Association of Bartonella spp bacteremia with Chagas cardiomyopathy, endocarditis and arrythmias in patients from South America

Abstract

Infection with Bartonella spp may cause cardiac arrhythmias, myocarditis and endocarditis in humans. The aim of the present study was to evaluate a possible association between Bartonella spp bacteremia and endocarditis, arrhythmia and Chagas cardiomyopathy in patients from Brazil and Argentina. We screened for the presence of bacterial 16S rRNA in human blood by PCR using oligonucleotides to amplify a 185-bp bacterial DNA fragment. Blood samples were taken from four groups of subjects in Brazil and Argentina: i) control patients without clinical disease, ii) patients with negative blood-culture endocarditis, iii) patients with arrhythmias, and iv) patients with chronic Chagas cardiomyopathy. PCR products were analyzed on 1.5% agarose gel to visualize the 185-bp fragment and then sequenced to confirm the identity of DNA. Sixty of 148 patients (40.5%) with cardiac disease and 1 of 56 subjects (1.8%) from the control group presented positive PCR amplification for Bartonella spp, suggesting a positive association of the bacteria with these diseases. Separate analysis of the four groups showed that the risk of a Brazilian patient with endocarditis being infected with Bartonella was 22 times higher than in the controls. In arrhythmic patients, the prevalence of infection was 45 times higher when compared to the same controls and 40 times higher for patients with Chagas cardiomyopathy. To the best of our knowledge this is the first report of the association between Bartonella spp bacteremia and Chagas disease. The present data may be useful for epidemiological and prevention studies in Brazil and Argentina.

Risk Factors for Bartonella species Infection in Blood Donors from Southeast Brazil

“…In addition, Correa et al . reported that the risk of Bartonella DNA bloodstream infection was 45 times higher in arrhythmic patients from Brazil or Argentina when compared to controls [ 31 ]. Our results expand the current understanding about Bartonella species infection in humans in Brazil by reinforcing the ecological role of cats and ectoparasites in the transmission of Bartonella .…”

Bartonellaspp. andCoxiella burnetiiAssociated with Community-Acquired, Culture-Negative Endocarditis, Brazil

“…Another series of 46 culture-negative endocarditis patients from the city of São Paulo used PCR to investigate Bartonella spp. in blood and found 13 (28%) patients with positive results ( 13 ).…”

Infectious agents and inflammation in donated hearts and dilated cardiomyopathies related to cardiovascular diseases, Chagas' heart disease, primary and secondary dilated cardiomyopathies

“…In the same direction, detection of other agents such as bacteria in myocardial tissue and blood of chagasic patients with cardiomyopathy has already been reported [13,14]. The finding of co-infection in chagasic DCM may turn the understanding of Chagas' disease pathogenesis even more difficult, considering its multifactorial feature and not well understood interactive pathways [38].…”

“…Recently, the potential role of co-infections on pathogenesis of Chagas' heart disease has been debated [13,14]. Chagas' disease is a common and endemic cause of acquired inflammatory DCM especially in Latin America accepted as caused by the protozoa Trypanosoma cruzi [15,16], however, doubts also persist regarding pathogenesis of chagasic DCM.…”