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Masséglia S, René-Martellet M, Rates M, Hizo-Teufel C, Fingerle V, Margos G, Bailly X. Development and validation of a multi-target TaqMan qPCR method for detection of Borrelia burgdorferi sensu lato. J Microbiol Methods 2024; 222:106941. [PMID: 38714225 DOI: 10.1016/j.mimet.2024.106941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/05/2024] [Accepted: 04/30/2024] [Indexed: 05/09/2024]
Abstract
Reliable detection of bacteria belonging to the Borrelia burgdorferi sensu lato species complex in vertebrate reservoirs, tick vectors, and patients is key to answer questions regarding Lyme borreliosis epidemiology. Nevertheless, the description of characteristics of qPCRs for the detection of B. burgdorferi s. l. are often limited. This study covers the development and validation of two duplex taqman qPCR assays used to target four markers on the chromosome of genospecies of B. burgdorferi s. l. Analytical specificity was determined with a panel of spirochete strains. qPCR characteristics were specified using water or tick DNA spiked with controlled quantities of the targeted DNA sequences of B. afzelii, B. burgdorferi sensu stricto or B. bavariensis. The effectiveness of detection results was finally evaluated using DNA extracted from ticks and biopsies from mammals whose infectious status had been determined by other detection assays. The developed qPCR assays allow exclusive detection of B. burgdorferi s. l. with the exception of the M16 marker which also detect relapsing fever Borreliae. The limit of detection is between 10 and 40 copies per qPCR reaction depending on the sample type, the B. burgdorferi genospecies and the targeted marker. Detection tests performed on various kind of samples illustrated the accuracy and robustness of our qPCR assays. Within the defined limits, this multi-target qPCR method allows a versatile detection of B. burgdorferi s. l., regardless of the genospecies and the sample material analyzed, with a sensitivity that would be compatible with most applications and a reproducibility of 100% under measurement conditions of limits of detection, thereby limiting result ambiguities.
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Affiliation(s)
- Sébastien Masséglia
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, F-63122 Saint-Genès-Champanelle, France.
| | - Magalie René-Martellet
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, F-63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Maxime Rates
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, F-63122 Saint-Genès-Champanelle, France; Université de Lyon, INRAE, VetAgro Sup, UMR EPIA, F-69280 Marcy l'Etoile, France
| | - Cecilia Hizo-Teufel
- Bavarian Health and Food Safety Authority, German National Reference Centre for Borrelia, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - Volker Fingerle
- Bavarian Health and Food Safety Authority, German National Reference Centre for Borrelia, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - Gabriele Margos
- Bavarian Health and Food Safety Authority, German National Reference Centre for Borrelia, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - Xavier Bailly
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, F-63122 Saint-Genès-Champanelle, France
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2
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McLennan G, Dale SE, Gillim L, Weinblatt V, Wallerstein R, Naides SJ. Developing a Prospective Gestational Lyme Disease Study. Methods Mol Biol 2024; 2742:259-278. [PMID: 38165628 DOI: 10.1007/978-1-0716-3561-2_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Lyme disease in pregnancy is understudied. The few available reports of Borrelia infection during pregnancy collecting clinical outcomes, with or without confirmed fetal infection both in utero and neonatal, are limited to case reports and small series. Population-based studies are not available. We propose a prospective study of Borrelia infection during pregnancy based in obstetrical practices in both endemic and nonendemic areas, with long term follow-up of pregnancy outcomes and development assessment of offspring infected or exposed to Borrelia in utero using current serological, microscopic, culture, and molecular techniques. In addition to detection of Borrelia burgdorferi sensu stricto, additional Borrelia species and other pathogens known to be transmitted by ticks will be tested. Serial biospecimens including maternal and cord blood, maternal peripheral blood mononuclear cells and urine, and, when clinically indicated, amniotic fluid, chorionic villi, intrauterine cord blood, will be collected with clinical data, imaging, and for infections treatment medications. Offspring will be followed until age 5 years with annual developmental assessments to assess pregnancy outcomes. The study will require parallel development of a biorepository with strategies for management, data security and data sharing. A public-private partnership will be required to support the study.
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Affiliation(s)
- Graham McLennan
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Suzanne E Dale
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Laura Gillim
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Vivian Weinblatt
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Robert Wallerstein
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA
| | - Stanley J Naides
- Laboratory Corporation of America Holdings (Labcorp), Burlington, NC, USA.
