title: Multi-Locus Sequence Typing of Bartonella bacilliformis DNA Performed Directly from Blood of Patients with Oroya's Fever During a Peruvian Outbreak.
abstract: BACKGROUND
  Bartonella bacilliformis is the etiological agent of Carrion's disease, a neglected tropical poverty-linked illness. This infection is endemic of Andean regions and it is estimated that approximately 1.7 million of South Americans are at risk. This bacterium is a fastidious slow growing microorganism, which is difficult and cumbersome to isolate from clinical sources, thereby hindering the availability of phylogenetic relationship of clinical samples. The aim of this study was to perform Multi Locus Sequence Typing of B. bacilliformis directly in blood from patients diagnosed with Oroya fever during an outbreak in Northern Peru.
  
  
  RESULTS
  DNA extracted among blood samples from patients diagnosed with Oroya's fever were analyzed with MLST, with the amplification of 7 genetic loci (ftsZ, flaA, ribC, rnpB, rpoB, bvrR and groEL) and a phylogenetic analysis of the different Sequence Types (ST) was performed. A total of 4 different ST were identified. The most frequently found was ST1 present in 66% of samples. Additionally, two samples presented a new allelic profile, belonging to new STs (ST 9 and ST 10), which were closely related to ST1.
  
  
  CONCLUSIONS
  The present data demonstrate that B. bacilliformis MLST studies may be possible directly from blood samples, being a promising approach for epidemiological studies. During the outbreak the STs of B. bacilliformis were found to be heterogeneous, albeit closely related, probably reflecting the evolution from a common ancestor colonizing the area. Additional studies including new samples and areas are needed, in order to obtain better knowledge of phylogenetic scenario B. bacilliformis.
authors.affiliation: Centro de Investigación de la Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Pons
authors.affiliation: Centro de Investigación de la Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
authors.forename: Wilmer
authors.initials: W
authors.lastname: Silva-Caso
authors.affiliation: Centro de Investigación de la Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru.
authors.forename: Juana
authors.initials: J
authors.lastname: Del Valle-Mendoza
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Spain.
authors.forename: Joaquim
authors.identifier: http://orcid.org/0000-0002-4431-2036
authors.initials: J
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D001474:Bartonella Infections / Q000453:epidemiology / Q000382:microbiology*; D045503:Bartonella bacilliformis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000097:blood / Q000235:genetics*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D010568:Peru / Q000453:epidemiology; D010802:Phylogeny; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial
references.citation: Infect Dis Clin North Am. 2000 Mar;14(1):1-22, vii
references.pmid: 10738670
references.citation: Rev Gastroenterol Peru. 1997 Jan-Apr;17(1):31-43
references.pmid: 12221435
references.citation: J Infect Dis. 2002 Oct 1;186(7):983-90
references.pmid: 12232839
references.citation: J Clin Microbiol. 2002 Oct;40(10):3606-12
references.pmid: 12354853
references.citation: J Clin Microbiol. 2003 Nov;41(11):5071-9
references.pmid: 14605141
references.citation: J Clin Microbiol. 2004 Aug;42(8):3675-80
references.pmid: 15297516
references.citation: Clin Dermatol. 2009 May-Jun;27(3):271-80
references.pmid: 19362689
references.citation: Med Hypotheses. 2010 Jan;74(1):45-9
references.pmid: 19665314
references.citation: PLoS One. 2010 Mar 19;5(3):e9765
references.pmid: 20333257
references.citation: Epidemics. 2010 Dec;2(4):165-72
references.pmid: 21352787
references.citation: Mol Biol Evol. 2011 Oct;28(10):2731-9
references.pmid: 21546353
references.citation: PLoS Negl Trop Dis. 2011 Jul;5(7):e1248
references.pmid: 21811647
references.citation: PLoS Negl Trop Dis. 2012;6(10):e1819
references.pmid: 23145188
references.citation: J Clin Microbiol. 2013 Nov;51(11):3865-8
references.pmid: 23985925
references.citation: PLoS One. 2013 Nov 21;8(11):e80894
references.pmid: 24278342
references.citation: PLoS One. 2014 Mar 20;9(3):e92283
references.pmid: 24651298
references.citation: J Glob Antimicrob Resist. 2015 Sep;3(3):222-223
references.pmid: 27873715
references.citation: FEMS Microbiol Lett. 1996 Oct 15;144(1):1-11
references.pmid: 8870245
references.citation: Proc Natl Acad Sci U S A. 1998 Mar 17;95(6):3140-5
references.pmid: 9501229