Bartonella quintana

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Bartonella quintana
Scientific classification OOjs UI icon edit-ltr.svg
Domain: Bacteria
Phylum: Pseudomonadota
Class: Alphaproteobacteria
Order: Hyphomicrobiales
Family: Bartonellaceae
Genus: Bartonella
Species:
B. quintana
Binomial name
Bartonella quintana
(Schmincke 1917) Brenner et al. 1993
Synonyms [1]
  • Rochalimaea quintana
    (Schmincke 1917) Krieg 1961
  • Wolhynia qintanae
    Zhdanov and Korenblit 1950
  • Rickettsia wolhynica
    Jungmann and Kuczynski 1918
  • Rickettsia weigli
    Mosing 1936
  • Rickettsia quintana
    Schmincke 1917
  • Rickettsia pediculi
    Munk and da Rocha-Lima 1917
  • Burnetia (Rocha-limae) wolhynica
    Macchiavello 1947

Bartonella quintana, originally known as Rochalimaea quintana, [2] and "Rickettsia quintana", [3] is a bacterium transmitted by the human body louse that causes trench fever. [4] This bacterial species caused outbreaks of trench fever affecting 1 million soldiers in Europe during World War I. [5]

Contents

Genome

B. quintana had an estimated genome size of 1,700 to 2,174 kilo-base pairs., [6] but the first genome sequence (of strain RM-11) contains a single circular chromosome of 1,587,646 base pairs. [7]

Background and characteristics

B. quintana is a fastidious, aerobic, Gram-negative(−), pole rod-shaped (bacillus) bacterium. The infection caused by this microorganism, trench fever, was first documented in soldiers during World War I, but has now been seen in Europe, Asia, and North Africa. Its primary vector is known to be Pediculus humanus variety corporis, also known as the human body louse. [8] It was first known to be isolated in axenic culture by J.W. Vinson in 1960, from a patient in Mexico City. He then followed Koch's postulates, infecting volunteers with the bacterium, showing consistent symptoms and clinical manifestations of trench fever. The medium best for growing this bacterium is blood-enriched in an atmosphere containing 5% carbon dioxide. [3]

Pathophysiology

Although lice are animal vectors, humans (and some other primates) are the only known animal reservoir hosts for this bacterium in vivo . [7] It infects endothelial cells and can infect erythrocytes by binding and entering with a large vacuole. Once inside, they begin to proliferate and cause nuclear atypia (intraerythrocytic B.quintana colonization). [9] This leads to apoptosis being suppressed, proinflammatory cytokines are released, and vascular proliferation increases. All of these processes result in patients possessing systemic symptoms (chills, fever, diaphoresis), bacteremia, and lymphatic enlargement. A major role in B. quintana infection is its lipopolysaccharide covering which is an antagonist of the toll-like receptor 4. [10] The reason this infection might persist is because this organism also results in monocytes overproducing interleukin-10 (IL-10), thus weakening the immune response. B. quintana also induces lesions seen in bacillary angiomatosis that protrude into vascular lumina, often occluding blood flow. The enhanced growth of these cells is believed to be due to the secretion of angiogenic factors, thus inducing neovascularization. Release of an icosahedral particle, 40 nm in length, has been detected in cultures of B. quintana's close relative, B. henselae. This particle contains a 14-kb linear DNA segment, but its function in Bartonella pathophysiology is still unknown. [11] In trench fever or B. quintana-induced endocarditis patients, bacillary angiomatosis lesions are also seen. Notably, endocarditis is a new manifestation of the infection, not seen in World War I troops.

Ecology and epidemiology

B. quintana infection has subsequently been seen in every continent except Antarctica. Local infections have been associated with risk factors such as poverty, alcoholism, and homelessness. Serological evidence of B. quintana infection showed, of hospitalized homeless patients, 16% were infected, as opposed to 1.8% of nonhospitalized homeless persons, and 0% of blood donors at large. [12] Lice have been demonstrated, as of recently, to be the key component in transmitting B. quintana. [13] [14] This has been attributed to living in unsanitary conditions and crowded areas, where the risk of coming into contact with other individuals carrying B. quintana and ectoparasites (body lice) is increased. Also noteworthy, the increasing migration worldwide may also play a role in spreading trench fever, from areas where it is endemic to susceptible populations in urban areas. Recent concern is the possibility of the emergence of new strains of B. quintana through horizontal gene transfer, which could result in the acquisition of other virulence factors. [8]

Clinical manifestations

B. quintana and Mycobacterium avium complex coinfecting an AIDS patient Bacteria on Warthin-Starry stain.jpg
B. quintana and Mycobacterium avium complex coinfecting an AIDS patient

The clinical manifestations of B. quintana infection are highly variable. The incubation period is now known to be 5–20 days; [15] [16] it was originally thought to be 3–38 days. The infection can start as an acute onset of a febrile episode, relapsing febrile episodes, or as a persistent typhoidal illness; commonly seen are maculopapular rashes, conjunctivitis, headache, and myalgias, with splenomegaly being less common. Most patients present with pain in the lower legs (shins), sore muscles of the legs and back, and hyperaesthesia of the shins. Rarely is B. quintana infection fatal, unless endocarditis develops and goes untreated. Weight loss, and thrombocytopenia are sometimes also seen. Recovery can take up to a month.

