Bartonella spp.為新興人畜共通傳染疾病病原，其自然宿主涵蓋種類廣泛，過去研究顯示小型哺乳類動物為其重要宿主之一。本研究樣本捕捉地點分別位於中部地區兩商業港口（2002年8月起到翌年7月間，台中港與麥寮港），中部地區乳牛牧場與都市地區（2003年8月起到翌年11月間）進行野生小型哺乳類動物捕捉採樣，共計捕獲310隻鼠類，包括六物種：溝鼠（Rattus norvegeicus）169隻，錢鼠（Suncus murinus）126隻，小黃腹鼠（Rattus losea）3隻，家鼷鼠（Mus domesticus）1隻，小月鼠（Mus formosanus）1隻，屋頂鼠（Rattus rattus）10隻。結果顯示，菌血症陽性率為41.0％（127/310）。菌種鑑定則利用16S/23S rRNA基因 ITS片段以及gltA基因片段進行限制片段長度多型性（RFLP）技術組合分析，可將目前已知大部分之菌種區分，其中16S/23S rRNA基因 ITS片段可以快速觀察菌種差異性，RFLP分析可更仔細區別各分離菌株在具有相同PCR增幅基因片段中的差異。進一步將分離株之gltA基因片段進行定序，依親緣樹分析結果發現台灣地區Bartonella屬菌於小型哺乳類動物中相當多樣，並有混合感染之發現；其中B. elizabethae佔25.1％（32/127）、B. grahamii佔7.8％（10/127）、B. taylorii佔2.4％（3/127）與B. tribocorum佔41.7％（53/127），其中有22個血液樣本出現兩種以上基因型別，推測為混合感染（17.3％）；此外並發現自錢鼠分離的菌株中有部分菌株為台灣特有的菌種佔30.7％（39/127），目前將其暫命為B. Taiwan-1 株，其種別特性待更深入研究。將全血萃取DNA後針對gltA 基因與16S/23S rRNA基因 ITS片段進行PCR檢測，所得總體陽性率分別為24.7％（75/304）及38.8％（118/304）。血清檢體利用間接螢光抗體法(IFA)針對台灣四種鼠類常見菌種抗原B. elizabethae， B. Taiwan-1， B. grahamii及B. tribocorum進行抗體檢測，陽性率結果分別為0.0％（0/308）、3.2％（10/308）、3.2％ （10/308）及5.6％（12/308）。總體樣本分析流行病學資料的結果顯示菌血症的有無與動物種別、性別、年齡與季節有顯著相關（p＜0.05）；外寄生蟲的暴露有無雖未達顯著相關，但觀察兩港區螨的寄生與菌血症仍具有相關性（p＜0.05）。本研究結果得知Bartonella屬菌在台灣野生小型哺乳動物中的生態分佈，而其中為人畜共通致病原的Bartonella屬菌株（B. elizabethae與 B. grahamii）分離結果，值得未來觀察與警戒台灣居民因意外接觸小型哺乳動物而感染Bartonella屬菌疾病的危險性。

Most of Bartonella spp. have been identified to be zoonotic pathogens. Previous studies showed that small mammals are important reservoirs for Bartonellae. This study was conducted in small mammals collected form harbor areas during August 2002 and July 2003, and one dairy cattle herd as well as urban area during August 2003 and November 2004 in central Taiwan. A total of 310 blood specimens were obtained, including specimens of Rattus norvegicus(169), Suncus murinus(126), Rattus losea(3), Mus domesticus(1), Mus formosanus(1) and Rattus rattus(10). It was identified that 41.0%(127/310) of the samples were Bartonella bacteremic. The isolates were further characterized by PCR of the 16S/23S ITS gene, and PCR/RFLP and partial sequencing of the gltA gene. The analysis of 16S/23S ITS gene could be used as a rapid diagnosis at the species level, and RFLP analysis of the gltA gene could further differentiate isolates with similar PCR products. According to the phylogentic analysis, various species of Bartonella were identified in small mammals tested, including B. elizabathae(25.1%, 32/127), B. grahamii(7.8%, 10/127), B. taylorii(2.4%, 3/127) and B. tribocorum(41.7%, 53/127). It was also found that 17.3%(22/127) of the animals were co-infected with different Bartonella species. Of major importance, 30.7%(39/127) of the