Cat scratch disease. Survey on the presence of Bartonella henselae among cats of Tuscany

To verify the presence of Bartonella henselae-infection in cats living in Tuscany (central Italy) serological and bacteriological surveys were carried out. The blood serum samples of 427 cats, 254 living in private houses and gardens and 173 in public or private catteries, were tested for anti-B. henselae antibodies by indirect immunofluorescence assay (IFA). Among these samples, 35 were examined by IFA to detect antibodies against Bartonella quintana. Bacteriological examinations were performed on the blood samples, collected in EDTA (ethylene diaminetetraacetic acid), of 18 cats (10 seropositive to B. henselae and 8 negative). From each of the same 18 specimens DNA was extracted and used as template in polymerase chain reaction (PCR). The primers p24E and p12B were employed in the PCR assay to amplify a 296 bp fragment of the Bartonella 16S rRNA gene. IFA detected 98 (22.95%) B. henselae-positive serum samples (40-40.82% from cats living in houses and gardens and 58-59.18% from cats of catteries) at different antibody titers (70 at 1:64 titer, 4 at 1:128, 22 at 1:256, 2 at 1:512). Among the 35 sera tested to detect antibodies against B. quintana, 9 (25.71%) resulted positive at 1:64 titer; all these samples showed higher antibody titers to B. henselae. Out of the 26 negative sera, 20 were negative to B. henselae too and 6 had antibodies against B. henselae at 1:64. Hemocultures gave negative results. PCR scored positive with DNA of 4 B. henselae-seropositive cats, two of which belonged to two children with cat scratch disease (CSD).     

Prevalence of Bartonella henselae in stray and domestic cats in different Italian areas: evaluation of the potential risk of transmission of Bartonella to humans

Bartonella henselae is the major etiological agent of Cat Scratch Disease in humans. Cats act as the natural reservoir of B. henselae and can transmit the infection to humans by bite or scratch. The diffusion of B. henselae was evaluated by seroprevalence and bacteremic status in different stray cat populations located in nine areas of Northern Italy. A total of 1585 cats were tested by blood culture and 361 (23%) resulted bacteremic; 1416 out off 1585 cats were also tested for Bartonella henselae antibodies and 553 (39%) resulted seropositive. The molecular typing of the isolates showed that 26% of bacteremic cats were infected with B. henselae type I, 52% with B. henselae type II, 16% were co-infected with both and 5% infected with B. Clarridgeiae. Moreover 165 domestic cats were tested by blood culture and serological test (IFA test cut-off: 1:64). 35 cats (21%) resulted bacteremic and 49 (43.5%) were seropositive. The molecular typing of the Bartonella isolates of the domestic cats showed that 45% of bacteremic cats were infected with B. henselae type I, 36.5% with B. henselae type II, 12% were coinfected with both and 6% infected with B. Clarridgeiae. For a completely evaluation of health status of the cat for B. henselae infection, the authors suggest both blood culture and serological tests. Nevertheless a nonbacteremic cat with positive serology result should be reevaluated for possible recurrent bacteremia.     

P26-based serodiagnosis for Bartonella spp. infection in cats

Bartonella henselae P26 has been identified as an immunodominant antigen expressed during feline infection. We used antisera from cats experimentally infected with B. henselae (n = 6), B. clarridgeiae (n = 4), or B. koehlerae (n = 2) and from a sample of naturally infected cats (B. henselae, n = 34; B. clarridgeiae, n = 1) to evaluate recombinant P26 (rP26) as a serodiagnostic antigen. Immunoblots using antisera from cats infected with B. henselae and B. clarridgeiae reacted strongly with rP26, whereas B. koehlerae antisera did not. A capture ELISA was designed to evaluate the kinetics of rP26 IgG in sera from experimentally infected cats. For B. henselae and B. clarridgeiae antisera, the kinetic profiles of reactivity were similar for rP26 capture ELISA and Bartonella spp. indirect fluorescence assay. However, for B. koehlerae antisera, reactivity in rP26 capture ELISA was consistently low. The serodiagnostic potential of rP26 capture ELISA was evaluated using sera from cats with known Bartonella sp. exposure histories. All 24 (100%) uninfected cats were seronegative, and 33 of 35 (94.3%) cats bacteremic for Bartonella spp. were seropositive. We propose that rP26-based serology can serve as a useful adjunct tool for the diagnosis of feline infection with B. henselae and B. clarridgeiae, but it may not be useful for feline infection with B. koehlerae.     

