1
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Knoll S, Springer A, Hauck D, Schunack B, Pachnicke S, Fingerle V, Strube C. Distribution of Borrelia burgdorferi s.l. and Borrelia miyamotoi in Ixodes tick populations in Northern Germany, co-infections with Rickettsiales and assessment of potential influencing factors. Med Vet Entomol 2021; 35:595-606. [PMID: 34180074 DOI: 10.1111/mve.12537] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/30/2021] [Accepted: 06/03/2021] [Indexed: 06/13/2023]
Abstract
To determine Borrelia spp. (Spirochaetales: Spirochaetaceae) prevalence and species distribution in Northern Germany, Ixodes ticks were sampled from April to October in 2018 and 2019 by the flagging method at three locations each in five regions. Analysis by quantitative real-time PCR of 3150 individual ticks revealed an overall prevalence of 30.6%, without significant differences between tick stages (31.7% positive adults, 28.6% positive nymphs). Significant differences were observed in seasonal infection rates, but not between regions, landscape types or sampling years. Analysis of co-infections with Rickettsiales indicated a negative association between Borrelia and Anaplasma phagocytophilum infection. The most frequent Borrelia species differentiated by Reverse Line Blot were B. afzelii and B. garinii/B. bavariensis, followed by B. valaisiana, B. burgdorferi sensu stricto, B. spielmanii and B. lusitaniae. Furthermore, B. miyamotoi was identified in 12.9% of differentiable samples. No effect of region nor landscape type on species composition was found, but significant variations in the distribution at the different sampling sites within a region were observed. The detected monthly fluctuations in prevalence and the differences in intra-regional Borrelia species distribution underline the importance of long-term and multi-location monitoring of Borrelia spp. in ticks as an essential part of public health assessment.
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Affiliation(s)
- S Knoll
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - A Springer
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - D Hauck
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - B Schunack
- Bayer Animal Health GmbH (part of Elanco Animal Health), Leverkusen, Germany
| | - S Pachnicke
- Bayer Vital GmbH, Leverkusen, Germany
- Elanco Deutschland GmbH, Monheim, Germany
| | - V Fingerle
- National Reference Centre for Borrelia, Oberschleißheim, Germany
| | - C Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
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2
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Fingerle V, Herzer P. [28/m-Acute gonarthritis : Preparation for the medical specialist examination: part 127]. Internist (Berl) 2021; 63:147-152. [PMID: 34550403 DOI: 10.1007/s00108-021-01147-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2021] [Indexed: 10/20/2022]
Affiliation(s)
- V Fingerle
- Nationales Referenzzentrum für Borrelien, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstr. 2, 85764, Oberschleißheim, Deutschland.
| | - P Herzer
- Medicover München MVZ, München, Deutschland
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3
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Rupprecht TA, Manz KM, Fingerle V, Lechner C, Klein M, Pfirrmann M, Koedel U. Diagnostic value of cerebrospinal fluid CXCL13 for acute Lyme neuroborreliosis. A systematic review and meta-analysis. Clin Microbiol Infect 2018; 24:1234-1240. [PMID: 29674128 DOI: 10.1016/j.cmi.2018.04.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 04/04/2018] [Accepted: 04/04/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES The utility of cerebrospinal fluid (CSF) CXCL13 for diagnosis of acute Lyme neuroborreliosis (LNB) has been debated and the test is not yet routinely performed. This study's aim was to evaluate its overall diagnostic accuracy through meta-analysis. METHODS Electronic searches in PubMed MEDLINE and Web of Science were performed to identify relevant articles published before January 2018. A summary receiver operating characteristic curve and an optimal cut-off were estimated modelling multiple cut-offs. Publication bias was evaluated using a funnel plot and the associated regression test. RESULTS A total of 18 studies involving 618 individuals with acute LNB and 2326 individuals with other neurological disorders meeting the eligibility criteria were identified. The pooled sensitivity for CSF CXCL13 was 89% (95% CI 85%-93%) and the pooled specificity was 96% (95% CI 92%-98%), using the identified optimal cut-off value of 162 pg/mL. There was marked heterogeneity between studies, caused by differences in the designs of the study populations and age distribution. The optimal cut-off in the seven studies with a cross-sectional design was 91 pg/mL (sensitivity 96%, 95% CI 92%-98%; specificity 94%, 95% CI 86%-97%) and in the 11 case-control studies it was 164 pg/mL (sensitivity 85%, 95% CI 78%-91%; specificity 95%, 95% CI 90%-98%). CSF CXCL13 values above the optimal cut-off level (determined in this meta-analysis) were also detectable in some other central nervous system disorders, namely neurosyphilis and central nervous system lymphoma. CONCLUSIONS Our meta-analysis shows that CSF CXCL13 has the potential to become a useful adjunct in the diagnosis of acute LNB.
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Affiliation(s)
- T A Rupprecht
- Department of Neurology, HELIOS-Clinic Munich West, Munich, Germany
| | - K M Manz
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - V Fingerle
- Bavarian Health and Food Safety Authority, Munich, Oberschleissheim, Germany
| | - C Lechner
- Department of Neurology, HELIOS-Clinic Munich West, Munich, Germany
| | - M Klein
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - M Pfirrmann
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - U Koedel
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany.
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Heinzinger S, Sing A, Fingerle V. Das LYDI-Sentinel (Lyme Disease Incidence) in den Jahren 2013 bis 2016. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1639264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Heinzinger
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL Bayern) GE2 - Public Health Mikrobiologie und Infektionsepidemiologie, Oberschleißheim, Germany
| | - A Sing
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL Bayern) GE2 - Public Health Mikrobiologie und Infektionsepidemiologie, Oberschleißheim, Germany
| | - V Fingerle
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit (LGL Bayern) GE2 - Public Health Mikrobiologie und Infektionsepidemiologie, Oberschleißheim, Germany
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5
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Dessau RB, van Dam AP, Fingerle V, Gray J, Hovius JW, Hunfeld KP, Jaulhac B, Kahl O, Kristoferitsch W, Lindgren PE, Markowicz M, Mavin S, Ornstein K, Rupprecht T, Stanek G, Strle F. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis - Author's reply. Clin Microbiol Infect 2017; 24:211-212. [PMID: 29079146 DOI: 10.1016/j.cmi.2017.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- R B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Region Sjælland, Denmark.
