Table 2.

Donor Diagnostic Testing for Bartonella quintana Infection

Test Category	Sample and Test Description	Comments
Bacterial culture	Blood culture samples Consider performing culture on donor spleen, if regularly extracted for other testing	Specialized techniques are required: Releasing pathogen from intracellular niche (eg, freeze-thaw, lysis centrifugation) [1, 2] Prolonged incubation in CO2-rich environment for up to 45 d [2] Consider addition of growth enrichment [3] Note: Bartonella species do not produce enough CO2 to trigger response from automatic culture systems [2]
Molecular	EDTA whole blood Consider performing on donor spleen or blood vessel samples proximal to donated organ	Molecular targets should include primers and probes specific to Bartonella genus (eg, ITS3) and B quintana species (eg, fabB, yopP, groEL) [1, 2, 4]
Serology	Serum for indirect immunofluorescent antibody test for both B quintana and Bartonella henselae; if serology for B quintana not available, proceed with serology for B henselae as cross-reactivity	Positive >1:100 (Infection-Marseille) or >1:124 (Focus/DiaSorin) Titers >1:800 (Infection-Marseille) or >1:1024 (DiaSorin/Focus Diagnostics) suggestive of infective endocarditis [5, 6]

References for Table 2 are listed in the Supplementary material.