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Current knowledge of Bartonella species
Abstract:
Bartonella species are now considered emerging pathogens. Of the 11 currently recognized species, four have been implicated in human disease, although only two have been encountered in Europe. Bartonella quintana infections are now being diagnosed among the urban homeless and deprived, manifesting as trench fever, and Bartonella henselae has been shown to be the causative agent of cat scratch disease. Both species also cause a variety of HIV-associated infections, including bacillary anglomatosis. However, perhaps the most significant presentation of bartonellae infection is culture-negative endocarditis. The epidemiologies of Bartonella infections are poorly understood; most Bartonella henselae infections are probably acquired from infected cats, either directly by contact with a cat or indirectly via fleas. No animal reservoir has been implicated for Bartonella quintana; however, infection can be transmitted via the human body louse. Diagnosis of Bartonella infections can be made using histological or microbiological methods. The demonstration of specific antibodies may be useful in some instances, although certainly not in all. Cultivation of Bartonella is difficult, as the bacteria are extremely fastidious. Polymerase chain reaction-based or immunological methods for the detection of bartonella in infected tissues have proven useful. Clinical relapse is often associated with Bartonella infections despite a wide range of prescribed regimens. Only aminoglycosides display in vitro bactericidal activity against intracellular Bartonella species; therefore, they are recommended for treatment of Bartonella infections.
Insights
Bartonella bacteria are emerging pathogens causing diseases like trench fever and cat scratch disease. Aminoglycosides are recommended for treatment due to their bactericidal activity against intracellular Bartonella.
Area of Science:
- Infectious Diseases
- Bacteriology
- Public Health
Background:
- Bartonella species are recognized as emerging infectious agents.
- Four of eleven species cause human disease, with two prevalent in Europe.
- Bartonella quintana causes trench fever in the homeless, and Bartonella henselae causes cat scratch disease.
Purpose of the Study:
- To review the epidemiology, diagnosis, and treatment of Bartonella infections.
- To highlight significant Bartonella-associated conditions, including HIV-related infections and culture-negative endocarditis.
- To discuss challenges in Bartonella diagnosis and treatment.
Main Methods:
- Review of existing literature on Bartonella epidemiology, clinical manifestations, and diagnostics.
- Discussion of diagnostic techniques including histology, microbiology, serology, and molecular methods (PCR).
- Analysis of treatment strategies and in vitro antimicrobial activity, focusing on bactericidal effects.
Main Results:
- Bartonella infections present with diverse clinical syndromes, notably trench fever, cat scratch disease, HIV-associated infections, and culture-negative endocarditis.
- Epidemiology is poorly understood; transmission routes include cats/fleas for B. henselae and body lice for B. quintana.
- Diagnosis is challenging due to fastidious bacterial growth, with PCR and immunological methods showing utility.
- Clinical relapses are common despite various treatment regimens.
Conclusions:
- Bartonella infections pose a significant public health challenge due to their emerging nature and diverse manifestations.
- Effective diagnosis requires a combination of methods, while treatment necessitates agents with proven bactericidal activity.
- Aminoglycosides demonstrate in vitro bactericidal activity against intracellular Bartonella and are recommended for treatment.