| | - A P van Dam
- OLVG General Hospital and Public Health Laboratory, Amsterdam, The Netherlands
| | - V Fingerle
- National Reference Centre for Borrelia, Munich, Oberschleissheim, Germany
| | - J Gray
- UCD School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - J W Hovius
- Centre for Experimental and Molecular Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - K-P Hunfeld
- Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe-University, Frankfurt/Main and INSTAND e.V., Düsseldorf, Germany
| | - B Jaulhac
- National Reference Centre for Borrelia, Hôpitaux Universitaires de Strasbourg, France
| | - O Kahl
- Tick-radar GmbH, Berlin, Germany
| | - W Kristoferitsch
- Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria
| | | | - M Markowicz
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - S Mavin
- National Lyme Borreliosis Testing Laboratory, Raigmore Hospital, Inverness, UK
| | - K Ornstein
- Division of Medicine, Skånevård Kryh, Region Skåne, Sweden
| | - T Rupprecht
- Department of Neurology, HELIOS Klinikum München West, Munich, Germany
| | - G Stanek
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - F Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Dessau RB, van Dam AP, Fingerle V, Gray J, Hovius JW, Hunfeld KP, Jaulhac B, Kahl O, Kristoferitsch W, Lindgren PE, Markowicz M, Mavin S, Ornstein K, Rupprecht T, Stanek G, Strle F. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis. Clin Microbiol Infect 2017; 24:118-124. [PMID: 28887186 DOI: 10.1016/j.cmi.2017.08.025] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 08/26/2017] [Accepted: 08/29/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. The most frequent clinical manifestations are erythema migrans and Lyme neuroborreliosis. Currently, a large volume of diagnostic testing for LB is reported, whereas the incidence of clinically relevant disease manifestations is low. This indicates overuse of diagnostic testing for LB with implications for patient care and cost-effective health management. AIM The recommendations provided in this review are intended to support both the clinical diagnosis and initiatives for a more rational use of laboratory testing in patients with clinically suspected LB. SOURCES This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national and international guidelines and supplemented with specific citations. IMPLICATIONS The main recommendations according to current European case definitions for LB are as follows. Typical erythema migrans should be diagnosed clinically and does not require laboratory testing. The diagnosis of Lyme neuroborreliosis requires laboratory investigation of the spinal fluid including intrathecal antibody production, and the remaining disease manifestations require testing for serum antibodies to B. burgdorferi. Testing individuals with non-specific subjective symptoms is not recommended, because of a low positive predictive value.
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Affiliation(s)
- R B Dessau
- Department of Clinical Microbiology, Slagelse Hospital, Region Sjælland, Denmark.
| | - A P van Dam
- OLVG General Hospital and Public Health Laboratory, Amsterdam, The Netherlands
| | - V Fingerle
- National Reference Centre for Borrelia, Munich, Oberschleissheim, Germany
| | - J Gray
- UCD School of Biology and Environmental Science, University College Dublin, Dublin, Ireland
| | - J W Hovius
- Centre for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K-P Hunfeld
- Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe-University, Frankfurt/Main and INSTAND e.V., Düsseldorf, Germany
| | - B Jaulhac
- National Reference Centre for Borrelia, Hôpitaux Universitaires de Strasbourg, France
| | - O Kahl
- Tick-radar GmbH, Berlin, Germany
| | - W Kristoferitsch
- Karl Landsteiner Institute for Neuroimmunological and Neurodegenerative Disorders, Vienna, Austria
| | | | - M Markowicz
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - S Mavin
- National Lyme Borreliosis Testing Laboratory, Raigmore Hospital, Inverness, UK
| | - K Ornstein
- Division of Medicine, Skånevård Kryh, Region Skåne, Sweden
| | - T Rupprecht
- Department of Neurology, HELIOS Klinikum München West, Munich, Germany
| | - G Stanek
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - F Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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7
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Margos G, Marosevic D, Cutler S, Derdakova M, Diuk-Wasser M, Emler S, Fish D, Gray J, Hunfeld KP, Jaulhac B, Kahl O, Kovalev S, Kraiczy P, Lane RS, Lienhard R, Lindgren PE, Ogden NH, Ornstein K, Rupprecht T, Schwartz I, Sing A, Straubinger RK, Strle F, Voordouw M, Rizzoli A, Stevenson B, Fingerle V. Corrigendum: There is inadequate evidence to support the division of the genus Borrelia. Int J Syst Evol Microbiol 2017; 67:2073. [PMID: 28665266 DOI: 10.1099/ijsem.0.002100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- G Margos
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - D Marosevic
- European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden.,National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - S Cutler
- School of Health Sport and Bioscience, University of East London, Water Lane, London, UK
| | - M Derdakova
- Department of Zoology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - M Diuk-Wasser
- Department of Ecology, Evolution and Environmental Biology, Columbia University, 1200 Amsterdam Avenue, New York, NY 10027, USA
| | - S Emler
- SmartGene Services SARL, Innovation Park, Building C, EPFL-Ecublens, CH-1015 Lausanne, Switzerland
| | - D Fish
- Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College Street, New Haven, CT 06510, USA
| | - J Gray
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR).,Emeritus Professor of Animal Parasitology, University College Dublin, Dublin, Ireland
| | - K-P Hunfeld
- Zentralinstitut für Labormedizin, Mikrobiologie and Krankenhaushygiene, Krankenhaus Nordwest, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Frankfurt, Germany.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - B Jaulhac
- Laboratoire de Bactériologie, CNR des Borrelia, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg et Faculté de Médecine de Strasbourg, 1 rue Koeberlé, Strasbourg 67000, France.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - O Kahl
- tick-radar GmbH, Haderslebener Str. 9, Berlin 12163, Germany.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - S Kovalev
- Molecular Genetics Lab (www.dnk-ural.ru) Biology Department, Ural Federal University named after the first President of Russia B.N.Yeltsin, Lenin Avenue, Yekaterinburg 620000, Russia
| | - P Kraiczy
- Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Paul-Ehrlich-Str, Frankfurt/Main 40, 60596, Germany
| | - R S Lane
- Environmental Science, Policy and Management, University of California Berkeley, 130 Mulford Hall, Berkeley CA 94720, California, USA
| | - R Lienhard
- Borrelia Laboratory for the National Reference Centre of Tick Diseases (CNRT/ NRZK), ADMed Microbiology, La Chaux-de-Fonds 2303, Switzerland
| | - P E Lindgren
- Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - N H Ogden
- Director, Public Health Risk Sciences Division, National Microbiology Laboratory, @ Saint-Hyacinthe and Guelph, Public Health Agency of Canada, Saint-Hyacinthe, Canada
| | - K Ornstein
- Clinical and Experimental Infectious Medicine Section, Department of Clinical Sciences, Lund University, Sweden.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - T Rupprecht
- Klinikum Dachau, Abt. Neurology u. Schlafmedizinisches Zentrum, Krankenhausstr. 15, 8521 Dachau, Germany.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - I Schwartz
- Department of Microbiology and Immunology, School of Medicine, New York Medical College, Basic Sciences Building, Valhalla, NY 10595, USA
| | - A Sing
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - R K Straubinger
- Chair Bacteriology and Mykology, Department of Veterinary Science, Veterinary Faculty, LMU Munich, Veterinärstraße, München 13, 80539, Gemany
| | - F Strle
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - M Voordouw
- Université de Neuchâtel, Institut de Biologie, Laboratoire d'Ecologie et Evolution des Parasites, Rue Emile-Argand 11, CH-2000, Neuchâtel, Switzerland
| | - A Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, Via Mach, 1, San Michele all'Adige, Trento, Italy
| | - B Stevenson
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, MS421 Chandler Medical Center, Lexington, Kentucky, 40536-0298, USA
| | - V Fingerle
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR).,National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
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8
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Margos G, Hepner S, Mang C, Marosevic D, Reynolds SE, Krebs S, Sing A, Derdakova M, Reiter MA, Fingerle V. Lost in plasmids: next generation sequencing and the complex genome of the tick-borne pathogen Borrelia burgdorferi. BMC Genomics 2017; 18:422. [PMID: 28558786 PMCID: PMC5450258 DOI: 10.1186/s12864-017-3804-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/17/2017] [Indexed: 11/21/2022] Open
Abstract
Background Borrelia (B.) burgdorferi sensu lato, including the tick-transmitted agents of human Lyme borreliosis, have particularly complex genomes, consisting of a linear main chromosome and numerous linear and circular plasmids. The number and structure of plasmids is variable even in strains within a single genospecies. Genes on these plasmids are known to play essential roles in virulence and pathogenicity as well as host and vector associations. For this reason, it is essential to explore methods for rapid and reliable characterisation of molecular level changes on plasmids. In this study we used three strains: a low passage isolate of B. burgdorferi sensu stricto strain B31(−NRZ) and two closely related strains (PAli and PAbe) that were isolated from human patients. Sequences of these strains were compared to the previously sequenced reference strain B31 (available in GenBank) to obtain proof-of-principle information on the suitability of next generation sequencing (NGS) library construction and sequencing methods on the assembly of bacterial plasmids. We tested the effectiveness of different short read assemblers on Illumina sequences, and of long read generation methods on sequence data from Pacific Bioscience single-molecule real-time (SMRT) and nanopore (Oxford Nanopore Technologies) sequencing technology. Results Inclusion of mate pair library reads improved the assembly in some plasmids as did prior enrichment of plasmids. While cp32 plasmids remained refractory to assembly using only short reads they were effectively assembled by long read sequencing methods. The long read SMRT and nanopore sequences came, however, at the cost of indels (insertions or deletions) appearing in an unpredictable manner. Using long and short read technologies together allowed us to show that the three B. burgdorferi s.s. strains investigated here, whilst having similar plasmid structures to each other (apart from fusion of cp32 plasmids), differed significantly from the reference strain B31-GB, especially in the case of cp32 plasmids. Conclusion Short read methods are sufficient to assemble the main chromosome and many of the plasmids in B. burgdorferi. However, a combination of short and long read sequencing methods is essential for proper assembly of all plasmids including cp32 and thus, for gaining an understanding of host- or vector adaptations. An important conclusion from our work is that the evolution of Borrelia plasmids appears to be dynamic. This has important implications for the development of useful research strategies to monitor the risk of Lyme disease occurrence and how to medically manage it. Electronic supplementary material The online version of this article (doi:10.1186/s12864-017-3804-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- G Margos
- German National Reference Centre for Borrelia (NRZ), Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany.
| | - S Hepner
- German National Reference Centre for Borrelia (NRZ), Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany
| | - C Mang
- German National Reference Centre for Borrelia (NRZ), Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany
| | - D Marosevic
- Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany.,European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - S E Reynolds
- Department of Biology and Biochemistry, University of Bath, Claverton Down, BA2 7AY, Bath, UK
| | - S Krebs
- Gene Centre, Laboratory for Functional Genome Analysis, LMU Munich, Feodor-Lynen-Strasse 25, 81377, Munich, Germany
| | - A Sing
- German National Reference Centre for Borrelia (NRZ), Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany
| | - M Derdakova
- Institute of Zoology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - M A Reiter
- Institut für Hygiene und Angewandte Immunologie, Medizinische Universität Wien, Kinderspitalgasse 15, A-1090, Wien, Austria
| | - V Fingerle
- German National Reference Centre for Borrelia (NRZ), Bavarian Health and Food Safety Authority (LGL), Veterinärstrasse 2, 85764, Oberschleissheim, Germany
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9
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Margos G, Marosevic D, Cutler S, Derdakova M, Diuk-Wasser M, Emler S, Fish D, Gray J, Hunfeldt KP, Jaulhac B, Kahl O, Kovalev S, Kraiczy P, Lane RS, Lienhard R, Lindgren PE, Ogden N, Ornstein K, Rupprecht T, Schwartz I, Sing A, Straubinger RK, Strle F, Voordouw M, Rizzoli A, Stevenson B, Fingerle V. There is inadequate evidence to support the division of the genus Borrelia. Int J Syst Evol Microbiol 2017; 67:1081-1084. [PMID: 27930271 DOI: 10.1099/ijsem.0.001717] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- G Margos
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - D Marosevic
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
- European Programme for Public Health Microbiology Training, European Centre of Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - S Cutler
- School of Health Sport and Bioscience, University of East London, Water Lane, London, UK
| | - M Derdakova
- Department of Zoology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - M Diuk-Wasser
- Department of Ecology, Evolution and Environmental Biology, Columbia University, 1200 Amsterdam Avenue, New York, NY 10027, USA
| | - S Emler
- SmartGene Services SARL, Innovation Park, Building C, EPFL-Ecublens, CH-1015 Lausanne, Switzerland
| | - D Fish
- Yale School of Public Health, Laboratory of Epidemiology and Public Health, 60 College Street, New Haven, CT 06510, USA
