Vol. 39, no.

2 Journal of Vector Ecology 261

Bartonella species in fleas from Palestinian territories: Prevalence and

genetic diversity
A. Nasereddin1, A. Risheq1, S. Harrus2, K. Azmi1, S. Ereqat1, G. Baneth2, H. Salant2,3, K.Y. Mumcuoglu3,
and Z. Abdeen1

Al-Quds Nutrition and Health Research Institute (ANAHRI), Al-Quds University, Jerusalem, Palestinian Authority,
1

abedn@ekmd.huji.ac.il
2
Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
3
Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases,
Hebrew University-Hadassah Medical School, Jerusalem, Israel

Received 20 January 2014; Accepted 22 May 2014

ABSTRACT: Bartonellosis is an infectious bacterial disease. The prevalence and genetic characteristics of Bartonella spp. in fleas
of wild and domestic animals from Palestinian territories are described. Flea samples (n=289) were collected from 121 cats,
135 dogs, 26 hyraxes and seven rats from northern (n=165), central (n=113), and southern Palestinian territories (n=11). The
prevalent flea species were: Ctenocephalides felis (n=119/289; 41.2%), Ctenocephalides canis (n=159/289; 55%), and Xenopsylla
sp. (n=7/289; 2.4%). Targeting the Intergenic Transcribed Spacer (ITS) locus, DNA of Bartonella was detected in 22% (64/289)
of all fleas. Fifty percent of the C. felis and 57% of the Xenopsylla sp. contained Bartonella DNA. DNA sequencing showed the
presence of Bartonella clarridgeiae (50%), Bartonella henselae (27%), and Bartonella koehlerae (3%) in C. felis. Xenopsylla sp.
collected from Rattus rattus rats were infected with Bartonella tribocorum, Bartonella elizabethae, and Bartonella rochalimae.
Phylogenetic sequence analysis using the 16S ribosomal RNA gene obtained four genetic clusters, B. henselae and B. koehlerae
as subcluster 1, B. clarridgeiae as cluster 2, while the rat Bartonella species (B. tribocorum and B. elizabethae) were an outgroup
cluster. These findings showed the important role of cat and rat fleas as vectors of zoonotic Bartonella species in Palestinian
territories. It is hoped that this publication will raise awareness among physicians, veterinarians, and other health workers of
the high prevalence of Bartonella spp. in fleas in Palestinian territories and the potential risk of these pathogens to humans and
animals in this region. Journal of Vector Ecology 39 (2): 261-270. 2014.

Keyword Index: Bartonella henselae, Bartonella clarridgeiae, Bartonella koehlerae, Ctenocephalides felis, Intergenic Transcribed
Spacer, Palestinian territories.

INTRODUCTION Several Bartonella species have been reported in wild rodents

and cats in Israel (Gutierrez et al. 2014, Gutierrez et al. 2013,
Bartonella are gram-negative bacteria including more Morick et al. 2009, Morick et al. 2013). In addition, several
than 22 known species, of which at least 12 are reported to studies showed that fleas are the main vectors of these bacteria.
be infectious to humans (Guptill 2010a). They infect the Fleas from cats and rodents have been reported to be infected
host endothelial cells and erythrocytes and are transmitted with B. hensalae and B. elizabethae, (Breitschwerdt et al. 2008,
by hematophagous arthropods such as fleas, sand flies, ticks, Kerkhoff et al. 1999), as well as B. koehlerae (Avidor et al.
and mosquitoes (Chomel and Boulouis 2005). Several human 2004, Chaloner et al. 2013). The infection has been identified
specific and zoonotic Bartonella spp. causing Cat-Scratch in Israeli cats and dogs (Baneth et al. 1996, Harrus et al. 2009,
Disease (CSD), endocarditis, Carrion´s disease, trench fever, Ohad et al. 2010). Infections in humans have been reported
bacillary angiomatosis, peliosis hepatis, chronic bacteremia, in Israel, a country neighboring Palestinian territories. For
chronic lymphadenopathy, and neurologic disorders in example, a five-year-old boy with cat scratch disease showed
humans have been identified to date (Guptill 2010a). In a complicated symptom with a painful twisted neck and
particular, Bartonella henselae and Bartonella clarridgeiae are osteomyelitis of the cervical spine associated with an epidural
known as the main causative agents for CSD, while Bartonella abscess (Tasher et al. 2009). In addition, visceral disease with
quintana, Bartonella elizabethae, B. henselae, and Bartonella endocarditis was demonstrated in an immunocompetent
koehlerae were reported to cause endocarditis in humans adult (Shasha et al. 2014). To the best of our knowledge, no
and animals (Chomel et al. 2009, Guptill 2010b). The cat reports on the prevalence of bartonellosis, Bartonella species,
flea (Ctenocephalides felis) is the main recognized vector of and their genotypes in Palestinian territories have been
B. henselae and transmission among cats and humans occurs published to date. Serologic and microscopic tests have a
mainly through infected flea feces (Bouhsira et al. 2013). In limited diagnostic value for detection of the specific Bartonella
addition, the cat flea is considered as a potential vector for species causing infection due to their low sensitivity and
B. clarridgeiae and B. koehlerae (Rolain et al. 2003), while C. specificity, as Bartonella can cross-react serologically with
canis is a suspected vector for B. henselae (Ishida et al. 2001). Coxiella burnetii and Chlamydophila spp. (Johnson et al.
 19487134, 2014, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jvec.12100 by Cochrane Mexico, Wiley Online Library on [26/05/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
262 Journal of Vector Ecology December 2014

