Bartonella species – PCR

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Background
This page provides PCR testing information for the detection of Bartonella species including but not limited to B. henselae and B. quintana from clinical specimens. Bartonella species are the causative agent of Bartonellosis (Trench Fever, Cat-scratch disease). For information regarding other testing options, refer to the following PHO webpages:

Serology Testing : Bartonella henselae

Updates
Update on the turnaround time and frequency of sending received specimens by PHO’s laboratory to National Microbiology Laboratory.

* Copie d'impression non contrôlée. Valide uniquement le jour de l'impression : 21 nov. 2024.

Testing Indications

Clinical manifestations of B. henselae infection, also referred to as “Cat-scratch disease” (CSD), may include localized infections such as subacute regional lymphadenopathy, skin lesions, musculoskeletal lesions, culture-negative endocarditis, and uveitis and retinitis; however systemic manifestations are also common resulting in symptoms of fever, meningitis, osteomyelitis and arthritis.

Infection with B. quintana (Trench fever) is characterized by fever, which may be present as a single bout or bouts of recurrent fever, headache, rash and bone pain mainly in the shins neck and back.

Both B. henselae and B. quintana may cause bacillary angiomatosis in immunocompromised individuals such as those with advanced HIV.¹

Acceptance/Rejection Criteria

Blood collected in a tube with heparin anticoagulant is not acceptable.

Specimen Collection and Handling

Specimen Requirements

Test Requested	Required Requisition(s)	Specimen Type	Minimum Volume	Collection Kit
Bartonella species – PCR	Reference Bacteriology Requisition	Fresh tissue (skin biopsy, lymph nodes, heart valve biopsy)	1 to 5 mg	Sterile leak-proof container made of freeze-thaw and shatter resistant plastic, without any preservative
Bartonella species – PCR	Reference Bacteriology Requisition	Fluid aspirate from wound, lymph nodes, heart; synovial fluid	0.5 ml	Sterile leak-proof container made of freeze-thaw and shatter resistant plastic, without any preservative
Bartonella species – PCR	Reference Bacteriology Requisition	CSF (see submission and collection note #3)	0.5 ml	Sterile leak-proof container made of freeze-thaw and shatter resistant plastic, without any preservative
Bartonella species – PCR	Reference Bacteriology Requisition	Whole Blood	5.0 ml	Sterile leak-proof container made of freeze-thaw and shatter resistant plastic, without any preservative
Bartonella species – PCR	Reference Bacteriology Requisition	Swab from suspected infected area(see submission and collection note #3)	Suspended in 1 mL of appropriate storage medium	Sterile container
Bartonella species – PCR	Reference Bacteriology Requisition	Paraffin block, scrolls	N/A	Sterile container

Submission and Collection Notes

Complete the Reference Bacteriology Requisition for identification and confirmation. Please be sure to complete all fields on the requisition, including:

Test requested
Clinical information

Label the specimen container(s) with the patient’s first and last name, date of collection, and one other unique identifier such as the patient’s date of birth or Health Card Number. For additional information see: Criteria for Acceptance of Patient Specimens. Failure to provide this information may result in rejection or testing delay.

Cerebrospinal fluid (CSF) and swab samples are not ideal specimen types but are acceptable for testing if other specimens are not able to be collected.

Storage and Transport

Place the labeled container containing the specimen in a biohazard bag and seal. Specimen should be stored at 2-8°C following collection and shipped to PHO’s laboratory on ice packs within 48 hours of collection. All clinical specimens must be shipped in accordance to the Transportation of Dangerous Good Act.

Special Instructions

If tissue blocks need to be returned to sender, please add courier information and account number to requisition. Alternatively, consider sending scrolls.

Complete the Reference Bacteriology Requisition. Please indicate clinical information, including relevant symptoms and history of any animal contact, bite or scratch wounds.

Requisitions and Kit Ordering

Test Frequency and Turnaround Time (TAT)

Specimens received at PHO’s laboratory are sent to National Microbiology Laboratory (NML) every Tuesday. Any specimen received after Tuesday will be sent to NML the next Tuesday.

Bartonella PCR is performed at the National Microbiology Laboratory (NML) in Winnipeg.

Turnaround time is up to 21 calendar days from receipt at the National microbiology Laboratory in Winnipeg.

Test Methods

Samples are sent to the National Microbiology Laboratory (NML) in Winnipeg.
Extracted DNA is screened by a real-time PCR assay specific for Bartonella species. If positive by real-time PCR, samples are tested by species-specific real-time PCR. If necessary, conventional PCR and sequencing may be performed for species determination.
Results of the test should be interpreted with consideration of all laboratory results and clinical findings.
Initiation of antibiotic treatment prior to testing may result in decreased bacterial genome which will affect the outcome of PCR testing.

Reporting

Results are reported to the physician, authorized health care provider (General O. Reg 45/22, s.18) or submitter as indicated on the requisition.

Results of the test should be interpreted with consideration of all laboratory results and clinical findings.

References

Detection of Bartonella species by PCR and sequencing - Guide to Services. Canadian Network for Public Health Intelligence -CNPHI (canada.ca). Accessed from: https://cnphi.canada.ca/gts/reference-diagnostic-test/4224?labId=1019. May 22, 2024