| | - J Gray
- Emeritus Professor of Animal Parasitology, University College Dublin, Dublin, Ireland
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
| | - K-P Hunfeldt
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Zentralinstitut für Labormedizin, Mikrobiologie and Krankenhaushygiene, Krankenhaus Nordwest, Akademisches Lehrkrankenhaus der Johann Wolfgang Goethe-Universität, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Frankfurt, Germany
| | - B Jaulhac
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Laboratoire de Bactériologie, CNR des Borrelia, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg et Faculté de Médecine de Strasbourg, 1 rue Koeberlé, Strasbourg 67000, France
| | - O Kahl
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- tick-radar GmbH, Haderslebener Str. 9, Berlin 12163, Germany
| | - S Kovalev
- Molecular Genetics Lab (www.dnk-ural.ru) Biology Department, Ural Federal University named after the first President of Russia B.N.Yeltsin, Lenin Avenue, Yekaterinburg 620000, Russia
| | - P Kraiczy
- Institute of Medical Microbiology and Infection Control, University Hospital Frankfurt, Paul-Ehrlich-Str, Frankfurt/Main 40, 60596, Germany
| | - R S Lane
- Environmental Science, Policy and Management, University of California Berkeley, 130 Mulford Hall, Berkeley CA 94720, California, USA
| | - R Lienhard
- Borrelia Laboratory for the National Reference Centre of Tick Diseases (CNRT/ NRZK), ADMed Microbiology, La Chaux-de-Fonds 2303, Switzerland
| | - P E Lindgren
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - N Ogden
- Director, Public Health Risk Sciences Division, National Microbiology Laboratory, @ Saint-Hyacinthe and Guelph, Public Health Agency of Canada, Saint-Hyacinthe, Canada
| | - K Ornstein
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Clinical and Experimental Infectious Medicine Section, Department of Clinical Sciences, Lund University, Sweden
| | - T Rupprecht
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Klinikum Dachau, Abt. Neurology u. Schlafmedizinisches Zentrum, Krankenhausstr. 15, 8521 Dachau, Germany
| | - I Schwartz
- Department of Microbiology and Immunology, School of Medicine, New York Medical College, Basic Sciences Building, Valhalla, NY 10595, USA
| | - A Sing
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - R K Straubinger
- Chair Bacteriology and Mykology, Department of Veterinary Science, Veterinary Faculty, LMU Munich, Veterinärstraße, München 13, 80539, Gemany
| | - F Strle
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - M Voordouw
- Université de Neuchâtel, Institut de Biologie, Laboratoire d'Ecologie et Evolution des Parasites, Rue Emile-Argand 11, CH-2000, Neuchâtel, Switzerland
| | - A Rizzoli
- Fondazione Edmund Mach, Research and Innovation Centre, Via Mach, 1, San Michele all'Adige, Trento, Italy
| | - B Stevenson
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky College of Medicine, MS421 Chandler Medical Center, Lexington, Kentucky, 40536-0298, USA
| | - V Fingerle
- National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleißheim, Germany
- Members of the Steering Committee of the ESCMID Study Group for Borrelia (ESGBOR)
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Seilmaier M, Guggemos W, Wieser A, Fingerle V, Balzer L, Fenzl T, Hoch M, von Both U, Schmidt HU, Wendtner CM, Strobel E. [Louse-borne-relapsing-fever in refugees from the Horn of Africa; a case series of 25 patients]. Dtsch Med Wochenschr 2016; 141:e133-42. [PMID: 27404939 DOI: 10.1055/s-0042-108180] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background | Relapsing fever is divided into tick borne relapsing fever (TBRF) and louse borne relapsing fever (LBRF). This report describes 25 refugees from East Africa who were diagnosed to suffer from LBRF within a period of 6 month only at a single hospital in Munich / Germany. Material & Methods | The aim was to point out common clinical features as well as laboratory findings and clinical symptoms before and after initiation of treatment in 25 patients with louse borne relapsing fever (LBRF) who were diagnosed and treated at Klinikum München Schwabing from August 2015 to January 2016. To the best of our knowledge this is the largest case series of LBRF in the western world for decades. Main focus of the investigation was put on clinical aspects. Results | All 25 patients suffered from acute onset of high fever with chills, headache and severe prostration. Laboratory analysis showed high CRP and a marked thrombocytopenia. A Giemsa blood stain was procured immediately in order to look for malaria. In the blood smear spirochetes with typical shape and aspect of borrelia species could be detected.The further PCR analysis confirmed infection with Borrelia recurrentis. Treatment with Doxycycline was started forthwith. The condition improved already on the second day after treatment was started and all were restored to health in less than a week. Apart from a mild to moderate Jarisch-Herxheimer-reaction we didn`t see any side effects of the therapy. Conclusion | LBRF has to be taken into account in feverish patients who come as refugees from East-Africa. It seems that our patients belong to a cluster which probably has its origin in Libya and more patients are to be expected in the near future. As LBRF might cause outbreaks in refugee camps it is pivotal to be aware of this emerging infectious disease in refugees from East-Africa.
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Marosevic D, Fingerle V, Hizo-Teufel C, Stockmeier S, Wieser A, Sing A, Margos G. Ganz-Genom Sequenzierung verschiedener Borrelia recurrentis Stämme. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Faller M, Margos G, Hizo-Teufel C, Koloczek J, Stockmeier S, Strehle W, Sing A, Fingerle V. Lyme-Borreliose: EU-weite externe Qualitätssicherungsstudie zur Leistungsfähigkeit verschiedener Amplifikationsprotokolle zum Nachweis von Borrelia burgdorferi sensu lato. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Margos G, Jungnick S, Rieger M, Koloczek J, Sing A, Fingerle V. Molekulare Typisierungsverfahren für Borrelia burgdorferi sensu lato. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Leeflang MMG, Ang CW, Berkhout J, Bijlmer HA, Van Bortel W, Brandenburg AH, Van Burgel ND, Van Dam AP, Dessau RB, Fingerle V, Hovius JWR, Jaulhac B, Meijer B, Van Pelt W, Schellekens JFP, Spijker R, Stelma FF, Stanek G, Verduyn-Lunel F, Zeller H, Sprong H. The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis. BMC Infect Dis 2016; 16:140. [PMID: 27013465 PMCID: PMC4807538 DOI: 10.1186/s12879-016-1468-4] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/14/2016] [Indexed: 11/20/2022] Open
Abstract
Background Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe. Methods We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. Results Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50 % (95 % CI 40 % to 61 %); neuroborreliosis 77 % (95 % CI 67 % to 85 %); acrodermatitis chronica atrophicans 97 % (95 % CI 94 % to 99 %); unspecified Lyme borreliosis 73 % (95 % CI 53 % to 87 %). Specificity was around 95 % in studies with healthy controls, but around 80 % in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches. Conclusions The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.