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Guérin M, Shawky M, Zedan A, Octave S, Avalle B, Maffucci I, Padiolleau-Lefèvre S. Lyme borreliosis diagnosis: state of the art of improvements and innovations. BMC Microbiol 2023; 23:204. [PMID: 37528399 PMCID: PMC10392007 DOI: 10.1186/s12866-023-02935-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/04/2023] [Indexed: 08/03/2023] Open
Abstract
With almost 700 000 estimated cases each year in the United States and Europe, Lyme borreliosis (LB), also called Lyme disease, is the most common tick-borne illness in the world. Transmitted by ticks of the genus Ixodes and caused by bacteria Borrelia burgdorferi sensu lato, LB occurs with various symptoms, such as erythema migrans, which is characteristic, whereas others involve blurred clinical features such as fatigue, headaches, arthralgia, and myalgia. The diagnosis of Lyme borreliosis, based on a standard two-tiered serology, is the subject of many debates and controversies, since it relies on an indirect approach which suffers from a low sensitivity depending on the stage of the disease. Above all, early detection of the disease raises some issues. Inappropriate diagnosis of Lyme borreliosis leads to therapeutic wandering, inducing potential chronic infection with a strong antibody response that fails to clear the infection. Early and proper detection of Lyme disease is essential to propose an adequate treatment to patients and avoid the persistence of the pathogen. This review presents the available tests, with an emphasis on the improvements of the current diagnosis, the innovative methods and ideas which, ultimately, will allow more precise detection of LB.
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Affiliation(s)
- Mickaël Guérin
- Unité de Génie Enzymatique Et Cellulaire (GEC), CNRS UMR 7025, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Marc Shawky
- Connaissance Organisation Et Systèmes TECHniques (COSTECH), EA 2223, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Ahed Zedan
- Polyclinique Saint Côme, 7 Rue Jean Jacques Bernard, 60204, Compiègne, France
| | - Stéphane Octave
- Unité de Génie Enzymatique Et Cellulaire (GEC), CNRS UMR 7025, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Bérangère Avalle
- Unité de Génie Enzymatique Et Cellulaire (GEC), CNRS UMR 7025, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Irene Maffucci
- Unité de Génie Enzymatique Et Cellulaire (GEC), CNRS UMR 7025, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Séverine Padiolleau-Lefèvre
- Unité de Génie Enzymatique Et Cellulaire (GEC), CNRS UMR 7025, Université de Technologie de Compiègne, 60203, Compiègne, France.
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4
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Leth TA, Nymark A, Knudtzen FC, Larsen SL, Skov MN, Jensen TG, Bek-Thomsen M, Jensen HB, Hovius JW, Skarphédinsson S, Møller JK, Andersen NS. Detection of Borrelia burgdorferi sensu lato DNA in cerebrospinal fluid samples following pre-enrichment culture. Ticks Tick Borne Dis 2023; 14:102138. [PMID: 36746091 DOI: 10.1016/j.ttbdis.2023.102138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/06/2023]
Abstract
Molecular methods for diagnosing Lyme neuroborreliosis (LNB) have shown suboptimal diagnostic sensitivities. The objective of this study was to improve the clinical sensitivity of PCR detection of Borrelia burgdorferi sensu lato spirochetes by inoculating cerebrospinal fluid (CSF) from patients suspected of LNB directly into culture medium at the time of lumbar puncture, with this pursuing enrichment of Borrelia spirochetes before PCR analysis. Adult patients with symptoms suggestive of LNB were prospectively enrolled at two hospitals in the Region of Southern Denmark. The CSF-culture samples were incubated for at least eight weeks. During this period, culture sample aliquots were analysed for the presence of Borrelia DNA by separate PCR protocols in two independent clinical laboratories. The included patients were diagnosed with definite (n=12) or possible (n=2) LNB, and non-LNB (n=171) based on clinical and paraclinical findings. Patients in the LNB and the non-LNB group had a median duration from symptom onset to lumbar puncture of 40 days (IQR [23-90] days) and 120 days (IQR [32-365] days), respectively. Pre-enrichment growth of Borrelia spirochetes was accomplished from three patients (21 %) in the LNB group. The positive culture samples were confirmed by both the digital droplet PCR and the real-time PCR methods employed. All CSF samples were PCR negative in the non-LNB group. The results of this study do not support the use of Borrelia-specific PCR as a general routine diagnostic tool in adults. Still, they suggest it may prove of additional value in selected patients with a limited time from symptom onset to sample collection.