Diagnosis and treatment

To have a definite diagnosis of infection with B. quintana requires either serological cultures or nucleic acid amplification techniques. To differentiate between different species, immunofluorescence assays that use mouse antisera are used, as well as DNA hybridization and restriction fragment length polymorphisms, or citrate synthase gene sequencing. [17] Treatment usually consists of a 4- to 6-week course of doxycycline, erythromycin, or azithromycin. [18] [19]

Related Research Articles

Trench fever is a moderately serious disease transmitted by body lice. It infected armies in Flanders, France, Poland, Galicia, Italy, Macedonia, Mesopotamia, Russia and Egypt in World War I. Three noted cases during WWI were the authors J. R. R. Tolkien, A. A. Milne, and C. S. Lewis. From 1915 to 1918 between one-fifth and one-third of all British troops reported ill had trench fever while about one-fifth of ill German and Austrian troops had the disease. The disease persists among the homeless. Outbreaks have been documented, for example, in Seattle and Baltimore in the United States among injection drug users and in Marseille, France, and Burundi.

Bloodstream infections (BSIs) are infections of blood caused by blood-borne pathogens. Blood is normally a sterile environment, so the detection of microbes in the blood is always abnormal. A bloodstream infection is different from sepsis, which is characterized by severe inflammatory or immune responses of the host organism to pathogens.

<span class="mw-page-title-main">Infective endocarditis</span> Medical condition

Infective endocarditis is an infection of the inner surface of the heart, usually the valves. Signs and symptoms may include fever, small areas of bleeding into the skin, heart murmur, feeling tired, and low red blood cell count. Complications may include backward blood flow in the heart, heart failure – the heart struggling to pump a sufficient amount of blood to meet the body's needs, abnormal electrical conduction in the heart, stroke, and kidney failure.

<i>Bartonella henselae</i> Species of bacterium

Bartonella henselae, formerly Rochalimæa henselae, is a bacterium that is the causative agent of cat-scratch disease (bartonellosis).

<span class="mw-page-title-main">Erysipeloid</span> Medical condition

In humans, Erysipelothrix rhusiopathiae infections most commonly present in a mild cutaneous form known as erysipeloid or fish poisoning. E. rhusiopathiae can cause an indolent cellulitis, more commonly in individuals who handle fish and raw meat. Erysipelothrix rhusiopathiae also causes Swine Erysipelas. It is common in domestic pigs and can be transmitted to humans who work with swine. It gains entry typically by abrasions in the hand. Bacteremia and endocarditis are uncommon but serious sequelae. Due to the rarity of reported human cases, E. rhusiopathiae infections are frequently misidentified at presentation.

<i>Bartonella</i> Genus of bacteria

Bartonella is a genus of Gram-negative bacteria. It is the only genus in the family Bartonellaceae. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens. Bartonella species are transmitted by vectors such as fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.

<span class="mw-page-title-main">Carrion's disease</span> Infectious disease caused by Bartonella bacilliformis

Carrion's disease is an infectious disease produced by Bartonella bacilliformis infection.

<i>Moraxella catarrhalis</i> Species of bacterium

Moraxella catarrhalis is a fastidious, nonmotile, Gram-negative, aerobic, oxidase-positive diplococcus that can cause infections of the respiratory system, middle ear, eye, central nervous system, and joints of humans. It causes the infection of the host cell by sticking to the host cell using trimeric autotransporter adhesins.

Bartonellosis is an infectious disease produced by bacteria of the genus Bartonella. Bartonella species cause diseases such as Carrión's disease, trench fever, cat-scratch disease, bacillary angiomatosis, peliosis hepatis, chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders.

<span class="mw-page-title-main">Bacillary angiomatosis</span> Medical condition

Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the genus Bartonella.

Bartonella rochalimae is a recently discovered strain of Gram-negative bacteria in the genus Bartonella, isolated by researchers at the University of California, San Francisco (UCSF), Massachusetts General Hospital, and the United States Centers for Disease Control and Prevention. The bacterium is a close relative of Bartonella quintana, the microbe which caused trench fever in thousands of soldiers during World War I. Named after Brazilian scientist Henrique da Rocha Lima, B. rochalimae is also closely related to Bartonella henselae, a bacterium identified in the mid-1990s during the AIDS epidemic in San Francisco as the cause of cat scratch fever, which still infects more than 24,000 people in the United States each year.

