title: Bartonella spp. bacteremia in high-risk immunocompetent patients.
abstract: Serum and blood samples from 192 patients, who reported animal exposure (100.0%) and recent animal bites or scratches (88.0%), were screened for antibodies by indirect immunofluorescence assays and for bacteremia using the BAPGM (Bartonella alpha Proteobacteria growth medium) platform. Predominant symptoms included fatigue (79.2%), sleeplessness (64.1%), joint pain (64.1%), and muscle pain (63.0%). Bartonella spp. seroreactivity or bacteremia was documented in 49.5% (n = 95) and 23.9% (n = 46) of the patients, respectively; however, indirect immunofluorescence antibodies were not detected in 30.4% (n = 14) of bacteremic patients. Regarding components of the BAPGM platform, Bartonella DNA was amplified from 7.5% of blood (n = 21), 8.7% of serum (n = 25), and 10.3% of enrichment culture samples (n = 29). Polymerase chain reaction (PCR) on only extracted blood would not have detected Bartonella infection in 34.7% (16/46) of bacteremic patients. Serology, in conjunction with blood, serum, and BAPGM enrichment culture PCR, facilitates the diagnosis of Bartonella spp. bacteremia in immunocompetent patients.
authors: Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
authors: Ricardo G
authors: RG
authors: Maggi
authors: Patricia E
authors: PE
authors: Mascarelli
authors: Elizabeth L
authors: EL
authors: Pultorak
authors: Barbara C
authors: BC
authors: Hegarty
authors: Julie M
authors: JM
authors: Bradley
authors: B Robert
authors: BR
authors: Mozayeni
authors: Edward B
authors: EB
authors: Breitschwerdt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D016470:Bacteremia / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D001431:Bacteriological Techniques / Q000379:methods*; D001473:Bartonella / Q000302:isolation & purification*; D001474:Bartonella Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D001733:Bites and Stings / Q000150:complications; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques / Q000379:methods; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D012867:Skin / Q000293:injuries; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial