Abstract: FR-PO0859
Bartonella Endocarditis Is Strongly Associated with a High Risk for Infection-Related Glomerulonephritis
Session Information
- Glomerular Diseases: Practice and New Concepts Shaping Modern Care
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Ren, Alison Li, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
- Shaw, Analee, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
- Peel, Nathaniel F., The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
- Nuzzo, Anna Rose, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
- Moussavi, Sarah, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
- Biggs, Erin, Ochsner Health, New Orleans, Louisiana, United States
- Jordan, Hannah Tram Anh Ha, Ochsner Health, New Orleans, Louisiana, United States
- Velez, Juan Carlos Q., The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
Group or Team Name
- Ochsner Nephrology
Background
A large academic center reported that Bartonella sp infective endocarditis (IE) is associated with greater risk to progress to acute kidney injury (AKI) due to IE-associated glomerulonephritis (IEGN) compared to IE caused by other organisms, such as Staphylococcus aureus or Streptococcus sp. Given a recent spike of Bartonella henselae IEGN at our center, we explored the association between IE causal organism and risk for IEGN.
Methods
We conducted a retrospective search for electronic records of patients diagnosed with IE (by ICD code) over 8-years. AKI ICD codes were also extracted. Subsequently, all cases with IE and AKI were manually reviewed to identify cases of KDIGO AKI from IEGN. Possible IEGN was defined as IE, AKI and hematuria (>10 RBC/hpf). Probable IEGN was defined as Possible + sterile pyuria (>4 WBC/hpf), and either proteinuria (1-3+) or low C3/C4. Definite IEGN was defined as Probable + either biopsy-proven pathology or glomerular hematuria by uSEDI (acanthocytes or RBC casts). Bartonella sp as causal organism required IgG ≥1:800, and 2 blood cultures were required for Staphylococcus aureus (both methicillin-resistant and sensitive) or Streptococcus viridans group IE cases. All other species were excluded.
Results
957 cases of IE were extracted. Definite IEGN were found in 6/10 (60%) cases of Bartonella IE compared to 39/673 (5.8%) of Staphylococcus IE and 5/274 (1.8%) of Streptococcus IE; p<0.0001 (RR for IEGN with Bartonella 10.4-fold vs Staphylococcus and 32.9-fold vs Streptococcus). All 6 Definite Bartonella IEGN were henselae, median age 27 (4 women, 2 men), median serum creatinine 2.1 mg/dL, 4 in prosthetic pulmonic valves and 2 in native mitral valves. Possible + Definite IEGN were found in 8/10 (80%) of Bartonella IE compared to 105/673 (15.6%) of Staphylococcus IE and 40/274 (14.6%) of Streptococcus IE (p<0.0001).
Conclusion
Bartonella henselae IE is strongly associated with greater risk for IEGN compared to Staphylococcus aureus or Streptococcus sp. Whether the associated risk corresponds to late recognition in the course of the disease or an inherent mechanistic link to kidney-specific autoimmunity remains unclear. Nevertheless, Bartonella serology should be promptly obtained in cases of suspected IEGN, especially in young adults with prosthetic pulmonic valves.