Skip to main content

Advertisement

SpringerLink
Log in

Evaluation of an in-house cat scratch disease IgM ELISA to detect Bartonella henselae in a routine laboratory setting

  • Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Cat scratch disease (CSD) is caused by Bartonella henselae infection and is a common cause of regional lymphadenopathy. The diagnosis of CSD largely depends on serology, but detection of B. henselae in an affected lymph node by PCR is also an important diagnostic tool. We evaluated an IgM in-house ELISA protocol and analyzed its performance in routine CSD serology. Serum samples from PCR-positive patients (n = 126), PCR-negative patients (n = 123), and age-matched controls (n = 126) were used for evaluation. The sensitivity of the IgM ELISA was only 56%, showing that the performance of B. henselae serology under routine laboratory settings is low, probably caused by the wide variability in disease duration in patients suspected of CSD whose samples were submitted to our laboratory. Most patients (46%) with a positive IgM response were between 0 and 20 years of age. We conclude that the serodiagnosis of B. henselae is hampered by the low sensitivity and specificity of the assays when used in a routine laboratory setting. For this reason, a negative IgM or PCR result can never exclude CSD, especially with late sample collection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brenner DJ, O’Conner SP, Winkler HH, Steigerwalt AG (1993) Proposals to unify the genera Bartonella and Rochalimaea, with descriptions of Bartonella Quintana comb. Nov., Bartonella vinsonii comb. Nov., Bartonella henselae comb. Nov, and Bartonella elizabethae comb. Nov. and to remove the family Bartonellaceae from the order Rickettsiales. Int J Syst Bacteriol 43:777–786

    Article  PubMed  CAS  Google Scholar 

  2. Emmons RW, Riggs JL, Schachter J (1976) Continuing the search for the etiology of cat scratch disease. J Clin Micro Biol 4:112–114

    CAS  Google Scholar 

  3. Emmons RW (1984) Cat scratch disease: the mystery finally solved? Ann Intern Med 100:303–304

    PubMed  CAS  Google Scholar 

  4. Regnery RL, Olson JG, Perkins BA, Bibb W (1992) Serological response to “Rochalimaea henselae” antigen in suspected cat scratch disease. Lancet 339:1443–1445

    Article  PubMed  CAS  Google Scholar 

  5. Regnery R, Tappero J (1995) Unraveling mysteries associated with cat-scratch disease, bacillary angiomatosis, and related syndromes. Emerg Infect Dis 1:16–21

    Article  PubMed  CAS  Google Scholar 

  6. Koehler JE, Glaser CA, Tappero JW (1994) Rochalimaea henselae infection: a new zoonosis with the domestic cat as reservoir. JAMA 271:531–535

    Article  PubMed  CAS  Google Scholar 

  7. Regnery RL, Martin M, Olsen JG (1992) Naturally occurring Rochalimaea henselae infection in domestic cat. Lancet 340:557–558

    Article  PubMed  CAS  Google Scholar 

  8. Chomel BB, Kasten RW, Floyd-Hawkins K, Chi B, Yamamoto K, Roberts-Wilson J, Gurfield AN, Abbott RC, Pedersen NC, Koehler JE (1996) Experimental transmission of Baronella henselae by the cat flea. J Clin Microbiol 34:1952–1956

    PubMed  CAS  Google Scholar 

  9. Rolain JM, Franc M, Davoust B, Raoult D (2003) Molecular detection of Bartonella quintana, B. koehlerae, B. henselae, B. clarridgeiae, Rickettsia felis, and Wolbachia pipientis in cat fleas, France. Emerg Infect Dis 9:338–342

    PubMed  CAS  Google Scholar 

  10. Shaw SE, Kenny MJ, Tasker S, Birtles RJ (2004) Pathogen carriage by the cat flea Ctenocephalides felis (Bouce) in the United Kingdom. Vet Microbiol 102:183–188

    Article  PubMed  CAS  Google Scholar 

  11. Warwick WJ (1967) The cat-sratch syndrome, many diseases or one disease? Prog Med Virol 9:256–301

    PubMed  CAS  Google Scholar 

  12. Zangwill KM, Hamilton DH, Perkins BA, Regnery RL, Plikaytis BD, Hadler JL, Cartter ML, Wenger JD (1993) Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test. N Engl J Med 329:8–13

    Article  PubMed  CAS  Google Scholar 

  13. Loutit JS (1997) Bartonella infections. Curr Clin Top Infect Dis 17:269–290

    PubMed  CAS  Google Scholar 

  14. Jameson PH, Greene CE, Regnery RL, Dryden M, Marks A, Brown J, Cooper J, Glaus B, Greene R (1995) Prevalence of Bartonella henselae in pet cats throughout regions of North America. J Infect Dis 172:1145–1149

    PubMed  CAS  Google Scholar 

  15. Carithers HA (1985) Cat scratch disease: an overview based on a study of 1,200 patients. Am J Dis Child 139:1124–1133

    PubMed  CAS  Google Scholar 

  16. Karim AA, Cockerell CJ, Petri WA (1994) Cat scratch disease, bacillary angiomatosis, and other infections due to Rochalimaea. N Engl J Med 330:1509–1515

