Posted 8/29/2024 7:04 AM (GMT -5)
as yet all testing for bartonella - especially chronic bartonella infections have significant limitations
serologic tests are particularly problematic - as its well documented that many patients - perhaps most patients - do not produce the expected antibodies that the test looks for.
the standard ELISA test has been withdrawn by the UK NHS in the last few years because of this issue ( it has to be pretty incontrovertible for the NHS to withdraw a test its been using for 40 years)
straight PCR of blood is also poor at detecting chronic bartonella - as the organism is often rare in the blood - not homogeneously mixed so often the sample simply does not contain it - so the test will report negative even in infected patients over 50% of the time. PCR of infected tissue - like a swollen lymph node is much better - but rarely done as its invasive
Igenex have a multi-species bartonella immunoblot test which is much better than a single antigen test - as it uses many antigens from different bartonella species - so if i had to test at Igenex i would use this one
after that there are specialist labs that offer more advanced tests
the best so far to publish a full validation study is galaxy diagnostics - and their - DD ePCR test
they use 3 blood draws and specialised culture - before performing advanced PCR on the resulting organisms. its published validation study proved a sensitivity of around 50% ( the best publicly available so far ) - but they are v professional founded by leading bartonella researchers in the field and are v conservative in their claims - so it likely performs much better than that.
i hope its of some help