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Test ID: BARRP Bartonella, Molecular Detection, PCR, Varies

Reporting Name

Bartonella PCR

Useful For

Aiding in the diagnosis of Bartonella infection

Clinical Information

Bartonella henselae and B 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 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.

Interpretation

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 PCR, sequence variability underlying primers or probes, or the presence of Bartonella DNA in quantities less than the limit of detection of the assay.

Analytic Time

2 days

Day(s) and Time(s) Performed

Monday, Wednesday, Friday

Clinical Reference

1. Karem KL, Paddock CD, Regnery RL: Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance. Microbes Infect 2000 August;2(10):1193-1205

2. Agan BK, Dolan MJ: Laboratory diagnosis of Bartonella infections. Clin Lab Med 2002 December;22(4):937-962

3. Maguina C, Gotuzzo E: Bartonellosis. New and old. Infect Dis Clin North Am 2000 March;14(1):1-22

4. Vikram HR, Bacani AK, Devaleria PA, et al: Bivalvular Bartonella henselae prosthetic valve endocarditis. J Clin Microbiol 2007 December;45(12):4081-4084

5. Lin EY, Tsigrelis C, Baddour LM, et al: Candidatus Bartonella mayotimonensis and endocarditis. Emerg Infect Dis 2010 Mar;16(3):500-503

Method Name

Real-Time Polymerase Chain Reaction (PCR)

Specimen Type

Varies


Advisory Information


BART / Bartonella Antibody Panel, IgG and IgM, Serum and Warthin-Starry tissue stain (PATHC / Pathology Consultation) should be considered if PCR is negative and there is a strong suspicion of disease caused by these organisms.



Necessary Information


Specimen source is required.



Specimen Required


The high sensitivity of amplification by PCR 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:

Supplies: Tissue Block Container (T553)

Specimen Type: Formalin-fixed, paraffin-embedded tissue block (FFPE)

Sources: Heart valve, liver, lymph node, spleen, or skin tissue papule/lesion/nodule

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

 

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


Specimen Minimum Volume

Fresh tissue or biopsy: 5 mm(3)
Paraffin-embedded tissue block: two 10-micron sections
Fluid: 0.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Varies

Reference Values

Not applicable

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87801

LOINC Code Information

Test ID Test Order Name Order LOINC Value
BARRP Bartonella PCR 48864-3

 

Result ID Test Result Name Result LOINC Value
SRC51 Specimen source 31208-2
84440 Bartonella PCR 48864-3

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Mayo Clinic Laboratories | Neurology Catalog Additional Information:

mml-CNS-Infections, mml-Pediatric