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Affiliation(s)
- Trine Andreasen Leth
- Department of Clinical Microbiology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Denmark
| | - Anita Nymark
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark; Research Unit of Infectious Diseases, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Research Unit for Clinical Microbiology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Fredrikke Christie Knudtzen
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark; Research Unit of Infectious Diseases, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Sanne Løkkegaard Larsen
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Research Unit for Clinical Microbiology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Marianne N Skov
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Research Unit for Clinical Microbiology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Thøger Gorm Jensen
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Research Unit for Clinical Microbiology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Malene Bek-Thomsen
- Department of Clinical Microbiology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark
| | - Henrik Boye Jensen
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Denmark; Department of Neurology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark
| | - Joppe W Hovius
- Amsterdam UMC, location AMC, Center for Experimental and Molecular Medicine, Amsterdam Multidisciplinary Lyme Borreliosis Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sigurdur Skarphédinsson
- Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark; Research Unit of Infectious Diseases, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jens Kjølseth Møller
- Department of Clinical Microbiology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Denmark
| | - Nanna Skaarup Andersen
- Department of Clinical Microbiology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Clinical Centre for Emerging and Vector-borne Infections, Odense University Hospital, J.B. Winsløwsvej 21. 2., Odense DK-5000, Denmark; Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark; Research Unit for Clinical Microbiology, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
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5
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Lager M, Wilhelmsson P, Matussek A, Lindgren PE, Henningsson AJ. Molecular Detection of Borrelia Bacteria in Cerebrospinal Fluid-Optimisation of Pre-Analytical Sample Handling for Increased Analytical Sensitivity. Diagnostics (Basel) 2021; 11:diagnostics11112088. [PMID: 34829435 PMCID: PMC8623531 DOI: 10.3390/diagnostics11112088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/02/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
The main tools for clinical diagnostics of Lyme neuroborreliosis (LNB) are based on serology, i.e., detection of antibodies in cerebrospinal fluid (CSF). In some cases, PCR may be used as a supplement, e.g., on CSF from patients with early LNB. Standardisation of the molecular methods and systematic evaluation of the pre-analytical handling is lacking. To increase the analytical sensitivity for detection of Borrelia bacteria in CSF by PCR targeting the 16S rRNA gene, parameters were systematically evaluated on CSF samples spiked with a known amount of cultured Borrelia bacteria. The results showed that the parameters such as centrifugation time and speed, the use of complementary DNA as a template (in combination with primers and a probe aiming at target gene 16S rRNA), and the absence of inhibitors (e.g., erythrocytes) had the highest impact on the analytical sensitivity. Based on these results, a protocol for optimised handling of CSF samples before molecular analysis was proposed. However, no clinical evaluation of the proposed protocol has been done so far, and further investigations of the diagnostic sensitivity need to be performed on well-characterised clinical samples from patients with LNB.
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Affiliation(s)
- Malin Lager
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
- Correspondence: ; Tel.: +46-(0)10-2425238
| | - Peter Wilhelmsson
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Andreas Matussek
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Laboratory Medicine, Oslo University Hospital, 0450 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Per-Eric Lindgren
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
| | - Anna J. Henningsson
- Division of Clinical Microbiology, Laboratory Medicine (Region Jönköping County, 553 05 Jönköping, Sweden), Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (P.W.); (A.M.); (P.-E.L.); (A.J.H.)
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
- Division of Clinical Microbiology, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden
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6
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Maggi R, Breitschwerdt EB, Qurollo B, Miller JC. Development of a Multiplex Droplet Digital PCR Assay for the Detection of Babesia, Bartonella, and Borrelia Species. Pathogens 2021; 10:pathogens10111462. [PMID: 34832618 PMCID: PMC8620149 DOI: 10.3390/pathogens10111462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/08/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
We describe the development, optimization, and validation of a multiplex droplet digital PCR (ddPCR) assay for the simultaneous detection of Babesia, Bartonella, and Borrelia spp. DNA from several sample matrices, including clinical blood samples from animals and humans, vectors, in-vitro infected human and animal cell lines, and tissues obtained from animal models (infected with Bartonella and/or B. burgdorferi). The multiplex ddPCR assay was able to detect 31 Bartonella, 13 Borrelia, and 24 Babesia species, including Theileria equi, T. cervi, and Cytauxzoon felis. No amplification of Treponema or Leptospira spp. was observed. Sensitivity of 0.2-5 genome equivalent DNA copies per microliter was achieved for different members of the Bartonella and Borrelia genus, depending on the species or matrix type (water or spiked blood DNA) tested. The ddPCR assay facilitated the simultaneous detection of co-infections with two and three vector-borne pathogens comprising four different genera (Babesia, Bartonella, Borrelia, and Theileria) from clinical and other sample sources.