2003). In addition, species-level identifications are difficult subjected to DNA extraction using the GeneJet Genomic
and often impossible using these tests. Moreover, Bartonella DNA purification Kit (Thermoscientific, Lithuania) following
species identification using conventional biochemical tests is the company manufacturer’s instructions. Briefly, samples
not possible (Maurin et al. 1997). DNA analysis by PCR and were lysed with 400 µl of the kit lysis solution that contained
sequencing has been shown to be efficient in diagnosis and 20 µl Proteinase K, ground, vortexed, incubated at 56˚C
identification of different Bartonella species (Agan and Dolan overnight, purified with GeneJet columns, and finally eluted
2002, Maurin et al. 1997). Different target genes can be/are in 100 µl of kit elution buffer.
employed for DNA analysis including the citrate synthase
(gltA), 16S rRNA gene, RNA polymerase beta subunit (rpoB), Selection of the appropriate PCR assay for Bartonella
cell division-associated protein (ftsZ), heat shock protein diagnosis
(groEL), and riboflavin synthase alpha chain (ribC) (Chaloner The Bartonella gltA gene (Morick et al. 2009) and
et al. 2011, Johnson et al. 2003, Maggi and Breitschwerdt the intergenic transcribed spacer (ITS) locus (Maggi and
2005). Previous systems using direct PCR for Bartonella Breitschwerdt 2005) were targeted for the bacterium DNA
detection were unable to differentiate between close species, detection. The Bartonella gltA gene (379 bp) was amplified as
such as B. hensalae and B. koehlerae. Here we investigate the follows: BhCS.781p (5′-GGGGACCAGCTCATGGTGG-3′)
use of restriction fragment length polymorphism to separate and BhCS.1137n (5′-AATGCAAAAAGAACAGTAAACA-3′)
these species. The goal of this study was to elucidate the (Norman et al. 1995). The ITS locus was amplified using the
presence and distribution of Bartonella spp. in Palestinian primers (321s: 5′-AGATGATGATCCCAAGCCTTCTGG
territories using molecular techniques. and H493as: 5′-TGAACCTCCGACCTCACGCTTATC)
as previously described (Gutierrez et al. 2013, Maggi and
MATERIALS AND METHODS Breitschwerdt 2005). PCR reactions were performed in 25-
μl syntezza PCR ready mix (Syntezza, Jerusalem), containing
Animal sampling 0.8 µM of each set of primers and 10 µl of the extracted DNA.
Cats, dogs, hyraxes, and rats, captured between February, The PCR conditions were as described previously (Maggi and
2011 and August, 2012, were included in the study. They Breitschwerdt 2005, Norman et al. 1995, Renesto et al. 2001).
were mainly outdoor animals that had been captured from All PCR products of the positive samples were sent for DNA
three geographic regions in Palestinian territories, including sequencing. PCR grade water (No DNA) was included as
Nablus (135), Tamoon, and Tubas (21) from the northern negative controls.
region of Palestine, East Jerusalem (113) as central, and 11 To evaluate the best system for diagnosis based on
fleas from Bethlehem as the southern region. The sampled high sensitivity and specificity, the first positive sample
population was categorized according to animal species, that was obtained and found belonging to B. henselae by
geographic location, host gender, flea species, flea sex, and DNA sequencing in both PCR assays, was used. A directly
number of fleas on the same animal. The ethnic group in the extracted DNA sample (10 µl) followed with serial dilution
area was noted for comparisons of prevalence, vector species, 1:5 was applied. A Wolbachia endosymbiont of Nasonia
and genotypes between Arab and Jewish neighborhoods. The longicornis positive sample previously identified by DNA
Ethics Research Committee of the University of Al-Quds sequencing of the gltA was used for specificity evaluation. The
(Palestinian territories) approved all the activities involving ITS PCR previously had a high sensitivity and specificity in
animal subjects. the amplification of Bartonella from flea samples (Morick et
al. 2009). Where there was more than one band in the agarose
Flea collection and identification gel, they were cut separately from the gel, purified and re-
Fleas were collected from infested animals either using amplified, and submitted for DNA sequencing.
a fine-toothed metal comb (11 teeth\per cm) (Lochdan,
Regev, Israel) or hair forceps, and were transferred in Statistical tests
sterile microfuge tubes (1.5 ml) (SARSTEDT, Nümbrecht, Statistical analysis was done using the SPSS program v13.
Germany) containing 70% ethanol. Samples were sent to A two-tailed t-test was performed and a significant Pearson
the Laboratory of Al-Quds Nutrition and Health Research Correlation was considered when p≤0.05.
Institute (ANAHRI), Al-Quds University, Jerusalem in
cool boxes (4˚ C), and then kept at −20˚ C until used. Fleas PCR for phylogenetic analysis
were subsequently sorted based on sex and species using PCR products from all samples that were positive by ITS
the stereoscopic microscope (Zeiss) according to published PCR using the above primers were sent for DNA sequencing.
identification keys (Smit 1973). Each individual flea was The gltA locus (379 bp) was amplified using the above-men-
placed in a separate tube for DNA extraction for Bartonella tioned set of primers, while the rpoB locus (825 bp) was am-
prevalence and species identification. plified using primers 1400F (5′-CGCATTGGCTTACTTC-
GTATG-3′) and 2300R (5′-GTAGACTGATTAGAAC-
DNA extraction GCTG-3′) (Renesto et al. 2001). All amplified products were
Each flea was removed from the alcohol tube and dried submitted for DNA sequencing. The PCR reactions and con-
on tissue paper, placed into a new microfuge tube, digested ditions were performed as described previously (Maggi and
by mechanical grinding using plastic pestles, and was then Breitschwerdt 2005, Norman et al. 1995, Renesto et al. 2001).
 19487134, 2014, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jvec.12100 by Cochrane Mexico, Wiley Online Library on [26/05/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
Vol. 39, no. 2 Journal of Vector Ecology 263

