Comer J A, Flynn C, Regnery R L, Vlahov D, Childs J E
Viral and Rickettsial Zoonoses Branch, Centers for Disease Control and Prevention, Atlanta, Ga, USA.
Arch Intern Med. 1996 Nov 25;156(21):2491-5.
Bartonella quintana has recently been associated with homeless alcoholic men. Both B quintana and Bartonella henselae have been shown to be opportunistic pathogens of people with acquired immunodeficiency syndrome. The reservoirs and modes of transmission of these infections are incompletely known.
To examine serum samples that were taken from inner-city intravenous (IV) drug users for antibodies to Bartonella organisms to determine whether there is an urban transmission cycle for Bartonella species and to examine the demographic and behavioral characteristics of IV drug users to identify possible risk factors for infection with any of these agents.
A serologic survey was conducted, using a convenience sample of serum specimens collected during a study of IV drug use and human immunodeficiency virus infection among 630 inner-city residents in Baltimore, Md. A detailed questionnaire was administered at the initial collection of serum, and additional serum collections and questionnaire updates were made at 6-month intervals. The most recent available serum sample was tested for Bartonella antibody titer by using the indirect immunofluorescent antibody test with 3 antigens: Bartonella elizabethae, B henselae, and B quintana. Univariate and multivariate analyses of selected potential demographic and behavioral risk factors were conducted.
Antibodies to Bartonella were highly prevalent in this group; more than 37% of all samples reacted with at least 1 antigen. Overall seroprevalence of antibodies to B elizabethae, B henselae, and B quintana was 33%, 11%, and 10%, respectively. Current IV drug use, frequency of injection, and seronegative human immunodeficiency virus status were significantly associated with Bartonella antibody presence, but these associations varied by analysis. There was a significant inverse association of antibody prevalence to B henselae and B quintana by using CD4+ cell counts among human immunodeficiency virus-seropositive individuals.
Intravenous drug users have an elevated prevalence of antibodies to Bartonella organisms and may be at significant risk of becoming infected. Current IV drug use, high frequency of injection, and seronegative human immunodeficiency virus status are significant risk factors for an increased prevalence of Bartonella antibodies. The current natural histories of Bartonella species are rapidly changing, and mechanisms of transmission remain unknown.
五日热巴尔通体最近被认为与无家可归的酗酒男性有关。五日热巴尔通体和亨氏巴尔通体均已被证明是获得性免疫缺陷综合征患者的机会性病原体。这些感染的储存宿主和传播方式尚不完全清楚。
检测从市中心静脉注射吸毒者采集的血清样本中巴尔通体属微生物的抗体，以确定巴尔通体属是否存在城市传播循环，并研究静脉注射吸毒者的人口统计学和行为特征，以确定感染这些病原体的可能危险因素。
采用血清学调查，使用在对马里兰州巴尔的摩市630名市中心居民进行的静脉注射吸毒与人类免疫缺陷病毒感染研究期间收集的血清标本便利样本。在初次采集血清时发放详细问卷，并每隔6个月进行额外的血清采集和问卷更新。使用间接免疫荧光抗体试验，以3种抗原（伊丽莎白巴尔通体、亨氏巴尔通体和五日热巴尔通体）检测最近可得的血清样本中的巴尔通体抗体滴度。对选定的潜在人口统计学和行为危险因素进行单变量和多变量分析。
该组中巴尔通体抗体高度流行；超过37%的样本与至少1种抗原发生反应。伊丽莎白巴尔通体、亨氏巴尔通体和五日热巴尔通体抗体的总体血清阳性率分别为33%、11%和10%。当前静脉注射吸毒、注射频率和血清阴性的人类免疫缺陷病毒状态与巴尔通体抗体的存在显著相关，但这些关联在不同分析中有所不同。在人类免疫缺陷病毒血清阳性个体中，使用CD4+细胞计数时，亨氏巴尔通体和五日热巴尔通体抗体流行率存在显著负相关。
静脉注射吸毒者中巴尔通体属微生物抗体流行率升高，可能有感染的重大风险。当前静脉注射吸毒、高注射频率和血清阴性的人类免疫缺陷病毒状态是巴尔通体抗体流行率增加的重要危险因素。巴尔通体属目前的自然史正在迅速变化，传播机制仍然未知。