<i>Bartonella bacilliformis</i> Species of bacterium

Bartonella bacilliformis is a bacterium, Gram negative aerobic, pleomorphic, flagellated, motile, coccobacillary, 2–3 μm long, 0.2–0.5 μm wide, and a facultative intracellular bacterium.

<span class="mw-page-title-main">African tick bite fever</span> Medical condition

African tick bite fever (ATBF) is a bacterial infection spread by the bite of a tick. Symptoms may include fever, headache, muscle pain, and a rash. At the site of the bite there is typically a red skin sore with a dark center. The onset of symptoms usually occurs 4–10 days after the bite. Complications are rare but may include joint inflammation. Some people do not develop symptoms.

<span class="mw-page-title-main">BH11960</span>

Bartonella henselae hypothetical protein 11960 (BH11960) is encoded by the BH11960 gene. This hypothetical protein is conserved in all Bartonella species whose genomes have been sequenced to date, and are highlighted in the picture below.

<span class="mw-page-title-main">Cat-scratch disease</span> Human disease

Cat-scratch disease (CSD) or felinosis is an infectious disease that most often results from a scratch or bite of a cat. Symptoms typically include a non-painful bump or blister at the site of injury and painful and swollen lymph nodes. People may feel tired, have a headache, or a fever. Symptoms typically begin within 3–14 days following infection.

Clostridium innocuum is an anaerobic, non-motile, gram-positive bacterium that reproduces by sporulation. While there are over 130 species of Clostridium, C. innocuum is the third most commonly isolated. Although it is not normally considered an aggressive human pathogen, it has been isolated in some disease processes. C. innocuum and other Clostridium line the oropharynx and gastrointestinal tract, and are considered normal gut flora.

<i>Aerococcus urinae</i> Species of bacterium

Aerococcus urinae is a Gram-positive bacterium associated with urinary tract infections.

Bartonella alsatica is a bacterium. Like other Bartonella species, it can cause disease in animals. It is small, aerobic, oxidase-negative, and Gram-negative. Its rod-like cells were localized within wild rabbit erythrocytes when first described. The type strain is IBS 382T. It is associated with cases of lymphadenitis and endocarditis.

Bartonella elizabethae, formerly known as Rochalimaea elizabethae, is a bacterium. As with other Bartonella species, it can cause disease in animals.

Bartonella vinsonii is a gram-negative bacteria from the genus Bartonella which was isolated from dogs. Rochalimaea vinsonii was reclassified to Bartonella vinsonii. B. vinsonii contains three validly published subspecies B. vinsonii subsp. arupensis, B. vinsonii subsp. berkhoffii, and B. vinsonii subsp. vinsonii, and one effectively published B. vinsonii subsp. yucatanensis. B. vinsonii subsp. vinsonii has been isolated from voles and B. vinsonii subsp. berkhofli was isolated from a dog with endocarditis. B. vinsonii subsp. berkhoffii can cause diseases in humans. Those two subspecies are named after J. William Vinson and Herman A. Berkhoff.

