Bartonella henselae infection in the pediatric solid organ transplant recipient.

Bartonella henselae infection can cause a wide spectrum of diseases in both the immunocompetent and immunocompromised host with BA a severe form relegated to immunocompromised hosts, including solid organ transplant population. There are established criteria for diagnosis of Bartonella infection based on clinical presentation, serologic testing, imaging studies and, when indicated, tissue sampling for histopathological evaluation, particularly for BA. However, treatment recommendations for BA are inconclusive. Furthermore, there are no studies in the pediatric solid organ transplant population for antimicrobial therapy during BA secondary to Bartonella henselae infection. A case of BA following heart transplant is presented along with a literature review of clinical presentation; diagnosis and therapy for BA in the pediatric solid organ transplant population.

Atypical bartonellosis in children: What do we know?

AIM: To characterise Bartonella infections in a paediatric population requiring hospital admission and review its treatment. METHODS: Longitudinal observational retrospective data analysis of children and adolescents admitted with Bartonella infection at a paediatric tertiary hospital from 2010 to 2019. RESULTS: We identified 16 cases of bartonellosis, with a mean age of 8.0 ± 4.5 years old, no sex predominance and 14 had contact with cats. Most of the cases occurred in fall and winter. Clinical presentations included osteomyelitis/arthritis (n = 9), hepatosplenic disease (n = 2), lymphadenitis (n = 2), neuroretinitis (n = 2) and encephalitis (n = 1). Clinical diagnosis was confirmed by serology (n = 16) and Bartonella DNA detection in patient's lymph nodes/hepatic lesion (n = 3). Therapeutic approach varied according to the clinical presentation: azithromycin in lymphadenitis, rifampicin plus ciprofloxacin in hepatosplenic disease, rifampicin and doxycycline in neuroretinitis, ceftriaxone in encephalitis and azithromycin, cotrimoxazole or rifampicin plus azithromycin, cefuroxime, ciprofloxacin or doxycycline in osteomyelitis/arthritis. Immunodeficiency was excluded in seven patients. Seven patients' cats were screened by veterinarians and treated when infected (n = 5). CONCLUSIONS: In these clinical presentations, where other infections may be involved, a high index of suspicion is necessary, with emphasis on the epidemiological context. The association of systemic forms with immunodeficiency did not occur in our study. The lack of recommendations for treatment of atypical infection makes the approach of these cases a challenge. Randomised control studies are essential to define the best approach in each case.

Cloning and identification of Bartonella α-enolase as a plasminogen-binding protein.

Bartonella infection is distributed worldwide with animal and public health. Recent studies have shown that host cells infection by Bartonella has a series of different infection stages, beginning with encounter and adherence to the cells. In this study, we expressed and purified recombinant Bartonella henselae (B. henselae) α-enolase. And we found that B. henselae α-enolase is highly conserved in Bartonella species. The interacting protein partners of B. henselae α-enolase were showed by String-11. The interactions between B. henselae α-enolase and human plasminogen were subsequently confirmed by ELISA, pull down, T7 phage display and molecular docking assays. And the plasminogen-binding sites of B. henselae α-enolase are predicted at 247FYKNGSYFY255. These findings will help elucidate and improve the understanding of the molecular mechanisms of Bartonella infection.

Characterization of Clinical Isolates of Bartonella henselae Strains, South Korea.

Bartonella henselae, a gram-negative bacterium, is a common causative agent of zoonotic infections. We report 5 culture-proven cases of B. henselae infection in South Korea. By alignment of the 16S rRNA sequences and multilocus sequencing typing analysis, we identified all isolates as B. henselae Houston-1 strain, which belongs to sequence type 1.

Self-remitting Bartonella neuroretinitis without a cat scratch.

•Bartonella infection is a leading cause in patients with neuroretinitis.•Ocular involvement occurs in 5-10% of people with cat-scratch disease (CSD).•Bartonella neuroretinitis presents without systemic signs and symptoms of CSD.•Some cases with bartonella neuroretinitis could be self-remitted.

Bartonella washoensis infection in red squirrels (Sciurus vulgaris) and their ectoparasites in Lithuania.