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Affiliation(s)
- Ricardo Maggi
- Department of Clinical Sciences, The Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; (E.B.B.); (B.Q.)
- Galaxy Diagnostics, Inc., 6 Davis Drive, Suite 201, Research Triangle Park, NC 27709, USA;
- Correspondence:
| | - Edward B. Breitschwerdt
- Department of Clinical Sciences, The Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; (E.B.B.); (B.Q.)
- Galaxy Diagnostics, Inc., 6 Davis Drive, Suite 201, Research Triangle Park, NC 27709, USA;
| | - Barbara Qurollo
- Department of Clinical Sciences, The Comparative Medicine Institute, College of Veterinary Medicine, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA; (E.B.B.); (B.Q.)
| | - Jennifer C. Miller
- Galaxy Diagnostics, Inc., 6 Davis Drive, Suite 201, Research Triangle Park, NC 27709, USA;
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7
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LoopTag FRET Probe System for Multiplex qPCR Detection of Borrelia Species. Life (Basel) 2021; 11:life11111163. [PMID: 34833039 PMCID: PMC8624210 DOI: 10.3390/life11111163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Laboratory diagnosis of Lyme borreliosis refers to some methods with known limitations. Molecular diagnostics using specific nucleic acid probes may overcome some of these limitations. Methods: We describe the novel reporter fluorescence real-time polymerase chain reaction (PCR) probe system LoopTag for detection of Borrelia species. Advantages of the LoopTag system include having cheap conventional fluorescence dyes, easy primer design, no restrictions for PCR product lengths, robustness, high sequence specificity, applicability for multiplex real-time PCRs, melting curve analysis (single nucleotide polymorphism analysis) over a large temperature range, high sensitivity, and easy adaptation of conventional PCRs. Results: Using the LoopTag probe system we were able to detect all nine tested European species belonging to the Borrelia burgdorferi (sensu lato) complex and differentiated them from relapsing fever Borrelia species. As few as 10 copies of Borrelia in one PCR reaction were detectable. Conclusion: We established a novel multiplex probe real-time PCR system, designated LoopTag, that is simple, robust, and incorporates melting curve analysis for the detection and in the differentiation of European species belonging to the Borrelia burgdorferi s.l. complex.
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8
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Chou E, Minor A, Cady NC. Quantitative multiplexed strategies for human Lyme disease serological testing. Exp Biol Med (Maywood) 2021; 246:1388-1399. [PMID: 33794698 PMCID: PMC8243215 DOI: 10.1177/15353702211003496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lyme disease, which is primarily caused by infection with the bacterium Borrelia burgdorferi in the United States or other Borrelia species internationally, presents an ongoing challenge for diagnostics. Serological testing is the primary means of diagnosis but testing approaches differ widely, with varying degrees of sensitivity and specificity. Moreover, there is currently no reliable test to determine disease resolution following treatment. A distinct challenge in Lyme disease diagnostics is the variable patterns of human immune response to a plurality of antigens presented by Borrelia spp. during the infection. Thus, multiplexed testing approaches that capture these patterns and detect serological response against multiple antigens may be the key to prompt, accurate Lyme disease diagnosis. In this review, current state-of-the-art multiplexed diagnostic approaches are presented and compared with respect to their diagnostic accuracy and their potential for monitoring response to treatment.