isolates were with similar results by molecular characterization but determined to be unknown Bartonella species; they were mostly isolated from Suncus murinus. The strain was thus designated as B. Taiwan-1 in this study. Using PCRs of the 16S/23S ITS and gltA genes for DNA extractants from whole blood samples, 24.7% and 38.8% of them were positive. Seroprevalence of B. elizabathae, B. Taiwan-1, B. grahamii and B. tribocorum by IFA test were 0%, 3.2%, 3.2% and 5.6%, respectively. Epidemiologic data analyses further showed that bacteremic status was significantly associated with species of small mammals, sex, age and season of collection (p<0.05). Although the presence of ectoparasites was not associated with Bartonella bacteremia overall, mite infestation was a significant risk factor for Bartonella bacteremia in small mammals from two harbor areas. The results of this study offered valuable information regarding Bartonella infections in small mammals in Taiwan. The identification of zoonotic Bartonella spp. further highlights the possible risk of people acquiring the infections from small mammals in Taiwan.

目次

致謝……………………………………………………………………………….i
中文摘要…………………………………………………………………………ii
英文摘要………………………………………………………………………...iv
第一章 前言…………………………………………………………………......1
第二章 文獻探討……………………………………………………………......2
第一節 Bartonella 屬菌細菌學特性及歷史…………………………….......2
第二節 Bartonella 屬菌所引起之人畜共通傳染疾病與自然傳播途徑.......2
第三節 Bartonella 屬菌於小型哺乳類的研究………………………….......4
第四節 Bartonella 屬菌之基因型分析……………………………………...5
第五節 Bartonella 屬菌演化關係與自然宿主特異性探討………………...6
第三章 材料與方法…………………………………………………………..11
第一節 Bartonella spp.標準菌株來源……………………………………..11
第二節 檢體收集與製備……………………………………………………11
2-1 鼠隻樣本捕捉……………………………………………………….11
2-2 血液樣本製備與保存……………………………………………….11
2-3 全血DNA萃取……………………………………………………...12
第三節 Bartonella spp. 培養、分離與鑑定………………………………..12
3-1 Bartonella spp. 培養與分離………………………………………..12
3-2 Bartonella spp. 菌種鑑定與分型…………………………………..13
第四節Bartonella spp. 間接螢光抗體檢測（Indirect Immunofluorescence antiboby Test, IFA）…………………………………………………….............14
4-1 抗原玻片製作………………………………………………..............15
4-2 間接螢光抗體檢測（Indirect Immunofluorescence antiboby Test, IFA）..16
第五節 各項分析法與使用軟體…………………………………………..16
5-1 統計…………………………………………..……………………...16
5-2 核酸序列分析………………………………..……………………...17
第四章 結果…………………………………………..……………………....18
第一節 樣本採集：鼠類捕捉記錄與地理分佈…..……………………....18
第二節 Bartonella spp.分離與各菌血症陽性率…..……………………....18
第三節 菌種鑑定與基因型分析…. ………………..………………..…....19
第四節 全血直接PCR檢測………………………..……………………....21
第五節 Bartonella spp. 間接螢光抗體檢測（IFA）……………………....21
第五章 討論…………………………………………..……………………....23
第六章 參考文獻……………………………………..……………………....30













圖表索引

