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Journal of Clinical Microbiology, May 1999, p. 1381-1384, Vol. 37, No. 5
Section of Infectious Diseases1 and
Section of Clinical Bacteriology,
Received 16 October 1998/Returned for modification 1 December
1998/Accepted 9 February 1999
Among the species that compose the expanding genus
Bartonella, thus far only B. henselae and
B. quintana have reportedly been isolated from humans in
Europe. To evaluate the prevalence of Bartonella infection
in Sweden, we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to
B. henselae, B. quintana, and B. elizabethae. Serum samples from 100 blood donors, who spanned the
ages of 20 to 60 and had no apparent clinical signs of illness, were
also studied as a control group. An immunoglobulin G indirect
fluorescence antibody assay revealed 4 and 8.3% Bartonella
positivity rates for the blood donor and patient group, respectively,
when a cutoff titer of
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Evaluation of Human Seroreactivity to Bartonella
Species in Sweden
64 was chosen. Among the blood donors, four
were seropositive to B. elizabethae; one of these also had
concordant positive titer to B. henselae. In the patient
group, 14 serum samples were positive against Bartonella
spp. These serum specimens represented nine patients. In three of these
seropositive patients, paired serum samples displayed a fourfold
increase in antibody titer to at least one of the three antigens. These
three patients are discussed. In this report we also present a case
study of a 60-year-old Swedish male with fatal myocarditis. Postmortem
serological analysis revealed a high titer against B. elizabethae. PCR and nucleotide sequencing of the myocardial
tissue from this patient, and of liver tissue from one of the other
three patients, showed sequences similar to B. quintana.
The age, geographical origin, animal contacts, and serological response
pattern to the different Bartonella antigens differed among
the four patients. This study substantiates the presence of
Bartonella spp. in Sweden, documents the seroreactivity to
three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden.
*
Corresponding author. Mailing address: Section of
Infectious Diseases, Uppsala University Hospital, 751 85 Uppsala,
Sweden. Phone: 46-18-66 56 72. Fax: 46-18-66 56 50. E-mail:
martin.holmberg{at}infektion.uu.se.
Journal of Clinical Microbiology, May 1999, p. 1381-1384, Vol. 37, No. 5
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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