Additional file 1: Table S1. of First molecular detection and characterization of zoonotic Bartonella species in fleas infesting domestic animals in Tunisia

Distribution of Bartonella species by bioclimatic zones, site, flea species and animal host and partial sequencing analysis of gltA gene and the ITS region. (PDF 23 kb

Comparison of Two Quantitative Real Time PCR Assays for <i>Rickettsia</i> Detection in Patients from Tunisia

<div><p>Background and objectives</p><p>Quantitative real time PCR (qPCR) offers rapid diagnosis of rickettsial infections. Thus, successful treatment could be initiated to avoid unfavorable outcome. Our aim was to compare two qPCR assays for <i>Rickettsia</i> detection and to evaluate their contribution in early diagnosis of rickettsial infection in Tunisian patients.</p><p>Patients and methods</p><p>Included patients were hospitalized in different hospitals in Tunisia from 2007 to 2012. Serology was performed by microimmunofluorescence assay using <i>R. conorii</i> and <i>R. typhi</i> antigens. Two duplex qPCRs, previously reported, were performed on collected skin biopsies and whole blood samples. The first duplex amplified all <i>Rickettsia</i> species (PanRick) and <i>Rickettsia typhi</i> DNA (Rtt). The second duplex detected spotted fever group <i>Rickettsiae</i> (RC00338) and typhus group <i>Rickettsiae</i> DNA (Rp278).</p><p>Results</p><p>Diagnosis of rickettsiosis was confirmed in 82 cases (57.7%). Among 44 skin biopsies obtained from patients with confirmed diagnosis, the first duplex was positive in 24 samples (54.5%), with three patients positive by Rtt qPCR. Using the second duplex, positivity was noted in 21 samples (47.7%), with two patients positive by Rp278 qPCR. Among79 whole blood samples obtained from patients with confirmed diagnosis, panRick qPCR was positive in 5 cases (6.3%) among which two were positive by Rtt qPCR. Using the second set of qPCRs, positivity was noted in four cases (5%) with one sample positive by Rp278 qPCR. Positivity rates of the two duplex qPCRs were significantly higher among patients presenting with negative first serum than those with already detectable antibodies.</p><p>Conclusions</p><p>Using qPCR offers a rapid diagnosis. The PanRick qPCR showed a higher sensitivity. Our study showed that this qPCR could offer a prompt diagnosis at the early stage of the disease. However, its implementation in routine needs cost/effectiveness evaluation.</p></div

Positivity of qPCR according to serologic status among patients with confirmed diagnosis.

<p>Positivity of qPCR according to serologic status among patients with confirmed diagnosis.</p

Standard curves constructed for the four quantitative PCRs.

<p>Standard curves constructed for the four quantitative PCRs.</p

Geographic distribution of patients with rickettsioses hospitalized in the three medical centers (Sfax, Sousse and Zarzis).

<p>The size of circles and triangles is related to the number of patients diagnosed. SFGR: spotted fever group rickettsioses, TGR: typhus group rickettsioses.</p