圖一. 粗糙型菌落外觀…………………..……………………………...…....38
圖二. 細小型菌落外觀…………………..……………………………...…....38
圖三. 結合16S/23S ITS基因與gltA基因PCR/RFLP分析所得之分型結果.39
圖四. 以最大簡約法（maximum parsimony method）進行親緣樹譜分析結
果（本研究分離株與標準株）…………………………………………40
圖五. 以最大可能性法(maximum Likelihood method）進行親緣樹譜分析
（本研究分離株與標準株）…………………………………………41
圖六. IFA陽性結果…………..……………………………...….....................38
圖七. IFA 陰性結果…………..……………………………...…....................38
圖八. 以最大簡約法（maximum parsimony method）進行親緣樹譜分析
（本研究分離株與世界各地小型哺乳類動物之分離株）…………..42
圖九. 以最大可能性法(maximum Likelihood method）進行親緣樹譜分析
（本研究分離株與世界各地小型哺乳類動物之分離株）…………43
表一.台灣中部地區三處捕捉地點所捕捉之鼠種記錄……………...…..........44
表二. 各鼠種於台灣中部地區各捕捉地點分佈情形……………...…............45
表三. 台灣中部地區Bartonella屬菌於小型哺乳類動物之菌血症盛行率.....46
表四. Bartonella屬菌之菌血症盛行率相關之危險因子分析……...…............47
表五. 三處採樣區內Bartonella屬菌之菌血症盛行率與相關危險因子分析.48
表六. 本研究中各分子型與其相關菌株標號…………………...…..............49
表七. 本研究分離株各型代表之gltA基因核酸序列與標準菌株之gltA基因序列基因相似度…………………...….......…………………...….......50
表八. 各潛在影響因子與各菌種分離株相關性分析.....………………….....51
表九. gltA基因及16S/23S rRNA基因ITS片段之PCR結果與菌血症分離結果比較.52
表十. 利用四種抗原所進行之Bartonella spp.血清抗體盛行率分析結果與各潛在危險因子相關性分析……………………………………………..53
表十一. 利用四種抗原所進行之Bartonella spp.血清抗體力價分佈………54

附錄
表一. 限制酵素作用表（廠商提供）…………………………………………55

1.Abbott RC, Chomel BB, Kasten RW, Floyd-Hawkins KA, Kikuchi Y, Koehler JE, Pedersen NC. Experimental and natural infection with Bartonella henselae in domestic cats. Comp Immunol Microbiol Infect Dis 1997;20:41-51.
2.Anderson BE, Neuman MA. Bartonella spp. as emerging human pathogens. Clin Microbiol Rev 1997;10:203-19.
3.Bai Y, Kosoy MY, Maupin GO, Tsuchiya KR, Gage KL. Genetic and Ecologic Characteristics of Bartonella communities in rodents in southern China. Am J Trop Med Hyg 2002;66:622-7.
4.Baker JA. A rickettsial infection in Canadian voles. J Exp Med 1946;84:37-51.
5.Bereswill S, Hinkelmann S, Kist M. Sander A. Molecular analysis of riboflavin synthesis genes in Bartonella henselae and use of the ribC gene for differentiation of Bartonella species by PCR. J Clin Microbiol 1999;37:3159-66.
6.Berry V. and Gascuel O. On the interpretation of bootstrap trees: appropriate threshold of clade selection and induced gain. Mol Biol Evol 1996;13:999-1011.
7.Birtles RJ, Canales J, Ventosilla P, Alvarez E, Guerra H, Llanos-Cuenta A, Raoult D, Doshi N, Harrison TG. Survey of Bartonella species infecting intradomicillary animals in the Huayllacallan Valley, Ancash, Peru, a region endemic for human bartonellosis. Am J Trop Med Hyg 1999;60:799-805.
8.Birtles RJ, Harrison TG, Molyneux DH. Grahamella in small woodland mammals in the U.K.: isolation, prevalence and host specificity. Ann Trop Med Parasitol 1994;88:317-27.