A non-experimental Rickettsia rickettsii 16S rRNA gene, Gen- ITS PCR positivity and the animal host (cats, p<0.01), flea
Bank: U11021.1 ribosomal RNA intergenic spacer was used species (C. felis; p<0.01), flea sex (female; p=0.012), and
as an out-group. number of fleas on each animal (p=0.008). More than half of
The CLUSTALW program (http://www.genome.jp/tools/ the tested cats (16/27, 59.3%) carried at least one infected flea.
clustalw/) was used for the multiple sequence alignment of The cat gender, host’s geographic location, and neighborhood
Bartonella sequences obtained in this study with those of ethnicity showed no significant correlation (p>0.05) with
known Bartonella species deposited in the GenBank/EMBL/ Bartonella presence.
DDBJ databases. A phylogenetic tree was drawn based on
the sequences of gltA (379 bp), rpoB (825 bp), and ITS (190 Selection of appropriate diagnostic system
bp), using the IUB scoring matrix used by BESTFIT for the Of the first 30 random screened samples, four were
comparison of nucleic acid sequences. positive for ITS PCR (showed a band of ~192 bp), and DNA
sequencing of the four positive samples showed B. henselae
PCR for restriction fragment length polymorphism (RFLP) (100% sequence identity) as the bacterial organism present in
A gel-based PCR-RFLP system for differentiation of B. these fleas by using nucleotide blast analysis (website: http://
henselae and B. koehlerae was prepared for this study. DNA blast.ncbi.nlm.nih.gov/Blast.cgi). While gltA showed eight
sequences of the ITS loci of the two species were scanned for samples to be positive (band at the level of 379 bp), four of
differential restriction sites using the nebcutter website, http:// those positive samples, all originating from C. felis collected
tools.neb.com/NEBcutter2/. A selected restriction enzyme from cats, were B. henselae (100% sequence identity). The other
(PsiI) was directly incubated for 2 h with the PCR product four gltA sequences matched with Wolbachia endosymbiont of
and then all products were subjected to electrophoresis after Nasonia longicornis (81% sequence identity), and originated
loading on a 2% agarose gel and visualized following ethidium from C. canis fleas collected from dogs.
bromide staining. Sequenced samples from both Bartonella Sensitivity of the ITS PCR assay was higher than that of
species were used to confirm the virtual digestion. the gltA with capability of detection at the dilution of 1:125,
while the gltA PCR system was positive with non-diluted
RESULTS DNA. The gltA was not specific because it detected Wolbachia
DNA in addition to Bartonella (data not shown).
Animal sampling
A total of 289 fleas was collected from 46 animals from Screening all flea samples by ITS PCR system
Nablus, Tubas and East Jerusalem. Overall, 119 C. felis were Since the ITS PCR showed better sensitivity and
collected from 27 cats, 133 C. canis and two Xenopsylla sp. specificity than the gltA PCR, it was used to screen all 289
from nine dogs, 23 C. canis were sampled from five hyraxes, flea samples. Bartonella DNA was detected in 22% of them
and seven Xenopsylla sp., three C. canis and two C. felis were (Table 1). Four band patterns were observed on agarose gel
isolated from five rats (Table 1). These included 212 female using the ITS locus PCR: a band at the molecular weight level
and 73 male fleas. The sex of four fleas was not determined of 192 bp was shown to belong to B. henselae or B. koehlerae;
due to their damage during handling. The most prevalent a band at the 182 bp level was shown by sequencing to belong
species were C. felis (n=119/289; 41.2%), C. canis (n=159/289; to B. clarridgeiae, a 250 bp band was shown to belong either to
55%), and Xenopsylla sp. (n=7/289; 2.4%). B. elizabethae or Bartonella tribocorum, and a dual infection
A significant correlation was observed between Bartonella shown with the presence of a 250 bp and a 182 bp band

