title: Seroprevalence to Bartonella quintana among patients at a community clinic in downtown Seattle.
abstract: In 1993, an outbreak of 10 cases of Bartonella quintana bacteremia occurred among homeless, alcoholic, human immunodeficiency virus (HIV)-negative persons in Seattle. To estimate the prevalence of past exposure B. quintana among this population, a serosurvey was conducted in 1994 among patients at a downtown Seattle clinic. Microimmunofluorescent titers to B. quintana in 192 clinic patients were compared with titers in 199 age- and sex-matched Seattle volunteer blood donors. Titers > or = 64 were detected in 20% (39/192) of clinic patients compared with 2% (4/199) of blood donors (P<.001). Among clinic patients, alcohol abuse was independently associated in multivariate analysis with titers > or = 64 (odds ratio, 3.3; 95% confidence interval, 1.6-6.9). Of the 39 patients with B. quintana titers > or = 64, 24 (62%) also had titers > or = 64 to Bartonella henselae, indicating serologic cross-reactivity between Bartonella species. These results suggest that a substantial proportion of this indigent, inner-city Seattle population was infected with B. quintana.
authors.affiliation: Department of Epidemiology (School of Public Health and Community Medicine), Seattle, WA 98195, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Jackson
authors.forename: D H
authors.initials: DH
authors.lastname: Spach
authors.forename: D A
authors.initials: DA
authors.lastname: Kippen
authors.forename: N K
authors.initials: NK
authors.lastname: Sugg
authors.forename: R L
authors.initials: RL
authors.lastname: Regnery
authors.forename: M H
authors.initials: MH
authors.lastname: Sayers
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000293:Adolescent; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D018413:Bartonella quintana / Q000276:immunology*; D003151:Community Health Centers; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012698:Serologic Tests; D014205:Trench Fever / Q000453:epidemiology*; D014861:Washington
chemical_list: D000907:Antibodies, Bacterial