9.Birtles RJ, Harrison TG, Saunders NA, Molyneux DH. Proposals to unify the genera Grahamella and Bartonella, with descriptions of Bartonella talpae comb.nov., Bartonella peromysci comb. nov., and three new species, Bartonella grahamii sp. nov., Bartonella taylorii sp. nov., and Bartonella doshiae sp. nov. Int J Syst Bacteriol 1995;45:1-8.
10.Birtles RJ, Hazel S, Bown K, Raoult D, Begon M. Bennett M. Subtyping of uncultured Bartonellae using sequence comparison of 16S/23S rRNA intergenic spacer regions amplified directly from infected blood. Mol Cell Probab 2000;14:79-87.
11.Birtles RJ, Raoult D. Comparison of partial citratesynthase gene (gltA) sequences for phylogenetic analysis of Bartonella species. Int J Syst Bacteriol 1996;46:891-7.
12.Bown KJ, Bennet M, Begon M. Flea-borne Bartonella grahamii and Bartonella taylorii in bank voles. Emerg Infect Dis 2004;10:684-7.
13.Boulouis HJ, Barrat F, Bermond D, Bernex F, Thibault D, Heller R, Fontaine JJ, Piemont Y, Chomel BB. Kinetics of Bartonella birtlesii infection in experimentally infected mice and pathogenic effect on reproductive functions. Infect Immun 2001;69:5313-7.
14.Breitschwerdt EB, Kordick DL. Bartonella infection in animals: carriership, reservoir potential, pathogenicity, and zoonotic potential for human infection. Clin Microbiol Rev 2000;13:428-38.
15.Breitschwerdt EB, Kordick DL, Malarkey DE, Keene B, Hadfield TL, Wilson K. Endocarditis in a dog due to infection with a novel Bartonella subspecies. J Clin Microbiol 1995;33:154-60.
16.Breitschwerdt EB, Sontakke S, Cannedy A, Hancock SI, Bradley J. Infection with Bartonella weissii and detection of nanobacterium antigens in a North Carolina beef herd. J Clin Microbiol 2001;39:879-82.
17.Brenner DJ, Connor SO, Winkler HH, Steigerwalt AG. Proposals to unify the genera Bartonella and Rochalimaea, with descriptions of Bartonella quintana comb. nov., Bartonella vinsonii comb. nov., Bartonella henselae comb. nov., and Bartonella elizabethae comb. nov., and to remove the family Bartonellaceae from the order Rickettsiales. Int J Syst Bacteriol 1993;43:777-86.
18.Brouqui P, Scola BL, Roux V, Raoult D. Chronic Bartonella quintana bacteremia in homeless patients. N Engl J Med 1999;340:184-9.
19.Brouqui P, Raoult D. Endocarditis due to rare and fastidious bacteria. Clin Microbiol Rev 2001;14:177-207.
20.Chang CC, Chomel BB, Kasten RW, Heller R, Kocan KM, Ueno H, Yamamoto K, Bleich V, Pierce B, Gonzales B, Swift P, Boyce W, Jang S, Boulouis HJ, Piemont YP. Bartonella spp. isolated from wild and domestic ruminants in North America. Emerg Infect Dis 2000;6:306-11.
21.Chang CC, Chomel BB, Kasten RW, Romano V, Tietze N. Molecular evidence of Bartonella spp. in questing adult Ixodes pacificus ticks in California. J Clin Microbiol 2001;39:1221-6.
22.Chang CC, Kasten RW, Chomel BB, Simpson DC, Hew CM, Kordick DL, Heller R, Piemont Y, Breitschwerdt EB. Coyotes (Canis latrans) as the reservoir for a human pathogenic Bartonella sp.: molecular epidemiology of Bartonella vinsonii subsp. berkhoffii infection in coyotes from central coastal California. J Clin Microbiol. 2000;38:4193-200.
23.Clarridge JE, Raich TJ, Pirwani D, Simon B, Tsai L, Rodriguez-Barradas MC, Regnery R, Zollo A, Jones DC, Rambo C. Strategy to detect and identify Bartonella species in routine clinical laboratory yields Bartonella henselae from human immunodeficiency virus-positive patient and unique Bartonella strain from his cat. J Clin Microbiol 1995;33:2107-13.
