Abstract
The presence of Acinetobacter baumannii was demonstrated in body lice, however, little is known about the mechanism of natural lice infection. In 2013 and 2014, cross-sectional one-day studies were therefore performed within two Marseille homeless shelters to assess the presence of A. baumannii DNA on human skin, blood and in body lice collected from the same homeless individuals. All 332 participants completed questionnaires, were examined for dermatologic signs, and provided four skin samples (hair, neck, armpits, and pelvic belt), blood samples and body lice (if any). We developed a new real-time PCR tool targeting the ompA/motB gene for the detection of A. baumannii for all collected samples. Blood culture was also performed. Body lice were found in 24/325 (7.4%) of subjects. We showed a prevalence of A. baumannii DNA skin-carriage in 33/305 (10.8%) of subjects. No difference was found in A. baumannii DNA prevalence according to body sites. A strong association between body lice infestation (OR = 3.07, p = 0.029) and A. baumannii DNA skin-carriage was noted. In lice, A. baumannii DNA was detected in 59/219 arthropods (26.9%). All blood cultures and real-time PCR on blood samples were negative for A. baumannii. Lice probably get infected with A. baumannii while biting through the colonized skin and likely transmit the bacteria in their feces. We found no evidence that lice facilitate the invasion of A. baumannii into the blood stream. Further investigations are needed to compare phenotypic and genotypic features of A. baumannii isolates from human skin and lice from the same individuals.
Highlights
Acinetobacter species are mostly free-living saprophytes found ubiquitously in nature and are considered part of the normal flora of the human skin (Vallenet et al, 2008)
It has been isolated at high rates from body lice collected from Ethiopian subjects (Kempf et al, 2012) and from body lice collected from Algerian homeless people (Louni et al, 2018a)
The blood samples were incubated in the BACTEC 9240 system (Reisner and Woods, 1999) and were considered negative for A. baumannii if no bacterial growth was detected after 5 days
Summary
Acinetobacter species are mostly free-living saprophytes found ubiquitously in nature and are considered part of the normal flora of the human skin (Vallenet et al, 2008). A. baumannii DNA have been detected in human body lice, suggesting that lice can possibly transmit this pathogen It was first isolated from body lice collected from homeless people in Marseille (La-Scola et al, 2001). A 21% prevalence of A. baumannii DNA was found in a large collection of 622 body lice collected in France, Burundi, Rwanda, Peru, Algeria, Portugal, and the Netherlands (La-Scola and Raoult, 2004). It has been isolated at high rates from body lice collected from Ethiopian subjects (Kempf et al, 2012) and from body lice collected from Algerian homeless people (Louni et al, 2018a). Infected body lice excreted living A. baumannii within their feces and did not transmit their infection to their nurse host during feeding or transovarially (Houhamdi and Raoult, 2006)
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