AUTHOR=Delaney Shannon , Robveille Cynthia , Maggi Ricardo G. , Lashnits Erin , Kingston Emily , Liedig Chance , Murray Lilly , Fallon Brian A. , Breitschwerdt Edward B. 

TITLE=Bartonella species bacteremia in association with adult psychosis

JOURNAL=Frontiers in Psychiatry

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1388442

DOI=10.3389/fpsyt.2024.1388442

ISSN=1664-0640

ABSTRACT=<sec><title>Introduction</title><p>The potential role of pathogens, particularly vector-transmitted infectious agents, as a cause of psychosis has not been intensively investigated. We have reported a potential link between <italic>Bartonella</italic> spp. bacteremia and neuropsychiatric symptoms, including pediatric acute onset neuropsychiatric syndrome and schizophrenia. The purpose of this study was to further assess whether <italic>Bartonella</italic> spp. exposure or infection are associated with psychosis.</p></sec><sec><title>Methods</title><p>In a blinded manner, we assessed the presence of anti-<italic>Bartonella</italic> antibodies by indirect immunofluorescence assays (IFA), and infection by amplification of bacterial DNA from blood by quantitative polymerase chain reaction (qPCR), digital PCR (dPCR), and droplet digital PCR (ddPCR) in 116 participants. Participants were categorized into one of five groups: 1) controls unaffected by psychosis (<italic>n</italic> = 29); 2) prodromal participants (<italic>n</italic> = 16); 3) children or adolescents with psychosis (<italic>n</italic> = 7); 4) adults with psychosis (<italic>n</italic> = 44); and 5) relatives of a participant with psychosis (<italic>n</italic> = 20).</p></sec><sec><title>Results</title><p>There was no significant difference in <italic>Bartonella</italic> spp. IFA seroreactivity between adults with psychosis and adult controls unaffected by psychosis. There was a higher proportion of adults with psychosis who had <italic>Bartonella</italic> spp. DNA in the bloodstream (43.2%) compared to adult controls unaffected by psychosis (14.3%, <italic>p</italic> = 0.021). The <italic>Bartonella</italic> species was determined for 18 of the 31 bacteremic participants, including infection or co-infection with <italic>Bartonella henselae</italic> (11/18), <italic>Bartonella vinsonii</italic> subsp. b<italic>erkhoffii</italic> (6/18), <italic>Bartonella quintana</italic> (2/18), <italic>Bartonella alsatica</italic> (1/18), and <italic>Bartonella rochalimae</italic> (1/18).</p></sec><sec><title>Discussion</title><p>In conjunction with other recent research, the results of this study provide justification for a large national or international multi-center study to determine if <italic>Bartonella</italic> spp. bacteremia is more prevalent in adults with psychosis compared to adults unaffected by psychosis. Expanding the investigation to include a range of vector-borne and other microbial infections with potential CNS effects would enhance knowledge on the relationship between psychosis and infection.</p></sec>