Bartonella koehlerae, a new cat-associated agent of culture-negative human endocarditis.
Bartonella koehlerae is reported for the first time to be a human pathogen that causes culture-negative endocarditis. It is also shown that this species, isolated twice before from domestic cats, can be recovered as well from a stray cat population in Israel. This work follows a recent report of the same case in which the causative agent was misidentified as B. henselae, based on serology and PCR-restriction fragment length polymorphism (RFLP) analysis (A. Schattner, O. Zimhony, B. Avidor, and M. Gilad, Lancet 361:1786, 2003). B. koehlerae was identified in the valvular tissue of an endocarditis patient by DNA sequencing of the PCR products of two Bartonella genes: the genes for citrate synthase (gltA) and riboflavin synthase (ribC). The commonly used PCR-RFLP analysis of the TaqI-digested gltA PCR product did not distinguish between B. koehlerae and B. quintana or between B. elizabethae and B. clarridgeiae. PmlI digestion of the gltA amplification product failed to differentiate between B. quintana, B. clarridgeiae, and B. elizabethae. RFLP analysis of the heat shock protein (htrA) gene by TaqI digestion misidentified B. koehlerae as B. henselae. However, RFLP analysis of the ribC PCR product, digested with TaqI, was able to distinguish between the human endocarditis-associated Bartonella species tested, B. henselae, B. quintana, B. elizabethae, and B. koehlerae, as well as between the cat-associated Bartonella species, B. henselae and B. clarridgeiae. Given the expanding number of Bartonella species emerging as human pathogens, it is suggested that PCR-RFLP analysis for the diagnosis of Bartonella infections target several genes and be coupled with DNA sequencing to avoid species identification.
Avidor
Boaz
B
The Bernard Pridan Laboratory for Molecular Biology of Infectious Diseases. Tel-Aviv Sourasky Medical Center, 6 Weizmann St., Tel-Aviv 64239, Israel. bavidor@tasmc.health.gov.il
Graidy
Merav
M
Efrat
Gabi
G
Leibowitz
Cecilia
C
Shapira
Gregory
G
Schattner
Ami
A
Zimhony
Oren
O
Giladi
Michael
M
D001473:Bartonella / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D001474:Bartonella Infections / Q000175:diagnosis*; D018416:Bartonella henselae / Q000235:genetics / Q000302:isolation & purification; D001483:Base Sequence; D017124:Conserved Sequence; D017931:DNA Primers; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D006801:Humans; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D016415:Sequence Alignment; D012689:Sequence Homology, Nucleic Acid; D012697:Serine Endopeptidases / Q000235:genetics
D017931:DNA Primers; D012697:Serine Endopeptidases