Seroprevalence of Bartonella species, Coxiella burnetii and Toxoplasma gondii among patients with hematological malignancies: A pilot study in Romania.
Patients receiving immunosuppressive cancer treatments in settings where there is a high degree of human-animal interaction may be at increased risk for opportunistic zoonotic infections or reactivation of latent infections. We sought to determine the seroprevalence of selected zoonotic pathogens among patients diagnosed with haematologic malignancies and undergoing chemotherapeutic treatments in Romania, where much of the general population lives and/or works in contact with livestock. A convenience sample of 51 patients with haematologic cancer undergoing chemotherapy at a referral clinic in Cluj-Napoca, Romania, was surveyed regarding animal exposures. Blood samples were obtained and tested for evidence of infection with Bartonella species, Coxiella burnetii and Toxoplasma gondii, which are important opportunistic zoonotic agents in immunocompromised individuals. 58.8% of participants reported living or working on a farm, and living or working on a farm was associated with contact with livestock and other animals. 37.5% of participants were IgG seroreactive against one or more of five Bartonella antigens, and seroreactivity was statistically associated with living on farms. Farm dwellers were 3.6 times more likely to test IgG seroreactive to Bartonella antibodies than non-farm dwellers. 47.1% of the participants tested T. gondii IgG positive and 13.7% tested C. burnetii IgG positive, indicating past or latent infection. C. burnetii IgM antibodies were detected in four participants (7.8%), indicating possible recent infection. These results indicate that a large proportion of patients with haematologic cancer in Romania may be at risk for zoonotic infections or for reactivation of latent zoonotic infections, particularly with respect to Bartonella species. Special attention should be paid to cancer patients' exposure to livestock and companion animals in areas where much of the population lives in rural settings.
Yale University, New Haven, CT, USA.
C J
0000-0002-0992-2111
CJ
Messinger
Environmental Health Center, Cluj-Napoca, Romania.|Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
E S
ES
Gurzau
Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.|Galaxy Diagnostics, Research Triangle Park, NC, USA.
E B
EB
Breitschwerdt
Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.|Department of Hematology, Oncology Institute Ion Chiricuta, Cluj-Napoca, Romania.
C I
CI
Tomuleasa
Center for One Health Research, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
S J
SJ
Trufan
Microbiology Laboratory, Infectious Diseases Hospital, Cluj-Napoca, Romania.
M M
MM
Flonta
Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.|Galaxy Diagnostics, Research Triangle Park, NC, USA.
R G
RG
Maggi
Research Center for Functional Genomics, Biomedicine and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.|Department of Experimental Pathology, Oncology Institute Ion Chiricuta, Cluj-Napoca, Romania.|Department of Experimental Therapeutics, M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA.
I
I
Berindan-Neagoe
Center for One Health Research, Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.
P M
PM
Rabinowitz
D000328:Adult; D000818:Animals; D001473:Bartonella / Q000302:isolation & purification; D001474:Bartonella Infections / Q000150:complications* / Q000453:epidemiology; D003381:Coxiella / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007938:Leukemia / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011778:Q Fever / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D014122:Toxoplasma / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000150:complications* / Q000453:epidemiology; D015047:Zoonoses

Bartonella
; 
Coxiella burnetii
; 
Toxoplasma
; immunocompromised patients; livestock; seroprevalence; zoonoses