Serological investigation of Bartonella henselae infections in clinically cat-scratch disease-suspected patients,patients with cardiovascular diseases,and healthy veterinary students in Japan

Seroprevalence of Bartonella henselae was investigated in Japan in 48 individuals clinically suspected of having cat-scratch disease (CSD), 159 patients with cardiovascular diseases, and 129 healthy veterinary students. Of 48 CSD-suspected patients examined, 19 (39.6%) were positive for B. henselae-IgG and 4 (8.3%) for B. henselae-IgM. Of 159 patients with cardiovascular diseases, 5 (3.1%) were positive for B. henselae-IgG. In healthy veterinary students, 14 of 129 (10.9%) were positive for B. henselae-IgG and 1 (0.8%) for B. henselae-IgM. The positive rates of B. henselae-IgG and -IgM in CSD-suspected patients were significantly higher than in other sources. Most CSD-suspected and healthy individuals who were positive for B. henselae antibody had had some contacts with cats. In CSD-suspected patients, the B. henselae positive rate in females was significantly higher than in males, and high seropositive rates to B. henselae were found in younger age groups.     

Differential effects of Bartonella henselae on human and feline macro- and micro-vascular endothelial cells

Bartonella henselae, a zoonotic agent, induces tumors of endothelial cells (ECs), namely bacillary angiomatosis and peliosis in immunosuppressed humans but not in cats. In vitro studies on ECs represent to date the only way to explore the interactions between Bartonella henselae and vascular endothelium. However, no comparative study of the interactions between Bartonella henselae and human (incidental host) ECs vs feline (reservoir host) ECs has been carried out because of the absence of any available feline endothelial cell lines.To this purpose, we have developed nine feline EC lines which allowed comparing the effects of Bartonella strains on human and feline micro-vascular ECs representative of the infection development sites such as skin, versus macro-vascular ECs, such as umbilical vein.Our model revealed intrinsic differences between human (Human Skin Microvascular ECs -HSkMEC and Human Umbilical Vein ECs - iHUVEC) and feline ECs susceptibility to Bartonella henselae infection.While no effect was observed on the feline ECs upon Bartonella henselae infection, the human ones displayed accelerated angiogenesis and wound healing.Noticeable differences were demonstrated between human micro- and macro-vasculature derived ECs both in terms of pseudo-tube formation and healing. Interestingly, Bartonella henselae effects on human ECs were also elicited by soluble factors.Neither Bartonella henselae-infected Human Skin Microvascular ECs clinically involved in bacillary angiomatosis, nor feline ECs increased cAMP production, as opposed to HUVEC.Bartonella henselae could stimulate the activation of Vascular Endothelial Growth Factor Receptor-2 (VEGFR-2) in homologous cellular systems and trigger VEGF production by HSkMECs only, but not iHUVEC or any feline ECs tested.These results may explain the decreased pathogenic potential of Bartonella henselae infection for cats as compared to humans and strongly suggest that an autocrine secretion of VEGF by human skin endothelial cells might induce their growth and ultimately lead to bacillary angiomatosis formation.     

Prevalence of Bartonella henselae and Bartonella clarridgeiae in cats in the south of Brazil: a molecular study

Bartonella spp are the causative agent of cat scratch disease in humans. Cats are the natural reservoir of these bacteria and may infect humans through scratches, bites or fleas. Blood samples from 47 cats aged up to 12 months were collected for this study. All animals were lodged in municipal animal shelters in the Vale do Sinos region, Rio Grande do Sul, Brazil. Bartonella spp were detected by genus-specific polymerase chain reaction (PCR) and when the PCR was positive, the species were determined by DNA sequencing. A Giemsa-stained blood smear was also examined for the presence of intraerythrocytic elements suggestive of Bartonella spp infection. Phylogenetic analysis was also performed for all positive samples. Using molecular detection methods, Bartonella spp were detected in 17.02% (8/47) of the samples. In seven out of eight samples confirmed to be positive for Bartonella spp, blood smear examination revealed the presence of intraerythrocytic elements suggestive of Bartonella spp. Phylogenetic analysis characterized positive samples as Bartonella henselae (5) or Bartonella clarridgeiae (3). To the best of our knowledge, this is the first molecular study demonstrating the presence of Bartonella spp in cats from the Southern Region of Brazil.     

