María Mercedes Nogueras

Seroprevalence of Bartonella spp. infection in HIV patients in Catalonia, Spain

BackgroundAlthough the first clinical descriptions of Bartonella infection were associated with immunocompromised patient with bacillary angiomatosis, we currently know that this organism is directly involved in diseases affecting a large number of patients, regardless of their immune status. Cat scratch disease, hepatic peliosis, and some cases of bacteraemia and endocarditis, are directly caused by some species of the genus Bartonella. The purpose of this study was to determinate the prevalence of IgG antibodies against Bartonella henselae and B. quintana in HIV patients and to identify the epidemiological factors involved.MethodsSerum samples were collected from HIV patients treated at Hospital de Sabadell. Antibodies to B. henselae and B. quintana from 340 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical test were determined by the Mann-Whitney U test and χ2 test.ResultsOf 340 patients, 82 were women and 258 men, with a median age of 42.21 ± 10.35 years (range 16–86 years). Seventy-six (22.3%) patients reacted with one or more Bartonella antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, intravenous drugs use, alcohol consumption, CD4 levels, AIDS, HCV, HBV, residential area), only age was statistically significant.ConclusionA high percentage of HIV patients presents antibodies to Bartonella and is increasing with age.

Molecular detection of Rickettsia typhi in cats and fleas.

Background Rickettsia typhi is the etiological agent of murine typhus (MT), a disease transmitted by two cycles: rat-flea-rat, and peridomestic cycle. Murine typhus is often misdiagnosed and underreported. A correct diagnosis is important because MT can cause severe illness and death. Our previous seroprevalence results pointed to presence of human R . typhi infection in our region; however, no clinical case has been reported. Although cats have been related to MT, no naturally infected cat has been described. The aim of the study is to confirm the existence of R . typhi in our location analyzing its presence in cats and fleas. Methodology/Principal Findings 221 cats and 80 fleas were collected from Veterinary clinics, shelters, and the street (2001-2009). Variables surveyed were: date of collection, age, sex, municipality, living place, outdoor activities, demographic area, healthy status, contact with animals, and ectoparasite infestation. IgG against R . typhi were evaluated by indirect immunofluorescence assay. Molecular detection in cats and fleas was performed by real-time PCR. Cultures were performed in those cats with positive molecular detection. Statistical analysis was carried out using SPSS. A p < 0.05 was considered significant. Thirty-five (15.8%) cats were seropositive. There were no significant associations among seropositivity and any variables. R . typhi was detected in 5 blood and 2 cultures. High titres and molecular detection were observed in stray cats and pets, as well as in spring and winter. All fleas were Ctenocephalides felis. R . typhi was detected in 44 fleas (55%), from shelters and pets. Co-infection with R . felis was observed. Conclusions Although no clinical case has been described in this area, the presence of R . typhi in cats and fleas is demonstrated. Moreover, a considerable percentage of those animals lived in households. To our knowledge, this is the first time R . typhi is detected in naturally infected cats.

Seroprevalence of Rickettsia typhi and Rickettsia felis in dogs from north-eastern Spain.

Rickettsia typhi is the aetiological agent of murine typhus (MT). This disease is often acute and mild, although some fatal cases have been observed [1]. In Spain, clinical cases and serological evidence of exposure to R. typhi in humans have been described [2,3]. In the past, MT has been associated with rodents and rat fleas. Later, a peridomestic animal cycle involving cats, dogs, opossums and their fleas [1] was described. In Spain, R. typhi seropositivity has been shown in dogs [4] from the central region. Rickettsia felis, transmitted by fleas, produces flea-borne spotted fever, a clinical syndrome indistinguishable from MT. Serological evidence of R. felis infection in humans has been observed in Spain [2,3]. R. felis has been detected in fleas commonly found on domestic cats and dogs in Spain [5]. Prevention of these infections depends on recognition of routes of transmission, risk factors for infection, and reservoirs. The aim of this study was to determine the prevalence of both rickettsiae in dog populations from the north-east of Spain.

The dog as an epidemiological marker of Rickettsia conorii infection.

Department of Medicine, Universitat Auto`noma de Barcelona(UAB), Barcelona, SpainINTRODUCTIONDogs are considered to be the sentinels of Rick-ettsia conorii infection, which is the causative agentof Mediterranean spotted fever, one of the mostprevalent tick-transmitted disease in our area. It istransmitted by the dog tick, Rhipicephalus sanguin-eus. This tick is relatively host-specific, and rarelyfeeds on people unless its preferred host—thedog—is not available [1]. This tick is active fromspring to autumn, but climatic changes influenceits activity and, consequently, Mediterraneanspotted fever epidemiology [2].As canine serology constitutes a useful epide-miological marker [3], the objective of this studywas to evaluate the presence of R. conorii in dogpopulations subjected to different exposure toR. sanguineus. For this purpose, three seroepide-miological studies were designed: serosurvey indogs with close contact with ticks, seasonaldifferences in antibodies to R. conorii in dogssubjected to natural tick infestation, and a com-parison of canine seroprevalence rates obtained in1997 and in 2007 in dogs regularly treated forectoparasites.MATERIALS AND METHODS

