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Evaluation of human seroreactivity to Bartonella species in Sweden
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Klinisk bakteriologi, L Engstrand)
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1999 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 37, no 5, 1381-1384 p.Article in journal (Refereed) Published
Abstract [en]

Among the species that compose the expanding genus Bartonella, thus far only B. henselae and B. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden,we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to B. henselae, B. quintana, and B. elizabethae, Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonella positivity rates for the blood donor and patient group, respectively, when a cutoff titer of greater than or equal to 64 was chosen. Among the blood donors, four were seropositive to B, elizabethae; one of these also had concordant positive titer to B. henselae, In the patient group, 14 serum samples were positive against Bartonella spp, These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens, These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis, Postmortem serological analysis revealed a high titer against B. elizabethae, PCR and nucleotide sequencing of the myocardial tissue from this patient, and of Liver tissue from one of the other three patients, showed sequences similar to B. quintana, The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence of Bartonella spp, in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.

Place, publisher, year, edition, pages
1999. Vol. 37, no 5, 1381-1384 p.
National Category
Other Medical Sciences not elsewhere specified
Identifiers
URN: urn:nbn:se:uu:diva-54537ISI: 000079792400029OAI: oai:DiVA.org:uu-54537DiVA: diva2:82446
Available from: 2013-04-24 Created: 2008-10-17 Last updated: 2017-12-04Bibliographically 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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Holmberg, MartinMcGill, SvenaEhrenborg, ChristianWesslen, LarsHjelm, EvaBlad, LarsRegnery, RussellFriman, Göran

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