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      The seroprevalence of Bartonella henselae in healthy adults in Korea

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          Abstract

          Background/Aims

          Cat-scratch disease (CSD), caused by Bartonella henselae is one of the most common zoonosis. However, only several cases of B. henselae infection have been reported in Korea. This study investigated the seroprevalence of B. henselae in healthy adults and related risk factors.

          Methods

          Serum samples from 300 healthy participants were analyzed using an immunoglobulin G immunof luorescence assay (IFA) for B. henselae isolated in Korea. Surveys on the risk factors for B. henselae infection were conducted simultaneously.

          Results

          Of the participants, 47.7% and 15.0% raised dogs and cats, respectively. The overall seroprevalence of B. henselae was 15.0% (IFA titer ≥ 1:64). Participants who had raised cats showed 22.2% seropositivity against B. henselae, and those with no experience with cats showed 13.7% seroprevalence ( p = 0.17). Participants who had cats as pets or been scratched by cats, showed 9.8% seropositivity against B. henselae (IFA titer ≥ 1:256). However, those who had not raised or been scratched by a cat showed 2.0% seropositivity ( p = 0.015).

          Conclusions

          In Korea, the seroprevalence of B. henselae is higher than expected, suggesting that Bartonella infection due to B. henselae is not uncommon. Cats are proposed to play a more important role than dogs in transmission of CSD.

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          Most cited references17

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          Bartonella spp. as emerging human pathogens.

          Members of the genus Bartonella (formerly Rochalimaea) were virtually unknown to modern-day clinicians and microbiologists until they were associated with opportunistic infections in AIDS patients about 6 years ago. Since that time, Bartonella species have been associated with cat scratch disease, bacillary angiomatosis, and a variety of other disease syndromes. Clinical presentation of infection with Bartonella ranges from a relatively mild lymphadenopathy with few other symptoms, seen in cat scratch disease, to life-threatening systemic disease in the immunocompromised patient. In some individuals, infection manifests as lesions that exhibit proliferation of endothelial cells and neovascularization, a pathogenic process unique to this genus of bacteria. As the spectrum of disease attributed to Bartonella is further defined, the need for reliable laboratory methods to diagnose infections caused by these unique organisms also increases. A brief summary of the clinical presentations associated with Bartonella infections is presented, and the current status of laboratory diagnosis and identification of these organisms is reviewed.
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            Beyond cat scratch disease: widening spectrum of Bartonella henselae infection.

            Bartonella henselae was discovered a quarter of a century ago as the causative agent of cat scratch disease, a clinical entity described in the literature for more than half a century. As diagnostic techniques improve, our knowledge of the spectrum of clinical disease resulting from infection with Bartonella is expanding. This review summarizes current knowledge regarding the microbiology, clinical manifestations, diagnostic techniques, and treatment of B. henselae infection.
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              Serological cross-reactions between Bartonella quintana, Bartonella henselae, and Coxiella burnetii.

              The clinical manifestations of Q fever and bartonelloses can be confused, especially in cases of infectious endocarditis. Differential diagnosis of the diseases is important because the treatments required for Q fever and bartonelloses are different. Laboratory confirmation of a suspected case of either Q fever or bartonelloses is most commonly made by antibody estimation with an indirect immunofluorescence assay. With an indirect immunofluorescence assay, 258 serum samples from patients with Q fever were tested against Bartonella henselae and Bartonella quintana antigens, and 77 serum samples from patients with infection by Bartonella sp. were tested against Coxiella burnetii antigen. Cross-reactivity was observed: more than 50% of the chronic Q fever patients tested had antibodies which reacted against B. henselae antigen to a significant level. This cross-reaction was confirmed by a cross-adsorption study and protein immunoblotting. However, because the levels of specific antibody titers in cases of Bartonella endocarditis are typically extremely high, low-level cross-reaction between C. burnetii antibodies and B. henselae antigen in cases of Q fever endocarditis should not lead to misdiagnosis, provided serology testing for both agents is performed.
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                Author and article information

                Journal
                Korean J Intern Med
                Korean J. Intern. Med
                KJIM
                The Korean Journal of Internal Medicine
                The Korean Association of Internal Medicine
                1226-3303
                2005-6648
                May 2017
                20 April 2017
                : 32
                : 3
                : 530-535
                Affiliations
                [1 ]Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
                [2 ]Clinical Research Center, Inha University School of Medicine, Incheon, Korea
                [3 ]Department of Occupational Medicine, Inha University School of Medicine, Incheon, Korea
                [4 ]Department of Microbiology, Inha University School of Medicine, Incheon, Korea
                Author notes
                Correspondence to Jin-Soo Lee, M.D Department of Internal Medicine, Inha University School of Medicine, 27 Inhang-ro, Jung-gu, Incheon 22332, Korea Tel: +82-32-890-2548 Fax: +82-32-890-2549 E-mail: ljinsoo@ 123456inha.ac.kr
                Article
                kjim-2016-010
                10.3904/kjim.2016.010
                5432800
                28490714
                0426bbd9-c4c1-4e21-a8b8-f160fc6dc2f3
                Copyright © 2017 The Korean Association of Internal Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 December 2015
                : 24 March 2016
                : 21 April 2016
                Categories
                Original Article
                Infectious Diseases

                Internal medicine
                bartonella henselae,seroepidemiologic studies,korea,cat-scratch disease
                Internal medicine
                bartonella henselae, seroepidemiologic studies, korea, cat-scratch disease

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