Molecular investigation of Bartonella infection among immunocompromised patients in Iran.

BACKGROUND

Bartonella infections are emerging zoonotic pathogens, primarily transmitted through arthropod vectors or direct contact with animals. Immunocompromised individuals are at increased risk of developing severe complications.

METHODS

In this cross-sectional study, a total of 370 blood samples were collected from immunocompromised individuals including patients with HIV, AIDS, common variable immunodeficiency (CVID), liver and kidney transplant recipients, and a control group in Imam Khomeini Hospital in Tehran from May 2024 to February 2025.

RESULT: Overall, Bartonella spp. were detected in 7 out of 370 participants (1.89%). All positive cases were among HIV+ (2.8) and AIDS patients (3.9%). Phylogenetic analysis identified all isolates as Bartonella quintana. Univariate analysis suggested that a history of drug abuse and flea infestation seemed to be associated with infection, but due to the rarity of events, multivariate penalized logistic regression did not confirm these as independent risk factors. Cautious interpretation is warranted.

CONCLUSION

This study provides the first molecular evidence of Bartonella quintana infection among immunocompromised patients in Iran, with a notable prevalence observed in HIV-infected individuals, highlighting the need for increased clinical awareness in this population.