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Affiliation(s)
- M M G Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - C W Ang
- VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - J Berkhout
- Canisius-Wilhelmina Hospital, PO Box 9015, 6500 GS, Nijmegen, The Netherlands
| | - H A Bijlmer
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - W Van Bortel
- European Centre for Disease Prevention and Control (ECDC), 171 83, Stockholm, Sweden
| | - A H Brandenburg
- Izore Centre for Infectious Diseases Friesland, PO Box 21020, 8900 JA, Leeuwarden, The Netherlands
| | - N D Van Burgel
- HagaZiekenhuis, Leyweg 275, 2545 CH, The Hague, Netherlands
| | - A P Van Dam
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, P.O. Box 95500, 1090 HM, Amsterdam, The Netherlands
| | - R B Dessau
- Slagelse Hospital, Fælledvej 1, 4200, Slagelse, Region Zealand, Denmark
| | - V Fingerle
- German National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority, Veterinärstraße 2, 85764, Oberschleißheim, Germany
| | - J W R Hovius
- Centre for Experimental and Molecular Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | - B Jaulhac
- National Reference Centre for Borrelia, Department Laboratory of Bacteriology, Strasbourg University Hospital, 1 Place de l'Hôpital, Strasbourg, France
| | - B Meijer
- Laboratory for Infectious Diseases, PO Box 30039, 9700 RM, Groningen, The Netherlands
| | - W Van Pelt
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - J F P Schellekens
- Laboratory for Infectious Diseases, PO Box 30039, 9700 RM, Groningen, The Netherlands
| | - R Spijker
- Dutch Cochrane Centre, Julius Center for Health Sciences and Primary Care/University Medical Center, PO Box 85500, 3508 GA, Utrecht, The Netherlands
| | - F F Stelma
- Radboud University Nijmegen Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - G Stanek
- Institute for Hygiene and Applied Immunology, Medical University of Vienna, Vienna, Austria
| | - F Verduyn-Lunel
- Department of Medical Microbiology University Medical Center Utrecht (UMC), P.O. Box 85500, 3508GA, Utrecht, The Netherlands
| | - H Zeller
- European Centre for Disease Prevention and Control (ECDC), 171 83, Stockholm, Sweden
| | - H Sprong
- National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
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Castillo-Ramírez S, Fingerle V, Jungnick S, Straubinger RK, Krebs S, Blum H, Meinel DM, Hofmann H, Guertler P, Sing A, Margos G. Trans-Atlantic exchanges have shaped the population structure of the Lyme disease agent Borrelia burgdorferi sensu stricto. Sci Rep 2016; 6:22794. [PMID: 26955886 PMCID: PMC4783777 DOI: 10.1038/srep22794] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/18/2016] [Indexed: 12/14/2022] Open
Abstract
The origin and population structure of Borrelia burgdorferi sensu stricto (s.s.), the agent of Lyme disease, remain obscure. This tick-transmitted bacterial species occurs in both North America and Europe. We sequenced 17 European isolates (representing the most frequently found sequence types in Europe) and compared these with 17 North American strains. We show that trans-Atlantic exchanges have occurred in the evolutionary history of this species and that a European origin of B. burgdorferi s.s. is marginally more likely than a USA origin. The data further suggest that some European human patients may have acquired their infection in North America. We found three distinct genetically differentiated groups: i) the outgroup species Borrelia bissettii, ii) two divergent strains from Europe, and iii) a group composed of strains from both the USA and Europe. Phylogenetic analysis indicated that different genotypes were likely to have been introduced several times into the same area. Our results demonstrate that irrespective of whether B. burgdorferi s.s. originated in Europe or the USA, later trans-Atlantic exchange(s) have occurred and have shaped the population structure of this genospecies. This study clearly shows the utility of next generation sequencing to obtain a better understanding of the phylogeography of this bacterial species.
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Affiliation(s)
- S. Castillo-Ramírez
- Programa de Genómica Evolutiva, Centro de Ciencias Genómicas, Universidad Nacional Autónoma de México, Apartado Postal 565-A, CP 62210, Cuernavaca, Morelos, México
| | - V. Fingerle
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - S. Jungnick
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - R. K. Straubinger
- LMU Munich, Department of Infection and Zoonoses, Veterinärstr. 13, 80539 Munich, Germany
| | - S. Krebs
- LMU Munich, Gene Centre, Lafuga, Feodor-Lynen-Strasse 25, 81377 Munich, Germany
| | - H. Blum
- LMU Munich, Gene Centre, Lafuga, Feodor-Lynen-Strasse 25, 81377 Munich, Germany
| | - D. M. Meinel
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - H. Hofmann
- TU Munich, Klinik für Dermatologie and Allergologie, 80802 Munich, Germany
| | - P. Guertler
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - A. Sing
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
| | - G. Margos
- National Reference Center for Borreliosis at the Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764 Oberschleissheim, Germany
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May K, Jordan D, Fingerle V, Strube C. Borrelia burgdorferi sensu lato and co-infections with Anaplasma phagocytophilum and Rickettsia spp. in Ixodes ricinus in Hamburg, Germany. Med Vet Entomol 2015; 29:425-429. [PMID: 26096626 DOI: 10.1111/mve.12125] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 03/04/2015] [Accepted: 03/11/2015] [Indexed: 06/04/2023]
Abstract
To obtain initial data on Borrelia burgdorferi sensu lato (Spirochaetales: Spirochaetaceae) in Ixodes ricinus (Ixodida: Ixodidae) ticks in Hamburg, Germany, 1400 questing ticks were collected by flagging at 10 different public recreation areas in 2011 and analysed using probe-based quantitative real-time polymerase chain reaction. The overall rate of infection with B. burgdorferi s.l. was 34.1%; 30.0% of adults were infected (36.7% of females and 26.0% of males), as were 34.5% of nymphs. Significant differences in tick infection rates were observed between the spring and summer/autumn months, as well as among sampling locations. Borrelia genospecies identification by reverse line blotting was successful in 43.6% of positive tick samples. The most frequent genospecies was Borrelia garinii/Borrelia bavariensis, followed by Borrelia afzelii, Borrelia valaisiana, B. burgdorferi sensu stricto, Borrelia spielmanii, Borrelia bissettii and Borrelia lusitaniae. Based on previously published data, co-infection of Borrelia and Rickettsiales spp. was determined in 25.8% of ticks. Overall, 22.9% of ticks were co-infected with Rickettsia spp. (Rickettsiales: Rickettsiaceae), 1.7% with Anaplasma phagocytophilum (Rickettsiales: Anaplasmataceae), and 1.2% with both pathogens. Study results show a high prevalence of Borrelia-positive ticks in recreation areas in the northern German city of Hamburg and the potential health risk to humans in these areas should not be underestimated.
