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. 1997 Sep;35(9):2283–2287. doi: 10.1128/jcm.35.9.2283-2287.1997

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

M Maurin 1, F Eb 1, J Etienne 1, D Raoult 1
PMCID: PMC229955  PMID: 9276403

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.

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Selected References

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  1. Anacker R. L., List R. H., Mann R. E., Wiedbrauk D. L. Antigenic heterogeneity in high- and low-virulence strains of Rickettsia rickettsii revealed by monoclonal antibodies. Infect Immun. 1986 Feb;51(2):653–660. doi: 10.1128/iai.51.2.653-660.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Anderson B., Sims K., Regnery R., Robinson L., Schmidt M. J., Goral S., Hager C., Edwards K. Detection of Rochalimaea henselae DNA in specimens from cat scratch disease patients by PCR. J Clin Microbiol. 1994 Apr;32(4):942–948. doi: 10.1128/jcm.32.4.942-948.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Birkhead J. S., Apostolov K. Endocarditis caused by a psittacosis agent. Br Heart J. 1974 Jul;36(7):728–731. doi: 10.1136/hrt.36.7.728. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Blasi F., Denti F., Erba M., Cosentini R., Raccanelli R., Rinaldi A., Fagetti L., Esposito G., Ruberti U., Allegra L. Detection of Chlamydia pneumoniae but not Helicobacter pylori in atherosclerotic plaques of aortic aneurysms. J Clin Microbiol. 1996 Nov;34(11):2766–2769. doi: 10.1128/jcm.34.11.2766-2769.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Block S., Hedrick J., Hammerschlag M. R., Cassell G. H., Craft J. C. Mycoplasma pneumoniae and Chlamydia pneumoniae in pediatric community-acquired pneumonia: comparative efficacy and safety of clarithromycin vs. erythromycin ethylsuccinate. Pediatr Infect Dis J. 1995 Jun;14(6):471–477. doi: 10.1097/00006454-199506000-00002. [DOI] [PubMed] [Google Scholar]
  6. Brearley B. F., Hutchinson D. N. Endocarditis associated with Chlamydia trachomatis infection. Br Heart J. 1981 Aug;46(2):220–221. doi: 10.1136/hrt.46.2.220. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dick D. C., McGregor C. G., Mitchell K. G., Sommerville R. G., Wheatley D. J. Endocarditis as a manifestation of Chlamydia B infection (psittacosis). Br Heart J. 1977 Aug;39(8):914–916. doi: 10.1136/hrt.39.8.914. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dimmitt S. B., Pearman J. W., Woollard K. V. Chlamydial endocarditis. Aust N Z J Med. 1985 Jun;15(3):340–342. doi: 10.1111/j.1445-5994.1985.tb04049.x. [DOI] [PubMed] [Google Scholar]
  9. Drancourt M., Mainardi J. L., Brouqui P., Vandenesch F., Carta A., Lehnert F., Etienne J., Goldstein F., Acar J., Raoult D. Bartonella (Rochalimaea) quintana endocarditis in three homeless men. N Engl J Med. 1995 Feb 16;332(7):419–423. doi: 10.1056/NEJM199502163320702. [DOI] [PubMed] [Google Scholar]
  10. Dumont D., Mathieu D., Alemanni M., Eb F., Manigand G. Endocardite d'Osler probablement due à Chlamydia pneumoniae (souche TWAR). Presse Med. 1990 Jun 2;19(22):1054–1054. [PubMed] [Google Scholar]
  11. Emmons R. W., Riggs J. L., Schachter J. Continuing search for the etiology of cat scratch disease. J Clin Microbiol. 1976 Jul;4(1):112–114. doi: 10.1128/jcm.4.1.112-114.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Emre U., Roblin P. M., Gelling M., Dumornay W., Rao M., Hammerschlag M. R., Schachter J. The association of Chlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med. 1994 Jul;148(7):727–732. doi: 10.1001/archpedi.1994.02170070065013. [DOI] [PubMed] [Google Scholar]
