doi:. PMID 12354859.
- ^ Jacomo V, Kelly PJ, Raoult D (2002). "Natural history of Bartonella infections (an exception to Koch's postulate)". Clin. Diagn. Lab. Immunol. 9 (1): 8-18. doi:. PMID 11777823.
- ^ Maco V, Maguiña C, Tirado A, Maco V, Vidal JE (2004). "Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru". Rev. Inst. Med. Trop. Sao Paulo 46 (3): 171-4. doi:. PMID 15286824.
- ^ Smith HM, Reporter R, Rood MP, et al (2002). "Prevalence study of antibody to ratborne pathogens and other agents among patients using a free clinic in downtown Los Angeles". J. Infect. Dis. 186 (11): 1673-6. doi:. PMID 12447746.
- ^ Comer JA, Flynn C, Regnery RL, Vlahov D, Childs JE (1996). "Antibodies to Bartonella species in inner-city intravenous drug users in Baltimore, Md". Arch. Intern. Med. 156 (21): 2491-5. doi:. PMID 8944742.
- ^ Comer JA, Diaz T, Vlahov D, Monterroso E, Childs JE (2001). "Evidence of rodent-associated Bartonella and Rickettsia infections among intravenous drug users from Central and East Harlem, New York City". Am. J. Trop. Med. Hyg. 65 (6): 855-60. PMID 11791987.
- ^ McGill S, Hjelm E, Rajs J, Lindquist O, Friman G (2003). "Bartonella spp. antibodies in forensic samples from Swedish heroin addicts". Ann. N. Y. Acad. Sci. 990: 409-13. PMID 12860665.
