Abstract
We have studied the diversity of B. henselae circulating in patients, reservoir hosts and vectors in Spain. In total, we have fully characterized 53 clinical samples from 46 patients, as well as 78 B. henselae isolates obtained from 35 cats from La Rioja and Catalonia (northeastern Spain), four positive cat blood samples from which no isolates were obtained, and three positive fleas by Multiple Locus Sequence Typing and Multiple Locus Variable Number Tandem Repeats Analysis. This study represents the largest series of human cases characterized with these methods, with 10 different sequence types and 41 MLVA profiles. Two of the sequence types and 35 of the profiles were not described previously. Most of the B. henselae variants belonged to ST5. Also, we have identified a common profile (72) which is well distributed in Spain and was found to persist over time. Indeed, this profile seems to be the origin from which most of the variants identified in this study have been generated. In addition, ST5, ST6 and ST9 were found associated with felines, whereas ST1, ST5 and ST8 were the most frequent sequence types found infecting humans. Interestingly, some of the feline associated variants never found on patients were located in a separate clade, which could represent a group of strains less pathogenic for humans.
Highlights
Bartonella henselae is a facultative intracellular alphaproteobacterium that can infect the erythrocytes and the endothelial cells of their hosts [1,2]
We have found a large variability of B. henselae variants, identifying a total of 10 multi-locus sequence typing (MLST) sequence types (ST) and 41 MLVA profiles
We have studied the diversity of B. henselae circulating in humans, reservoirs and vectors in Spain
Summary
Bartonella henselae is a facultative intracellular alphaproteobacterium that can infect the erythrocytes and the endothelial cells of their hosts [1,2]. Flea feces are the main source of infection and can be inoculated by contaminated cat claws to other cats or accidentally to humans [4]. B. henselae is the etiological agent of cat scratch disease (CSD), whose main symptom is a regional lymphadenopathy that may be accompanied by other manifestations such as fever or fatigue [5,6]. This disease is self-limiting and mainly produces a regional affectation, dissemination can occur, leading to other symptoms such as bacteremia, neuroretinitis, endocarditis or neurological manifestations [5,6]. The immunological status of the patient can influence the presentation of the disease; immunocompromised patients can present multi-vasoproliferative lesions in the liver or spleen (visceral peliosis), or on the skin (bacillary angiomatosis) [5,6]
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