Guidance

Bartonella: diagnostic and reference services

Information on Bartonella and how to obtain diagnostic and reference services.

Background

Bartonella bacteria cause several diseases in humans. Immunocompromised people are more at risk. Infections can present with a wide variety of symptoms.

The most common human infections are:

  • cat scratch disease, caused by Bartonella henselae (B. henselae)
  • trench fever, caused by Bartonella quintana (B. quintana)
  • Carrion’s disease, caused by Bartonella bacilliformis (B. bacilliformis)

Other Bartonella species may also cause human disease and have been found in various animals including cat, dogs and rats.

Transmission of infection

Several insect vectors are or may be involved in transmission of infection, including:

  • cat fleas (B. henselae)
  • human body lice (B. quintana)
  • sand flies (B. bacilliformis)

Bartonella infections mostly occur worldwide except Bartonella bacilliformis, which only occurs in certain parts of South America.

Types of testing

Bartonella spp do not grow readily in the laboratory and diagnosis may be difficult. Culture needs special medium and can take several weeks, and serology tests may cross react with other infections so may not be reliable.

Molecular testing by polymerase chain reaction (PCR) to look for bacterial DNA may be used but requires invasive sampling, such as lymph node biopsy, to get good quality tissue for diagnosis.

Bartonella services

There are limited Bartonella diagnostic services currently provided by the UK Health Security Agency (UKHSA).

Rare and imported pathogens laboratory (RIPL)

Antibody testing for B. henselae and B. quintana, previously available at Norwich and Colindale, has been withdrawn as a UKHSA service and is not currently available. However, we aim to offer a new service in 2023 delivered through RIPL.

RIPL does provide a developmental Bartonella PCR service, which may be offered in some circumstances. For information about testing, please contact RIPL on 01980 612348. The laboratory is happy to discuss and advise on diagnosis and clinical cases. If testing is agreed, please see the RIPL user manual for general information on how to submit samples. Make sure a completed RIPL request form is sent with the sample.

Antimicrobial Resistance and Healthcare Associated Infections (AMRHAI) laboratory

Alternatively, the UKHSA’s AMRHAI laboratory offers 16S rDNA gene sequencing from clinical material (except blood and serum), and identification of referred isolates in appropriate circumstances. This may also be of use in identifying infections due to Bartonella spp.

For 16S rDNA gene sequencing requests, contact Dr Julie Logan (AMRHAI) on 020 8327 6059.

For 16S rDNA bacterial identification reference services, refer to the AMRHAI reference and diagnostic services.



Published 11 September 2008
Last updated 4 January 2023 + show all updates
  1. Updated guidance.

  2. First published.