Bartonella spp. Infections Identified by Molecular Methods, United States

David W. McCormick, Sara L. Rassoulian-Barrett, Daniel R. Hoogestraat, Stephen J. Salipante, Dhruba SenGupta, Elizabeth A. Dietrich, Brad T. Cookson, Grace E. Marx1Comments to Author , and Joshua A. Lieberman1
Author affiliations: Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (D.W. McCormick, E.A. Dietrich, G.E. Marx)University of Washington, Seattle, Washington, USA (S.L. Rassoulian-Barrett, D.R. Hoogestraat, S.J. Salipante, D. SenGupta, B.T. Cookson, J.A. Lieberman)
March, 2023


Molecular methods can enable rapid identification of Bartonella spp. infections, which are difficult to diagnose by using culture or serology. We analyzed clinical test results of PCR that targeted bacterial 16S rRNA hypervariable V1–V2 regions only or in parallel with PCR of Bartonella-specific ribC gene. We identified 430 clinical specimens infected with Bartonella spp. from 420 patients in the United States. Median patient age was 37 (range 1–79) years; 62% were male.

We identified:

  • B. henselae in 77%
  • B. quintana in 13%
  • B. clarridgeiae in 1%
  • B. vinsonii in 1%
  • B. washoensis in 1% of specimens
  • B. quintana was detected in 83% of cardiac specimens
  • B. henselae was detected in 34% of lymph node specimens

We detected novel or uncommon Bartonella spp. in 9 patients. Molecular diagnostic testing can identify Bartonella spp. infections, including uncommon and undescribed species, and might be particularly useful for patients who have culture-negative endocarditis or lymphadenitis.


Currently, 12 species of Bartonella genus are associated with human infection, but that number is constantly changing. Because Bartonella spp. infections are not nationally notifiable diseases, there is limited knowledge of the epidemiology of this disease in the US.  In my experience it is prolific.

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