  13. Eremeeva M. E., Balayeva N. M., Ignatovich V. F., Raoult D. Proteinic and genomic identification of spotted fever group rickettsiae isolated in the former USSR. J Clin Microbiol. 1993 Oct;31(10):2625–2633. doi: 10.1128/jcm.31.10.2625-2633.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Etienne J., Ory D., Thouvenot D., Eb F., Raoult D., Loire R., Delahaye J. P., Beaune J. Chlamydial endocarditis: a report on ten cases. Eur Heart J. 1992 Oct;13(10):1422–1426. doi: 10.1093/oxfordjournals.eurheartj.a060077. [DOI] [PubMed] [Google Scholar]
  15. Freeman A. P., Freeman Z. S. Chlamydia endocarditis. Med J Aust. 1981 Jun 13;1(12):642–642. [PubMed] [Google Scholar]
  16. Grayston J. T., Campbell L. A., Kuo C. C., Mordhorst C. H., Saikku P., Thom D. H., Wang S. P. A new respiratory tract pathogen: Chlamydia pneumoniae strain TWAR. J Infect Dis. 1990 Apr;161(4):618–625. doi: 10.1093/infdis/161.4.618. [DOI] [PubMed] [Google Scholar]
  17. Hyman C. L., Roblin P. M., Gaydos C. A., Quinn T. C., Schachter J., Hammerschlag M. R. Prevalence of asymptomatic nasopharyngeal carriage of Chlamydia pneumoniae in subjectively healthy adults: assessment by polymerase chain reaction-enzyme immunoassay and culture. Clin Infect Dis. 1995 May;20(5):1174–1178. doi: 10.1093/clinids/20.5.1174. [DOI] [PubMed] [Google Scholar]
  18. Jariwalla A. G., Davies B. H., White J. Infective endocarditis complicating psittacosis: response to rifampicin. Br Med J. 1980 Jan 19;280(6208):155–155. doi: 10.1136/bmj.280.6208.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Jones R. B., Priest J. B., Kuo C. Subacute chlamydial endocarditis. JAMA. 1982 Feb 5;247(5):655–658. [PubMed] [Google Scholar]
  20. Knobloch J., Bialek R., Müller G., Asmus P. Common surface epitope of Bartonella bacilliformis and Chlamydia psittaci. Am J Trop Med Hyg. 1988 Nov;39(5):427–433. doi: 10.4269/ajtmh.1988.39.427. [DOI] [PubMed] [Google Scholar]
  21. Konttinen A., Karjalainen J., Piirainen H. Ornitoosin aiheuttama endokardiitti ja aorttainsuffisienssi. Duodecim. 1978;94(7):449–453. [PubMed] [Google Scholar]
  22. Kuo C. C., Shor A., Campbell L. A., Fukushi H., Patton D. L., Grayston J. T. Demonstration of Chlamydia pneumoniae in atherosclerotic lesions of coronary arteries. J Infect Dis. 1993 Apr;167(4):841–849. doi: 10.1093/infdis/167.4.841. [DOI] [PubMed] [Google Scholar]
  23. La Scola B., Raoult D. Serological cross-reactions between Bartonella quintana, Bartonella henselae, and Coxiella burnetii. J Clin Microbiol. 1996 Sep;34(9):2270–2274. doi: 10.1128/jcm.34.9.2270-2274.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Laemmli U. K. Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970 Aug 15;227(5259):680–685. doi: 10.1038/227680a0. [DOI] [PubMed] [Google Scholar]
  25. Levison D. A., Guthrie W., Ward C., Green D. M., Robertson P. G. Infective endocarditis as part of psittacosis. Lancet. 1971 Oct 16;2(7729):844–847. doi: 10.1016/s0140-6736(71)90221-2. [DOI] [PubMed] [Google Scholar]
  26. Marrie T. J., Harczy M., Mann O. E., Landymore R. W., Raza A., Wang S. P., Grayston J. T. Culture-negative endocarditis probably due to Chlamydia pneumoniae. J Infect Dis. 1990 Jan;161(1):127–129. doi: 10.1093/infdis/161.1.127. [DOI] [PubMed] [Google Scholar]