Table 1. Prevalence of Bartonella spp. in fleas from different animals in Palestinian territories.

Fleas source (flea ITS PCR results (number; %)

species; number of Positive
fleas) Species
(%)
B. clarridgeiae (30/64; 46.7); B. henselae (16/64; 25);
Cats (C. felis; 119) 60 (50.4)
B. koehlerae (2/64; 3.1)
4 (57) B. elizabethae (3; 5); B. tribocorum (1/64; 1.6); B.
Rats (Xenopsylla sp.; 7)
rochalimae (1/64; 1.6)
Dogs (C. canis; 135) 0 (0)*

Hyraxes (23) 0 (0)

Unknown (5) 0 (0)

Total (289) 64 (22)

*By sequencing of the gltA DNA products, 18.5% (25/135) of the dog fleas were found to
harbor Wolbachia DNA.
 19487134, 2014, 2, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/jvec.12100 by Cochrane Mexico, Wiley Online Library on [26/05/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
264 Journal of Vector Ecology December 2014

Figure 1. Restriction fragment length

polymorphism (RFLP) analysis after digestion
of the ITS entire product using PsiI enzyme.
Product was loaded on 2% agarose gel. H1 and
H2 represent samples proven of B. henselae. K1
and K2 are B. koehlerae, both were from fleas
originated from cats and previously confirmed
by DNA sequencing.