The use of Bartonella henselae-specific age dependent IgG and IgM in diagnostic models to discriminate diseased from non-diseased in Cat Scratch Disease serology

Cat Scratch Disease (CSD) is caused by Bartonella henselae infection and is a common cause of regional lymphadenopathy. The diagnosis of CSD largely depends on serology, but is hampered by both low sensitivity and specificity of the applied IgG and IgM assays. Using an in-house ELISA, we detected a significant age-dependent increase in the IgG levels in the general population compared to CSD patients. With this knowledge, we developed diagnostic models to differentiate diseased from non-diseased persons. Evaluation of these models using samples from PCR-positive patients (n=155) and age-matched controls (n=244) showed an important increase in the assay performance if the combination of the IgG and IgM results were taken into account. If the specificity was set at 98% the sensitivity was only 45% and 32% for the IgM and IgG ELISA, respectively but increased to 59% when these results were combined. Also the use of age-dependent factors further improved the clinical relevance of the outcome raising the sensitivity to 64%. Although the sensitivity of the ELISA remains low we conclude that the use of models using the combination of both IgM and IgG test results and age-depending factors can be a useful diagnostic tool in the serodiagnosis of CSD.     

Population Structure of Bartonella henselae in Algerian Urban Stray Cats

Whole blood samples from 211 stray cats from Algiers, Algeria, were cultured to detect the presence of Bartonella species and to evaluate the genetic diversity of B. henselae strains by multiple locus VNTR analysis (MLVA). Bartonella henselae was the only species isolated from 36 (17%) of 211 cats. B. henselae genotype I was the predominant genotype (64%). MLVA typing of 259 strains from 30 bacteremic cats revealed 52 different profiles as compared to only 3 profiles using MLST. Of these 52 profiles, 48 (92.3%) were identified for the first time. One-third of the cats harbored one MLVA profile only. As there was a correlation between the age of cats and the number of MLVA profiles, we hypothesized that the single profile in these cats was the profile of the initial infecting strain. Two-third of the cats harbored 2 to 6 MLVA profiles simultaneously. The similarity of MLVA profiles obtained from the same cat, neighbor-joining clustering and structure-neighbor clustering indicate that such a diversity likely results from two different mechanisms occurring either independently or simultaneously: independent infections and genetic drift from a primary strain.     

Bartonella and Rickettsia in fleas and lice from mammals in South Carolina, U.S.A.

Species in the genera Bartonella and Rickettsia are vector-borne pathogens of humans and domestic animals. The natural reservoirs and enzootic transmission cycles of these bacteria are poorly known in South Carolina. Thirteen species of lice and fleas were collected from urban animals and screened for the presence of Bartonella and Rickettsia by PCR amplification using genus-specific primers. Bartonella henselae was present in cat fleas (Ctenocephalides felis) from Virginia opossums (Didelphis virginiana) and a novel genotype of Bartonella was detected in Orchopeas howardi from an eastern gray squirrel (Sciurus carolinensis). We detected R. typhi and three novel genotypes Rickettsia in other species of fleas and lice. Rickettsia typhi, the causative agent of murine typhus, was detected in two pools of lice (Enderleinellus marmotae) from the woodchuck (Marmota monax). Cat fleas harbored one of two novel genotypes of Rickettsia. A third novel Rickettsia was detected in Orchopeas howardi from an eastern gray squirrel.     

Bacteriological and molecular identification of Bartonella species in cats from different regions of China

With the improvements in diagnostic techniques, Bartonella henselae (B. henselae) infection has recently been recognized to cause a widening spectrum of diseases. Cats are the natural reservoir hosts of B. henselae. The current study aims to investigate the prevalence of B. henselae infection in the cat populations in China. Polymerase chain reaction (PCR) and bacterial cultures confirm that 12.7% of the tested cats were positive for the infection. Old age and outdoor exposure were statistically associated with the infection. Multilocus sequence typing and eBURST analysis of the cat isolates collected in the present study show that 65.4% of the isolates belong to sequence type 1 (ST1). Three new STs (ST16-18) were identified in Midwestern China. These results may aid our understanding of the population structure of B. henselae in China and the relationship between human and cat strains in subsequent studies.     

