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Abstract:

species are members of the alpha-2 subgroup of the class , within the order. There are now more than 22 species or subspecies described, and DNA sequences from numerous other species or strains have been deposited in GenBank. Warthin-Starry silver stain is recommended for microscopic detection of organisms in fixed tissue sections but is not highly specific and is insensitive, even with lymph node biopsy samples from cat scratch disease (CSD) patients. In contrast, even when isolation of the infecting species is not possible, PCR amplification of internal transcribed spacer (ITS) DNA directly from diagnostic samples and/or from enrichment cultures followed by nucleic acid sequencing is an invaluable tool for primary identification at the species, subspecies, and genotype levels. The first serologic test for CSD was an immunofluorescence antibody assay (IFA) based on bacilli that were cocultivated with Vero cells to inhibit autoagglutination. Antimicrobial susceptibility testing can be performed by agar dilution methods using either blood or chocolate agar or by microdilution techniques using various media supplemented with blood. CSD typically does not respond to antibiotic therapy. Most investigators have observed no or minimal benefit with antibiotic treatment, whereas anecdotal reports indicate that ciprofloxacin, rifampin, and co-trimoxazole may be effective. Diagnosis of infection in humans, especially for typical forms of CSD, is mainly based on serologic data, which is the most cost-effective approach.

Citation: Maggi R, Kempf V, Chomel B, Breitschwerdt E. 2011. , p 786-798. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch46

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Multiple-Locus Variable-Number Tandem-Repeat Analysis
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Restriction Fragment Length Polymorphism
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FIGURE 1

(A and B) Electron micrographs of Marseille (A) and subsp. genotype III (B); (C) strain Houston I isolated on a blood agar plate after 10 days in culture at 36°C and 5% CO. Panel A is reprinted from reference .

Citation: Maggi R, Kempf V, Chomel B, Breitschwerdt E. 2011. , p 786-798. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch46
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References

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Tables

Generic image for table
TABLE 1

species or subspecies presently described, their main reservoirs, their confirmed or possible vectors, and the potential accidental hosts

Citation: Maggi R, Kempf V, Chomel B, Breitschwerdt E. 2011. , p 786-798. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch46
Generic image for table
TABLE 2

MICs for spp.

Determined by the agar dilution technique with Columbia agar supplemented with 5% horse blood. Table adapted from reference . Abbreviations: TMPSMX, trimethoprim-sulfamethoxazole; ND, not done.

Citation: Maggi R, Kempf V, Chomel B, Breitschwerdt E. 2011. , p 786-798. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch46

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