Evidence of Infection in Humans with Rickettsia typhi and Rickettsia felis in Catalonia in the Northeast of Spain

Abstract:  Murine typhus is a cause of fever of intermediate duration in the south of Spain, where antibodies against Rickettsia typhi and Rickettsia felis were observed in humans. This study presents the first report from the northeast of Spain. Human serum samples were tested by serological test. R. typhi and R. felis seroprevalences were 8.8% and 3.2%, respectively.

Rickettsia slovaca infection in humans in the northeast of Spain: seroprevalence study.

Catalonia is an endemic area of Mediterranean spotted fever. In 1997, A. Lakos described a new tick-borne infectious disease called tick-borne lymphadenopathy. The causative agent is Rickettsia slovaca, which is transmitted by Dermacentor marginatus ticks. We have diagnosed human cases in Catalonia. The objective of this study was to determinate seroprevalence of R. slovaca infection in humans in the northeast of Spain. The population included 217 subjects from Catalonia, northeast of Spain and was stratified by age and living place (rural, suburban, and urban). Age, gender, residence area, contact with animals, occupation, and history of rickettsioses was surveyed. Immunoglobulin G was measured by indirect immunofluorescence assay. Titers >or= 1/40 were considered. Seroprevalence of R. slovaca was 5.5% at titers of 1/40-1/320. Eight (3.7%) sera had antibodies against R. slovaca exclusively. Four sera reacted also against Rickettsia conorii and/or Bar29. Seroprevalence of R. slovaca would range from 3.7% to 5.5%. The only statistically significant association was that between R. slovaca seropositivity and age. We present serologic evidence of R. slovaca infection among population of Catalonia, northeast of Spain.

Serosurvey of Rickettsia typhi and Rickettsia felis in HIV‐infected patients

Consistent with the effects of HIV on cell‐mediated immunity, an increased susceptibility to intracellular microorganisms has been observed. Rickettsiae are obligate intracellular microorganisms. The aim of this study was to examine Rickettsia typhi and Rickettsia felis infections in HIV+ population. Sera of 341 HIV+ patients were evaluated by indirect immunofluorescent assay. Age, sex, residential locality, risk behavior, stage according to criteria of the Center for Disease Control and Prevention, CD4+/CD8+ T cells, Hepatitis B antigen, and Hepatitis C serology were surveyed. Seroprevalences of R. typhi and R. felis infection were 7.6% and 4.4%, respectively. No associations were found between seropositivities and the assessed variables. Findings were similar to those obtained in healthy subjects from the same region.

Seroepidemiological Survey of Hantavirus Infection in Healthy People in Vallès Occidental, Barcelona

INTRODUCTION Hantaviruses are the etiological agents of hemorrhagic fever with renal syndrome in Europe and Asia, and hantavirus pulmonary syndrome in America. Approximately 150,000 cases are reported annually worldwide. In Spain, some hantavirus infection cases have been described. Besides, rodents that have been described as hantavirus reservoirs are present. The aim of the present study was to determinate the seroprevalence of hantavirus in humans in the northeast of Spain. MATERIALS AND METHODS During a 5-month period, 217 serum samples were collected. The study population was stratified by age, gender, and residential area. Age, gender, residential area, contact with pets, contact with wild animals, contact with farm animals, and occupation were surveyed. Immunoglobulin G antibodies to Hantaan virus, Seoul virus, or Puumala virus were examined by immunofluorescence assay. Titles ≥1/32 against any of the hantavirus were considered positive. RESULTS Four (1.8%) positive samples were detected. Age ranged from 14 to 67 years. Two subjects were male. Three samples reacted to both Puumala virus and Hantaan virus. The other one reacted against all three hantavirus surveyed. Titles ranged from 32 to 1024. The highest titles were found against Seoul virus. CONCLUSIONS Our data show serological evidence about hantavirus infection among population of Catalonia, northeast of Spain. Seroprevalence rate was (around 2%) similar to other regions of Spain.

Coinfection with “Rickettsia sibirica subsp. mongolotimonae” and Rickettsia conorii in a Human Patient: a Challenge for Molecular Diagnosis Tools

ABSTRACT Rickettsioses are zoonoses transmitted by vectors. More than one agent can coexist in vectors. Although vectors may transmit more than one microorganism to humans, information on dual infections is scarce. We present a case of a patient with an atypical rickettsiosis diagnosis in whom two species of Rickettsia were detected.