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Affiliation(s)
- Eunice Chou
- Nanobioscience Constellation, College of Nanoscale Science &
Engineering, State University of New York Polytechnic Institute, Albany, NY
12203, USA
- College of Medicine, State University of New York, Downstate
Medical Center, Brooklyn, NY 11203, USA
| | - Armond Minor
- Nanobioscience Constellation, College of Nanoscale Science &
Engineering, State University of New York Polytechnic Institute, Albany, NY
12203, USA
| | - Nathaniel C Cady
- Nanobioscience Constellation, College of Nanoscale Science &
Engineering, State University of New York Polytechnic Institute, Albany, NY
12203, USA
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Jaenson TGT, Wilhelmsson P. First Record of a Suspected Human-Pathogenic Borrelia Species in Populations of the Bat Tick Carios vespertilionis in Sweden. Microorganisms 2021; 9:1100. [PMID: 34065313 PMCID: PMC8160990 DOI: 10.3390/microorganisms9051100] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/29/2022] Open
Abstract
The bat tick Cariosvespertilionis has been reported from Sweden to occasionally feed on humans resulting in disease symptoms. The aim of this study was to investigate C. vespertilionis as a potential vector and reservoir of Borrelia species. In 2015 and 2018 in south-central Sweden, C. vespertilionis ticks were collected from a wooden bat box harboring Soprano pipistrelle bats, Pipistrellus pygmaeus. In addition, one C. vespertilionis tick found inside a house in southern Sweden in 2019 was collected. Ticks were screened for Borrelia spp. using a genus-specific quantitative PCR assay. The Borrelia species of the positive specimens were determined by conventional PCR followed by DNA sequencing and phylogenetic analyses. A total of 24% (22 of 92) of the analyzed C. vespertilionis ticks were Borrelia-positive. Phylogenetic analyses indicate that the bacteria belong to the relapsing fever group of borreliae; some of them appear to be identical with Borrelia sp. CPB1, a spirochete only found twice before-in the United Kingdom and in France. Our results also indicate a temporal and spatial distribution of this Borrelia species. Since C. vespertilionis occasionally bites humans, and since it exhibits a high prevalence of Borrelia bacteria, it is possible that it presents a risk of human disease. Further studies are needed to characterize Borrelia sp. CPB1 to determine if it is human-pathogenic and to determine if C. vespertilionis is a vector and/or reservoir of this agent.
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Affiliation(s)
- Thomas G. T. Jaenson
- Evolutionary Biology Centre, Department of Organismal Biology, Uppsala University, 752 36 Uppsala, Sweden;
| | - Peter Wilhelmsson
- Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection, Linköping University, 581 83 Linköping, Sweden
- Department of Clinical Microbiology, Region Jönköping County, 553 05 Jönköping, Sweden
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10
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Skogman BH, Wilhelmsson P, Atallah S, Petersson AC, Ornstein K, Lindgren PE. Lyme neuroborreliosis in Swedish children-PCR as a complementary diagnostic method for detection of Borrelia burgdorferi sensu lato in cerebrospinal fluid. Eur J Clin Microbiol Infect Dis 2021; 40:1003-1012. [PMID: 33387122 PMCID: PMC8084766 DOI: 10.1007/s10096-020-04129-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/13/2020] [Indexed: 12/23/2022]
Abstract
The aim of this study was to evaluate polymerase chain reaction (PCR) as a diagnostic method for the detection of Borrelia burgdorferi s.l. in CSF of Swedish children with LNB. This study was performed retrospectively on CSF and serum samples collected from children evaluated for LNB (n = 233) and controls with other specific neurological disorders (n = 59) in a Swedish Lyme endemic area. For anti-Borrelia antibody index, the IDEIA Lyme Neuroborreliosis kit (Oxoid) was used. Two in-house real-time PCR assays targeting the 16S rRNA gene were evaluated (TaqMan® and LUX™). Among patients classified as LNB cases (n = 102), five children (5%) were Borrelia PCR-positive in CSF with the TaqMan® assay. In the Non-LNB group (n = 131), one patient was Borrelia PCR positive with the TaqMan® assay. Among controls (n = 59), all CSF samples were PCR negative. When amplifying and sequencing ospA, we found B. garinii (n = 2), B. afzelii (n = 2), B. bavariensis (n = 1), and one untypable (n = 1). With the LUX™ technology, all CSF samples were PCR negative. The TaqMan® assay could detect only few cases (n = 6) of B. burgdorferi s.l. in CSF among children with LNB and the sensitivity was very low (5%). However, using larger CSF volumes and centrifugation of samples, the PCR technique could still be useful as a complementary diagnostic method when evaluating LNB. Furthermore, detection of spirochete DNA in clinical matrices, including CSF, is the method of choice for studying epidemiological aspects of LNB, a tick-borne emerging disease.
