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A study on forensic samples of Bartonella spp. antibodies in Swedish intravenous heroin addicts
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Friman)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
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2003 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, APMIS, ISSN 0903-4641, Vol. 111, no 4, 507-513 p.Article in journal (Refereed) Published
Abstract [en]

Infection with Bartonella, an emerging bacterial pathogen which often affects immunodeficient patients, has been reported in Sweden over the past few years, with a high seroprevalence of B. elizabethae. A high prevalence of antibodies against B. elizabethae has also been found in urban intravenous drug users in the USA. Using immunofluorescence, we retrospectively examined serum samples taken at autopsy from 59 Swedish intravenous drug addicts from the Stockholm area for evidence of antibodies against 6 pathogenic strains of Bartonella. The 59 addicts died following heroin injection during the years 1987–1992 and include 24 individuals (41%) who were additionally HIV-positive. An overall seropositivity rate for Bartonella spp. of 39% (23/59) was found with the following antigenic reactivities: B. elizabethae, 39% (23/59); B. grahamii, 3% (2/59); B. henselae (Houston-1), 14% (8/59); and B. quintana, 3% (2/59). There were no positive reactions for B. henselae (Marseille) or B. vinsonii subsp. vinsonii. The Bartonella-seropositive cases included 11/23 (48%) individuals who were HIV-positive. Subacute to chronic myocarditis was seen in 2/11 microscopically investigated Bartonella-seropositive cases that were HIV-negative and in 1/14 seronegative cases. No cases of endocarditis or other common manifestations of Bartonella infection were found. An overall Bartonella seropositivity of 21% (9/44) was observed in control forensic autopsy samples.

Place, publisher, year, edition, pages
2003. Vol. 111, no 4, 507-513 p.
Keyword [en]
Adult, Antibodies; Bacterial/*blood, Bartonella/*immunology, Bartonella Infections/blood/immunology/*microbiology, Female, Fluorescent Antibody Technique; Indirect, Heroin, Humans, Male, Middle Aged, Myocarditis/epidemiology/microbiology, Research Support; Non-U.S. Gov't, Retrospective Studies, Seroepidemiologic Studies, Substance Abuse; Intravenous/blood/etiology/immunology/*microbiology, Sweden/epidemiology
National Category
Other Medical Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:uu:diva-74385DOI: 10.1034/j.1600-0463.2003.1110409.xPubMedID: 12780526OAI: oai:DiVA.org:uu-74385DiVA: diva2:102295
Available from: 2008-04-20 Created: 2008-04-20 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Serological Parameters of Bartonella spp. Infection: Focus on Prevalences in Various Subgroups of the Swedish Population
Open this publication in new window or tab >>Serological Parameters of Bartonella spp. Infection: Focus on Prevalences in Various Subgroups of the Swedish Population
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Bartonella spp. are emerging bacterial pathogens which continue to achieve an ever-increasing level of clinical importance and awareness.  As Bartonella infections are common zoonoses in the U.S., the existence of Bartonella infection in Sweden, which had not been documented prior to the onset of our investigations, was of considerable interest.

Initially, serological parameters of Bartonella infection were evaluated using a series of immunoblot analyses in an effort to elucidate the human humoral immunity induced by this pathogen.  An immunodominant epitope of B. henselae was identified, designated Bh83, which was hypothesized to be a conserved antigen during Bartonella infection. Further, an in-depth characterization of the immunoglobulin (Ig) isotype and IgG subclass response revealed a primary role of IgA and IgG1 in the immune induction during Bartonella infection.

As the presence and degree of exposure to Bartonella spp. in Sweden was previously unknown, several studies were initiated to evaluate the level of seroreactivity to Bartonella spp. antigen in various subgroups of the Swedish human and animal population using indirect fluorescent-antibody assay (IFA).  A preliminary study of a select group of patients and blood donors represented the first documentation of Bartonella exposure in Sweden, as well as identified the first two cases of B. quintana-like infections in Sweden.  To assess the endemic level of antibodies to Bartonella spp. in Sweden, a large sampling of blood donor sera collected nationwide were subsequently analyzed for reactivity to six Bartonella strains.  The largest seroprevalence was to B. elizabethae, with relatively low baseline levels of reactivity to the other Bartonella antigens tested.  Correlated risk factors for infection included working outdoors and contact with cats, among others.  Further studies of sera obtained from elite orienteers and intravenous drug users in Sweden revealed a high level of exposure to Bartonella spp. in such cohorts, predominantly to B. elizabethae antigen.  Consistent with the aforementioned findings of elevated titers to B. elizabethae in humans, a high seroprevalence was found in cats, a known reservoir for Bartonella spp., as well.

With relatively little known of the pathogenicity and epidemiology of Bartonella infection, these studies provide insight into various aspects of the distribution, risk factors for infection, specific humoral immune response to infection, and the prevalence of Bartonella spp. in human and cat populations in Sweden and serve as a framework for future studies.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2012. 81 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 730
Keyword
Bartonella, Sweden, serological studies
National Category
Other Medical Sciences not elsewhere specified
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-162504 (URN)978-91-554-8238-1 (ISBN)
Public defence
2012-01-21, Uppsala, Sweden, 09:00 (English)
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Supervisors
Available from: 2012-01-10 Created: 2011-11-30 Last updated: 2012-01-16Bibliographically approved

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McGill, SvenaHjelm, EvaLindquist, OlleFriman, Göran

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