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This article is about the bacteria. For the disease, see Bartonellosis.

Bartonella is a genus of Gram-negative bacteria. Facultative intracellular parasites, Bartonella species can infect healthy people, but are considered especially important as opportunistic pathogens.[1] Bartonella species are transmitted by vectors such as ticks, fleas, sand flies, and mosquitoes. At least eight Bartonella species or subspecies are known to infect humans.[2]

Bartonella henselae is the organism responsible for cat scratch disease, a self-limited disease except in immunocompromised hosts.


Bartonella species have been infecting humans for thousands of years, as demonstrated by Bartonella quintana DNA in a 4000-year-old tooth.[3] The genus is named for Alberto Leonardo Barton Thompson (1871 - October 26, 1950), a Peruvian scientist born in Argentina.

Infection cycle[edit]

The currently accepted model explaining the infection cycle holds that the transmitting vectors are blood-sucking arthropods and the reservoir hosts are mammals. Immediately after infection, the bacteria colonize a primary niche, the endothelial cells. Every five days, some of the Bartonella bacteria in the endothelial cells are released into the blood stream, where they infect erythrocytes. The bacteria then invade a phagosomal membrane inside the erythrocytes, where they multiply until they reach a critical population density. At this point, they simply wait until they are taken up with the erythrocytes by a blood-sucking arthropod.

Though some studies have found "no definitive evidence of transmission by a tick to a vertebratehost," [4][5] Bartonella species are well-known to be transmissible to both animals and humans through various other vectors, such as fleas, lice, and sand flies.[6] Recent studies have shown a strong correlation between tick exposure and bartonellosis,[6][7] including human bartonellosis. Bartonella bacteria are associated with cat-scratch disease, but a study in 2010 concluded, "Clinicians should be aware that . . . a history of an animal scratch or bite is not necessary for disease transmission." [8] All current Bartonella species identified in canines are human pathogens.[9]


Bartonella infections are remarkable in the wide range of symptoms they can produce: the time course (acute or chronic) and the underlying pathology are highly variable.[10]

Bartonella pathophysiology in humans
SpeciesHuman reservoir or
incidental host?
B. bacilliformisReservoirCauses Carrion's disease(Oroya fever, Verruga peruana)Peru, Ecuador, and Colombia
B. quintanaReservoirCauses trench fever, bacillary angiomatosis, and endocarditisWorldwide
B. clarridgeiaeIncidentalDomestic catCat scratch disease
B. elizabethaeIncidentalRatEndocarditis
B. grahamiiIncidentalMouseEndocarditis and neuroretinitis
B. henselaeIncidentalDomestic catCat scratch disease, bacillary angiomatosis, peliosis hepatis, endocarditis, bacteremia with fever, and neuroretinitisWorldwide
B. koehleraeIncidentalDomestic cat
B. vinsoniiIncidentalMouse, dog, domestic cat
B. washoensisIncidentalSquirrelMyocarditis
B. rochalimaeIncidentalUnknownCarrion's disease-like symptoms


Treatment is dependent on which species or strain of Bartonella is found in a given patient. While Bartonella species are susceptible to a number of standard antibiotics in vitromacrolides and tetracycline, for example — the efficacy of antibiotic treatment in immunocompetent individuals is uncertain.[10] Immunocompromised patients should be treated with antibiotics because they are particularly susceptible to systemic disease and bacteremia. Drugs of particular effectiveness include trimethoprim-sulfamethoxazole, gentamicin, ciprofloxacin, and rifampin; B. henselae is generally resistant to penicillin, amoxicillin, and nafcillin.[10]


Homeless intravenous drug users are at high risk for Bartonella infections, particularly B. elizabethae. B. elizabethae seropositivity rates in this population range from 12.5% in Los Angeles,[14] to 33% in Baltimore, Maryland,[15] 46% in New York City,[16] and 39% in Sweden.[17]