  27. Maurin M., Raoult D. Bartonella (Rochalimaea) quintana infections. Clin Microbiol Rev. 1996 Jul;9(3):273–292. doi: 10.1128/cmr.9.3.273. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Ramirez J. A. Isolation of Chlamydia pneumoniae from the coronary artery of a patient with coronary atherosclerosis. The Chlamydia pneumoniae/Atherosclerosis Study Group. Ann Intern Med. 1996 Dec 15;125(12):979–982. doi: 10.7326/0003-4819-125-12-199612150-00008. [DOI] [PubMed] [Google Scholar]
  29. Raoult D., Fournier P. E., Drancourt M., Marrie T. J., Etienne J., Cosserat J., Cacoub P., Poinsignon Y., Leclercq P., Sefton A. M. Diagnosis of 22 new cases of Bartonella endocarditis. Ann Intern Med. 1996 Oct 15;125(8):646–652. doi: 10.7326/0003-4819-125-8-199610150-00004. [DOI] [PubMed] [Google Scholar]
  30. Regan R. J., Dathan J. R., Treharne J. D. Infective endocarditis with glomerulonephritis associated with cat chlamydia (C. psittaci) infection. Br Heart J. 1979 Sep;42(3):349–352. doi: 10.1136/hrt.42.3.349. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Regnery R. L., Olson J. G., Perkins B. A., Bibb W. Serological response to "Rochalimaea henselae" antigen in suspected cat-scratch disease. Lancet. 1992 Jun 13;339(8807):1443–1445. doi: 10.1016/0140-6736(92)92032-b. [DOI] [PubMed] [Google Scholar]
  32. Saikku P., Leinonen M., Mattila K., Ekman M. R., Nieminen M. S., Mäkelä P. H., Huttunen J. K., Valtonen V. Serological evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction. Lancet. 1988 Oct 29;2(8618):983–986. doi: 10.1016/s0140-6736(88)90741-6. [DOI] [PubMed] [Google Scholar]
  33. Saikku P., Leinonen M., Tenkanen L., Linnanmäki E., Ekman M. R., Manninen V., Mänttäri M., Frick M. H., Huttunen J. K. Chronic Chlamydia pneumoniae infection as a risk factor for coronary heart disease in the Helsinki Heart Study. Ann Intern Med. 1992 Feb 15;116(4):273–278. doi: 10.7326/0003-4819-116-4-273. [DOI] [PubMed] [Google Scholar]
  34. Shapiro D. S., Kenney S. C., Johnson M., Davis C. H., Knight S. T., Wyrick P. B. Brief report: Chlamydia psittaci endocarditis diagnosed by blood culture. N Engl J Med. 1992 Apr 30;326(18):1192–1195. doi: 10.1056/NEJM199204303261805. [DOI] [PubMed] [Google Scholar]
  35. Thom D. H., Grayston J. T., Siscovick D. S., Wang S. P., Weiss N. S., Daling J. R. Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease. JAMA. 1992 Jul 1;268(1):68–72. [PubMed] [Google Scholar]
  36. Thom D. H., Wang S. P., Grayston J. T., Siscovick D. S., Stewart D. K., Kronmal R. A., Weiss N. S. Chlamydia pneumoniae strain TWAR antibody and angiographically demonstrated coronary artery disease. Arterioscler Thromb. 1991 May-Jun;11(3):547–551. doi: 10.1161/01.atv.11.3.547. [DOI] [PubMed] [Google Scholar]
  37. Walker L. J., Adgey A. A. Successful treatment by doxycycline of endocarditis caused by ornithosis. Br Heart J. 1987 Jan;57(1):58–60. doi: 10.1136/hrt.57.1.58. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Ward C., Sagar H. J., Cooper D., Ward A. M. Insidious endocarditis caused by Chlamydia psittaci. Br Med J. 1975 Dec 27;4(5999):734–735. doi: 10.1136/bmj.4.5999.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Weiss E., Coolbaugh J. C., Williams J. C. Separation of viable Rickettsia typhi from yolk sac and L cell host components by renografin density gradient centrifugation. Appl Microbiol. 1975 Sep;30(3):456–463. doi: 10.1128/am.30.3.456-463.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. van der Bel-Kahn J. M., Watanakunakorn C., Menefee M. G., Long H. D., Dicter R. Chlamydia trachomatis endocarditis. Am Heart J. 1978 May;95(5):627–636. doi: 10.1016/0002-8703(78)90305-8. [DOI] [PubMed] [Google Scholar]

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