    Article  Google Scholar 

  17. Margileth AM (1993) Cat scratch disease. Adv Pediatr Infect Dis 8:1–21

    PubMed  CAS  Google Scholar 

  18. La Scola B, Raoult D (1999) Culture of Bartonella Quintana and Bartonella henselae from human samples: a 5-year experience (1993 to 1998). J Clin Microbiol 37:1899–1905

    PubMed  Google Scholar 

  19. Bergmans AM, Groothedde JW, Schellekens JF, van Embden JD, Ossewaarde JM, Schouls LM (1995) Etiology of cat sratch disease: comparison of polymerase chain reaction detection of Bartonella (formerly Rochalimaea) and Afipia felis DNA with serology and skin test. J Infect Dis 171:916–923

    PubMed  CAS  Google Scholar 

  20. Sander A, Posselt M, Bohm N, Ruess M, Altwegg M (1999) Detection of Bartonella henselae DNA by two different PCR assays and determination of the genotypes of strains involved in histologically defined cat scratch disease. J Clin Microbiol 37:993–997

    PubMed  CAS  Google Scholar 

  21. Giladi M, Kletter Y, Avidor B, Metzkor-Cotter E, Varon M, Golan Y, Weinberg M, Riklis I, Ephros M, Slater L (2001) Enzyme immunoassay for the diagnosis of cat scratch disease defined by polymerase chain reaction. Clin Infect Dis 33:1852–1858

    Article  PubMed  CAS  Google Scholar 

  22. Sander A, Posselt M, Oberle K, Bredt W (1998) Seroprevalence of antibodies to Bartonella henselae in patients with cat scratch disease and in healthy controls: evaluation and comparison of two commercial serological tests. Clin Diagn Lab Immunol 5:486–490

    PubMed  CAS  Google Scholar 

  23. Zbinden R, Strohle A, Nadal D (1998) IgM to Bartonella henselae in cat scratch disease and during acute Epstein Barr virus infection. Med Microbiol Immunol (Berl) 186:167–170

    Article  CAS  Google Scholar 

  24. Bergmans AMC, Peeters MF, Schellekens JFP, Vos MC, Sabbe LJM, Ossewaarde JM, Verbakel H, Hooft HJ, Schouls LM (1997) Pitfalls and fallacies of cat scratch serology: evaluation of Bartonella henselae-based indirect fluorescence assay and enzyme-linked immuno assay. J Clin Microbiol 35:1931–1937

    PubMed  CAS  Google Scholar 

  25. Metzkor-Cotter E, Kletter Y, Avidor B, Varon M, Golan Y, Ephros M, Giladi M (2003) Long-term serological analysis and clinical follow-up of patients with cat scratch disease. Clin Infect Dis 37:1149–1154

    Article  PubMed  Google Scholar 

  26. Vermeulen M, Herremans T, Verbakel H, Bergmans A, Roord J, van Dijken P, Peeters M (2007) Serological testing for Bartonella henselae infections in the Netherlands: clinical evaluation of IFA and ELISA. Clin Microbiol Infect 13:627–634

    Article  PubMed  CAS  Google Scholar 

  27. De Melker HE, Conyn-van Spaendonck MAE (1998) Immunosurveillance and the evaluation of national immunization programmes: a population-based approach. Epidemiol Infect 121:637–643

    Article  PubMed  Google Scholar 

  28. Barka NE, Hadfield T, Patnaik M, Schwartzman WA, Peter JB (1993) EIA for detection of Rochalimaea henselae-reactive IgG, IgM and IgA antibodies in patients with suspected Cat Scratch Disease. J Infect Dis 167:1503–1504

    PubMed  CAS  Google Scholar 

  29. Herremans M, Vermeulen MJ, Van de Kassteele J, Bakker J, Schellekens JFP, Koopmans MPG (2007) The use of Bartonella henselae-specific age dependent IgG and IgM in diagnostic models to discriminate diseased from non-diseased in cat scratch disease serology. J Microbiol Methods 71:107–113

    Article  PubMed  CAS  Google Scholar 

  30. Maman E, Bickels J, Ephros M, Paran D, Comaneshter D, Metzkor-Cotter E, Avidor B, Varon-Graidy M, Wientroub S, Giladi M (2007) Musculoskeletal manifestations of cat scratch disease. Clin Infect Dis 45:1535–1540

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

We greatly acknowledge Luise Beens for her technical support.

Author information

Authors and Affiliations

  1. Laboratory for Infectious Diseases and Perinatal Screening, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands

    M. Herremans, J. Bakker & M. P. G. Koopmans

  2. VU Medical Centre, Amsterdam, The Netherlands

    M. J. Vermeulen

  3. Laboratory for Infectious Diseases, Van Ketwich Verschuurlaan 92, Groningen, The Netherlands

    J. F. P. Schellekens

Authors
  1. M. Herremans
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Bakker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. J. Vermeulen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. F. P. Schellekens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. P. G. Koopmans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Herremans.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Herremans, M., Bakker, J., Vermeulen, M.J. et al. Evaluation of an in-house cat scratch disease IgM ELISA to detect Bartonella henselae in a routine laboratory setting. Eur J Clin Microbiol Infect Dis 28, 147–152 (2009). https://doi.org/10.1007/s10096-008-0601-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-008-0601-8

Keywords

Search

Navigation