Intracellular Pathogens Research Laboratory, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
Diagn Microbiol Infect Dis. 2011 Dec;71(4):430-7. doi: 10.1016/j.diagmicrobio.2011.09.001. Epub 2011 Oct 13.
Serum and blood samples from 192 patients, who reported animal exposure (100.0%) and recent animal bites or scratches (88.0%), were screened for antibodies by indirect immunofluorescence assays and for bacteremia using the BAPGM (Bartonella alpha Proteobacteria growth medium) platform. Predominant symptoms included fatigue (79.2%), sleeplessness (64.1%), joint pain (64.1%), and muscle pain (63.0%). Bartonella spp. seroreactivity or bacteremia was documented in 49.5% (n = 95) and 23.9% (n = 46) of the patients, respectively; however, indirect immunofluorescence antibodies were not detected in 30.4% (n = 14) of bacteremic patients. Regarding components of the BAPGM platform, Bartonella DNA was amplified from 7.5% of blood (n = 21), 8.7% of serum (n = 25), and 10.3% of enrichment culture samples (n = 29). Polymerase chain reaction (PCR) on only extracted blood would not have detected Bartonella infection in 34.7% (16/46) of bacteremic patients. Serology, in conjunction with blood, serum, and BAPGM enrichment culture PCR, facilitates the diagnosis of Bartonella spp. bacteremia in immunocompetent patients.
对 192 名报告有动物接触史（100.0%）和近期动物咬伤或抓伤史（88.0%）的患者的血清和血液样本进行了间接免疫荧光检测和 BAPGM（巴尔通体α变形菌生长培养基）平台检测，以筛查抗体和菌血症。主要症状包括疲劳（79.2%）、失眠（64.1%）、关节痛（64.1%）和肌肉痛（63.0%）。分别有 49.5%（95/192）和 23.9%（46/192）的患者检测到巴尔通体 spp. 血清反应性或菌血症，但 30.4%（46/146）的菌血症患者未检测到间接免疫荧光抗体。关于 BAPGM 平台的组成部分，从 7.5%的血液（n=21）、8.7%的血清（n=25）和 10.3%的富集培养物样本（n=29）中扩增出了巴尔通体 DNA。如果仅对提取的血液进行聚合酶链反应（PCR），将无法检测到 34.7%（16/46）的菌血症患者的巴尔通体感染。结合血清学、血液、血清和 BAPGM 富集培养物 PCR，有助于诊断免疫功能正常患者的巴尔通体 spp.菌血症。
