Bartonella Infection Associated with Rheumatoid Illnesses in Humans

一种细菌一历史性cally associated with cat scratch fever and transmitted predominately by fleas may also play a role in human rheumatoid illnesses such as arthritis, according to new research from North Carolina State University.

Bartonellais a bacterium that is maintained in nature by fleas, ticks and other biting insects. It can be transmitted to humans both by these parasites as well as by bites or scratches from infected cats and dogs. The most commonly knownBartonella-related illness is cat scratch disease, caused byB. henselae, a species ofBartonellathat can be carried in a cat’s blood for months to years.

In collaboration with Dr. Robert Mozayeni, a rheumatologist based in Maryland, and Dr. Ricardo Maggi, a research assistant professor at NC State,Dr. Ed Breitschwerdt, professor of internal medicine at NC State’s College of Veterinary Medicine and adjunct professor of medicine at Duke University, tested blood samples from 296 patients for evidence ofBartonellainfection. The patients had previously been diagnosed with conditions ranging from Lyme disease to arthritis to chronic fatigue. Since rheumatic symptoms have sometimes been reported following cat scratch disease, the researchers wanted to see if these patients tested positive forB. henselae.

Of the 296 patients, 62 percent hadBartonellaantibodies, which supported prior exposure to these bacteria. Bacterial DNA was found in 41 percent of patient samples, allowing investigators to narrow the species ofBartonellapresent, withB. henselae,B. kohleraeandB. vinsoniisubsp.berkhoffiithe most prevalent. The study appears inEmerging Infectious Diseases.

“Based upon this one study we can’t definitively say that a subset of rheumatoid illnesses have an infectious origin,” Breitschwerdt says. “However, our results thus far do implicateBartonellaas a factor in at least some cases. If the link betweenBartonellaand rheumatoid illnesses is valid, it may also open up more directed treatment options for patients with rheumatoid illnesses.”

-peake-

Note to editors: Abstract of the paper follows.

“Bartonellaspp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region”

Authors:Ricardo G. Maggi, Elizabeth L. Pultorak, Barbara C. Heggarty, Julie M. Bradley, Maria Correa, Ed Breitschwerdt, North Carolina State University; B. Robert Mozayeni, Translational Medicine Group, PC, Maryland

Published:Online ahead of print inEmerging Infectious Diseases

Abstract

Bartonellaspp. infection has been reported in association with an expanding spectrum of symptoms and lesions. Among 296 patients examined by a rheumatologist, prevalence of antibodies againstBartonella henselae, B. koehlerae,orB. vinsoniisubsp.berkhoffii(185 [62%]) andBartonellaspp. bacteremia (122 [41.1%]) was high. Conditions diagnosed before referral included Lyme disease (46.6%), arthralgia/arthritis (20.6%), chronic fatigue (19.6%), and fibromyalgia (6.1%).B. henselae菌血症明显与之前相关联referral to a neurologist, most often for blurred vision, subcortical neurologic deficits, or numbness in the extremities, whereasB. koehleraebacteremia was associated with examination by an infectious disease physician. This cross-sectional study cannot establish a causal link betweenBartonellaspp. infection and the high frequency of neurologic symptoms, myalgia, joint pain, or progressive arthropathy in this population; however, the contribution ofBartonellaspp. infection, if any, to these symptoms should be systematically investigated.