24.Comer JA, Flynn C, Regnery RL, Vlahov D, Childs JE. Antibodies to Bartonella spp. in inner-city Baltimore intravenous drug users. Arch Intern Med 1996;156:2491-5.
25.Daly JS, Worthington MG, Brenner DJ, Moss CW, Hollis DG, Weyant RS, Steigerwalt AG, Weaver RE, Daneshvar MI, O'Connor SP. Rochalimaea elizabethae sp. nov. isolated from a patient with endocarditis. J Clin Microbiol 1993;31:872-81.
26.Drancourt M, Mainardi JL, Brouqui P, Vandenesch F, Carta A, Lehnert F, Etienne J, Vigier E, Goldstein F, Acar J, Raoult D. Bartonella (Rochalimaea) quintana endocarditis in homeless patients: report of three cases. N Engl J Med 1995;332:419-23.
27.Droz S, Chi B, Horn E, Steigerwalt AG, Whitney AM, Brenner DJ. Bartonella koehlerae sp. nov., isolated from cats. J Clin Microbiol 1999;37:1117-22.
28.Ellis BA, Regnery RL, Beati L, Bacellar F, Rood M, Glass GG, Marston E, Ksiazek TG, Jones D, Childs JE. Rats of the genus Rattus are reservoir hosts for pathogenic Bartonella species: an Old World origin for a new world disease? J Infect Dis 1999;180:220-4.
29.Gurfield AN, Boulouis HJ, Chomel BB, Heller R, Kasten RW, Yamamoto K, Piemont Y. Coinfection with Bartonella clarridgeiae and Bartonella henselae and with different Bartonella henselae strains in domestic cats. J Clin Microbiol 1997;35:2120-3.
30.Hadfield TL, Warren R, Kass M, Brun E, Levy C. Endocarditis caused by Rochalimaea henselae. Hum Pathol 1993;24:1140-1.
31.Heller R, Kubina M, Mariet P, Riegel P, Delacour G, Dehio C, Lamarque F, Kasten R, Boulouis HJ, Monteil H, Chomel BB, Piemont Y. Bartonella alsatica sp. nov., a new Bartonella species isolated from the blood of wild rabbits. Int J Syst Bacteriol 1999;49:283-8.
32.Heller R, Riegel P, Hansmann Y, Delacour G, Bermond D, Dehio C, Lamarque F, Monteil H, Chomel BB, Piemont Y. Bartonella tribocorum sp. nov., a new Bartonella species isolated from the blood of wild rats. Int J Syst Bacteriol 1998;48:1333-9.
33.Hofmeister EK, Kolbert CP, Abdulkarim AS, Magera JM, Hopkins MK, Uhl JR, Ambyaye A, Telford III SR, Cockerill III FR, Persing DH. Cosegregation of a novel Bartonella species with Borrelia burgdorferi and Babesia microti in Peromyscus leucopus. J Infect Dis 1998;177:409-16.
34.Holmes AH, Greenough TC, Balady GJ, Regnery RL, Anderson BE, Oikeane JC, Fonger JD, McCrone EL. Bartonella henselae endocarditis in an immunocompetent adult. Clin Infect Dis 1995;21:1004-7.
35.Jensen WA, Majilinde ZF, Rooney J, Kordick DL, Breitschwerdt EB. Rapid identification and differentiation of Bartonella species using a single-step PCR assay. J Clin Microbiol 2000;38:1717-22.
36.Karem KL, Paddock CD, Regnery RL. Bartonella henselae, B. quintana, and B. bacilliformis: historical pathogens of emerging significance. Microbes Infect 2000;2:1193-205.
37.Kelly TM, Padmalayam I, Baumstarck BR. Use of the cell division protein ftsZ as a means of differentiating among Bartonella species. Clin Diagn Lab Immunol 1998;5:766-72.
