Volume 18, Number 5—May 2012
Research
Bartonella spp. Bacteremia and Rheumatic Symptoms in Patients from Lyme Disease–endemic Region
Ricardo G. Maggi, B. Robert Mozayeni, Elizabeth L. Pultorak, Barbara C. Hegarty, Julie M. Bradley, Maria Correa, and Edward B. Breitschwerdt
Table 1
Characteristics and Bartonella spp. PCR results for 296 patients examined by a rheumatologist, Maryland–Washington, DC, USA, August 25, 2008–April 1, 2009*
| Characteristic | Overall study population, no. (%) | Positive Bartonella sp. result by PCR, no. (%) |
||||
|---|---|---|---|---|---|---|
| Overall positive | B. henselae | B. koehlerae | B. vinsonii subsp. berkhoffii | Bartonella spp.† | ||
| Total | 296 (100) | 122 (62.5) | 40 (13.5) | 54 (18.2) | 10 (3.4) | 29 (9.8) |
| Sex | ||||||
| F | 205 (69.3) | 86 (29.0) | 24 (11.7) | 38 (18.5) | 7 (3.4) | 21 (10.3) |
| M | 91 (30.7) | 36 (12.2) | 16 (17.6) | 16 (17.5) | 3 (3.3) | 8 (8.8) |
| State of residence | ||||||
| Maryland | 148 (50.0) | 58 (39.2) | 20 (13.5) | 27 (18.2) | 5 (3.4) | 13 (8.8) |
| Virginia | 76 (25.7) | 37 (48.7) | 13 (17.1) | 19 (25.0) | 0 | 7 (9.2) |
| Pennsylvania | 26 (8.8) | 9 (34.6) | 2 (7.7) | 3 (11.5) | 2 (7.7) | 3 (11.5) |
| District of Columbia | 16 (5.4) | 5 (31.3) | 1 (6.3) | 1 (6.25) | 1 (6.3) | 2 (12.5) |
| Other | 30 (10.1) | 13 (43.3) | 4 (13.3) | 4 (13.3) | 2 (6.7) | 4 (13.3) |
| Immunofluorescence antibody results | ||||||
| All Bartonella spp. | 185 (62.5) | 77 (41.6) | 25 (13.5) | 33 (17.8) | 4 (2.1) | 20 (10.8) |
| B. henselae | 67 (22.6) | 24 (35.8) | 7 (10.3) | 8 (11.7) | 2 (2.9) | 8 (11.7) |
| B. koehlerae | 89 (30.1) | 38 (42.7) | 10 (11.2) | 24 (26.9) | 3 (3.4) | 5 (5.6) |
| B. vinsonii subsp. berkhoffii | 148 (50.0) | 59 (39.8) | 21 (14.1) | 21 (14.1) | 3 (2.0) | 18 (12.1) |
| Self-report health assessment | ||||||
| Healthy | 82 (27.7) | 32 (39.0) | 12 (14.6) | 13 (15.8) | 3 (3.6) | 7 (8.5) |
| Infrequently Ill | 53 (17.9) | 26 (49.1) | 7 (13.2) | 14 (26.4) | 3 (5.6) | 5 (9.4) |
| Chronically Ill | 149 (50.3) | 54 (36.2) | 17 (11.4) | 31 (14.1) | 4 (2.7) | 15 (10.1) |
| No response | 12 (4.0) | 10 (83.3) | 4 (33.3) | 6 (50.0) | 0 | 2 (16.7) |
| Animal contact | ||||||
| Yes | 283 (95.6) | 116 (40.9) | 38 (13.4) | 51 (18.0) | 9 (3.2) | 27 (9.5) |
| No | 13 (4.4) | 6 (46.2) | 2 (15.4) | 3 (23.1) | 1 (7.7) | 2 (15.4) |
| Type | ||||||
| Dog | 252 (85.1) | 104 (41.3) | 33 (13.1) | 45 (17.9) | 7 (2.8) | 27 (10.7) |
| Cat | 202 (68.2) | 77 (38.1) | 24 (11.8) | 34 (16.8) | 7 (3.5) | 19 (9.4) |
