Seroprevalence of Bartonella henselae in patients awaiting heart transplant in Southern Italy

Background: Bartonella henselae is the etiologic agent of cat-scratch disease. B. henselae infectionsare responsible for a widening spectrum of human diseases, although often symptomless,ranging from self-limited to life-threatening and show different courses and organinvolvement due to the balance between host and pathogen. The role of the host immuneresponse to B. henselae is critical in preventing progression to systemic disease. Indeed inimmunocompromised patients, such as solid organ transplant patients, B. henselae results insevere disseminated disease and pathologic vasoproliferation. The purpose of this study wasto determine the seroprevalence of B. henselae in patients awaiting heart transplantcompared to healthy individuals enrolled in the Regional Reference Laboratory of TransplantImmunology of Second University of Naples.Methods: Serum samples of 38 patients awaiting heart transplant in comparison to 50 healthydonors were examined using immunfluorescence assay.Results: We found a B. henselae significant antibody positivity rate of 21% in patients awaitingheart transplant (pZ0.002). There was a positive rate of 8% (p > 0.05) for immunoglobulin (Ig)M and a significant value of 13% (pZ0.02) for IgG, whereas controls were negative both for IgMand IgG antibodies against B. henselae. The differences in comorbidity between cases and controlswere statistically different (1.41 0.96 vs 0.42 0.32; p Z 0.001).Conclusions: Although this study was conducted in a small number of patients, we suggest thatthe identification of these bacteria should be included as a routine screening analysis in pretransplantpatients.