Isolation ofBartonella quintana from an HIV-positive patient with bacillary angiomatosis

Schmidt, Hans; Kaliebe, T.; Poppinger, J.; Bühler, Christian; Sander, Anna

doi:10.1007/bf01691961

Cited by 19 publications

(12 citation statements)

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“…The significance (P) of whole blood versus blood culture broth is Ͻ10 Ϫ7 . olate agar, especially when enriched with 20% sheep blood for B. quintana (13,14,27,29,34,36,47,(55)(56)(57)(58)(59)62). B. henselae is also better isolated on CDC blood agar (13).…”

Section: Discussionmentioning

confidence: 99%

Culture of Bartonella quintana and Bartonella henselae from Human Samples: a 5-Year Experience (1993 to 1998)

1999

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Bartonella quintana and Bartonella henselaeare fastidious gram-negative bacteria responsible for bacillary angiomatosis, trench fever, cat scratch disease, and endocarditis. During a 5-year period, we received 2,043 samples for culture ofBartonella sp. We found Bartonella sp. to be the etiologic agent in 38 cases of endocarditis, 78 cases of cat scratch disease, 16 cases of bacteremia in homeless people, and 7 cases of bacillary angiomatosis. We correlated the results of positive cultures with the clinical form of the disease, type of sample, culture procedure, PCR-based genomic detection, and antibody determination. Seventy-two isolates of B. quintana and nine isolates ofB. henselae from 43 patients were obtained. Sixty-three of the B. quintana isolates and two of the B. henselae isolates, obtained from patients with no prior antibiotic therapy, were stably subcultured. The sensitivity of culture was low when compared with that of PCR-based detection methods in valves of patients with endocarditis (44 and 81%, respectively), skin biopsy samples of patients with bacillary angiomatosis (43 and 100%, respectively), and lymph nodes of cat scratch disease (13 and 30%, respectively). Serological diagnosis was also more sensitive in cases of endocarditis (97%) and cat scratch disease (90%). Among endocarditis patients, the sensitivity of the shell vial culture assay was 28% when inoculated with blood samples and 44% when inoculated with valvular biopsy samples, and the sensitivity of both was significantly higher than that of culture on agar (5% for blood [P = 0.045] and 4% for valve biopsy samples [P < 0.0005]). The most efficient culture procedure was the subculture of blood culture broth into shell vials (sensitivity, 71%). For patients with endocarditis, previous antibiotic therapy significantly affected results of blood culture; no patient who had been administered antibiotics yielded a positive blood culture, whereas 80% of patients with no previous antibiotic therapy yielded positive blood cultures (P = 0.0006). Previous antibiotic therapy did not, however, prevent isolation ofBartonella sp. from cardiac valves but did prevent the establishment of strains, as none of the 15 isolates from treated patients could be successfully subcultured. For the diagnosis ofB. quintana bacteremia in homeless people, the efficiency of systematic subculture of blood culture broth onto agar was higher than that of direct blood plating (respective sensitivities, 98 and 10% [P < 10−7]). Nevertheless, both procedures are complementary, since when used together their sensitivity reached 100%. All homeless people with positive blood cultures had negative serology. The isolation rate of B. henselae from PCR-positive lymph nodes, in patients with cat scratch disease, was significantly lower than that from valves of endocarditis patients and skin biopsy samples from bacillary angiomatosis patients (13 and 33%, respectively [P = 0.084]). In cases of bacillary angiomatosis for which an agent was identified to species level, the isolation rate of B. henselae was lower than the isolation rate of B. quintana (28 and 64%, respectively [P = 0.003]). If culture is to be considered an efficient tool for the diagnosis of several Bartonella-related diseases, methodologies need to be improved, notably for the recovery of B. henselae from lymph nodes of patients with cat scratch disease.

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Section: Discussionmentioning

confidence: 99%

Culture of Bartonella quintana and Bartonella henselae from Human Samples: a 5-Year Experience (1993 to 1998)

1999

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“…can be isolated from biopsies or blood by inoculation on various blood agar or into tissue culture. including chocolate agar (Dolan et al, 1993;Koehler et al, 1992;Slater et al, 1990), sheep blood (Clarridge et al, 1995;Regnery et al, 1992;Schmidt et al, 1996), rabbit blood (Regnery et al, 1992), CDC anaerobic blood agar (Dolan et al, 1993), peptone horse serum yeast extract broth (Cockerell et al, 1991;Wong et al, 1995), horse serum (Cockerell et al, 1991;Wong et al, 1995), and trypticase soy fildes horse serum broth (Cockerell et al, 1991;Wong, et al, 1995). Increased recovery rate of Bartonella sp.…”

