Bartonellosis: an emerging infectious disease of zoonotic importance to animals and human beings
01 Feb 2010-Journal of Veterinary Emergency and Critical Care (J Vet Emerg Crit Care (San Antonio))-Vol. 20, Iss: 1, pp 8-30
TL;DR: A review of clinically relevant observations related to Bartonella species as emerging pathogens in veterinary and human medicine to provide a review of clinical relevant observations.
Abstract: Objective – To provide a review of clinically relevant observations related to Bartonella species as emerging pathogens in veterinary and human medicine.
Data Sources – Literature as cited in PubMed and as generated by each of the authors who have contributed to various aspects of the clinical understanding of bartonellosis.
Human Data Synthesis – Important historical and recent publications illustrating the evolving role of animal reservoirs as a source of human infection.
Veterinary Data Synthesis – Comprehensive review of the veterinary literature.
Conclusions – In addition to inducing life-threatening illnesses, such as endocarditis, myocarditis, and meningoencephalitis and contributing to chronic debilitating disease, such as arthritis, osteomyelitis, and granulomatous inflammation in cats, dogs, and potentially other animal species; pets and wildlife species can serve as persistently infected reservoir hosts for the transmission of Bartonella spp. infection to veterinary professionals and others with direct animal contact.
Citations
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TL;DR: MALDI-TOF-MS is a powerful, rapid, precise, and cost-effective method for identification of intact bacteria, compared to conventional phenotypic techniques or molecular biology.
183 citations
TL;DR: This review considers the role of small companion animals in One Health and specifically addresses the major vector-borne infectious diseases that are shared by man, dogs and cats.
Abstract: The international prominence accorded the 'One Health' concept of co-ordinated activity of those involved in human and animal health is a modern incarnation of a long tradition of comparative medicine, with roots in the ancient civilizations and a golden era during the 19th century explosion of knowledge in the field of infectious disease research. Modern One Health tends to focus on zoonotic pathogens emerging from wildlife and production animal species, but one of the most significant One Health challenges is rabies for which there is a canine reservoir. This review considers the role of small companion animals in One Health and specifically addresses the major vector-borne infectious diseases that are shared by man, dogs and cats. The most significant of these are leishmaniosis, borreliosis, bartonellosis, ehrlichiosis, rickettsiosis and anaplasmosis. The challenges that lie ahead in this field of One Health are discussed, together with the role of the newly formed World Small Animal Veterinary Association One Health Committee.
179 citations
Cites background from "Bartonellosis: an emerging infectio..."
...henselae acquired directly from an infected cat and mostly likely transmitted between cats by the cat flea Ctenocephalides felis [21-23]....
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...Attention is now focussed on these organisms due to a series of investigations showing that they may be associated with a wide range of human syndromes that were often considered chronic idiopathic diseases [21,25]....
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...There remains much to learn about the transmission of Bartonella from companion animals to man, but veterinary professionals have an occupational exposure risk due to their frequency of exposure to animal bites, arthropods, arthropod faeces and animal bodily fluids [21]....
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TL;DR: Disease-specific recommendations include incentives to undertake research aimed at the development of new diagnostic tests, veterinary-specific antimicrobial products and vaccines, as well as initiatives to promote best practices in veterinary diagnostic laboratories and prudent antimicrobial usage.
142 citations
Cites background from "Bartonellosis: an emerging infectio..."
...Bartonella bacteraemia is most frequent in stray cats, cats in shelters/catteries and young cats infested with fleas (Boulouis et al., 2005; Chomel et al., 2009; Breitschwerdt et al., 2010)....
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...Domestic cats are the natural reservoir of B. henselae, which is the main agent of CSD. Bartonella bacteraemia is most frequent in stray cats, cats in shelters/catteries and young cats infested with fleas (Boulouis et al., 2005; Chomel et al., 2009; Breitschwerdt et al., 2010)....
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TL;DR: A One Health approach to bartonellosis and other zoonotic infections is needed to properly address animal health, public health, and environmental factors that influence the distribution and transmission of these bacteria.
