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HelpTest Code BARTB Bartonella, Molecular Detection, PCR, Blood
Reporting Name
Bartonella PCR, BUseful For
Aiding in the diagnosis of Bartonella infection when Bartonella DNA would be expected to be present in blood, especially endocarditis
Method Name
Real-Time Polymerase Chain Reaction (PCR)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole Blood EDTAOrdering Guidance
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 Required
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.
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Royal blue top (EDTA), pink top (EDTA), or sterile vial containing EDTA-derived aliquot
Specimen Volume: 1 mL
Collection Instructions: Send specimen in original tube (preferred).
Specimen Minimum Volume
0.5 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood EDTA | Refrigerated (preferred) | 7 days | |
| Ambient | 7 days | ||
| Frozen | 7 days |
Reject Due To
| All specimens will be evaluated at Mayo Clinic Laboratories for test suitability. |
Reference Values
Not applicable
Day(s) Performed
Monday through Friday
CPT Code Information
87801
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| BARTB | Bartonella PCR, B | 16275-0 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| SRC98 | Specimen Source | 31208-2 |
| 56056 | Bartonella PCR | 16275-0 |
Clinical Information
Bartonella henselae and Bartonella quintana are small, pleomorphic, gram-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 and serology. However, these methods may be nonspecific or falsely negative, especially in the early stages of disease.
Evaluation of infected tissue or blood 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 (gltA) 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.
Cautions
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.
Method Description
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 K, Pfaller M, eds. Manual of Clinical Microbiology. 12th ed. ASM Press; 2019:893-904)