Bartonella

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Bartonella

Bartonella (formerly known as Rochalimaea) is a genus

Genus

A genus is a low-level taxonomic rank used in the classification of living and fossil organisms. The taxonomic ranks are domain , kingdom , phylum, class , order , family , genus, and species....
of Gram-negative

Gram-negative

Gram-negative bacteria are those bacteria that do not retain crystal violet dye in the Gram staining protocol. In a Gram stain test, a counterstain is added after the crystal violet, coloring all Gram-negative bacteria with a red or pink color....
bacteria. Facultative intracellular parasites, Bartonella species can infect healthy people but are considered especially important as opportunistic

Opportunistic infection

An opportunistic infection is an infection caused by pathogens that usually do not cause disease in a healthy immune system. A Immunodeficiency, however, presents an "opportunity" for the pathogen to infect....
pathogen

Pathogen

A pathogen , infectious agent, or germ, is a biological agent that causes disease or illness to its Host .There are several substrates and pathways whereby pathogens can invade a host; the principal pathways have different episodic time frames, but soil contamination has the longest or most persistent potential for harboring...
s. Bartonella are transmitted by insect vectors

Vector (biology)

In epidemiology, a vector is an organism that does not cause disease itself but that transmits infection by conveying pathogens from one Host to another, serving as a transmission ....
such as tick

Tick

Tick is the common name for the small arachnids in superfamily Ixodoidea that, along with other mites, constitute the Acarina. Ticks are ectoparasites , living by hematophagy on the blood of mammals, birds, and occasionally reptiles and amphibians....
s, fleas, sand flies and mosquitoes. At least eight Bartonella species or subspecies

Subspecies

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Encyclopedia

Bartonella (formerly known as Rochalimaea) is a genus

Genus

Gram-negative

Opportunistic infection

Pathogen

Vector (biology)

Tick

Subspecies

In biology, subspecies is the taxonomic rank immediately subordinate to a species. A subspecies is a taxonomic group which is less distinct than the Common descent or species from which it originates....
are known to infect humans. In June 2007, a new species under the genus, called Bartonella melophagi, was discovered. This is the sixth species known to infect humans, and the ninth species and subspecies, overall, known to infect humans.

History

Bartonella species have been infecting humans for thousands of years, as demonstrated by Bartonella quintana DNA in a 4000 year old tooth. The genus is named after Alberto Leonardo Barton

Barton

Barton is an archaic English word meaning lands of the manor or meadow and may refer to several places or people:PlacesAustralia...
Thompson, a Peru

Peru

Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean....
vian scientist born in Argentina

Argentina

Argentina, officially the Argentine Republic , is a country in South America, constituted as a federation of 23 provinces and an autonomous city....
.

Bartonella was detected in ticks in 1999. Several species are human pathogens carried on rats.

In 2001 doctors treating Lyme disease

Lyme disease

Lyme disease, or borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia....
first reported that their patients were co-infected with Bartonella. Multiple reports of this finding seem to indicate that Bartonella is not only a tick borne but a tick-transmitted pathogen.

Infection cycle

The currently accepted model explaining the infection cycle holds that the transmitting vectors are blood-sucking arthropod

Arthropod

Arthropods are animals belonging to the Scientific classification Arthropoda , and include the insects, arachnids, crustaceans, and others....
s and the reservoir hosts are mammals. Immediately after infection, the bacteria colonize a primary niche, the endothelial cells. Every five days, a part of the Bartonella in the endothelial cells are released in the blood stream where they infect erythrocytes. The bacteria then invade and replicate within a phagosomal membrane inside the erythrocytes. Inside the erythrocytes, bacteria multiply until they reach a critical population density. At this point, the Bartonella has simply to wait until it is taken with the erythrocytes by a blood-sucking arthropod.

Pathophysiology

Bartonella infections are remarkable in the wide range of symptoms an infection can produce: the time course (acute or chronic) as well as the underlying pathology are highly variable.

