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. It occurs in Europe, Asia, and North Africa. Its primary vector is Pediculus humanus variety corporis, also known as the human body louse. [8]

It was first isolated in axenic culture by J.W. Vinson in 1960, from a patient in Mexico City and named Rickettsia quintana. He infected volunteers with the bacterium, showing consistent symptoms and clinical manifestations of trench fever, proving etiology via Koch's postulates.

The best medium for growing Bartonella quintana is blood-enriched agar at an atmosphere containing 5% carbon dioxide. [3]

Rickettsia quintana was later reclassified as Rochalimaea quintana and subsequently Bartonella quintana. [9] [10] [11]

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). [12] 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. [13] 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; they are seen in B. quintana-induced endocarditis patients. 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. [14]

Notably, endocarditis is a new manifestation of the infection, not seen in World War I troops.[ citation needed ]

Ecology and epidemiology

B. quintana infection occurs on every continent except Antarctica. Infections have been associated with risk factors such as poverty, alcoholism and homelessness. In a French seroprevalence study from 1996, 16% of hospitalized homeless patients were infected, as opposed to 1.8% of nonhospitalized homeless persons, and 0% of blood donors at large. [15] Lice are the key component in transmitting B. quintana. [16] [17] This has been attributed to living in unsanitary conditions,i.e. without consistent access to shower and laundry, and living in crowded areas, where the risk of coming into contact with other individuals carrying B. quintana and ectoparasites like 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; [18] [19] 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

A definite diagnosis of infection with B. quintana requires either serum antibodies or positive nucleic acid amplification. 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. [20]

Treatment usually consists of a 4- to 6-week course of doxycycline as first-line, or erythromycin, or azithromycin. [21] [22]

Related Research Articles

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Trench fever is a moderately serious infectious disease caused by the bacterium Bartonella quintana and transmitted by body lice. 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 injecting drug users and in Marseille, France, and Burundi.

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

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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. ↑ Anstead, Gregory M (2016-08-01). "The centenary of the discovery of trench fever, an emerging infectious disease of World War 1". The Lancet Infectious Diseases. 16 (8): e164–e172. doi:10.1016/S1473-3099(16)30003-2. ISSN   1473-3099. PMC   7106389 . PMID   27375211.
  10. ↑ Raoult, D.; Ndihokubwayo, J. B.; Tissot-Dupont, H.; Roux, V.; Faugere, B.; Abegbinni, R.; Birtles, R. J. (1998-08-01). "Outbreak of epidemic typhus associated with trench fever in Burundi". Lancet (London, England). Vol. 352, no. 9125. pp. 353–358. doi:10.1016/s0140-6736(97)12433-3. ISSN   0140-6736. PMID   9717922 . Retrieved 2024-11-27.
  11. ↑ Okorji, Onyinyechukwu; Olarewaju, Olubunmi; Smith, Travis; Pace, William C. (13 March 2024). "Trench Fever". StatPearls. Treasure Island, Florida: StatPearls Publishing. PMID   32965930. NLM Bookshelf Identification NBK562259. Retrieved 22 November 2024– via National Library of Medicine, National Center for Biotechnology Information.
  12. ↑ 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.
  13. ↑ 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.
  14. ↑ 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.
  15. ↑ 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.
  16. ↑ 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.
  17. ↑ 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.
  18. ↑ 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.
  19. ↑ 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.
  20. ↑ 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.
  21. ↑ 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.
  22. ↑ 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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