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Affiliation(s)
- K May
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - D Jordan
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
| | - V Fingerle
- German National Reference Centre for Borrelia, Oberschleissheim, Germany
| | - C Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hanover, Germany
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Faller M, Margos G, Koloczek J, Hizo-Teufel C, Strehle W, Stockmeier S, Sing A, Fingerle V. EU-weite externe Qualitätssicherungsstudie zur Sensitivität und Spezifität verschiedener Amplifikationsprotokolle zum Nachweis von Borrelia burgdorferi sensu lato. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1562991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Margos G, Jungnick S, Rieger M, Koloczek J, Sing A, Fingerle V. Molekulare Typisierungsverfahren bei Borrelia. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Binder K, Reich A, Sing A, Wildner M, Liebl B, Fingerle V, Hautmann W. LB-Meldedaten in Bayern. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1562990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fingerle V. Die neuen mikrobiologisch-infektiologischen Qualitätsstandards zu Lyme Borreliose (MiQ12). Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1562992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wilking H, Fingerle V, Klier C, Thamm M, Stark K. Risk factors associated with seropositivity against Lyme borreliosis: Results from a representative serosurvey of adults in Germany. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1562993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jurke A, Bannert N, Brehm K, Fingerle V, Kempf VAJ, Kömpf D, Lunemann M, Mayer-Scholl A, Niedrig M, Nöckler K, Scholz H, Splettstoesser W, Tappe D, Fischer SF. Serological survey of Bartonella spp., Borrelia burgdorferi, Brucella spp., Coxiella burnetii, Francisella tularensis, Leptospira spp., Echinococcus, Hanta-, TBE- and XMR-virus infection in employees of two forestry enterprises in North Rhine-Westphalia, Germany, 2011-2013. Int J Med Microbiol 2015; 305:652-62. [PMID: 26422407 DOI: 10.1016/j.ijmm.2015.08.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We initiated a survey to collect basic data on the frequency and regional distribution of various zoonoses in 722 employees of forestry enterprises in the German state of North Rhine-Westphalia (NRW) from 2011 to 2013. Exposures associated with seropositivity were identified to give insight into the possible risk factors for infection with each pathogen. 41.2% of participants were found to be seropositive for anti-Bartonella IgG, 30.6% for anti-Borrelia burgdorferi IgG, 14.2% for anti-Leptospira IgG, 6.5% for anti-Coxiella burnetii IgG, 6.0% for anti-Hantavirus IgG, 4.0% for anti-Francisella tularensis IgG, 3.4% for anti-TBE-virus IgG, 1.7% for anti-Echinococcus IgG, 0.0% for anti-Brucella IgG and anti-XMRV IgG. Participants seropositive for B. burgdorferi were 3.96 times more likely to be professional forestry workers (univariable analysis: OR 3.96; 95% CI 2.60-6.04; p<0.001); and participants seropositive for Hantavirus 3.72 times more likely (univariable analysis: OR 3.72; 95% CI 1.44-9.57; p=0.007). This study found a surprisingly high percentage of participants seropositive for anti-B. henselae IgG and for anti-F. tularensis IgG. The relatively high seroprevalence for anti-Leptospira IgG seen in this study could be related to living conditions rather than to exposure at work. No specific risk for exposure to C. burnetii and Echinococcus was identified, indicating that neither forestry workers nor office workers represent a risk population and that NRW is not a typical endemic area. Forestry workers appear to have higher risk for contact with B. burgdorferi-infected ticks and a regionally diverse risk for acquiring Hantavirus-infection. The regional epidemiology of zoonoses is without question of great importance for public health. Knowledge of the regional risk factors facilitates the development of efficient prevention strategies and the implementation of such prevention measures in a sustainable manner.
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Affiliation(s)
- Annette Jurke
- Department of Infectiology and Hygiene, NRW Centre for Health, Münster, Germany
| | - N Bannert
- Consultant Laboratory for Diagnostic Electron Microscopy of Infectious Pathogens, Robert Koch-Institute, Berlin, Germany
| | - K Brehm
- Consultant Laboratory for Echinococcus, Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany
| | - V Fingerle
- National Reference Centre for Borrelia, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleißheim, Germany
| | - V A J Kempf
- Consultant Laboratory for Bartonella, Institute for Medical Microbiology and Infection Control, University Hospital of Goethe, University Frankfurt am Main, Frankfurt, Germany
| | - D Kömpf
- Consultant Laboratory for Coxiella, Baden-Württemberg State Health Office, Stuttgart, Germany
| | - M Lunemann
- Department of Infectiology and Hygiene, NRW Centre for Health, Münster, Germany
| | - A Mayer-Scholl
- Consultant Laboratory for Leptospira, Federal Institute for Risk Assessment, Berlin, Germany
| | - M Niedrig
- Consultant Laboratory for Tick-borne Encephalitis, Robert Koch-Institute, Berlin, Germany
| | - K Nöckler
- Consultant Laboratory for Leptospira, Federal Institute for Risk Assessment, Berlin, Germany
| | - H Scholz
- Consultant Laboratory for Brucella, Bacteriology and Toxicology, Bundeswehr Institute of Microbiology, München, Germany
| | - W Splettstoesser
- Consultant Laboratory for Francisella, Bundeswehr Institute of Microbiology, München, Germany
| | - D Tappe
- Consultant Laboratory for Echinococcus, Institute of Hygiene and Microbiology University of Würzburg, Würzburg, Germany
| | - Silke F Fischer
- Consultant Laboratory for Coxiella, Baden-Württemberg State Health Office, Stuttgart, Germany.
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Venczel R, Knoke L, Pavlovic M, Dzaferovic E, Vaculova T, Silaghi C, Overzier E, Konrad R, Kolenčík S, Derdakova M, Sing A, Schaub GA, Margos G, Fingerle V. A novel duplex real-time PCR permits simultaneous detection and differentiation of Borrelia miyamotoi and Borrelia burgdorferi sensu lato. Infection 2015; 44:47-55. [PMID: 26168860 DOI: 10.1007/s15010-015-0820-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 06/29/2015] [Indexed: 01/09/2023]
Abstract
PURPOSE For simultaneous detection of Borrelia miyamotoi (relapsing fever spirochete) and Borrelia burgdorferi sensu lato, we have developed a duplex real-time PCR targeting the flagellin gene (flaB; p41), a locus frequently used in routine diagnostic PCR for B. burgdorferi s.l. detection. METHODS Primers and probes were designed using multiple alignments of flaB sequences of B. miyamotoi and B. burgdorferi s.l. species. The sensitivity and specificity of primers and probes were determined using serial dilutions (ranging from 10(4) to 10(-1)) of B. miyamotoi and B. burgdorferi s.l. DNA and of several species of relapsing fever spirochetes. Conventional PCR on recG and glpQ and sequencing of p41 PCR products were used to confirm the species assignment. RESULTS The detection limit of both singleplex and duplex PCR was 10 genome equivalents except for B. spielmanii and two B. garinii genotypes which showed a detection limit of 10(2) genome equivalents. There was no cross reactivity of the B. miyamotoi primers/probes with B. burgdorferi s.l. DNA, while the B. burgdorferi s.l. primer/probe generated a signal with B. hermsii DNA. Out of 2341 Ixodes ricinus ticks from Germany and Slovakia that were screened simultaneously for the presence of B. miyamotoi and B. burgdorferi s.l., 52 were positive for B. miyamotoi and 276 for B. burgdorferi s.l., denoting an average prevalence of 2.2% for B. miyamotoi and 11.8% for B. burgdorferi s.l., and B. miyamotoi DNA was also detectable by PCR using artificial clinical samples. CONCLUSION The duplex real-time PCR developed here represents a method that permits simultaneous detection and differentiation of B. burgdorferi s.l. and B. miyamotoi in environmental and potentially clinical samples.