Species	Human reservoir or incidental host?	Animal reservoir	Pathophysiology	Distribution
Bartonella pathophysiology in humans
B. bacilliformis	Reservoir		Causes Carrion's disease Carrion's disease Oroya fever or Carrion's Disease is an infectious disease produced by Bartonella bacilliformis infection.It is named for Daniel Alcides Carri?n.... (Oroya fever, Verruga peruana)	Peru Peru Peru , officially the Republic of Peru , is a country in western South America. It is bordered on the north by Ecuador and Colombia, on the east by Brazil, on the southeast by Bolivia, on the south by Chile, and on the west by the Pacific Ocean.... , Ecuador Ecuador Ecuador , officially the , literally, "Republic of the equator") is a representative democratic republic in South America, bordered by Colombia on the north, by Peru on the east and south, and by the Pacific Ocean to the west.... , and Colombia Colombia Colombia , officially the Republic of Colombia , is a country in north-western South America. Colombia is bordered to the east by Venezuela and Brazil; to the south by Ecuador and Peru; to the north by the Caribbean Sea; to the north west by Panama; and to the west by the Pacific Ocean....
B. quintana Bartonella quintana *Bartonella quintana, also known as Rochalimaea quintana*, is a microorganism that is transmitted by the human body louse. This microorganism is trench fever's etiologic agent....	Reservoir		Causes Trench fever Trench fever Trench fever is a moderately serious disease transmitted by body louse. It infected armies in Flanders, France, Poland, Galicia, Italy, Salonika, Macedonia, Mesopotamia, and Egypt in World War I and the German army in Russia during World War II.... , Bacillary angiomatosis Bacillary angiomatosis Bacillary angiomatosis is a form of angiomatosis associated with bacteria of the Bartonella genus.... , and endocarditis Endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures which may be involved include the interventricular septum, the chordae tendinae, the mural endocardium, or even on intracardiac devices....	Worldwide
B. clarridgeiae	Incidental	Domestic cat	Cat-scratch Disease
B .elizabethae	Incidental	Rat	Endocarditis Endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures which may be involved include the interventricular septum, the chordae tendinae, the mural endocardium, or even on intracardiac devices....
B. grahamii	Incidental	Mouse	Endocarditis Endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures which may be involved include the interventricular septum, the chordae tendinae, the mural endocardium, or even on intracardiac devices.... and Neuroretinitis
B. henselae Bartonella henselae *Bartonella henselae* is a proteobacteria that can cause bacteremia, endocarditis, bacillary angiomatosis, and peliosis hepatis. It is also the causative agent of cat-scratch disease which, as the name suggests, occurs after a cat bite or scratch....	Incidental	Domestic cat	Cat-scratch Disease, Bacillary angiomatosis Bacillary angiomatosis Bacillary angiomatosis is a form of angiomatosis associated with bacteria of the Bartonella genus.... , Peliosis hepatis Peliosis hepatis Peliosis Hepatis is an uncommon Blood vessel condition characterised by randomly distributed multiple blood-filled cavities throughout the liver.... , Endocarditis Endocarditis Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves . Other structures which may be involved include the interventricular septum, the chordae tendinae, the mural endocardium, or even on intracardiac devices.... , Bacteremia Bacteremia Bacteraemia is the presence of bacterium in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood is always abnormal.... with fever and Neuroretinitis	Worldwide
B. koehlerae	Incidental	Domestic cat
B. vinsonii	Incidental	Mouse, Dog
B. washoensis	Incidental	Squirrel	Myocarditis Myocarditis In medicine , myocarditis is inflammation of the myocardium , the muscular part of the heart. It is generally due to infection . It may cause chest pain, rapid signs of heart failure, or sudden death....
B. rochalimae Bartonella rochalimae *Bartonella rochalimae* is a recently discovered strain of Gram-negative bacteria in the Bartonella genus, isolated by researchers at the University of California, San Francisco , Massachusetts General Hospital, and the United States Centers for Disease Control and Prevention....	Incidental	Unknown	Carrion´s disease like symptoms
References:

Treatment

Treatment is dependent on which strain of Bartonella is found in a given patient. While Bartonella species are susceptible to a number of standard antibiotics in vitro

In vitro

In vitro refers to the technique of performing a given procedure in a controlled environment outside of a living organism. Some may argue that in vitro refers to a process that is created in a "test tube"; however, Robert Kail and John Cavanaugh on page 58 in the 4th edition of Human Development: A Life-Span View cite that in fact th...
—macrolide
Macrolide

The macrolides are a group of Medication whose activity stems from the presence of a macrolide ring, a large macrocycle lactone ring to which one or more deoxy sugars, usually cladinose and desosamine, may be attached....
s and tetracycline
Tetracycline antibiotics

Tetracyclines are a group of broad-spectrum antibiotics whose general usefulness has been reduced with the onset of bacterial resistance. Despite this, they remain the treatment of choice for some specific indications....
, for example—the efficacy of antibiotic treatment in immunocompetent individuals is uncertain. Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include trimethoprim-sulfamethoxazole, gentamicin
Gentamicin

Gentamicin is an aminoglycoside antibiotic, used to treat many types of bacteriuml infections, particularly those caused by Gram-negative bacteria....
, ciprofloxacin
Ciprofloxacin

Ciprofloxacin is a synthetic chemotherapeutic agent used to treat severe and life threatening bacterial infections. Ciprofloxacin is commonly referred to as a fluoroquinolone drug and is a member of the quinolone class of antibacterials....
, and rifampin; B. henselae is generally resistant to penicillin
Penicillin

Penicillin is a group of antibiotics derived from Penicillium fungi. They are Beta-lactam antibiotics used in the treatment of bacterial infections caused by susceptible, usually Gram-positive, organisms....
, amoxicillin
Amoxicillin

Amoxicillin or amoxycillin is a moderate-spectrum, bacteriolytic, beta-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms....
, and nafcillin.

Epidemiology

Whether because rodent associated, IV transmitted or because tick borne disease is higher risk for the homeless, homeless IV drug users are at high risk for Bartonella infections, particularly B. elizabethae. B. elizabethae seropositivity rates in this population range from 12.5% in Los Angeles, to 33% in Baltimore, Maryland, 46% in New York, and in Sweden 39%.

Bartonella

History

Infection cycle

Pathophysiology

Treatment

Epidemiology

See also