Aiding in the diagnosis of Bartonella infection
For more information see Infective Endocarditis: Diagnostic Testing for Identification of Microbiological Etiology.
Real-Time Polymerase Chain Reaction (PCR)
Cat Scratch Disease (CSD)
Bartonella henselae
Bartonella quintana
Peliosis hepatitis
Endocarditis
Trench fever
Bacillary angiomatosis
B. henselae
B. quintana
CSD (Cat Scratch Disease)
For more information see Infective Endocarditis: Diagnostic Testing for Identification of Microbiological Etiology.
Varies
If this test result is negative and there is a strong suspicion of disease caused by these organisms, consider BART / Bartonella Antibody Panel, IgG and IgM, Serum and Warthin-Starry tissue stain (PATHC / Pathology Consultation) testing.
Specimen source is required.
Question ID | Description | Answers |
---|---|---|
SRC51 | Specimen Source |
The high sensitivity of amplification by polymerase chain reaction requires the specimen to be processed in an environment in which contamination of the specimen by Bartonella species DNA is unlikely.
Submit only 1 of the following specimens:
Specimen Type: Fresh tissue or biopsy
Sources: Heart valve, liver, lymph node, spleen, or skin tissue papule/lesion/nodule
Container/Tube: Sterile container
Specimen Volume: Entire collection or 5 mm(3) - approximately the size of a pencil eraser
Collection Instructions:
1. Collect fresh tissue specimen.
2. Submit tissue only, do not add fluid to tissue.
3. Refrigerate or freeze specimen.
Specimen Stability Information: Refrigerated (preferred) <7 days/ Frozen <7 days
Preferred Paraffin-embedded tissue block:
Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)
Sources: Heart valve, liver, lymph node, spleen, or skin tissue papule/lesion/nodule
Supplies: Tissue Block Container (T553)
Container/Tube: Tissue block
Collection Instructions: Submit a formalin-fixed, paraffin-embedded tissue block to be cut and returned.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Acceptable: Paraffin-embedded tissue block:
Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)
Sources: Heart valve, liver, lymph node, spleen, or skin tissue papule/lesion/nodule
Container/Tube: Sterile container for each individual cut section (scroll).
Collection Instructions: Perform microtomy and prepare five separate 10-micron sections. Each section (scroll) must be placed in a separate sterile container for submission.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Specimen Type: Fluid
Sources: Cerebrospinal or ocular (eg, vitreous humor fluid)
Container/Tube: Sterile vial
Specimen Volume: 0.5 mL
Specimen Stability Information: Refrigerated (preferred) <7 days/Frozen <7 days
Collection Instructions: For CSF, submit specimen from collection vial 2.
Specimen Type: Synovial fluid
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Pink top (EDTA), royal blue top (EDTA), sterile vial containing EDTA-derived aliquot, red clot tube (no anticoagulant), or sterile container
Specimen Volume: 0.5 mL
Collection Instructions: Send specimen in original tube (preferred).
Specimen Stability Information: Refrigerated (preferred) <7 days /Frozen <7 days
If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.
Fresh tissue or biopsy: 5 mm(3)
Paraffin-embedded tissue block: two 10-micron sections
Fluid: See Specimen Required
Tissue in formalin, formaldehyde, or acetone Bone marrow Slides | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Varies |
Aiding in the diagnosis of Bartonella infection
For more information see Infective Endocarditis: Diagnostic Testing for Identification of Microbiological Etiology.
Bartonella henselae and Bartonella quintana are small, pleomorphic Gram stain-negative bacilli that are difficult to isolate by culture due to their fastidious growth requirements. B henselae has been associated with cat scratch disease, bacillary angiomatosis, peliosis hepatitis, and endocarditis. B quintana has been associated with trench fever, bacillary angiomatosis, and endocarditis.
The diagnosis of Bartonella infection has traditionally been made by Warthin-Starry staining of infected tissue or serology. However, these methods may be falsely negative or nonspecific, respectively. Culture is insensitive.
Evaluation of infected tissue using polymerase chain reaction (PCR) has been shown to be an effective tool for diagnosing Bartonella infection. Mayo Clinic Laboratories has developed a real-time PCR test that permits rapid identification of Bartonella species. The assay targets a unique sequence of the citrate synthase gene present in Bartonella species.
Not applicable
A positive result indicates the presence of Bartonella species DNA.
A negative result indicates the absence of detectable Bartonella DNA but does not negate the presence of the organism and may occur due to inhibition of the polymerase chain reaction, sequence variability underlying primers or probes, or the presence of Bartonella DNA in quantities less than the limit of detection of the assay.
This test does not differentiate between Bartonella henselae and Bartonella quintana.
Test results should be used as an aid in diagnosis. The single assay should not be used as the only criteria to form a clinical conclusion, but results should be correlated with patient symptoms and clinical presentation. A negative result does not negate the presence of the organism or active disease.
Inhibition of less than 2% has been noted in formalin-fixed, paraffin-embedded tissues. In a study of 178 ocular fluids, no inhibition was detected, although this is a possibility due to the relatively small number of specimens tested.
1. Liesman RM, Pritt BS, Maleszewski JJ, Patel R: Laboratory diagnosis of infective endocarditis. J Clin Microbiol. 2017 Sep;55(9):2599-2608. doi: 10.1128/jcm.00635-17
2. Dumler JS, Carroll KC, Patel R: Bartonella. In: Carroll K, Pfaller M, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:chap 50
Bacterial nucleic acid is extracted from the specimen using the automated MagNA Pure instrument. The purified DNA is placed on the LightCycler instrument, which amplifies and monitors by fluorescence the development of target nucleic sequences after each polymerase chain reaction (PCR) cycle. A specific target sequence from Bartonella species is amplified and the resulting segment is detected using specific hybridization probes. Detection of the Bartonella target is performed through melting curve analysis using the LightCycler software.(Cockerill FR, Uhl JR: Applications and challenges of real-time PCR for the clinical microbiology laboratory. In: Reischl U, Wittwer C, Cockerill F, eds. Rapid Cycle Real-Time PCR Methods and Applications. Springer-Verlag; 2002:3-27; Dumler JS, Carroll KC, Patel R: Bartonella. In: Carroll KC, Pfaller M, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:893-904)
Monday through Friday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
87801
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
BARRP | Bartonella PCR | 48864-3 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
SRC51 | Specimen source | 31208-2 |
84440 | Bartonella PCR | 48864-3 |