Le Traitement des infections à Bartonella henselae et Bartonella quintana

Abstract

Bacteria of the genus Bartonella are now considered as agent of emerging and re-emerging infectious diseases, because of the recent description of new species among this genus. These bacteria are implicated in human infectious diseases especially in cat scratch disease, bacillary angiomatosis or blood culture negative endocarditis. Development of molecular tools in the past few years, especially PCR amplification and sequencing, allow the improvment of the diagnosis of such diseases. Diagnosis can be made directly (by culture, immunodetection in situ or PCR amplification) or indirectly (by serology). These bacteria are susceptible in vitro to almost all antibiotics which contrasts with in vivo data. This paradigm could be explain in part by the fact that only aminoglycosides are bactericidal against these pathogens. Thus, clinical efficacy of antibiotics against Bartonella spp. is heterogeneous depending on the disease considered and current therapeutic recommendations should be adapted in each clinical situation. Such therapeutic recommendations are given in this review according to the clinical situation.