Abstract: In recent years, an increasing number of Bartonella species have been identified as zoonotic pathogens, transmitted by animal bites, scratches, arthropods and even by needle sticks. Considering the diversity of newly discovered Bartonella species and subspecies and the large number and ecologically diverse animal reservoir hosts and the evolving spectrum of arthropod vectors that can transmit these bacteria among animals and humans, the clinical and diagnostic challenges posed by Bartonella transmission in nature are presumably much more complex than is currently appreciated by diagnosticians, vector biologists, ecologists, physicians, or veterinarians. Historically the term "bartonellosis" was attributed to infections with Bartonella bacilliformis, transmitted by sandflies in the Peruvian Andes. Currently, however, bartonellosis now includes infections caused by any Bartonella sp. anywhere in the world. Potentially, because Bartonella spp. can infect erythrocytes, endothelial cells, pericytes, CD34(+) progenitor cells, and various macrophage-type cells, including microglial cells, dendritic cells, and circulating monocytes in vitro, the clinical and pathological manifestations of bartonellosis appear to be very diverse in both sick animals and human patients. Because 75% of emerging infectious diseases are zoonoses, many of which are vector-transmitted by an arthropod, a One Health approach to bartonellosis and other zoonotic infections is needed to properly address animal health, public health, and environmental factors that influence the distribution and transmission of these bacteria. The One Health concept encourages a spirit of cooperation among animal, environmental, and human health professionals and promotes developing integrated solutions for complex problems that impact the health of animals, humans, and the planet. Importantly, substantial research is needed to define the medical importance of this genus as a cause of animal and human illnesses.
116 citations
Cites background or result from "Bartonellosis: an emerging infectio..."
...Pet cats and dogs often develop very similar or the same disease manifestations as human patients (Beerlage et al. 2012; Breitschwerdt et al. 2010a; Chomel et al. 2009)....
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...B ecause of rapid changes in microbiological, pathophysiological, and medically relevant information regarding bartonellosis, One Health professionals, including ecologists, environmentalists, microbiologists, physicians, vector biologists, and veterinarians, have published numerous authoritative reviews during the past two decades, of which a subset are cited (Billeter et al. 2008; Boulouis et al. 2005; Breitschwerdt and Kordick 2000; Breitschwerdt et al. 2010a; Chomel et al. 2006; Harms and Dehio 2012; Kaiser et al. 2011; Minnick and Battisti 2009)....
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...…have published numerous authoritative reviews during the past two decades, of which a subset are cited (Billeter et al. 2008; Boulouis et al. 2005; Breitschwerdt and Kordick 2000; Breitschwerdt et al. 2010a; Chomel et al. 2006; Harms and Dehio 2012; Kaiser et al. 2011; Minnick and Battisti 2009)....
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...As evidenced by reports in the past 4 years, the spectrum of human disease associated with the genus Bartonella continues to expand, requiring periodic reassessment as new information becomes available (Breitschwerdt et al. 2010a; Harms and Dehio 2012; Kaiser et al. 2011; Zangwill 2013)....
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...Although the literature is not exhaustive, the clinical and pathological manifestations of bartonellosis in animals (Breitschwerdt et al. 2010a; Pérez Vera, Diniz, et al. 2013) and humans (Breitschwerdt et al. 2012; Florin et al. 2008; Lamas et al. 2008) have been reviewed....
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TL;DR: There is a continuing need for consumer awareness of products registered for cats and dogs and their safety, and the possibility of feral animals serving as potential reservoirs for flea infestations has taken on additional importance because of the lack of effective environmental controls in recent years.
Abstract: The cat flea Ctenocephalides felis felis (Bouche) is the most important ectoparasite of domestic cats and dogs worldwide. It has been two decades since the last comprehensive review concerning the biology and ecology of C. f. felis and its management. Since then there have been major advances in our understanding of the diseases associated with C. f. felis and their implications for humans and their pets. Two rickettsial diseases, flea-borne spotted fever and murine typhus, have been identified in domestic animal populations and cat fleas. Cat fleas are the primary vector of Bartonella henselae (cat scratch fever) with the spread of the bacteria when flea feces are scratched in to bites or wounds. Flea allergic dermatitis (FAD) common in dogs and cats has been successfully treated and tapeworm infestations prevented with a number of new products being used to control fleas. There has been a continuous development of new products with novel chemistries that have focused on increased convenience and the control of fleas and other arthropod ectoparasites. The possibility of feral animals serving as potential reservoirs for flea infestations has taken on additional importance because of the lack of effective environmental controls in recent years. Physiological insecticide resistance in C. f. felis continues to be of concern, especially because pyrethroid resistance now appears to be more widespread. In spite of their broad use since 1994, there is little evidence that resistance has developed to many of the on-animal or oral treatments such as fipronil, imidacloprid or lufenuron. Reports of the perceived lack of performance of some of the new on-animal therapies have been attributed to compliance issues and their misuse. Consequentially, there is a continuing need for consumer awareness of products registered for cats and dogs and their safety.