(later both proved B. elizabethae and Bartonella rochalimae, apparently belonged to a separate sub-cluster (B. koehlerae),
respectively, by DNA sequencing) (data not shown). BLAST while the B. clarridgeiae-like cluster separated into three sub-
analysis of the positive Bartonella DNA sequences showed the clusters (Figure 2a). A non-experimental Rickettsia rickettsii
following species distribution: B. clarridgeiae 30/64 (46.7%), 16S rRNA gene (GenBank: U11021.1) was used as an out-
B. henselae 16/64 (25%), B. koehlerae 2/64 (3.1%), and B. group. Previous studies (Houpikian and Raoult 2001, Sato et
elizabethae 3/64 (4.6%). In addition, both B. tribocorum and al. 2012) indicated that the ITS phylogenetic analysis was a
B. rochalimae were detected in one out of 64 samples (1.6%) useful tool to identify Bartonella species.
Both were from the same sample but with two different band Two main clusters for gltA and four clusters for rpoB
levels, they were extracted, purified from the gel, and then genes were observed (Figure 2b,c). Each cluster of rpoB
sequenced (Table 1). Since both B. henselae and B. koehlerae correlated with one of the clusters of the gltA and ITS loci. All
showed a 192 bp band, we developed restriction fragment Bartonella genotypes seemed to follow a pattern in which the
length polymorphism for distinguishing between the two spp. genotype in cluster I of the rpoB also belonged to cluster I of
Bartonella spp. were only observed in C. felis and gltA and ITS (B. henselae group) (Figure 2a,b,c).
Xenopsylla sp. fleas, of which 60/119 (50.4%) and 4/7 (57%)
were infected, respectively. Wolbachia endosymbionts DNA DISCUSSION
was only detected in C. canis fleas of which 25/135 (18.5%)
were infected. Wolbachia endosymbionts-infected C. canis This study investigated the prevalence of Bartonella
fleas originated only from dogs. No Bartonella DNA was organisms in fleas from cats, dogs, rats, and hyraxes in
obtained from fleas that originated from dogs and hyraxes. Palestinian territories and characterized their genetic
Out of 12 fleas which originated from rats, one was positive composition. The overall prevalence of Bartonella infection
for B. tribocorum, two for B. elizabethae, and one showed dual in fleas from these animals was 22% (64/289); these results
infection with B. elizabethae and B. rochalimae (Billeter et al. were similar to those obtained from Israeli cats, according
2013). to which 25.1% were infected with Bartonella species
(Gutierrez et al. 2013). In the present study, no Bartonella
RFLP analysis DNA was detected in fleas collected from dogs (n = 135) or
The digestion of the ITS locus was clear as the RFLP hyraxes (n = 23). Interestingly, fleas collected from dogs in
was able to differentiate between the closely related species other Mediterranean countries, including Greece and Italy,
B. henselae and B. koehlerae. Bartonella henselae produced were reported to be infected with Bartonella spp. with a
bands at the DNA molecular weight level of 97 bp and 94 prevalence of 4% and 11.7%, respectively (Diniz et al. 2009).
bp, which appeared as one band since it is difficult to show The prevalence of different Bartonella spp. found in cat fleas
a 3 bp difference on 2% agarose gel. B. koehlerae showed two in this study, i.e., B. clarridgeiae (46.7%), B. henselae (25%),
bands at the DNA molecular weight levels of 114 bp and 74 and B. koehlerae (3.1%) was remarkable. It is interesting to
bp (Figure 1). These two patterns were easily distinguishable note that the same three Bartonella species were detected in
in the agarose gel (Figure 1). cats from Israel (Gutierrez et al. 2013). Rattus rattus rats and
cats captured in the Palestinian areas were highly infested
DNA sequencing and genetic characterization with fleas infected with Bartonella spp. (57% and 50.4%,
Successful DNA sequencing was obtained from 64 respectively), suggesting that those mammals might be major
positive fleas as follows: ITS (52/64)81%, gltA (48/64) 75%, reservoirs of Bartonella species in Palestinian territories.
and rpoB (33/64) 52%. Not every ITS positive Bartonella gave However, as the rat-flea sample size examined in this study
positive PCR results for the other two genes. ITS phylogenetic was very small (n=7), further studies of rodent populations
analysis showed three main clusters, a B. henselae and B. and their fleas in this region are warranted. Rattus rattus rats
koehlerae-like cluster, a B. clarridgeiae-like cluster, and a rat captured in this study were infected with B. tribocorum, B.
Bartonella-associated cluster (including B. elizabethae and elizabethae, and B. rochalimae. As B. rochalimae was reported
B. tribocorum) which showed as an out-group in the ITS to infect humans and animals, its potential zoonotic role is
locus phylogeny analysis (Figure 2). The B. henselae clade emphasized (Chomel et al. 2009, Eremeeva et al. 2007). Co-
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Vol. 39, no. 2 Journal of Vector Ecology 265

