Diagnostic Tests for Bartonella

BARTONELLA IFA

The B. henselae immuno-fluorescence assay (IFA) is designed to detect human IgM and IgG antibodies to Bartonella henselae antigens in human serum. For diagnostic purposes, B. henselae IFA test results should be used in conjunction with other information available to the physician.

Principal

The B. henselae IFA assay is a “two-stage” sandwich assay, based upon an antigen-antibody complex formation in the following steps:

  1. Binding of anti-B. henselae specific antibodies in human serum to fixed B. henselae on a slide. Binding of fluorescent-labeled anti-human IgG/IgM antibodies specific to the human anti– B. henselae antibodies bound to fixed B. henselae on the slide. 
  2. Identifying green fluorescing B. henselae organisms with a fluorescent microscope.

Result Interpretation

Reference Range

  • Bartonella henselae antibody titers IgM        <20
  • Bartonella henselae antibody titers IgG        <40

Clinical Significance

The B. henselae immunofluorescent antibody test is used to detect antibodies to B. henselae in human serum. Infections with B. henselae have been associated with Cat Scratch Disease, bacillary angiomatosis, peliosis hepatis, and bacteremia. Titers rise during the first 2 to 4 weeks of illness and decline over 6 to 12 months. In patients with previously high titers, presence of only IgG titer of < 160 may indicate a resolving infection. If the IFA is negative but the clinical symptoms are present, PCR testing is suggested.

B. henselae is most often transmitted to humans by cats. Recently, it has been suggested that B. henselae can also be present in same tick that transmits pathogens causing Lyme disease, Babesiosis, and Ehrlichiosis. Thus, patients with positive titers should also be tested for the other tick-borne diseases.

Limitations

  1. A negative IFA test result does not exclude the possibility of B.henselae infection.
  2. Results should be interpreted in conjunction with other laboratory and clinical findings.

Ordering Information

  • Specimen: Serum – minimum volume 0.5 ml
  • Container: SST (Serum Separator Tube) or Leak-proof tube
  • Collection and Shipping Instructions: See Serum and Whole Blood Samples- Collection & Shipping Instructions [THIS WILL LINK TO THAT PAGE]

Test Offered

Test# 285 Bartonella henselae IgG & IgM Antibody CPT Code 86611 x2
Bartonella henselae IgG & IgM Antibody is part of the following Test Panels:
Test Panel# 8095 NN Co-infection Panel**
Test Panel# 5080 Western Regional Co-infection Panel**
Test Panel# 5085 New Western Regional Co-infection Panel**(includes Bartonella FISH)
Test Panel# 5090 Complete Co-infection Panel
Test Panel# 5095 New Complete Co-infection Panel(includes Bartonella FISH)
Test Panel# 5060 TBD Panel**
Test Panel# 2010 Complete Bartonella Panel

**Test/Panels are not yet available for New York Residents

BARTONELLA PCR – WHOLE BLOOD AND CSF

The Bartonella henselae PCR test is an assay that detects B. henselae specific DNA in whole blood and/or cerebral spinal fluid (CSF). The combination of the following three steps imparts a very high specificity and sensitivity to the test.

  • Hybridization/Selection
  • Amplification of Bartonella-specific DNA
  • Detection of Bartonella-specific amplified DNA fragments

Result Interpretation

Reference Range

Negative: B. henselae rDNA was not detected

Clinical Significance

The B. henselae PCR test is an assay that detects B. henselae specific DNA in whole blood or cerebral spinal fluid. B. henselae rDNA fragments are hybrid-selected by probes, followed by PCR amplification of selected B. henselae rDNA. PCR products are confirmed by B. henselae specific probes in a Southern Blot Assay. The primers and probes used for the selection of B. henselae rDNA fragments are designed from published small subunit ribosomal RNA sequences.

Limitations

  1. Results should be interpreted in conjunction with other laboratory and clinical findings.
  2. Test results can only help the physician in confirming clinical diagnosis.

Ordering Information

  • Specimen: EDTA Whole Blood (280); CSF (281)
  • Minimum volume: 2.0 ml
  • Container: EDTA lavender top tube for whole blood; sterile leak-proof tube for CSF
  • Collection and Shipping Instructions: See Serum and Whole Blood Samples and Miscellaneous Specimen Collection & Shipping Instructions [THIS WILL LINK TO THAT PAGE]

Test Offered

Test# 280 Bartonella henselae PCR – Whole Blood CPT Code 87471
Test# 281 Bartonella henselae PCR – CSF CPT Code 87471

Bartonella henselae PCR – Whole Blood is part of the following Test Panels:

Test Panel# 2010 Complete Bartonella Panel

**Test/Panels are not yet available for New York Residents

BARTONELLA FISH

The Fluorescent In-Situ Hybridization (FISH) assay is designed for qualitative detection of ribosomal RNA of the Bartonella directly in a blood smear. The test’s highest degree of specificity is provided by nucleic acid probes, which bind to RNA sequences of the pathogen.

Principal

The FISH assay is based on two fundamental principles:

1) Hybridization directly on a thin blood smear with a fluorescein-labeled Bartonella – specific probe.

2) Identification of Bartonella on a blood smear by viewing under a fluorescent microscope.

ferrari

B. quintana B. henseale

Result Interpretation

Reference Range

Negative: No green fluorescing rod-shaped bacteria.

Clinical Significance

The Bartonella Fluorescence In-Situ Hybridization assay is designed for qualitative detection of ribosomal RNA of bacteria belonging to the Genus Bartonella. Bartonella are rod-shaped gram negative bacteria. The FISH test provides a significant increase in specificity over standard gram stain for the presence of Bartonella in a whole blood smear. A positive result indicates the presence of bacterium from the Genus Bartonella including B. berkhoffii, B. henselae, B. Quintana, or B. vinsonii. The presence of an organism is a strong indication for the presence of disease. A positive result can aid in diagnosis during the course of the disease..

Limitations

  1. A negative FISH test result does not exclude the possibility of Bartonella infection.
  2. Results should be interpreted in conjunction with other laboratory and clinical findings.

Ordering Information

  • Specimen: Whole Blood – Minimum volume 2.0 ml
  • Container: EDTA lavender top tube
  • Collection and Shipping Instructions: See Serum and Whole Blood Samples- Collection & Shipping Instructions [THIS WILL LINK TO THAT PAGE]
  • Rejection Criteria: Refer to general collection procedure

Test Offered

Test# 289 Bartonella FISH CPT Code 88365
Bartonella FISH** is part of the following Test Panels:
Test Panel# 8095 NN Co-infection Panel**
Test Panel# 5085 New Western Regional Co-infection Panel**
Test Panel# 5095 New Complete Co-infection Panel
Test Panel# 2010 Complete Bartonella Panel

**Test/Panels are not yet available for New York Residents