99 citations
References
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TL;DR: Data demonstrate that the cat flea readily transmits B. henselae to cats, and control of feline infestation with this arthropod vector may provide an important strategy for the prevention of infection of both humans and cats.
Abstract: Bartonella henselae is an emerging bacterial pathogen, causing cat scratch disease and bacillary angiomatosis. Cats bacteremic with B. henselae constitute a large reservoir from which humans become infected. Prevention of human infection depends on elucidation of the natural history and means of feline infection. We studied 47 cattery cats in a private home for 12 months to determine the longitudinal prevalence of B. henselae bacteremia, the prevalence of B. henselae in the fleas infesting these cats, and whether B. henselae is transmitted experimentally to cats via fleas. Vector-mediated transmission of B.henselae isolates was evaluated by removing fleas from the naturally bacteremic, flea-infested cattery cats and transferring these fleas to specific-pathogen-free (SPF) kittens housed in a controlled, arthropod-free University Animal Facility. B. henselae bacteremia was detected in 89% of the 47 naturally infected cattery cats. A total of 132 fleas were removed from cats whose blood was simultaneously cultured during different seasons and were tested individually for the presence of B. henselae DNA by PCR. B. henselae DNA was detected in 34% of 132 fleas, with seasonal variation, but without an association between the presence or the level of bacteremia in the corresponding cat. Cat fleas removed from bacteremic cattery cats transmitted B. henselae to five SPF kittens in two separate experiments; however, control SPF kittens housed with highly bacteremic kittens in the absence of fleas did not become infected. These data demonstrate that the cat flea readily transmits B. henselae to cats. Control of feline infestation with this arthropod vector may provide an important strategy for the prevention of infection of both humans and cats.
555 citations
TL;DR: The in vitro antibiotic susceptibility data and the knowledge of the in vivo efficacies of antibiotics for each clinical manifestation are compiled, and the treatment recommendations are summarized and ranked according to the Infectious Diseases Society of America practice guidelines.
Abstract: Members of the genus Bartonella are facultative intracellular bacteria belonging to the alpha 2 subgroup of the class Proteobacteria and are phylogenetically closely related to Brucella species (15, 73). Until 1993, only three diseases were known to be caused by Bartonella species: Carrion's disease (Bartonella bacilliformis), trench fever (Bartonella quintana), and cat scratch disease (CSD; Bartonella henselae). The genus now comprises B. bacilliformis, species of the former genera Rochalimea and Grahamella (14, 18), and additional, recently described species (Table (Table1).1). In mammals, each Bartonella species is highly adapted to its reservoir host; the bacteria can persist in the bloodstream of the host as the result of intraerythrocytic parasitism (49). Intraerythrocytic localization of B. henselae has been demonstrated in cat erythrocytes (88), and B. bacilliformis bacilli have been observed within erythrocytes during the acute phase of Carrion's disease (Oroya fever) (88). Bartonellae also have a tropism for endothelial cells, and intracellular B. henselae can be identified in endothelial cells infected in vitro (28), although intraendothelial cell bacilli have not been identified in vivo.
TABLE 1.
Epidemiological and clinical data for species of the genus Bartonella
Bartonella species cause long-recognized diseases, such as Carrion's disease, trench fever, and CSD, and more recently recognized diseases, such as bacillary angiomatosis (BA), peliosis hepatis (PH), chronic bacteremia, endocarditis, chronic lymphadenopathy, and neurological disorders (Table (Table2)2) (73). A remarkable feature of the genus Bartonella is the ability of a single species to cause either acute or chronic infection and either vascular proliferative or suppurative manifestations.