Prevalence of Rickettsia and Bartonella species in Spanish cats and their fleas

The aim of this study was to determine the prevalence of Bartonella henselae, Rickettsia felis, and Rickettsia typhi in fleas and companion cats (serum and claws) and to assess their presence as a function of host, host habitat, and level of parasitism. Eighty‐nine serum and claw samples and 90 flea pools were collected. Cat sera were assayed by IFA for Bartonella henselae and Rickettssia species IgG antibodies. Conventional PCRs were performed on DNA extracted from nails and fleas collected from cats. A large portion (55.8%) of the feline population sampled was exposed to at least one of the three tested vector‐borne pathogens. Seroreactivity to B. henselae was found in 50% of the feline studied population, and to R. felis in 16.3%. R. typhi antibodies were not found in any cat. No Bartonella sp. DNA was amplified from the claws. Flea samples from 41 cats (46%) showed molecular evidence for at least one pathogen; our study demonstrated a prevalence rate of 43.3 % of Rickettsia sp and 4.4% of Bartonella sp. in the studied flea population. None of the risk factors studied (cat's features, host habitat, and level of parasitation) was associated with either the serology or the PCR results for Bartonella sp. and Rickettsia sp.. Flea‐associated infectious agents are common in cats and fleas and support the recommendation that stringent flea control should be maintained on cats.     

Presence of Bartonella species in wild carnivores of northern Spain

The genus Bartonella was detected by PCR in 5.7% (12/212) of wild carnivores from Northern Spain. Based on hybridization and sequence analyses, Bartonella henselae was identified in a wildcat (Felis silvestris), Bartonella rochalimae in a red fox (Vulpes vulpes) and in a wolf (Canis lupus), and Bartonella sp. in badgers (Meles meles).     

Characterization of the genome composition of Bartonella koehlerae by microarray comparative genomic hybridization profiling

Bartonella henselae is present in a wide range of wild and domestic feline hosts and causes cat-scratch disease and bacillary angiomatosis in humans. We have estimated here the gene content of Bartonella koehlerae, a novel species isolated from cats that was recently identified as an agent of human endocarditis. The investigation was accomplished by comparative genomic hybridization (CGH) to a microarray constructed from the sequenced 1.93-Mb genome of B. henselae. Control hybridizations of labeled DNA from the human pathogen Bartonella quintana with a reduced genome of 1.58 Mb were performed to evaluate the accuracy of the array for genes with known levels of sequence divergence. Genome size estimates of B. koehlerae by pulsed-field gel electrophoresis matched that calculated by the CGH, indicating a genome of 1.7 to 1.8 Mb with few unique genes. As in B. quintana, sequences in the prophage and the genomic islands were reported absent in B. koehlerae. In addition, sequence variability was recorded in the chromosome II-like region, where B. koehlerae showed an intermediate retention pattern of both coding and noncoding sequences. Although most of the genes missing in B. koehlerae are also absent from B. quintana, its phylogenetic placement near B. henselae suggests independent deletion events, indicating that host specificity is not solely attributed to genes in the genomic islands. Rather, the results underscore the instability of the genomic islands even within bacterial populations adapted to the same host-vector system, as in the case of B. henselae and B. koehlerae.     

Seroprevalence of Bartonella henselae,Toxoplasma gondii,FIV and FeLV infections in domestic cats in Japan

Seroprevalence of Bartonella henselae, Toxoplasma gondii, feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) infections was investigated in 1,447 domestic cats derived from the north (Hokkaido) to the south (Okinawa) prefectures in Japan. Of the cats investigated, 8.8% (128/1,447) were seropositive to B. henselae, 5.4% (78/1,447) to T. gondii, 9.8% (107/1,088) to FIV, and 2.9% (32/1,088) to FeLV, respectively. For B. henselae infection, the positive rate varied from 11.5% in cats of 1 to <2 years old to 7.2% in those over 3 years old. Outdoor cats showed higher positive rate (14.5%) than that (7.0%) in indoor ones. The rate (13.5%) in flea-infested cats was significantly higher than that (7.4%) in flea-negative cats. The positive rates in southern and urban sites were more likely to be higher than those in northern and suburban sites, suggesting that warm and humid environments, density of cat population, and raising status, including hygienic condition and flea infestation in cats may correlate to higher seroprevalence of B. henselae infection. For T. gondii, FIV and FeLV infections, the seroprevalence also tended to be higher in outdoor, flea-infested cats and advanced age groups. For FIV infection, the positive rates in male (14.3%) and outdoor cats (15.0%) were significantly higher than those in female (5.0%) and indoor cats (4.6%). On the other hand, no significant difference in seropositivities was observed in FeLV and T. gondii infections concerning to both genders and raising status.     

