Chronic Bartonella quintana bacteremia in homeless patients.
Background Infection with Bartonella quintana can cause trench fever, endocarditis, bacillary angiomatosis, and peliosis.
An outbreak of bacteremia due to B. quintana has been reported among homeless people in Seattle, and the seroprevalence is high among homeless people in both the United States and Europe.
Body lice are known to be the vectors of B. quintana.
Methods We studied all the homeless people who presented in 1997 to the emergency departments of the University Hospital, Marseilles, France.
Blood was collected for microimmunofluorescence testing for antibodies against B. quintana and for culture of the bacterium.
Body lice were collected and analyzed by the polymerase chain reaction and sequencing of a portion of the citrate synthase gene of B. quintana.
Results In 10 of 71 homeless patients (14 percent), blood cultures were positive for B. quintana, and 21 of the patients (30 percent) had high titers of antibody against the organism.
A total of 17 patients (24 percent) had evidence of recent infection (bacteremia or seroconversion).
Tests of lice from 3 of the 15 patients from whom they were collected were positive for B. quintana.
The homeless people with B. quintana bacteremia were more likely to have been exposed to lice (P=0.002), were more likely to have headaches (P=0.03) and severe leg pain (P<0.001), and had lower platelet counts (P=0.006) than the homeless people who were seronegative for B. (...)
Mots-clés Pascal : Bactériémie, Bactériose, Infection, Chronique, Sans domicile fixe, Service urgence, Bartonella quintana, Bartonellaceae, Bactérie, Fièvre des tranchées, Rickettsiose, Rickettsialose, Exploration bactériologique, Sérologie, France, Europe, Epidémiologie, Prévalence, Homme, Exploration microbiologique, Pou
Mots-clés Pascal anglais : Bacteremia, Bacteriosis, Infection, Chronic, Homeless, Emergency department, Bartonella quintana, Bartonellaceae, Bacteria, Trench fever, Rickettsial infection, Rickettsialosis, Bacteriological investigation, Serology, France, Europe, Epidemiology, Prevalence, Human, Microbiological investigation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0095200
Code Inist : 002B05B02L8. Création : 31/05/1999.