Antibodies to Bartonella species in inner-city intravenous drug users in Baltimore, MD

被引:75
作者
Comer, JA [1 ]
Flynn, C [1 ]
Regnery, RL [1 ]
Vlahov, D [1 ]
Childs, JE [1 ]
机构
[1] JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT EPIDEMIOL,PROGRAM INFECT DIS,BALTIMORE,MD
关键词
D O I
10.1001/archinte.156.21.2491
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Bartonella quintana has recently been associated with homeless alcoholic men. Both B quintana and Bartonella henselae have been shown to be opportunistic pathogens of people with acquired immunodeficiency syndrome. The reservoirs and modes of transmission of these infections are incompletely known. Objectives: To examine serum samples that were taken from inner-city intravenous (IV) drug users for antibodies to Bartonella organisms to determine whether there is an urban transmission cycle for Bartonella species and to examine the demographic and behavioral characteristics of IV drug users to identify possible risk factors for infection with any of these agents. Materials and Methods: A serologic survey was conducted, using a convenience sample of serum specimens collected during a study of IV drug use and human immunodeficiency virus infection among 630 inner-city residents in Baltimore, Md. A detailed questionnaire was administered at the initial collection of serum, and additional serum collections and questionnaire updates were made at 6-month intervals. The most recent available serum sample was tested for Bartonella antibody titer by using the indirect immunofluorescent antibody test with 3 antigens: Bartonella elizabethae, B henselae, and B quintana. Univariate and multivariate analyses of selected potential demographic and behavioral risk factors were conducted. Results: Antibodies to Bartonella were highly prevalent in this group; more than 37% of all samples reacted with at least 1 antigen. Overall seroprevalence of antibodies to B elizabethae, B henselae, and B quintana was 33%, 11%, and 10%, respectively. Current IV drug use, frequency of injection, and seronegative human immunodeficiency virus status were significantly associated with Bartonella antibody presence, but these associations varied by analysis. There was a significant inverse association of antibody prevalence to B henselae and B quintana by using CD4(+) cell counts among human immunodeficiency virus-seropositive individuals. Conclusions: Intravenous drug users have an elevated prevalence of antibodies to Bartonella organisms and may be at significant risk of becoming infected. Current IV drug use, high frequency of injection, and seronegative human immunodeficiency virus status are significant risk factors for an increased prevalence of Bartonella antibodies. The current natural histories of Bartonella species are rapidly changing, and mechanisms of transmission remain unknown.
引用
收藏
页码:2491 / 2495
页数:5
相关论文
共 29 条
[1]   DETECTION OF ROCHALIMAEA-HENSELAE DNA IN SPECIMENS FROM CAT-SCRATCH DISEASE PATIENTS BY PCR [J].
ANDERSON, B ;
SIMS, K ;
REGNERY, R ;
ROBINSON, L ;
SCHMIDT, MJ ;
GORAL, S ;
HAGER, C ;
EDWARDS, K .
JOURNAL OF CLINICAL MICROBIOLOGY, 1994, 32 (04) :942-948
[2]   DETECTION OF ROCHALIMAEA-HENSELAE IN CAT-SCRATCH DISEASE SKIN-TEST ANTIGENS [J].
ANDERSON, B ;
KELLY, C ;
THRELKEL, R ;
EDWARDS, K .
JOURNAL OF INFECTIOUS DISEASES, 1993, 168 (04) :1034-1036
[3]  
CHILDS JE, 1994, J AM VET MED ASSOC, V204, P1775
[4]   USE OF BARTONELLA ANTIGENS FOR SEROLOGIC DIAGNOSIS OF CAT-SCRATCH DISEASE AT A NATIONAL REFERRAL CENTER [J].
DALTON, MJ ;
ROBINSON, LE ;
COOPER, J ;
REGNERY, RL ;
OLSON, JG ;
CHILDS, JE .
ARCHIVES OF INTERNAL MEDICINE, 1995, 155 (15) :1670-1676
[5]   ROCHALIMAEA-ELIZABETHAE SP-NOV ISOLATED FROM A PATIENT WITH ENDOCARDITIS [J].
DALY, JS ;
WORTHINGTON, MG ;
BRENNER, DJ ;
MOSS, CW ;
HOLLIS, DG ;
WEYANT, RS ;
STEIGERWALT, AG ;
WEAVER, RE ;
DANESHVAR, MI ;
OCONNOR, SP .
JOURNAL OF CLINICAL MICROBIOLOGY, 1993, 31 (04) :872-881
[6]   BARTONELLA (ROCHALIMAEA) QUINTANA ENDOCARDITIS IN 3 HOMELESS MEN [J].
DRANCOURT, M ;
MAINARDI, JL ;
BROUQUI, P ;
VANDENESCH, F ;
CARTA, A ;
LEHNERT, F ;
ETIENNE, J ;
GOLDSTEIN, F ;
ACAR, J ;
RAOULT, D .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (07) :419-423
[7]   ENDOCARDITIS CAUSED BY ROCHALIMAEA-HENSELAE [J].
HADFIELD, TL ;
WARREN, R ;
KASS, M ;
BRUN, E ;
LEVY, C .
HUMAN PATHOLOGY, 1993, 24 (10) :1140-1141
[8]   Seroprevalence to Bartonella quintana among patients at a community clinic in downtown Seattle [J].
Jackson, LA ;
Spach, DH ;
Kippen, DA ;
Sugg, NK ;
Regnery, RL ;
Sayers, MH ;
Stamm, WE .
JOURNAL OF INFECTIOUS DISEASES, 1996, 173 (04) :1023-1026
[9]   ROCHALIMAEA-HENSELAE INFECTION - A NEW ZOONOSIS WITH THE DOMESTIC CAT AS A RESERVOIR [J].
KOEHLER, JE ;
GLASER, CA ;
TAPPERO, JW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1994, 271 (07) :531-535
[10]   ISOLATION OF ROCHALIMAEA SPECIES FROM CUTANEOUS AND OSSEOUS LESIONS OF BACILLARY ANGIOMATOSIS [J].
KOEHLER, JE ;
QUINN, FD ;
BERGER, TG ;
LEBOIT, PE ;
TAPPERO, JW .
NEW ENGLAND JOURNAL OF MEDICINE, 1992, 327 (23) :1625-1631