  1. ^ Walker DH (1996). Rickettsiae. In: Barron's Medical Microbiology (Barron S et al., eds.) (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1. 
  2. ^ Chomel BB, Boulouis HJ (2005). "Zoonoses dues aux bactéries du genre Bartonella: nouveaux réservoirs? nouveaux vecteurs?" [Zoonotic diseases caused by bacteria of the genus Bartonella: new reservoirs? new vectors?]. Bull. Acad. Natl. Med. (in French) 189 (3): 465–77; discussion 477–80. PMID 16149211. 
  3. ^ Drancourt M, Tran-Hung L, Courtin J, Lumley H, Raoult D (2005). "Bartonella quintana in a 4000-year-old human tooth". J. Infect. Dis. 191 (4): 607–11. doi:10.1086/427041. PMID 15655785. 
  4. ^ Angelakis E, Billeter SA, Breitschwerdt EB, Chomel BB, Raoult D (March 2010). "Potential for tick-borne bartonellosis". Emerg Infect Dis 16 (3): 385–91. doi:10.3201/eid1603.091685. PMC 3322042. PMID 20202411. 
  5. ^ Telford SR III, Wormser GP (March 2010). "Bartonella spp. transmission by ticks not established". Emerg Infect Dis 16 (3): 379–84. doi:10.3201/eid1603.090443. PMC 3322007. PMID 20202410. 
  6. ^ a b Billeter SA, Levy MG, Chomel BB, Breitschwerdt EB (Mar 2008). "Vector transmission of Bartonella species with emphasis on the potential for tick transmission". Med Vet Entomol 22 (1): 1–15. doi:10.1111/j.1365-2915.2008.00713.x. PMID 18380649. 
  7. ^ Eskow E, Rao RV, Mordechai E (Sep 2001). "Concurrent infection of the central nervous system by Borrelia burgdorferi and Bartonella henselae: evidence for a novel tick-borne disease complex". Arch Neurol 58 (9): 1357–63. doi:10.1001/archneur.58.9.1357. PMID 11559306. 
  8. ^ Mosbacher M, Elliott SP, Shehab Z, Pinnas JL, Klotz JH, Klotz SA (Sep–Oct 2010). "Cat scratch disease and arthropod vectors: more to it than a scratch?". J Am Board Fam Med 23 (5): 685–6. doi:10.3122/jabfm.2010.05.100025. PMID 20823366. 
  9. ^ Chomel BB, Boulouis HJ, Maruyama S, Breitschwerdt EB (Mar 2006). "Bartonella spp. in pets and effect on human health". Emerg Infect Dis 12 (3): 389–94. doi:10.3201/eid1203.050931. PMC 3291446. PMID 16704774. 
  10. ^ a b c Rolain JM, Brouqui P, Koehler JE, Maguina C, Dolan MJ, Raoult D (2004). "Recommendations for treatment of human infections caused by Bartonella species". Antimicrob. Agents Chemother. 48 (6): 1921–33. doi:10.1128/AAC.48.6.1921-1933.2004. PMC 415619. PMID 15155180. 
  11. ^ Zeaiter Z, Liang Z, Raoult D (2002). "Genetic classification and differentiation of Bartonella species based on comparison of partial ftsZ gene sequences". J. Clin. Microbiol. 40 (10): 3641–7. doi:10.1128/JCM.40.10.3641-3647.2002. PMC 130884. PMID 12354859. 
  12. ^ Jacomo V, Kelly PJ, Raoult D (2002). "Natural history of Bartonella infections (an exception to Koch's postulate)". Clin. Diagn. Lab. Immunol. 9 (1): 8–18. doi:10.1128/CDLI.9.1.8-18.2002. PMC 119901. PMID 11777823. 
  13. ^ Maco V, Maguiña C, Tirado A, Maco V, Vidal JE (2004). "Carrion's disease (Bartonellosis bacilliformis) confirmed by histopathology in the High Forest of Peru". Rev. Inst. Med. Trop. Sao Paulo 46 (3): 171–4. doi:10.1590/S0036-46652004000300010. PMID 15286824. 
  14. ^ Smith HM; Reporter R; Rood MP et al. (2002). "Prevalence study of antibody to ratborne pathogens and other agents among patients using a free clinic in downtown Los Angeles". J. Infect. Dis. 186 (11): 1673–6. doi:10.1086/345377. PMID 12447746. 
  15. ^ Comer JA, Flynn C, Regnery RL, Vlahov D, Childs JE (1996). "Antibodies to Bartonella species in inner-city intravenous drug users in Baltimore, Md". Arch. Intern. Med. 156 (21): 2491–5. doi:10.1001/archinte.156.21.2491. PMID 8944742. 
  16. ^ Comer JA, Diaz T, Vlahov D, Monterroso E, Childs JE (2001). "Evidence of rodent-associated Bartonella and Rickettsia infections among intravenous drug users from Central and East Harlem, New York City". Am. J. Trop. Med. Hyg. 65 (6): 855–60. PMID 11791987. 
  17. ^ McGill S, Hjelm E, Rajs J, Lindquist O, Friman G (2003). "Bartonella spp. antibodies in forensic samples from Swedish heroin addicts". Ann. N. Y. Acad. Sci. 990: 409–13. doi:10.1111/j.1749-6632.2003.tb07402.x. PMID 12860665. 


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