TABLE 2.
Human diseases caused by Bartonella spp.
The pathological response to infection with Bartonella spp. varies substantially with the status of the host immune system. Indeed, infection with the same Bartonella species (e.g., B. henselae) can result in a focal suppurative reaction (CSD in immunocompetent patients), a multifocal angioproliferative response (BA in immunocompromised patients), endovascular multiplication of the bacteria (endocarditis), or an exaggerated inflammatory response without evidence of bacteria in patient tissues (meningoencephalitis) (86).
Some of the diseases due to Bartonella species can resolve spontaneously without treatment, but in other cases, the disease is fatal without antibiotic treatment and/or surgery. The clinical situations are so different that a single treatment for all Bartonella-related diseases has not been identified, and the approach to treatment must be adapted to each species and clinical situation (49). Moreover, the database of clinical studies with a standard case definition, culture confirmation, rigidly defined disease outcomes, and patients with similar host defenses is very limited. Thus, case reports with a very limited number of subjects often serve to dictate therapy. The objective of this minireview is to summarize the antibiotic treatment recommendations for the different infections caused by Bartonella species. We have compiled the in vitro antibiotic susceptibility data and our knowledge of the in vivo efficacies of antibiotics for each clinical manifestation, and finally, we have summarized and ranked our treatment recommendations according to the Infectious Diseases Society of America (IDSA) practice guidelines (see Table Table5)5) (51).
TABLE 5.
System for ranking recommendations in clinical guidelines recommended by IDSAa
450 citations
TL;DR: Recognition of the procedures required to identify this and other Rochalimaea species suggests that clinical laboratories should prolong the incubation times of cultures of blood and tissue from patients with suspected endocarditis, patients with fever of unknown origin, and immunocompromised patients with Fever so that the full spectrum of disease caused by these organisms can be recognized.
Abstract: A Rochalimaea-like organism (strain F9251) was isolated from a patient with endocarditis after blood drawn for culture before antimicrobial therapy was subcultured onto blood and chocolate agars and incubated for 2 weeks in 5% CO2. The strain was phenotypically similar to known Rochalimaea species. The cellular fatty acid composition of strain F9251 was close to but distinct from those of the three known Rochalimaea species and was most similar to that of R. vinsonii. Labeled DNA from strain F9251 was 59 to 67% related to DNAs from type strains of the three described Rochalimaea species, and its 16S rRNA gene sequence was 98.9% or more homologous to their 16S rRNA gene sequences. These findings support classification of F9251 as a new Rochalimaea species, for which the name Rochalimaea elizabethae sp. nov. is proposed. The patient infected with the organism had large bacterial vegetations on his aortic valve and was cured with antibiotics and valve-replacement surgery. Recognition of the procedures required to identify this and other Rochalimaea species suggests that clinical laboratories should prolong the incubation times of cultures of blood and tissue from patients with suspected endocarditis, patients with fever of unknown origin, and immunocompromised patients with fever so that the full spectrum of disease caused by these organisms can be recognized.
398 citations
TL;DR: Pets represent a large reservoir for human infection and can be a source of infection for humans and animals alike.
Abstract: Among the many mammals infected with Bartonella spp., pets represent a large reservoir for human infection because most Bartonella spp. infecting them are zoonotic. Cats are the main reservoir for Bartonella henselae, B. clarridgeiae, and B. koehlerae. Dogs can be infected with B. vinsonii subsp. berkhoffii, B. henselae, B. clarridgeiae, B. washoensis, B. elizabethae, and B. quintana. The role of dogs as an important reservoir of Bartonella spp. is less clear than for cats because domestic dogs are more likely to be accidental hosts, at least in nontropical regions. Nevertheless, dogs are excellent sentinels for human infections because a similar disease spectrum develops in dogs. Transmission of B. henselae by cat fleas is better understood, although new potential vectors (ticks and biting flies) have been identified. We review current knowledge on the etiologic agents, clinical features, and epidemiologic characteristics of these emerging zoonoses.
398 citations
TL;DR: The improved clinical presentation and prognosis of the disease observed during the last decades is confirmed, and an evolution could be related to earlier diagnosis due to better physician awareness and more sensitive diagnostic techniques.
398 citations