Infective endocarditis due to Bartonella quintana: a severe disease and underdiagnosed etiology

Džupová, Olga; Pekova, Sona; Sojková, Naděžda; Feuereĭsl, R; Beneš, Jiří

doi:10.1007/s12223-013-0235-9

Cited by 2 publications

(1 citation statement)

References 17 publications

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“…B. quintana infects humans as its host and is spread by human body lice (Pediculus humanus humanus), causing trench fever, which is a potentially serious illness [13] . First discovered during the World War One, trench fever was widespread among soldiers.…”

Section: Pathogenesismentioning

confidence: 99%

Role of the CtrA cell cycle regulator in the bloodborne bacterial pathogen, Bartonella quintana.

Thomson¹

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<p>Bartonella quintana is an important re-emerging human pathogen and the causative agent of trench fever. It utilizes a stealth invasion strategy to infect hosts and is transmitted by lice. Throughout infection it is crucial for the bacteria to maintain a tight regulation of cell division, to prevent immune detection and allow for transmission to new hosts. CtrA is an essential master cell cycle regulatory protein found in the alpha-proteobacteria. It regulates many genes, ensuring the appropriate timing of gene expression and DNA replication. In the model organism Caulobacter crescentus, it regulates 26% of cell cycle-regulated genes. CtrA has been reported to bind two specific DNA motifs in gene promoter regions, TTAAN7TTAAC, and TTAACCAT. Genes regulated by CtrA encode proteins with a wide range of activities, including initiation of DNA replication, cell division, DNA methylation, polar morphogenesis, flagellar biosynthesis, and cell wall metabolism. However, the role of the CtrA homologue in Bartonella spp. has not been investigated. In this project we aimed to make an initial characterisation of the master cell cycle regulator CtrA. This was done by identifying gene regulatory regions containing putative CtrA binding sites and testing for direct interactions via a -galactosidase assay. It was found B. quintana CtrA shared 81 % amino acid identity with its C. crescentus homologue. Within the genome of B. quintana str. Toulouse we discovered 21 genes containing putative CtrA binding sites in their regulatory regions. Of these genes we demonstrated interactions between CtrA and the promoter region of ftsE a cell division gene [1], hemS, and hbpC, two heme regulatory genes. We also found no evidence of CtrA regulating its own expression, which was unexpected because CtrA autoregulation has been demonstrated in C. crescentus.</p>

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Section: Pathogenesismentioning

confidence: 99%

Role of the CtrA cell cycle regulator in the bloodborne bacterial pathogen, Bartonella quintana.

Thomson¹

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Bartonella quintana Endocarditis: A Systematic Review of Individual Cases

Boodman,

Gupta,

Nelson

et al. 2023

Clinical Infectious Diseases

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Introduction Bartonella quintana is a louse-borne bacterium that remains a neglected cause of endocarditis in low-resource settings. Our understanding of risk factors, clinical manifestations and treatment of B. quintana endocarditis are biased by older studies from high-income countries. Methods We searched Pubmed Central, Medline, Scopus, Embase, EBSCO (CABI) Global Health, Web of Science and international trial registers for articles published before March 2023 with terms related to Bartonella quintana endocarditis. We included articles containing case-level information on B. quintana endocarditis and extracted data related to patient demographics, clinical features, diagnostic testing, treatment and outcome. Results A total of 975 records were identified, of which 569 duplicates were removed prior to screening. 84 articles were eligible for inclusion, describing a total of 167 cases. Infections were acquired in 40 different countries. 62 cases (37.1%) were acquired in low and middle-income countries (LMICs). Disproportionately more female and pediatric patients were from LMICs. More patients presented with heart failure (n = 70/167 [41.9%]) than fever (n = 65/167 [38.9%]). Mean time from symptom onset to presentation was 5.1 months. 25.7% of cases (n = 43/167) were associated with embolization, most commonly to the spleen and brain. 65.5% of antimicrobial regimens included doxycycline. The vast majority of cases underwent valve replacement surgery (n = 154/167, [98.0%]). Overall case fatality rate was 9.6% (n = 16/167). Conclusion B. quintana endocarditis has a global distribution, and long delays between symptom onset and presentation frequently occur. Improved clinician education and diagnostic capacity are needed to screen at-risk populations and identify infection before endocarditis develops.

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Infective endocarditis due to Bartonella quintana: a severe disease and underdiagnosed etiology

Cited by 2 publications

References 17 publications

Role of the CtrA cell cycle regulator in the bloodborne bacterial pathogen, Bartonella quintana.

Role of the CtrA cell cycle regulator in the bloodborne bacterial pathogen, Bartonella quintana.

Bartonella quintana Endocarditis: A Systematic Review of Individual Cases

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