References

  1. ↑ "Bartonella quintana". National Center for Biotechnology Information. Retrieved November 10, 2013.
  2. ↑ "Definition of Bartonella quintana". MedicineNet. Archived from the original on 5 June 2011. Retrieved May 3, 2011.
  3. 1 2 Ohl, ME; Spach, DH (2000). "Bartonella quintana and urban trench fever". Clinical Infectious Diseases. 31 (1): 131–5. doi:10.1086/313890. PMID   10913410.
  4. ↑ O'Rourke, Laurie G.; Pitulle, Christian; Hegarty, Barbara C.; Kraycirik, Sharon; Killary, Karen A.; Grosenstein, Paul; Brown, James W.; Breitschwerdt, Edward B. (2005). "Bartonella quintana in Cynomolgus Monkey (Macaca fascicularis)". Emerging Infectious Diseases. 11 (12): 1931–4. doi:10.3201/eid1112.030045. PMC   3367614 . PMID   16485482.
  5. ↑ Jackson, Lisa A.; Spach, David H. (1996). "Emergence of Bartonella quintana Infection among Homeless Persons". Emerging Infectious Diseases. 2 (2): 141–4. doi:10.3201/eid0202.960212. PMC   2639836 . PMID   8903217.
  6. ↑ Roux, V; Raoult, D (1995). "Inter- and intraspecies identification of Bartonella (Rochalimaea) species". Journal of Clinical Microbiology. 33 (6): 1573–9. doi:10.1128/JCM.33.6.1573-1579.1995. PMC   228218 . PMID   7650189.
  7. 1 2 Li H, Tong Y, Huang Y, Bai J, Yang H, Liu W, Cao W (2012). "Complete Genome Sequence of Bartonella quintana, a Bacterium Isolated from Rhesus Macaques". J. Bacteriol. 194 (22): 6347. doi:10.1128/JB.01602-12. PMC   3486344 . PMID   23105078.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  8. 1 2 Maurin, M; Raoult, D (1996). "Bartonella (Rochalimaea) quintana infections". Clinical Microbiology Reviews. 9 (3): 273–92. doi:10.1128/CMR.9.3.273. PMC   172893 . PMID   8809460.
  9. ↑ Hadfield, T.L.; Warren, R.; Kass, M.; Brun, E.; Levy, C. (1993). "Endocarditis caused by Rochalimaea henselae". Human Pathology. 24 (10): 1140–1. doi:10.1016/0046-8177(93)90196-N. PMID   8406424.
  10. ↑ Popa, C.; Abdollahi-Roodsaz, S.; Joosten, L. A. B.; Takahashi, N.; Sprong, T.; Matera, G.; Liberto, M. C.; Foca, A.; et al. (2007). "Bartonella quintana Lipopolysaccharide Is a Natural Antagonist of Toll-Like Receptor 4". Infection and Immunity. 75 (10): 4831–7. doi:10.1128/IAI.00237-07. PMC   2044526 . PMID   17606598.
  11. ↑ Leboit, Philip E.; Berger, Timothy G.; Egbert, Barbara M.; Beckstead, Jay H.; Benedict Yen, T. S.; Stoler, Mark H. (1989). "Bacillary Angiomatosis: The Histopathology and Differential Diagnosis of a Pseudoneoplastic Infection in Patients with Human Immunodeficiency Virus Disease". The American Journal of Surgical Pathology. 13 (11): 909–20. doi:10.1097/00000478-198911000-00001. PMID   2802010. S2CID   25225247.
  12. ↑ Brouqui, P.; Houpikian, P.; Dupont, H. T.; Toubiana, P.; Obadia, Y.; Lafay, V.; Raoult, D. (1996). "Survey of the Seroprevalence of Bartonella quintana in Homeless People". Clinical Infectious Diseases. 23 (4): 756–9. doi:10.1093/clinids/23.4.756. PMID   8909840.
  13. ↑ Koehler, Jane E.; Sanchez, Melissa A.; Garrido, Claudia S.; Whitfeld, Margot J.; Chen, Frederick M.; Berger, Timothy G.; Rodriguez-Barradas, Maria C.; Leboit, Philip E.; Tappero, Jordan W. (1997). "Molecular Epidemiology of Bartonella Infections in Patients with Bacillary Angiomatosis–Peliosis". New England Journal of Medicine. 337 (26): 1876–83. doi: 10.1056/NEJM199712253372603 . PMID   9407154.
  14. ↑ Brouqui, Philippe; Lascola, Bernard; Roux, Veronique; Raoult, Didier (1999). "Chronic Bartonella quintana Bacteremia in Homeless Patients". New England Journal of Medicine. 340 (3): 184–9. doi: 10.1056/NEJM199901213400303 . PMID   9895398.
  15. ↑ Vinson JW, Varela G, Molina-Pasquel C (September 1969). "Trench fever. 3. Induction of clinical disease in volunteers inoculated with Rickettsia quintana propagated on blood agar". Am. J. Trop. Med. Hyg. 18 (5): 713–22. doi:10.4269/ajtmh.1969.18.713. PMID   5810799.
  16. ↑ Badiaga S, Brouqui P (April 2012). "Human louse-transmitted infectious diseases". Clin. Microbiol. Infect. 18 (4): 332–7. doi: 10.1111/j.1469-0691.2012.03778.x . PMID   22360386.
  17. ↑ Cooper, M. D.; Hollingdale, M. R.; Vinson, J. W.; Costa, J. (1976). "A Passive Hemagglutination Test for Diagnosis of Trench Fever Due to Rochalimaea quintana". Journal of Infectious Diseases. 134 (6): 605–9. doi:10.1093/infdis/134.6.605. PMID   63526.
  18. ↑ Slater, Leonard N.; Welch, David F.; Hensel, Diane; Coody, Danese W. (1990). "A Newly Recognized Fastidious Gram-negative Pathogen as a Cause of Fever and Bacteremia". New England Journal of Medicine. 323 (23): 1587–93. doi: 10.1056/NEJM199012063232303 . PMID   2233947.
  19. ↑ Myers, WF; Grossman, DM; Wisseman Jr, CL (1984). "Antibiotic susceptibility patterns in Rochalimaea quintana, the agent of trench fever". Antimicrobial Agents and Chemotherapy. 25 (6): 690–3. doi:10.1128/aac.25.6.690. PMC   185624 . PMID   6742814.
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