38.Kerkhoff FT, Bergmans AM, Van der Zee A, Rothova A. Demonstration of Bartonella grahamii DNA in ocular fluids of a patient with neuroretinitis. J Clin Microbiol 1999;37:4034-8.
39.Kordick DL, Hilyard EJ, Hadfield TL, Wilson KH, Steigerwalt AG, Brenner DJ, Breitschwerdt EB. Bartonella clarridgeiae, a newly recognized zoonotic pathogen causing inoculation papules, fever, and lymphadenopathy (cat scratch disease). J Clin Microbiol 1997;35:1813-8.
40.Koehler JE, Glaser CA, Tappero JW. Rochalimaea henselae infection: a new zoonosis with the domestic cat as a reservoir. JAMA 1994;271:531-5.
41.Koehler JE, Quinn FD, Berger TG, Leboit PE, Tappero JW. Isolation of Rochalimaea species from cutaneous and osseous lesions of bacillary angiomatosis. N Engl J Med 1992;327:1625-31.
42.Koehler JE, Sanchez MA, Garrido CS, Whitfeld MJ, Chen FM, Berger TG, Rodriguez-Barradas MC, Leboit PE, Tappero JW. Molecular epidemiology of Bartonella infections in patients with bacillary angiomatosis-peliosis. N Engl J Med 1997;337:1876-83.
43.Kordick DL, Swaminathan B, Greene CE, Wilson KH, Whitney AM, O'Connor SP, Hollis DG, Matar GM, Steigerwalt AG, Malcolm GB, Hayes PS, Hadfield TL, Breitschwerdt EB, Brenner DJ. Bartonella vinsonii subsp. berkhoffii subsp. nov., isolated from dogs; Bartonella vinsonii subsp. vinsonii; and emended description of Bartonella vinsonii. Int J Syst Bacteriol 1996;46:704-9.
44.Kosoy MY, Regnery RL, Kosaya OI, Childs JE. Experimental infection of cotton rats with three naturally occurring Bartonella species. Wildl Dis 1999;35:275-84.
45.Kosoy MY, Regnery RL, Kosaya OI, Jones DC, Marston EL, Childs JE. Isolation of Bartonella spp. from embryos and neonates of naturally infected rodents. J Wildl Dis 1998;34:305-9.
46.Kosoy MY, Regnery RL, Tzianabos T, Marston EL, Jones DC, Green D, Maupin GO, Olson JG, Childs JE. Distribution, diversity and host specificity of Bartonella in rodents from the southeastern Unite States. Am J Trop Med Hyg 1997;57:578-88.
47.Kosoy MY, Saito EK, Green D, Marston EL, Jones DC, Childs JE. Experimental evidence of host specificity of Bartonella infection in rodents. Comp Immunol Microbiol Infect Dis 2000;23:221-38.
48.Lucey D, Dolan MJ, Moss CW, Garcia M, Hollis DG, Weigner S. Relapsing illness due to Rochalimaea henselae in immunocompetent hosts: implication for therapy and new epidemiological associations. Clin Infect Dis 1992;14:683-8.
49.Marston EL, Sumner JW, Regnery RL. Evaluation of intraspecies genetic variation within the 60 kDa heat-shock protein gene (groEL) of Bartonella species. Int J Syst Bacteriol 1999;49:1015-23.
50.Maurin M, Raoult D. Bartonella (Rochalimaea) quintana infections. Clin Microbiol Rev 1996;9:273-92.
51.Maurin M, Roux V, Stein A, Ferrier F, Viraben R, Raoult D. Isolation and characterization by immunofluorescence, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Western blot, restriction fragment length polymorphism-PCR, 16S rRNA gene sequencing, and pulsed-field gel electrophoresis of Rochalimaea quintana from a French patient with bacillary angiomatosis. J Clin Microbiol 1994;32:1166-71.
