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Earlier this week, we announced that IFA serology (IgG) testing is now available at Galaxy Diagnostics for two additional Bartonella species: B. vinsonii berkhoffii and B. koehlerae. Access to reliable testing for a broader range of Bartonella species will improve the clinical outcomes of high-risk patient populations, such as veterinarians and other people who regularly interact with wild or domesticated animals.
Bartonellosis is an emerging flea and tick-borne disease caused by slow-growing and elusive Bartonella bacteria that often fly under t
he radar of conventional testing. There are more than 30 named species of Bartonella found in a wide range of animals and vectors, with almost half being implicated in an array of human and animal illnesses.
The bartonellosis manifestation that is most recognized is acute cat scratch disease caused by B. henselae infection. However, research over the past twenty years increasingly suggests that B. henselae as well as other species can cause multi-system disease impacting the heart, eyes, joints, and central nervous system. Studies focused on HIV/AIDS patients show that they experience severe symptoms, such as bacillary angiomatosis and bacillary peliosis, more frequently from B. henselae and B. quintana infection compared to immunocompetent patients. More research is still needed to uncover the prevalence of Bartonella infection in immunocompetent populations, but individuals who are highly exposed to animals and insect vectors are more likely to be at a high risk for acute and chronic disease.
An article published earlier this year by the American Veterinary Medical Association (AVMA) highlighted the risk of bartonellosis to veterinarians and other animal healthcare professionals. Throughout this piece, the author cited studies in which Galaxy’s chief scientific officer/co-founder, Dr. Ed Breitschwerdt, and his team at North Carolina State University isolated various Bartonella species from symptomatic veterinary workers. Bartonella vinsonii berkhoffii and Bartonella koehlerae were two of the species described in their work, indicating the importance of broadening our test options to reduce the likelihood of missing a potential positive case.
Infection has been documented worldwide in people who live and work with animals and can lead to systemic diseases. Transmission is thought to occur primarily in the context of contact with dogs and fleas.
A 2010 case report described a veterinarian who developed non-specific symptoms including headaches, fatigue, and intermittent paresthesia following an accidental needle stick after working with an ill dog. Evidence of B. vinsonii berkhoffii infection in the dog was confirmed using PCR testing following BAPGM™ enrichment of a mass aspirate. Both IFA serology and PCR testing following BAPGM™ enrichment were used to confirm B. vinsonii berkhoffii infection in the veterinarian.
Infection is associated with cats and their fleas, like B. henselae, and has been implicated in illnesses impacting the central nervous system in people. Commercial testing for this species is not currently available anywhere else in the world.
A 2011 case report described an 18-year-old woman with hallucinations and visual deficits who tested positive for B. koehlerae using both IFA serology and PCR testing following BAPGM™ enrichment. Her symptoms resolved following antimicrobial therapy.
Galaxy continues to advocate for a broader approach to diagnosing bartonellosis and other vector-borne diseases in high-risk patient populations. Experts recommend combining the newly expanded Bartonella IFA Serology Panel, IgG with Bartonella Digital ePCR™ to maximize diagnostic sensitivity for these elusive infections.
References
Oliveira, A. M. et al. (2010). Suspected needle stick transmission of Bartonella vinsonii subspecies berkhoffii to a veterinarian. Journal of Veterinary Medicine, 25(5), 1229-1232. 10.1111/j.1939-1676.2010.0563.x https://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2010.0563.x
Breitschwerdt, E. B. et al. (2011). Hallucinations, sensory neuropathy, and peripheral visual deficits in a young woman infected with Bartonella koehlerae. Journal of Clinical Microbiology, 49(9), 3415-3417. 10.1128/JCM.00833-11 https://journals.asm.org/doi/full/10.1128/JCM.00833-11
Maggi, R. G. et al. (2011). Bartonella spp. bacteremia in high-risk immunocompetent patients. Diagnostic Microbiology and Infectious Disease, 71(4), 430-437. 10.1016/j.diagmicrobio.2011.09.001 https://www.sciencedirect.com/science/article/abs/pii/S0732889311003555
Maggi, R. G. et al. (2012). Bartonella spp. bacteremia and rheumatic symptoms in patients from Lyme disease-endemic region. Emerging Infectious Diseases, 18(5), 783-791. 10.3201/eid1805.111366 . https://wwwnc.cdc.gov/eid/article/18/5/11-1366_article
Oteo, J. A. et al. (2017). Prevalence of Bartonella spp. by culture, PCR and serology, in veterinary personnel from Spain. Parasites & Vectors, 10, 553. https://parasitesandvectors.biomedcentral.com/articles/10.1186/s13071-017-2483-z
Mozayeni, B. R. et al. (2018). Rheumatological presentation of Bartonella koehlerae and Bartonella henselae bacteremias. Medicine, 97(17), e0465. 10.1097/MD.0000000000010465 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944489/