HIGH PREVALENCE OF BARTONELLA QUINTANA ENDOCARDITIS IN SFAX, TUNISIA

ABIR ZNAZEN Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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JEAN-MARC ROLAIN Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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NADER HAMMAMI Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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SAMIR KAMMOUN Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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ADNANE HAMMAMI Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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DIDIER RAOULT Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Marseille, France; Laboratoire de Microbiologie, Chu Habib Bourguiba, Sfax, Tunisia; Service de Cardiologie, Chu Hedi Chaker, Sfax, Tunisia

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Bartonella quintana is a fastidious microorganism associated with blood culture negative endocarditis. In this study, 40 sera with cross-reactivity between Chlamydia species from patients from Sfax, Tunisia, were serologically tested for Bartonella. Thirteen sera were positive for Bartonella with IgG titers ≥1:800. Western blot and cross-absorption confirmed the diagnosis of Bartonella quintana endocarditis in 12 cases and Bartonella henselae endocarditis in 1 case. These sera were also positive by LightCycler nested PCR amplification for the rnpb (7 of 13) and fur (11of 13) genes. Eleven patients had a definite diagnosis of endocarditis, which represents 9.8% of all endocarditis. Because Bartonella endocarditis seems to be very common in Tunisia, we suggest that its serology be performed systematically whenever endocarditis is suspected.

Author Notes

Reprint requests: Didier Raoult, Unité des Rickettsies, CNRS UMR 6020, Université de la Méditerranée, Faculté de Médecine, Boulevard Jean Moulin, 13385 Marseille Cedex 05, France, Telephone: 00 33 4 91 32 43 75, Fax: 00 33 4 38 77 72, E-mail: Didier.Raoult@medecine.univ-mrs.fr.
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