The Best Test for Detecting Bartonella

The diagnosis of Bartonellosis typically relies on a combination of factors, including clinical symptoms, medical history, and laboratory tests. There isn't a single definitive test for Bartonella, but several tests can aid in its diagnosis. The choice of test depends on the stage of the disease and other factors. The AcuDart Bartonellosis Test, which is powered by the ImmunoBlot technology from IGeneX Laboratory, is considered the best test for Bartonella because of its superior sensitivity and specificity. The AcuDart Bartonella test tests for the Bartonella genus and speciates to multiple species of Bartonella that infect humans, including B. henselae, B. quintana, B. elizabethae, and B. vinsonii.

Bartonellosis, also known as cat scratch disease or cat scratch fever, is a bacterial infection caused by Bartonella bacteria. It typically occurs after a scratch or bite from an infected cat, hence the name, but it can also be transmitted through flea bites, by contact with the saliva of an infected animal, and from ticks.

While Lyme disease is the most commonly known tick-borne illness, ticks can transmit other pathogens, including Bartonella species. Ticks carrying Bartonella bacteria can bite humans and transmit the infection, leading to a condition known as bartonellosis.

Bartonellosis can manifest with a variety of symptoms, including fever, fatigue, headache, muscle aches, joint pain, and in some cases, a rash. These symptoms can be nonspecific and overlap with those of other illnesses, making diagnosis challenging. Additionally, Bartonella infections can sometimes be chronic and difficult to treat, especially if not diagnosed early.

In most cases, the illness resolves on its own without treatment, but in some cases, antibiotics may be prescribed, especially if the symptoms are severe or if the infection has spread to other parts of the body.

Bartonellosis symptoms typically develop within 3-14 days after being scratched or bitten by an infected cat or kitten. Common symptoms include:

1. Swollen lymph nodes: This is usually the first sign of the infection and can occur near the site of the scratch or bite.

2. Fever: Many people with bartonellosis develop a fever, which may come and go.

3. Fatigue: Feeling tired or weak is a common symptom.

4. Headache: Headaches are another common symptom.

5. Body aches: Muscles and joints may ache, similar to flu-like symptoms.

6. Skin lesions: Some people develop small bumps or pustules at the site of the scratch or bite.

7. Sore throat: Throat discomfort or pain can occur.

8. Poor appetite: Some individuals may experience a loss of appetite.

In severe cases or in individuals with weakened immune systems, complications such as encephalopathy (brain inflammation), neuroretinitis (eye inflammation), or endocarditis (heart valve infection) may occur. If you suspect you have bartonellosis, it's essential to see a healthcare professional for diagnosis and treatment.

There are several tests available for diagnosing Bartonella infection. Here are some common ones:

1. Serological tests: These tests look for antibodies that the body produces in response to Bartonella infection. They include enzyme immunoassays (EIAs), indirect immunofluorescence assays (IFAs), and Western blot assays. However, serological tests may have limitations, such as cross-reactivity with other bacteria, and may not always accurately detect active infection.

2. Polymerase chain reaction (PCR) tests: PCR tests detect the genetic material of the bacteria in blood, tissue, or fluid samples. This test can directly detect Bartonella DNA and is often used to confirm active infection.

3. Culture: Culturing Bartonella bacteria from blood or tissue samples is another method of diagnosis. However, Bartonella species can be difficult to culture, and this method is less commonly used.

4. Immunohistochemistry (IHC): This technique involves staining tissue samples with antibodies specific to Bartonella antigens, allowing for visualization of the bacteria under a microscope. It is often used in diagnosing Bartonella-related conditions such as bacillary angiomatosis.

5. PCR/ESI-MS (PCR/electrospray ionization-mass spectrometry): This is a newer diagnostic method that combines PCR amplification of bacterial DNA with mass spectrometry to detect and identify various pathogens, including Bartonella species.