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Affiliation(s)
- Barbro H Skogman
- Center for Clinical Research Dalarna - Uppsala University, Region Dalarna County, Falun, Sweden. .,Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Peter Wilhelmsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Microbiology, Region Jönköping County, Jönköping, Sweden
| | - Stephanie Atallah
- Department of infectious diseases, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Katarina Ornstein
- Ystad Hospital, Skåne University Health Care, Region Skåne, Ystad, Sweden
| | - Per-Eric Lindgren
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Division of Clinical Microbiology, Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden
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11
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Hvidsten D, Frafjord K, Gray JS, Henningsson AJ, Jenkins A, Kristiansen BE, Lager M, Rognerud B, Slåtsve AM, Stordal F, Stuen S, Wilhelmsson P. The distribution limit of the common tick, Ixodes ricinus, and some associated pathogens in north-western Europe. Ticks Tick Borne Dis 2020; 11:101388. [PMID: 32122808 DOI: 10.1016/j.ttbdis.2020.101388] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 11/30/2022]
Abstract
In north-western Europe, the common tick, Ixodes ricinus, is widely established, its distribution appears to be increasing and the spread of tick-borne diseases is of increasing concern. The project 'Flått i Nord' (Ticks in northern Norway) commenced in spring 2009 with the intention of studying the tick's distribution and that of its pathogens in northern Norway. Several methods were used: cloth-dragging, collecting from trapped small mammals, and collecting from pets. Since 2010, the occurrence of ticks in the region of northern Norway was determined directly by cloth-dragging 167 times in 109 separate locations between the latitudes of 64 °N and 70 °N (included seven locations in the northern part of Trøndelag County). The northernmost location of a permanent I. ricinus population was found to be Nordøyvågen (66.2204 °N, 12.59 °E) on the Island of Dønna. In a sample of 518 nymphal and adult ticks, the Borrelia prevalence collected close to this distribution limit varied but was low (1-15 %) compared with the locations in Trøndelag, south of the study area (15-27 %). Five specimens (1 %) were positive for Rickettsia helvetica. The length of the vegetation growing season (GSL) can be used as an approximate index for the presence of established populations of I. ricinus. The present study suggests that the threshold GSL for tick establishment is about 170 days, because the median GSL from 1991 to 2015 was 174-184 days at sites with permanent tick populations, showing a clear increase compared with the period 1961-1990. This apparent manifestation of climate change could explain the northward extension of the range of I. ricinus.
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Affiliation(s)
- D Hvidsten
- University Hospital of North Norway, Department of Microbiology and Infection Control, Tromsø, Norway; Nordland Hospital, Division of Diagnostic Services, Department of Microbiology, Bodø, Norway.
| | - K Frafjord
- UiT The Arctic University of Norway, Tromsø University Museum, Tromsø, Norway
| | - J S Gray
- University College Dublin, Dublin, Ireland
| | - A J Henningsson
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - A Jenkins
- University of South-Eastern Norway, Department of Natural Science and Environmental Health, Bø, Norway
| | | | - M Lager
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - B Rognerud
- University of Oslo, Department of Geosciences, Oslo, Norway
| | - A M Slåtsve
- Nordland Hospital, Division of Diagnostic Services, Department of Microbiology, Bodø, Norway
| | - F Stordal
- University of Oslo, Department of Geosciences, Oslo, Norway
| | - S Stuen
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Section for Small Ruminants Research, Sandnes, Norway
| | - P Wilhelmsson
- Department of Clinical Microbiology, Jönköping, Region Jönköping County, AND Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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12
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Stafford KC, Williams SC, van Oosterwijk JG, Linske MA, Zatechka S, Richer LM, Molaei G, Przybyszewski C, Wikel SK. Field evaluation of a novel oral reservoir-targeted vaccine against Borrelia burgdorferi utilizing an inactivated whole-cell bacterial antigen expression vehicle. EXPERIMENTAL & APPLIED ACAROLOGY 2020; 80:257-268. [PMID: 31898760 DOI: 10.1007/s10493-019-00458-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Blacklegged ticks (Ixodes scapularis) are the principal vector for Borrelia burgdorferi, among other infectious agents, in the northeastern, mid-Atlantic, and upper midwestern USA. White-footed mice (Peromyscus leucopus) are the primary and most competent reservoir host of B. burgdorferi in the Northeast. Live reservoir-targeted vaccines (RTVs) to limit enzootic transmission of B. burgdorferi were previously developed and successfully evaluated in laboratory and controlled field trials. A novel, inactivated RTV was developed to minimize regulatory and market challenges facing previous RTVs based on live bacterial or viral vehicles. Thirty-two residential properties in Redding, Connecticut, participated in a field trial of an orally delivered, inactivated RTV efficacy study (2015-2016). During the two-year vaccination period, a significant decrease in the percentage of B. burgdorferi-infected I. scapularis larvae parasitizing P. leucopus was observed, as was a significant reduction in the percentage of infected P. leucopus on RTV-treated properties when compared to control properties. This novel inactivated RTV was effective in reducing numbers of B. burgdorferi-infected I. scapularis and B. burgdorferi-infected P. leucopus on properties where it was distributed.