| Horse | 86 (29.0) | 41 (47.7) | 12 (13.9) | 14 (16.3) | 2 (2.3) | 13 (15.1) |
| Bird | 59 (19.3) | 26 (44.0) | 8 (13.5) | 8 (13.5) | 2 (3.4) | 9 (15.2) |
| Cattle | 32 (10.8) | 11 (34.4) | 3 (9.3) | 4 (12.5) | 0 | 4 (12.5) |
| Poultry | 30 (10.1) | 13 (43.3) | 6 (20.0) | 3 (10.0) | 0 | 4 (30.7) |
| Swine | 25 (8.5) | 10 (25.0) | 5 (20.0) | 2 (8.0) | 0 | 3 (12.0) |
| Sheep | 25 (8.5) | 12 (48.0) | 6 (24.0) | 2 (8.0) | 0 | 4 (16.0) |
| Other | 12 (4.0) | 12 (58.3) | 4 (33.3) | 1 (8.3) | 0 | 2 (16.7) |
| Animal bites/scratches | ||||||
| Cat | 154 (52.0) | 64 (41.6) | 21 (13.6) | 27 (17.5) | 6 (3.9) | 14 (9.1) |
| Dog | 118 (39.8) | 52 (44.1) | 18 (15.3) | 22 (18.6) | 2 (1.7) | 13 (11.0) |
| Bird | 12 (4.0) | 10 (83.3) | 3 (25.0) | 4 (33.3) | 2 (16.7) | 3 (25.0) |
| Horse | 14 (4.7) | 9 (64.2) | 2 (14.3) | 3 (21.4) | 1 (8.3) | 3 (21.4) |
| Insect exposure | ||||||
| Mosquitoes | 256 (86.5) | 106 (41.4) | 37 (14.4) | 46 (17.9) | 8 (3.1) | 24 (9.4) |
| Ticks | 229 (77.4) | 96 (41.9) | 29 (12.6) | 43 (18.7) | 10 (4.3) | 23 (10.0) |
| Fleas | 148 (50.0) | 66 (44.5) | 23 (15.5) | 26 (17.5) | 7 (4.7) | 16 (10.8) |
| Biting Flies | 160 (54.0) | 68 (42.5) | 25 (15.6) | 27 (16.9) | 5 (3.1) | 16 (10.0) |
| Lice | 38 (12.8) | 17 (44.7) | 7 (18.4) | 3 (7.8) | 0 | 7 (18.4) |
| Spiders | 5 (1.7) | 4 (80.0) | 1 (20.0) | 2 (40.0) | 0 | 1 (20.0) |
| Sarcoptes mite | 3 (1.0) | 1 (33.3) | 0 | 0 | 0 | 1 (33.3) |
| Outdoor exposure | ||||||
| Hiking | 154 (52.0) | 66 (42.9) | 21 (13.6) | 28 (18.2) | 5 (3.3) | 16 (10.4) |
| Wildlife rescue/rehabilitation | 22 (7.4) | 7 (31.8) | 2 (9.1) | 2 (9.1) | 0 | 3 (14.3) |
| Hunting | 21 (7.1) | 9 (42.9) | 1 (4.7) | 4 (19.0) | 0 | 4 (19.1) |
| Other | 36 (12.2) | 16 (44.4) | 6 (16.7) | 8 (22.2) | 2 (5.6) | 1 (2.8) |
*Positive sample and exposure categories are not mutually exclusive (i.e., some persons had positive test results by both IFA and PCR, or could have been exposed to both cats and dogs). Median patient ages, for women and men, respectively, were as follows: overall study population, 46.0 and 36.0 y; those with positive results for overall Bartonella, 47.0 and 38.0 y, B. henselae, 44.0 and 41.0 y, B. koehlerae, 49.0 and 40.5 y, B. vinsonii subsp. berkhoffii, 43.0 and 64.0 y, and Bartonella spp., 48.0 and 24.0 y.
†Positive PCR results after using Bartonella genus primers but unable to obtain a clean sequence to determine species.
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