6. Fluorescence in situ hybridization (FISH): FISH is a molecular biology technique used to detect and localize specific nucleic acid sequences within cells or tissue samples. In the context of Bartonella, FISH can be used to detect and visualize the parasites' genetic material (DNA or RNA) within host cells or tissues. FISH offers several advantages, including high sensitivity and specificity, as well as the ability to provide spatial information about the distribution of Bartonella within host tissues. This technique is particularly useful for research purposes and can aid in understanding the pathogenesis of Bartonella infections and assessing treatment efficacy. However, it may not be routinely used in clinical diagnostics due to its complexity and specialized equipment requirements.

7. EliSpot: The Bartonella ELISPOT (Enzyme-Linked Immunospot Assay) test is a diagnostic tool used to detect specific T cell responses to Bartonella antigens. ELISPOT assays are commonly used in immunology to measure the frequency of antigen-specific T cells by capturing cytokine-producing cells at the single-cell level.

In the context of Bartonella infection, the ELISPOT test aims to detect T cells that respond to Bartonella antigens by producing cytokines such as interferon-gamma (IFN-γ). This can provide information about the immune response to Bartonella and help diagnose active infection or determine past exposure.

The Bartonella ELISPOT test is a relatively new approach and may not be widely available in all healthcare settings. Its utility and accuracy may vary depending on factors such as the specific antigens used in the assay and the stage of infection. As with any diagnostic test, interpretation should be done by a qualified healthcare professional in conjunction with other clinical findings and tests.

The choice of test depends on various factors, including the patient's symptoms, the stage of the infection, and the availability of specific testing facilities. It's essential to consult with a healthcare professional for proper evaluation and diagnosis if Bartonella infection is suspected.

Several species of Bartonella cause severe diseases in humans, such as Cat scratch disease (CSD), endocarditis, trench fever, and Carrion’s disease. Currently, around half the species of the gram-negative bacterial genus Bartonella are known to cause human disease. Some of these species include B. elizabethae, B. washoensis, B. vinsonii, B. koehlare, and B. alsatica.

Bartonella henselae is the causative agent for Cat Scratch Disease and has also been known to cause bacillary angiomatosis, peliosis hepatis, bacteremia, and endocarditis in immunocompromised individuals. CSD was first described in 1931, but the causative agent was unknown at the time, so CSD was not reported until decades later, in 1990.

Bartonella quintana causes Trench Fever, described as such due to outbreaks during WWI and WWII. Fewer cases were reported after the wars, but during the 1990s, infections caused by B. quintana were re-emerging among destitute populations in the US and Europe.

B. bacilliformis causes Carrion’s disease is caused by , and is only known to infect humans. The first reported outbreak occurred in 1871, causing over 4,000 casualties.

The AcuDart Bartonellosis Test is not based on any of the above mentioned technologies, but rather the ImmunoBlot technology developed by IGeneX Laboratory. An ImmunoBlot has two key differentiators. First, it looks for multiple pathogens, instead of one with a test such as IFA. And second, it uses recombinant proteins instead of proteins from natural sources. The recombinant DNA technology provides a more efficient method to obtain large amounts of proteins (i.e. billions of copies). Additionally, by using recombinant technology, scientists are able to create DNA sequences that would not naturally exist under normal circumstances and environmental conditions, leading to more sensitive and specific tests.

The Bartonella ImmunoBlot detects antibodies to multiple species of Bartonella in a single test without compromising specificity. The ImmunoBlot is a great complement to direct tests, such as PCR and FISH, which look for pathogens.

• Allows for identification of a broad range of Bartonella species, including B. henselae, B. quintana, B. elizabethae, and B. vinsonii

• Detects multiple species in one test, unlike IFA which detects one species at a time

• Uses specifically created recombinant proteins and not proteins from cell cultures

• Detects the full spectrum of disease: early, active, and late-stage disease

• Can be made genus and species-specific

• Quantity and location of the antigens are controlled by a printing-like process, improving consistency and specificity

• Avoids the old-fashioned, manual, error prone and time-consuming process of visualizing glass slides through a microscope

• Renders Western blot and IFA obsolete, and is meant to replace them