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Affiliation(s)
- Kirby C Stafford
- Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station, 123 Huntington Street, New Haven, CT, 06511, USA
| | - Scott C Williams
- Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station, 123 Huntington Street, New Haven, CT, 06511, USA.
| | | | - Megan A Linske
- Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station, 123 Huntington Street, New Haven, CT, 06511, USA
| | | | | | - Goudarz Molaei
- Center for Vector Biology & Zoonotic Diseases, The Connecticut Agricultural Experiment Station, 123 Huntington Street, New Haven, CT, 06511, USA
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA
| | | | - Stephen K Wikel
- U.S. Biologic, Inc., Memphis, TN, USA
- Department of Medical Sciences, School of Medicine, Quinnipiac University, Hamden, CT, USA
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13
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Hepner S, Fingerle V, Duscher GG, Felsberger G, Marosevic D, Rollins RE, Okeyo M, Sing A, Margos G. Population structure of Borrelia turcica from Greece and Turkey. INFECTION GENETICS AND EVOLUTION 2019; 77:104050. [PMID: 31676445 DOI: 10.1016/j.meegid.2019.104050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/19/2019] [Accepted: 09/22/2019] [Indexed: 10/25/2022]
Abstract
Borrelia turcica, a member of the reptile-associated Borrelia clade, is vectored by Hyalomma aegyptium. The only suggested reservoir hosts of B. turcica are tortoises of the genus Testudo. Borrelia turcica has been described to occur in several Southeastern European countries including Turkey, Romania, Bulgaria and Greece but so far nothing is known about the relationship of these populations and whether or how they are structured. Using multilocus sequence typing (MLST) on eight chromosomally located housekeeping loci (clpA, clpX, nifS, pepX, pyrG, recG, rplB and uvrA) we analyzed 43 B. turcica isolates from Serres, Greece (n = 15) collected in 2017 and Izmir, Turkey (n = 28) collected in 2018. To understand their relationship a maximum-likelihood phylogenetic tree and goeBURST analysis were done based on MLST sequence data and allelic profiles, respectively. The data we generated confirmed that the samples of B. turcica investigated here were divergent from Lyme disease (LD) and relapsing fever (RF) species. Within the B. turcica clade, samples of different geographic origin (Greece, Turkey) clustered together in terminal branches; no obvious differences between the Greek and Turkish samples were noticeable. A goeBURST analysis using triple-locus variants revealed very few clonal complexes with the majority of samples appearing as singletons. Minor clonal complexes (consisting of two sequence types) comprised only Greek isolates, only Turkish isolates or both, so no pattern of clustering of isolates from the two geographical regions was observed. Interestingly, very little population structure was discerned in our study. This was surprising in view of the large geographic distance between collection sites of B. turcica and raises questions about the evolution or spatial spread of this species.
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Affiliation(s)
- Sabrina Hepner
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany.
| | - Volker Fingerle
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany
| | - Georg Gerhard Duscher
- Institute of Parasitology, Department of Pathobiology, Veterinary University of Vienna, Veterinärplatz 1, Vienna 1210, Austria
| | - Gerit Felsberger
- AGES-Austrian Agency for Health and Food Safety, Währingerstr. 25a, Vienna 1090, Austria
| | - Durdica Marosevic
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany
| | - Robert Ethan Rollins
- Division of Evolutionary Biology, Faculty of Biology, Ludwig-Maximilians University, Großhaderner Str.2, Martinsried 82152, Germany
| | - Mercy Okeyo
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany
| | - Andreas Sing
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany
| | - Gabriele Margos
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, Oberschleissheim 85764, Germany
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14
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Hristov DR, Rodriguez-Quijada C, Gomez-Marquez J, Hamad-Schifferli K. Designing Paper-Based Immunoassays for Biomedical Applications. SENSORS (BASEL, SWITZERLAND) 2019; 19:E554. [PMID: 30699964 PMCID: PMC6387326 DOI: 10.3390/s19030554] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/14/2019] [Accepted: 01/21/2019] [Indexed: 12/18/2022]
Abstract
Paper-based sensors and assays have been highly attractive for numerous biological applications, including rapid diagnostics and assays for disease detection, food safety, and clinical care. In particular, the paper immunoassay has helped drive many applications in global health due to its low cost and simplicity of operation. This review is aimed at examining the fundamentals of the technology, as well as different implementations of paper-based assays and discuss novel strategies for improving their sensitivity, performance, or enabling new capabilities. These innovations can be categorized into using unique nanoparticle materials and structures for detection via different techniques, novel biological species for recognizing biomarkers, or innovative device design and/or architecture.
