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High Bartonella spp. seroprevalence in a Swedish homeless population but no evidence of trench fever
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases. (Sjölin)
Beroendecentrum, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Bacteriology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases. (Sjölin)
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2008 (English)In: Scandinavian Journal of Infectious Diseases, ISSN 0036-5548, E-ISSN 1651-1980, Vol. 40, no 3, 208-215 p.Article in journal (Refereed) Published
Abstract [en]

Blood samples and epidemiological data were collected from 50 homeless patients in central Stockholm, Sweden. Sera were analysed for antibodies to B. henselae, B. quintana, B. elizabethae and B. grahamii. Whole blood was cultured and used as substrate for a newly developed quantitative real time polymerase chain reaction (QPCR) specifically targeting Bartonella spp. DNA. 61 matched blood donor sera were used as controls. Homeless patients were significantly more often seropositive to Bartonella spp. than controls (OR 7.58 (3.30-17.39), p<0.05). Reactivity to the B. elizabethae antigen was dominating, although the difference between patients and controls was most significant in seroreactivity to the B. henselae antigen. There was no evidence of an ongoing B. quintana epidemic. The absence of louse infestation could explain the lack of B. quintana bacteraemia and the failure to amplify Bartonella DNA.

Place, publisher, year, edition, pages
2008. Vol. 40, no 3, 208-215 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-11960DOI: 10.1080/00365540701632972ISI: 000253335900003PubMedID: 17852922OAI: oai:DiVA.org:uu-11960DiVA: diva2:39729
Available from: 2007-11-07 Created: 2009-03-19 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Bartonella Infections in Sweden:: Clinical Investigations and Molecular Epidemiology
Open this publication in new window or tab >>Bartonella Infections in Sweden:: Clinical Investigations and Molecular Epidemiology
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Characteristically, in infections that are caused by the zoonotic pathogen Bartonella naturally infected reservoir hosts are asymptomatic, where infected incidental, non-natural, hosts develop symptomatic disease. Cat-scratch disease (CSD) is a well known example. Bartonella infections in humans may be self-limiting or fulminant and affect different organ systems.

The objectives of the present thesis were to (1) identify and characterise Bartonella infection cases in Sweden, (2) to investigate certain human populations regarding Bartonella infections, and (3) compare natural populations of different Bartonella species.

Cases with typical and atypical CSD were recognised by using a combination of PCR and serology. Gene sequence comparisons of different genes in B. henselae isolates from the United States and Europe showed that ftsZ gene variation is a useful tool for Bartonella genotyping.

Myocarditis was a common finding among Swedish elite orienteers succumbing to sudden unexpected cardiac death (SUCD). The natural cycle of Bartonella spp., the life style of orienteers, elevated antibody titres to Bartonella antigens, Bartonella DNA amplified from myocardium and the lack of another feasible explanation make Bartonella a plausible aetiological factor.

The first reported case of Bartonella endocarditis (B. quintana) was identified in an immunocompromised patient who underwent heart valve replacement. The patient had been body louse-infested during his childhood. It is hypothesised that a chronic B. quintana infection was activated by the immunosuppression.

There was no evidence of an ongoing trench fever (TF) epidemic in a Swedish homeless population, although an increased risk for exposure to Bartonella antigens was demonstrated. The lack of louse infestation might explain the absence of B. quintana bacteremia and low B. quintana antibody titres.

Comparisons of genetic loci and the whole genomes of environmental B. grahamii isolates from the Uppsala region, Sweden displayed variants that were not related to specific host species but to geographic locality. Natural boundaries seemed to restrict gene flow.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 62 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 257
Keyword
Communicable diseases, Bartonella, clinical studies, molecular epidemiology, Infektionssjukdomar
Identifiers
urn:nbn:se:uu:diva-7860 (URN)978-91-554-6886-6 (ISBN)
Public defence
2007-05-18, Enghoffsalen, Ingång 50, Akademiska sjukhuset, Uppsala, 09:15
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Available from: 2007-04-26 Created: 2007-04-26 Last updated: 2011-04-14Bibliographically approved

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Ehrenborg, ChristianHjelm, EvaFriman, GöranHolmberg, Martin

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