2a

Figure 2. Phylogenetic classification of Palestinian Bartonella based on sequences of a) ITS, b) gltA, and c) rpoB loci. The
phylogenetic trees were constructed by the neighbor-joining method using the CLUSTAL_X program (http://www.genome.
jp/tools/clustalw/) for the alignment of Bartonella sequences obtained in this study with those of known Bartonella species
deposited in the GenBank/EMBL/DDBJ databases. They were drawn using the IUB scoring matrix used by BESTFIT for the
comparison of nucleic acid sequences.
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2b
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Journal of Vector Ecology

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268 Journal of Vector Ecology December 2014

infection with more than one Bartonella sp. was documented previously (Billeter et al. 2013, Inoue et al. 2008, Sato et al.
in this study in 6% (4/64) of the infected fleas and in 16 (59.3%) 2012). Rodent Bartonella spp. was shown to be an out-group
of the cats harboring at least one ITS PCR-positive flea. This as expected (Billeter et al. 2013, Inoue et al. 2008). Bartonella
was shown through sequencing of different individual fleas clarridgeiae presented a higher heterogeneous group than the
that originated from the same cat. The percentage of cats other species. The phylogenetic tree based on DNA sequences
that hosted Bartonella-positive fleas was strongly associated of gltA divided the Bartonella species into two main clades:
with the number of fleas from each cat (p=0.008). Similar B. clarridgeiae and B. henselae with less inter-species genetic
results were found in fleas from northeastern Thailand, variability in both species than the ITS locus. The DNA
where Bartonella DNA was detected in 59.1% (114 of 193) of sequences of rpoB clustered the Bartonella species into two
the fleas examined (Billeter et al. 2013). Previous studies in main ones: B. henselae, and B. koehlerae species. Higher
other countries, including Israel, have shown that wild rats, genetic variability of B. henselae was observed using this gene
including the species Rattus norvegicus as well as R. rattus, than the gltA and ITS loci.
are reservoirs of B. tribocorum and B. elizabethae (Harrus et In conclusion, a high infection rate with different
al. 2009, Morick et al. 2009). The latter Bartonella spp. were Bartonella spp. was found in fleas from animal hosts in
also detected in fleas collected from other rodent species Palestinian territories. Our findings are of potential public
from Israel (Morick et al. 2010), France (Heller et al. 1998), health importance and should alert local physicians and
the United States (Gundi et al. 2012), and Indonesia (Winoto public health authorities to the possibility of human infections
et al. 2005). The detection of B. elizabethae, a causative agent with these Bartonella species.
of human endocarditis and neuroretinitis, is of particular
potential public health importance in this region (Boulouis et Acknowledgments
al. 2005, Winoto et al. 2005).
In the present study, different fleas collected from the This study was a partial fulfillment of MSc degree in the
same animal showed mixed Bartonella species and genotypes. biochemistry and molecular biology program for A. Risheq
Co-infection of fleas with different Bartonella species has at Al-Quds University. The study was funded by The Ministry
already been described. A previous study conducted in Israel of Foreign Affairs, The Hague, The Netherlands, project M27-
(Gutierrez et al. 2013) showed co-infection with two or more 072NVHU 2009 02 ‘Vector-Borne Pathogens in Israel and the
different Bartonella spp. in 2.1% of stray and domestic cats. Palestinian Authority’.
Domestic cats from Thailand were also demonstrated to
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