Abstract
Bacteria from the genus Bartonella are emerging blood-borne bacteria, capable of causing long-lasting infection in marine and terrestrial mammals, including humans. Bartonella are generally well adapted to their main host, causing persistent infection without clinical manifestation. However, these organisms may cause severe disease in natural or accidental hosts. In humans, Bartonella species have been detected from sick patients presented with diverse disease manifestations, including cat scratch disease, trench fever, bacillary angiomatosis, endocarditis, polyarthritis, or granulomatous inflammatory disease. However, with the advances in diagnostic methods, subclinical bloodstream infection in humans has been reported, with the potential for transmission through blood transfusion been recently investigated by our group. The objective of this study was to determine the risk factors associated with Bartonella species infection in asymptomatic blood donors presented at a major blood bank in Southeastern Brazil. Five hundred blood donors were randomly enrolled and tested for Bartonella species infection by specialized blood cultured coupled with high-sensitive PCR assays. Epidemiological questionnaires were designed to cover major potential risk factors, such as age, gender, ethnicity, contact with companion animals, livestock, or wild animals, bites from insects or animal, economical status, among other factors. Based on multivariate logistic regression, bloodstream infection with B. henselae or B. clarridgeiae was associated with cat contact (adjusted OR: 3.4, 95% CI: 1.1–9.6) or history of tick bite (adjusted OR: 3.7, 95% CI: 1.3–13.4). These risk factors should be considered during donor screening, as bacteremia by these Bartonella species may not be detected by traditional laboratory screening methods, and it may be transmitted by blood transfusion.
Highlights
IntroductionAt least 15 species have been associated with human infections, with at least eight species capable of infecting dogs and cats
Bartonella species are fastidious alpha-proteobacteria with worldwide distribution
500 asymptomatic human blood donors from Brazil were screened for infection with species of Bartonella by blood culture coupled with molecular detection and genetic sequencing, and risk factors associated with such infection were identified
Summary
At least 15 species have been associated with human infections, with at least eight species capable of infecting dogs and cats. Select species of Bartonella were confirmed as etiologic agents of cat scratch disease (CSD), trench fever, bacillary angiomatosis and Oroya fever [2]. Bartonella infections have been documented by culture or molecular methods in human cases of endocarditis, myocarditis, polyarthritis and granulomatous inflammatory disease [1, 2]. In countries throughout the world, most diseases associated with Bartonella species infection are not reportable; incidence data is scarce. One study performed at the end of the 20th century estimated that 22,000 new cases of cat scratch disease appear every year in the United States, and roughly 10% of these infections were thought to require hospitalization [3]
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