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Affiliation(s)
- Delyan R Hristov
- Department of Engineering, University of Massachusetts, Boston, MA 02125, USA.
| | | | - Jose Gomez-Marquez
- Little Devices Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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15
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Abstract
Lyme disease (LD) is the most common tick-borne disease in the Northern Hemisphere. As the most prevalent vector-borne disease in the USA, LD affects 300,000 human cases each year. LD is caused by inoculation of the bacterial spirochete, Borrelia burgdorferi sensu lato, from an infected tick. If not treated quickly and completely, the bacteria disseminate from the tick's biting site into multiple organs including the joints, heart, and brain. Thus, the best outcome from medical intervention can be expected with early detection and treatment with antibiotics, prior to multi-organ dissemination. In the absence of a characteristic rash, LD is diagnosed using serological testing involving enzyme-linked immunosorbent assay (ELISA) followed by western blotting, which is collectively known as the two-tier algorithm. These assays detect host antibodies against the bacteria, but are hampered by low sensitivity, which can miss early LD cases. This review discusses the application of some current assays for diagnosing LD clinically, thus providing a foundation for exploring newer techniques being developed in the laboratory for more sensitive detection of early LD.
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Affiliation(s)
- Eunice Chou
- Vassar College in Poughkeepsie, NY SUNY Downstate Medical School and SUNY Polytechnic Institute
| | - Yi-Pin Lin
- University in Ithaca, NY and postdoctoral training from Tufts University in Boston, MA
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16
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Direct Molecular Detection and Genotyping of Borrelia burgdorferi Sensu Lato in Cerebrospinal Fluid of Children with Lyme Neuroborreliosis. J Clin Microbiol 2018; 56:JCM.01868-17. [PMID: 29467195 DOI: 10.1128/jcm.01868-17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/17/2018] [Indexed: 01/01/2023] Open
Abstract
The current diagnostic marker of Lyme neuroborreliosis (LNB), the Borrelia burgdorferisensu lato antibody index (AI) in the cerebrospinal fluid (CSF), has insufficient sensitivity in the early phase of LNB. We aimed to elucidate the diagnostic value of PCR for B. burgdorferisensu lato in CSF from children with symptoms suggestive of LNB and to explore B. burgdorferisensu lato genotypes associated with LNB in children. Children were prospectively included in predefined groups with a high or low likelihood of LNB based on diagnostic guidelines (LNB symptoms, CSF pleocytosis, and B. burgdorferisensu lato antibodies) or the detection of other causative agents. CSF samples were analyzed by two B. burgdorferisensu lato-specific real-time PCR assays and, if B. burgdorferisensu lato DNA was detected, were further analyzed by five singleplex real-time PCR assays for genotype determination. For children diagnosed as LNB patients (58 confirmed and 18 probable) (n = 76) or non-LNB controls (n = 28), the sensitivity and specificity of PCR for B. burgdorferisensu lato in CSF were 46% and 100%, respectively. B. burgdorferisensu lato DNA was detected in 26/58 (45%) children with AI-positive LNB and in 7/12 (58%) children with AI-negative LNB and symptoms of short duration. Among 36 children with detectable B. burgdorferisensu lato DNA, genotyping indicated Borrelia garinii (n = 27) and non-B. garinii (n = 1) genotypes, while 8 samples remained untyped. Children with LNB caused by B. garinii did not have a distinct clinical picture. The rate of detection of B. burgdorferisensu lato DNA in the CSF of children with LNB was higher than that reported previously. PCR for B. burgdorferisensu lato could be a useful supplemental diagnostic tool in unconfirmed LNB cases with symptoms of short duration. B. garinii was the predominant genotype in children with LNB.
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