Though some studies have found "no definitive evidence of transmission by a tick to a vertebrate host,"[8][9]Bartonella species are well-known to be transmissible to both animals and humans through various other vectors, such as fleas, lice, and sand flies.[10][11]Bartonella bacteria are associated with cat-scratch disease, but a study in 2010 concluded, "Clinicians should be aware that ... a history of an animal scratch or bite is not necessary for disease transmission."[12] All current Bartonella species identified in canines are human pathogens.[13]
Pathophysiology
Bartonella infections are remarkable in the wide range of symptoms they can produce. The course of the diseases (acute or chronic) and the underlying pathologies are highly variable.[14]
Treatment is dependent on which species or strain of Bartonella is found in a given patient. While Bartonella species are susceptible to a number of standard antibiotics in vitro—macrolides and tetracycline, for example—the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.[14] Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and rifampin; B. henselae is generally resistant to penicillin, amoxicillin, and nafcillin.[14]
Epidemiology
Homeless intravenous drug users are at high risk for Bartonella infections, particularly B. elizabethae. B. elizabethae seropositivity rates in this population range from 12.5% in Los Angeles,[19] to 33% in Baltimore, Maryland,[20] 46% in New York City,[21] and 39% in Sweden.[22]
↑ Vilcins I, Kosoy M, Old JM, Deane EM (2009). Bartonella-like DNA detected in Ixodes ticks (Acari: Ixodida) infesting koalas (Phascolarctos cinereus) in Victoria, Australia. Vector-Borne & Zoonotic Diseases. 9(5), 499-503. DOI: 10.1089/vbz.2008.0132
↑ Comer JA, Flynn C, Regnery RL, Vlahov D, Childs JE (1996). "Antibodies to Bartonella species in inner-city intravenous drug users in Baltimore, Md". Arch. Intern. Med. 156 (21): 2491–5. doi:10.1001/archinte.156.21.2491. PMID8944742.
↑ Comer JA, Diaz T, Vlahov D, Monterroso E, Childs JE (2001). "Evidence of rodent-associated Bartonella and Rickettsia infections among intravenous drug users from Central and East Harlem, New York City". Am. J. Trop. Med. Hyg. 65 (6): 855–60. doi:10.4269/ajtmh.2001.65.855. PMID11791987. S2CID22138835.
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