Section: Culturementioning

confidence: 99%

Reemergence of Established Pathogens in the 21st Century

Fong¹,

Drlica²

2003

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“…It was demonstrated previously that infection with B. henselae results in secretion of proangiogenic compounds, such as vascular endothelial growth factor (VEGF) (18,34 (41) were grown on Columbia blood agar plates supplemented with 5% defibrinated sheep blood (CBA) (Becton Dickinson, Heidelberg, Germany) in a humidified atmosphere at 37°C with 5% CO 2 . For production of bacterial stock suspensions, bacteria were harvested from agar plates after 5 days of culture, resuspended in Luria-Bertani medium containing 20% glycerol, and stored at Ϫ80°C.…”

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Bartonella quintana Variably Expressed Outer Membrane Proteins Mediate Vascular Endothelial Growth Factor Secretion but Not Host Cell Adherence

et al. 2006

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Bartonella quintana causes trench fever, endocarditis, and the vasculoproliferative disorders bacillary angiomatosis and peliosis hepatis in humans. Little is known about the interaction of this pathogen with host cells. We attempted to elucidate the interaction of B. quintana with human macrophages (THP-1) and epithelial cells (HeLa 229). Remarkably, only B. quintana strain JK-31 induced secretion of vascular endothelial growth factor (VEGF) from THP-1 and HeLa 229 cells upon infection similar to the secretion induced by B. henselae Marseille, whereas other strains (B. quintana 2-D70, B. quintana Toulouse, and B. quintana Munich) did not induce such secretion. Immunofluorescence testing and electron microscopy revealed that the B. quintana strains unable to induce VEGF secretion did not express the variable outer membrane proteins (Vomps) on their surfaces. Surprisingly, the increase in VEGF secretion mediated by B. quintana JK-31 was not paralleled by elevated host cell adherence rates compared with the rates for Vomp-negative B. quintana strains. Our results suggest that the Vomps play a leading role in the angiogenic reprogramming of host cells by B. quintana but not in the adherence to host cells.Bartonella quintana and Bartonella henselae are reemerging, gram-negative, facultative intracellular bacteria which cause a variety of human diseases. B. henselae is the most common cause of cat scratch disease. In immunocompromised patients (e.g., AIDS patients), both B. henselae and the closely related species B. quintana (1) cause the vasculoproliferative disorders bacillary angiomatosis (BA) and peliosis hepatis (PH) (20). Infections with B. quintana can result in "trench fever," which is characterized by periodic feverish relapses every fifth day due to intraerythrocytic bacteremia (12). B. quintana was most important during World War I, when more than one million soldiers suffered from this disease. The confirmed transmission vector is the human body louse (33). Today, B. quintana is a well-recognized cause of fever, bacteremia, and endocarditis in human immunodeficiency virus-seronegative, inner-city patients living under poor hygienic conditions, such as the homeless or alcoholics (5, 13, 43). Prolonged periods of intracellular erythrocyte parasitism appear to be a crucial aspect of the pathogenicity of Bartonella spp. (21, 38).Very little is known about the pathogenicity of B. quintana. It has been shown that Bartonella spp. replicate within endothelial cells in a Bartonella-containing vacuole (6), adhere to endothelial and epithelial cells (3, 9, 17), and invade erythrocytes (36, 39). There is also evidence that B. quintana might interact with human erythroblast cells (37). Contradictory results about the induction of apoptosis by B. quintana have been obtained; while early during B. quintana infection apoptosis of endothelial cells was detectable, this apoptosis was inhibited at later times (26). Recently, variably expressed outer membrane proteins VompA, VompB, VompC, and VompD mediating collagen bindin...

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Isolation ofBartonella quintana from an HIV-positive patient with bacillary angiomatosis

Cited by 19 publications

References 19 publications

Culture of Bartonella quintana and Bartonella henselae from Human Samples: a 5-Year Experience (1993 to 1998)

Culture of Bartonella quintana and Bartonella henselae from Human Samples: a 5-Year Experience (1993 to 1998)

Reemergence of Established Pathogens in the 21st Century

Bartonella quintana Variably Expressed Outer Membrane Proteins Mediate Vascular Endothelial Growth Factor Secretion but Not Host Cell Adherence

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