52.Olsen GJ, Woese CR. Ribosomal RNA: a key to phylogeny. FASEB J. 1993;7:113-23.
53.Perkocha LA, Geaghan SM, Yen BTS, Nishimura SL, Chan SP, Garcia-Kennedy R, Honda G, Stoloff AC, Klein HZ, Goldman RL, Meter SV, Ferrel L, Leboit PE. Clinical and pathological features of bacillary peliosis hepatis in association with human immunodeficiency virus infection. N Engl J Med 1990;323:1581-6.
54.Raoult D, Roux V. The body louse as a vector of reemerging human diseases. Clin Infect Dis 1999;29:888-911.
55.Regnery RL, Anderson BE, Clarridge JE, Rodriguez-Barradas MC, Jones DC, Carr JH. Characterization of a novel Rochalimaea species, R. henselae sp. nov., isolated from blood of a febrile, human immunodeficiency virus-positive patient. J Clin Microbiol 1992;30:265-74.
56.Relman DA, Loutit JS, Schmidt TM, Falkow S, Tompkins LS. The agent of bacillary angiomatosis: an approach to the identification of uncultured pathogens. N Engl J Med. 1990;323:1573-80.
57.Rolain JM, Franc M, Davoust B, Raoult D. Molecular detection of Bartonella quintana, B. koehlerae, B. henselae, B. clarridgeiae, Rickettsia felis, and Wolbachia pipientis in cat fleas, France. Emerg Infect Dis 2003;9:338-42.
58.Roux V, Eykyn SJ, Wyllie S, Raoult D. Bartonella vinsonii subsp. berkhoffii as an agent of afebrile blood culture-negative endocarditis in a human. J Clin Microbiol 2000;38:1698-700.
59.Roux V, Raoult D. The 16S-23S rRNA intergenic spacer region of Bartonella (Rochalimaea) species is longer than usually described in other bacteria. Gene 1995;156:107-11.
60.Slater LN, Welch DF, Hensel D, Coody DW. A newly recognized fastidious gram-negative pathogen as a cause of fever and bacteremia. N Engl J Med 1990;323:1587-93.
61.Spach DH, Kanter AS, Dougherty MJ, Larson AM, Coyle MB, Brenner DJ, Swaminathan B, Matar GM, Welch DF, Root RK, Stamm WE. Bartonella (Rochalimaea) quintana bacteremia in inner-city patients with chronic alcoholism. N Engl J Med 1995;332:424-8.
62.Stevenson HL, Bai Y, Kosoy MY, Montenieri JA, Lowell JL, Chu MC, Gage KL. Detection of novel Bartonella strains and Yersinia pestis in prairie dogs and their fleas (Siphonaptera: Ceratophyllidae and Pulicidae) using multiplex polymerase chain reaction. J Med Entomol 2003;40:329-37.
63.Stoler MH, Bonfiglio TA, Steigbigel RT, Pereira M. An atypical subcutaneous infection associated with acquired immune deficiency syndrome. Am J Clin Pathol 1983;80:714-8.
64.Gundi VAKB, Davoust B, Khamis A, Boni M, Raoult D, Scola BL. Isolation of Bartonella rattimassiliensis sp. nov. and Bartonella phoceensis sp. nov. from European Rattus norvegicus. J Clin Microbiol 2004;42:3816-3818.
65.Welch DF, Carroll KC, Hofmeister EK, Persing DH, Robinson DA, Steigerwalt AG, Brenner DJ. Isolation of a new subspecies, Bartonella vinsonii subsp. arupensis, from a cattle rancher identity with isolates found in conjunction with Borrelia burgdorferii and Babesia microti among naturally infected mice. J Clin Microbiol 1999;37:2598-601.
66.Wong MT, Thornton DC, Kennedy RC, Dolan MJ. A chemically defined liquid medium that supports primary isolation of Rochalimae (Bartonella) henselae from blood and tissue specimens. J Clin Microbiol 1995;33:742-4.