Detection of the Bartonella DNA by the method of nested PCR in patients after tick bites in Novosibirsk region

Arthropod-borne bacterial pathogen Bartonella DNA was detected in human blood cells after tick bites in summer 2003 and 2004 in Novosibirsk region by nested PCR with primers specific to groEL gene of HSP60 protein. Comparative assay of 190 p.b. of long PCR fragment revealed that the nucleotide sequences might belong to Bartonella henselae and Bartonella quintana.     

Does Coinfection of Bartonella henselae and FIV Induce Clinical Disorders in Cats?

It was found that Bartonella henselae (B. henselae) may induce clinical disorders in cats in natural conditions from a comparison of the serological status for B. henselae with the serostatus for feline immunodeficiency virus (FIV) and several clinical characteristics in 170 domestic cats. Seropositivity for B. henselae was not significantly different between FIV antibody-positive and -negative cats (18.4% vs 16.0%). The incidence of clinical characteristics were compared among four cat groups distinguished by the reactivity of sera against B. henselae and FIV. The incidence of lymph node swelling was lower in only FIV antibody-positive cats (3.0%), but higher in B. henselae antibody-positive cats (13.6%) and significantly higher in both B. henselae and FIV antibody-positive cats (42.9%) compared with the incidence of lymph node swelling in cats which were negative for both antibodies (5.5%). The same relation was also observed for the incidence of gingivitis among the 4 cat groups, suggesting that coinfection of B. henselae and FIV may be associated with gingivitis and lymphadenopathy in cats.     

Staining of Bartonella henselae with carboxyfluorescein diacetate succinimidyl ester for tracking infection in erythrocytes and epithelial cells

Bartonella infection (Bartonella henselae in particular) is responsible for a widening spectrum of human diseases. The persistent colonization of erythrocytes is a feature of Bartonella infection. Endothelial and epithelial cells are also widely used to study the pathogenesis of bartonellosis in vitro. Exploring a convenient method for visualizing the bacillus without affecting infectivity would be very interesting. Carboxyfluorescein diacetate succinimidyl ester (CFSE) has been previously used for staining several bacterial species to study their adhesion to host cells. The present study demonstrated the efficiency and safety of using CFSE in staining B. henselae. The staining of bacillus-invaded erythrocytes and epithelial cells in vitro successfully allowed for flow cytometry and confocol microscopy analyses. Parallel tests using untreated bacteria confirmed that CFSE staining did not result in side effects on the infectivity of B. henselae. Labeling Bartonella with CFSE is a valuable method for studying the bacteria-host interaction.     

Genome rearrangements, deletions, and amplifications in the natural population of Bartonella henselae

Cats are the natural host for Bartonella henselae, an opportunistic human pathogen and the agent of cat scratch disease. Here, we have analyzed the natural variation in gene content and genome structure of 38 Bartonella henselae strains isolated from cats and humans by comparative genome hybridizations to microarrays and probe hybridizations to pulsed-field gel electrophoresis (PFGE) blots. The variation in gene content was modest and confined to the prophage and the genomic islands, whereas the PFGE analyses indicated extensive rearrangements across the terminus of replication with breakpoints in areas of the genomic islands. We observed no difference in gene content or structure between feline and human strains. Rather, the results suggest multiple sources of human infection from feline B. henselae strains of diverse genotypes. Additionally, the microarray hybridizations revealed DNA amplification in some strains in the so-called chromosome II-like region. The amplified segments were centered at a position corresponding to a putative phage replication initiation site and increased in size with the duration of cultivation. We hypothesize that the variable gene pool in the B. henselae population plays an important role in the establishment of long-term persistent infection in the natural host by promoting antigenic variation and escape from the host immune response.     

Rapid allelic discrimination from real-time DNA amplification

A rapid method based on fluorescence resonance energy transfer and real-time polymerase chain reaction (PCR) is used to identify the Factor V genotype or to identify the bacterial species Bartonella qunitana or Bartonella henselae. Allelic discrimination was performed on the post-PCR product. Thermal cyclers other than the 7700 sequence detection system can be used for PCR, after which the products can be transferred to the 7700 sequence detection system for measurement of fluorescence. The Delta R (the change in fluorescence) for each dye can be collected at the final thermal cycle and an xy scatterplot used to identify the specific genotype based on graph location. There are many advantages to this method. A maximum of 96 samples can be genotyped in less than 2 h. The method tolerates a wide range of DNA concentrations and can be determined without prior DNA determination. Fluorescence is very sensitive, with a low failure rate for allelic discrimination.