This is the first study to investigate the presence of Bartonella infections in different internal organs of red squirrels and their ectoparasites in Lithuania. A total of 39 roadkill red squirrels were collected. Squirrels were infested with Ixodes ricinus ticks (191) and Ceratophyllus sciurorum fleas (36). The presence of Bartonella spp. was screened using 16 S-23 S rRNA internal transcribed spacer region and bacteria were detected in 38.5 % (15/39) samples of squirrels, 1.0 % (2/191) samples of ticks and 55.5 % (20/36) samples of fleas. The infection rate of different internal organs of squirrels varied from 11.1%-47.4%. The 16 S-23 S rRNA ITS region sequences showed that Bartonella washoensis were detected in squirrels and their ectoparasites. The results from this study support the hypothesis that S. vulgaris and their fleas, C.sciurorum, serve as a major reservoir and a vector, respectively, of zoonotic B. washoensis in Lithuania.

Bartonella dromedarii sp. nov. isolated from domesticated camels (Camelus dromedarius) in Israel.

Bartonella spp. are fastidious, Gram-negative bacilli that cause a wide spectrum of diseases in humans. Most Bartonella spp. have adapted to a specific host, generally a domestic or wild mammal. Dromedary camels (Camelus dromedarius) have become a focus of growing public-health interest because they have been identified as a reservoir host for the Middle East respiratory syndrome coronavirus. Nevertheless, data on camel zoonoses are limited. We aimed to study the occurrence of Bartonella bacteremia among dromedaries in Israel. Nine of 51 (17.6%) camels were found to be bacteremic with Bartonella spp.; bacteremia levels ranged from five to >1000 colony-forming units/mL. Phylogenetic reconstruction based on the concatenated sequences of gltA and rpoB genes demonstrated that the dromedary Bartonella isolates are closely related to other ruminant-derived Bartonella spp., with B. bovis being the nearest relative. Using electron microscopy, the novel isolates were shown to be flagellated, whereas B. bovis is nonflagellated. Sequence comparisons analysis of the housekeeping genes ftsZ, ribC, and groEL showed the highest homology to B. chomelii, B. capreoli, and B. birtlesii, respectively. Sequence analysis of the gltA and rpoB revealed ∼96% identity to B. bovis, a previously suggested cutoff value for sequence-based differentiation of Bartonella spp., suggesting that this approach does not have sufficient discriminatory power for differentiating ruminant-related Bartonella spp. A comprehensive multilocus sequence typing (MLST) analysis based on nine genetic loci (gltA, rpoB, ftsZ, internal transcribed spacer (ITS), 16S rRNA, ribC, groEL, nuoG, and SsrA) identified seven sequence types of the new dromedary isolates. This is the first description of a Bartonella sp. from camelids. On the basis of a distinct reservoir and ecological niche, sequence analyses, and expression of flagella, we designate these isolates as a novel Bartonella sp. named Bartonella dromedarii sp. nov. Further studies are required to explore its zoonotic potential.

Infección por Bartonella henselae con compromiso de sistema nervioso central, asociado a un papiloma del plexo coroídeo / Central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma

Resumen La infección por Bartonella henselae es una enfermedad prevalente en nuestro país. En general, se presenta como la enfermedad por arañazo de gato o un síndrome febril prolongado. Existen manifestaciones atípicas dentro de las cuales está el compromiso óseo, cardíaco, hepatoesplénico y del sistema nervioso central. Se presenta el caso de una adolescente con historia de vómitos, fiebre y ataxia, en que se diagnosticó una infección por Bartonella henselae con compromiso del sistema nervioso central, asociada a un papiloma del plexo coroídeo. Este caso corresponde a una presentación inusual, de difícil diagnóstico. Su tratamiento es motivo de controversia, tanto en si es necesario tratar, la elección del antimicrobiano, como su duración.

Bartonella henselae infection is a prevalent illness in Chile. It presents generally as a cat scratch disease or as a prolonged fever syndrome. There are atypical manifestations, which include central nervous system, bone, cardiac and hepato-esplenic compromised. We present an adolescent case with a history of fever, vomiting and ataxia, whose diagnosis was a central nervous system infection by Bartonella henselae associated with a choroid plexus papilloma. This case corresponds to an unusual presentation, with a challenging diagnosis. It is controversial whether to treat this patient, which antimicrobial is the right choice and how long the treatment should be.