Diagnosis of Carrion’s Disease by Direct Blood PCR in Thin Blood Smear Negative Samples

Abstract

Bartonella bacilliformis is the etiologic agent of Carrion's disease. This disease has two well established phases, the most relevant being the so called Oroya Fever, in which B. bacilliformis infect the erythrocytes resulting in severe anemia and transient immunosuppression, with a high lethality in the absence of adequate antibiotic treatment. The presence of B. bacilliformis was studied in 113 blood samples suspected of Carrion’s disease based on clinical criteria, despite the absence of a positive thin blood smear, by two different PCR techniques (using Bartonella-specific and universal 16S rRNA gene primers), and by bacterial culture. The specific 16S rRNA gene primers revealed the presence of 21 B. bacilliformis and 1 Bartonella elizabethae, while universal primers showed both the presence of 3 coinfections in which a concomitant pathogen was detected plus Bartonella, in addition to the presence of infections by other microorganisms such as Agrobacterium or Bacillus firmus. These data support the need to implement molecular tools to diagnose Carrion’s disease.

Antibiotic resistance in Bartonella bacilliformis clinical isolates from an endemic area of Peru

“…Blood samples (n = 21) collected during March 2009 from patients from Cajamarca Region clinically diagnosed with Oroya fever were evaluated. The presence of B. bacilliformis was confirmed by amplification of the 16S rRNA gene [4]. Samples were cultured as previously described [4].…”

“…The presence of B. bacilliformis was confirmed by amplification of the 16S rRNA gene [4]. Samples were cultured as previously described [4].…”

An unidentified cluster of infection in the Peruvian Amazon region

“…In northern Peru, the presence of different etiologic causes of febrile syndromes, including dengue, oropuche, mayaro, Plasmodium spp., or Bartonella bacilliformis, is well established [1][2][3][4]. Their correct diagnosis is necessary to enable administration of correct treatment.…”

Possible Vertical Transmission of Bartonella bacilliformis in Peru

“…11, 12 The microorganisms were further identified as B. bacilliformis by amplification and sequence of the 16s ribosomal RNA (rRNA) gene both directly from blood samples and from growing microorganisms. 12 After 10 days in the Intensive Care Unit, the child was transferred to the Infectious Diseases Department, in which concomitant pneumonia was also diagnosed.…”

“…12 After 10 days in the Intensive Care Unit, the child was transferred to the Infectious Diseases Department, in which concomitant pneumonia was also diagnosed.…”