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Affiliation(s)
- R Venczel
- German National Reference Centre for Borrelia, Veterinärstr. 2, 85764, Oberschleissheim, Germany. .,Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - L Knoke
- Zoology/Parasitology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany.
| | - M Pavlovic
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - E Dzaferovic
- German National Reference Centre for Borrelia, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - T Vaculova
- Institute of Zoology, Slovak Academy of Sciences, Dúbravská cesta 9, 84506, Bratislava, Slovakia.
| | - C Silaghi
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität München, Munich, Leopoldstr. 5, 80802, Munich, Germany. .,Swiss National Reference Center for Vector Entomology, Institute of Parasitology, Vetsuisse Faculty, University of Zurich, Winterthurerstr. 266A, 8057, Zurich, Switzerland.
| | - E Overzier
- Comparative Tropical Medicine and Parasitology, Ludwig-Maximilians-Universität München, Munich, Leopoldstr. 5, 80802, Munich, Germany. .,Lehrstuhl für Bakteriologie und Mykologie, Veterinärwissenschaftliches Department, Tierärztliche Fakultät der LMU, Veterinärstr. 13, 80539, Munich, Germany.
| | - R Konrad
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - S Kolenčík
- University of Veterinary and Pharmaceutical Sciences, Palackého 1/3, 612 42, Brno, Czech Republic.
| | - M Derdakova
- Institute of Zoology, Slovak Academy of Sciences, Dúbravská cesta 9, 84506, Bratislava, Slovakia.
| | - A Sing
- Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - G A Schaub
- Zoology/Parasitology, Ruhr University Bochum, Universitätsstr. 150, 44780, Bochum, Germany.
| | - G Margos
- German National Reference Centre for Borrelia, Veterinärstr. 2, 85764, Oberschleissheim, Germany. .,Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
| | - V Fingerle
- German National Reference Centre for Borrelia, Veterinärstr. 2, 85764, Oberschleissheim, Germany. .,Bavarian Health and Food Safety Authority, Veterinärstr. 2, 85764, Oberschleissheim, Germany.
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Silling S, Wieland U, Fingerle V, Rasokat H, Fabri M. Painful blister-free HSV-type 1 reactivation on the site of acute Lyme borreliosis. J Eur Acad Dermatol Venereol 2015; 30:1217-8. [PMID: 25864367 DOI: 10.1111/jdv.13142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Silling
- Institute of Virology, University of Cologne, Koeln, Germany
| | - U Wieland
- Institute of Virology, University of Cologne, Koeln, Germany
| | - V Fingerle
- National Reference Center for Borrelia, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Oberschleissheim, Germany
| | - H Rasokat
- Department of Dermatology and Venereology, University of Cologne, Koeln, Germany
| | - M Fabri
- Department of Dermatology and Venereology, University of Cologne, Koeln, Germany.,Center for Molecular Medicine, University of Cologne, Koeln, Germany
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Abstract
Lyme borreliosis is a multisystem infectious disease affecting mainly the skin, nervous system, joints and heart. It is caused by spirochetes of the Borrelia burgdorferi sensu lato complex which are transmitted by ticks. The diagnosis of Lyme borreliosis is based primarily on typical clinical symptoms and signs with serological confirmation. Antibiotic therapy is beneficial for all manifestations and treatment refractory cases are rare. The diagnosis "chronic Lyme borreliosis" is increasingly being misused for all conceivable medically unexplained symptoms.
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Affiliation(s)
- P Herzer
- Internistisch-rheumatologische Schwerpunktpraxis, Tal 6, 80331, München, Deutschland,
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Dessau R, Fingerle V, Gray J, Hunfeld KP, Jaulhac B, Kahl O, Kristoferitsch W, Stanek G, Strle F. The lymphocyte transformation test for the diagnosis of Lyme borreliosis has currently not been shown to be clinically useful. Clin Microbiol Infect 2014; 20:O786-7. [DOI: 10.1111/1469-0691.12583] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 01/27/2014] [Indexed: 11/28/2022]
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Dobler G, Fingerle V, Hagedorn P, Pfeffer M, Silaghi C, Tomaso H, Henning K, Niedrig M. Gefahren der Übertragung von Krankheitserregern durch Schildzecken in Deutschland. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57:541-8. [DOI: 10.1007/s00103-013-1921-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Klier C, Liebl B, Sing A, Wildner M, Fingerle V. LYDI-Sentinel (Sentinel on the Incidence of LYme DIsease in Bavaria) - Etablierung eines Praxisnetzwerks zur Surveillance der Inzidenz von Lyme-Borreliose in Bayern. Gesundheitswesen 2013. [DOI: 10.1055/s-0033-1337555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Scholz HC, Margos G, Derschum H, Speck S, Tserennorov D, Erdenebat N, Undraa B, Enkhtuja M, Battsetseg J, Otgonchimeg C, Otgonsuren G, Nymadulam B, Römer A, Thomas A, Essbauer S, Wölfel R, Kiefer D, Zöller L, Otgonbaatar D, Fingerle V. High prevalence of genetically diverse Borrelia bavariensis-like strains in Ixodes persulcatus from Selenge Aimag, Mongolia. Ticks Tick Borne Dis 2013; 4:89-92. [DOI: 10.1016/j.ttbdis.2012.08.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Revised: 08/07/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
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Albrecht P, Henke N, Lehmann HC, Macht S, Hefter H, Goebels N, Mackenzie C, Rupprecht TA, Fingerle V, Hartung HP, Methner A. A case of relapsing-remitting neuroborreliosis? Challenges in the differential diagnosis of recurrent myelitis. Case Rep Neurol 2012; 4:47-53. [PMID: 22649342 PMCID: PMC3362302 DOI: 10.1159/000337223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report the case of a 31-year-old woman with 4 episodes of myelitis with pleocytosis, a positive Borrelia burgdorferi serology with positive antibody indices, and full recovery each time after antibiotic and steroid treatment, suggesting neuroborreliosis. We nevertheless believe that recurrent neuroborreliosis is improbable based on the levels of the chemokine CXCL13 in cerebrospinal fluid and favor the diagnosis of post-infectious autoimmune-mediated transverse myelitis possibly triggered by an initial neuroborreliosis as the cause of the relapses observed in our patient. We demonstrate the diagnostic steps and procedures which were important in the differential diagnosis of this unusual and challenging case.
