Serological cross-reactions between Bartonella and Chlamydia species: implications for diagnosis

Abstract

Diagnosis of Chlamydia or Bartonella infections continues to rely mainly on serology. However, serological cross-reactions between members of these genera have recently been described. Sera from eight patients originally diagnosed as having Chlamydia pneumoniae endocarditis reacted with both Chlamydia sp. and Bartonella quintana antigens (microimmunofluorescence technique). Adsorption of sera with B. quintana or C. pneumoniae antigens removed anti-C. pneumoniae antibodies, whereas adsorption with C. pneumoniae antigens did not change antibody titers to B. quintana. Western blot analysis confirmed the presence of cross-reacting antigens and showed antibody patterns in all sera to be compatible with a Bartonella infection. These patients were therefore probably suffering from Bartonella-induced rather than Chlamydia-induced endocarditis. In contrast, sera from 10 patients presumed to be suffering from C. pneumoniae pneumonia did not display anti-B. quintana antibodies, although cross-reacting antigens were revealed by Western blotting. This work highlights the possibility that cases of infective Bartonella endocarditis are erroneously diagnosed as chlamydial infections.

Does infection with chlamydia pneumoniae and/or helicobacter pylori increase the expression of endothelial cell adhesion molecules in humans?

“…Good agreement, as well as low detection rates, have been reported in different patient groups [30]. Even though the MIF test is regarded as species-specific, both genus [30,31] and species cross-reactivity [32] have been reported. Nevertheless, the MIF test has generally been regarded as the reference standard internationally.…”

New insight into the diagnosis of fastidious bacterial endocarditis

“…Furthermore, cross-reactions may occur at a low level with C. burnetii (La Scola & Raoult, 1996) and significantly with Chlamydia spp. (Maurin et al, 1997). Patients with proven B. quintana endocarditis have been reported with IgG titres of 41 : 256 against Ch.…”

Pneumonia due to Chlamydia pneumoniae in children: Epidemiology, diagnosis, and treatment

“…Some IgG antibodies may result from a heterotypic response to other chlamydial species, because there are cross-reactions with the major outer-membrane protein between the three species as well as cross-reactions due to the genus lipopolysaccharide antigen. Other organisms that were reported as possibly causing cross-reactions with MIF are Bartonella 40 and Bordetella pertussis. 41 The latter could be significant, as adults with pertussis frequently present with a chronic cough or severe bronchitis, which is a clinical presentation often ascribed to C. pneumoniae.…”