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Affiliation(s)
- P Albrecht
- Department of Neurology, Heinrich Heine University, Düsseldorf, Oberschleissheim, Germany
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Huppertz HI, Bartmann P, Heininger U, Fingerle V, Kinet M, Klein R, Korenke GC, Nentwich HJ. Rational diagnostic strategies for Lyme borreliosis in children and adolescents: recommendations by the Committee for Infectious Diseases and Vaccinations of the German Academy for Pediatrics and Adolescent Health. Eur J Pediatr 2012; 171:1619-24. [PMID: 22782450 PMCID: PMC3491193 DOI: 10.1007/s00431-012-1779-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Accepted: 06/11/2012] [Indexed: 12/27/2022]
Abstract
The varying clinical manifestations of Lyme borreliosis, transmitted by Ixodes ricinus and caused by Borrelia burgdorferi, frequently pose diagnostic problems. Diagnostic strategies vary between early and late disease manifestations and usually include serological methods. Erythema migrans is pathognomonic and does not require any further laboratory investigations. In contrast, the diagnosis of neuroborreliosis requires the assessment of serum and cerebrospinal fluid. Lyme arthritis is diagnosed in the presence of newly recognized arthritis and high-titer serum IgG antibodies against B. burgdorferi. The committee concludes the following recommendations: Borrelial serology should only be ordered in case of well-founded clinical suspicion for Lyme borreliosis, i.e., manifestations compatible with the diagnosis. Tests for borrelial genomic sequences in ticks or lymphocyte proliferation assays should not be ordered. When results of such tests or of serological investigations that were not indicated are available, they should not influence therapeutic decisions. Laboratories should be cautious when interpreting results of serological tests and abstain from giving therapeutic recommendations and from proposing retesting after some time without intimate knowledge of patient's history and disease manifestations.
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Affiliation(s)
| | - P. Bartmann
- Department of Neonatology, University Bonn, 53113 Bonn, Germany
| | - U. Heininger
- University Children’s Hospital Basel (UKBB), Spitalstrasse 33, 4056 Basel, Switzerland
| | - V. Fingerle
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Veterinärstr. 2, 85764 Oberschleißheim, Germany
| | - M. Kinet
- Graf-Luckner-Str. 4f, 24159 Kiel, Germany
| | - R. Klein
- Ministerium für Gesundheit und Verbraucherschutz, Referat B1, Ursulinenstraße 8-16, 66111 Saarbrücken, Germany
| | - G. C. Korenke
- Neuropädiatrie, Elisabeth-Kinderkrankenhaus, Rahel-Straus-Straße 10, 26133 Oldenburg, Germany
| | - H. J. Nentwich
- Deutsche Akademie für Kinder- und Jugendmedizin e.V., Chausseestr. 128/129, 10115 Berlin, Germany
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Klempner MS, Halperin JJ, Baker PJ, Shapiro ED, O'Connell S, Fingerle V, Wormser GP. Lyme borreliosis: the challenge of accuracy. Neth J Med 2012; 70:3-5. [PMID: 22271807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A, Kristoferitsch W, O'Connell S, Ornstein K, Strle F, Gray J. Lyme borreliosis: Clinical case definitions for diagnosis and management in Europe. Clin Microbiol Infect 2011; 17:69-79. [DOI: 10.1111/j.1469-0691.2010.03175.x] [Citation(s) in RCA: 402] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Adams NG, Adekambi T, Afeltra J, Aguado J, Aires de Sousa M, Akiyoshi K, Al Hasan M, Ala-Kokko T, Albert M, Alfandari S, Allen D, Allerberger F, Almyroudis N, Alp E, Amin R, Anderson-Berry A, Andes DR, Andremont A, Andreu A, Angelakis M, Antachopoulos C, Antoniadou A, Arabatzis M, Arlet G, Arnez M, Arnold C, Asensio A, Asseray N, Ausiello C, Avni T, Ayling R, Baddour L, Baguelin M, Bányai K, Barbour A, Basco LK, Bauer D, Bayston R, Beall B, Becker K, Behr M, Bejon P, Belliot G, Benito-Fernandez J, Benjamin D, Benschop K, Berencsi G, Bergeron MG, Bernard K, Berner R, Beyersmann J, Bille J, Bizzini A, Bjarnsholt T, Blanc D, Blanco J, Blot S, Bohnert J, Boillat N, Bonomo R, Bonten M, Bordon JM, Borel N, Boschiroli ML, Bosilkovski M, Bosso JA, Botelho-Nevers E, Bou G, Bretagne S, Brouqui P, Brun-Buisson C, Brunetto M, Bucher H, Buchheidt D, Buckling A, Bulpa P, Cambau E, Canducci F, Cantón R, Capobianchi M, Carattoli A, Carcopino X, Cardona-Castro N, Carling PC, Carrat F, Castilla J, Castilletti C, Cavaco L, Cavallo R, Ceccherini-Silberstein F, Centrón D, Chappuis F, Charrel R, Chen M, Chevaliez S, Chezzi C, Chomel B, Chowers M, Chryssanthou E, Ciammaruconi A, Ciccozzi M, Cid J, Ciofu O, Cisneros D, Ciufolini MG, Clark C, Clarke SC, Clayton R, Clementi M, Clemons K, Cloeckaert A, Cloud J, Coenye T, Cohen Bacri S, Cohen R, Coia J, Colombo A, Colson P, Concerse P, Cordonnier C, Cormican M, Cornaglia G, Cornely O, Costa S, Cots F, Craxi A, Creti R, Crnich C, Cuenca Estrella M, Cusi MG, d'Ettorre G, da Cruz Lamas C, Daikos G, Dannaoui E, De Barbeyrac B, De Grazia S, de Jager C, de Lamballerie X, de Marco F, del Palacio A, Delpeyroux F, Denamur E, Denis O, Depaquit J, Deplano A, Desenclos JC, Desjeux P, Deutch S, Di Luca D, Dianzani F, Diep B, Diestra K, Dignani C, Dimopoulos G, Divizia M, Doi Y, Dornbusch HJ, Dotis J, Drancourt M, Drevinek P, Dromer F, Dryden M, Dubreuil L, Dubus JC, Dumitrescu O, Dumke R, DuPont H, Edelstein M, Eggimann P, Eis-Huebinger AM, El Atrouni WI, Entenza J, Ergonul O, Espinel-Ingroff A, Esteban J, Etienne J, Fan XG, Fenollar F, Ferrante P, Ferrieri P, Ferry T, Feuchtinger T, Finegold S, Fingerle V, Fitch M, Fitzgerald R, Flori P, Fluit A, Fontana R, Fournier PE, François M, Francois P, Freedman DO, Friedrich A, Gallego L, Gallinella G, Gangneux JP, Gannon V, Garbarg-Chenon A, Garbino J, Garnacho-Montero J, Gatermann S, Gautret P, Gentile G, Gerlich W, Ghannoum M, Ghebremedhin B, Ghigo E, Giamarellos-Bourboulis E, Girgis R, Giske C, Glupczynski Y, Gnarpe J, Gomez-Barrena E, Gorwitz RJ, Gosselin R, Goubau P, Gould E, Gradel K, Gray J, Gregson D, Greub G, Grijalva CG, Groll A, Groschup M, Gutiérrez J, Hackam DG, Hall WA, Hallett R, Hansen S, Harbarth S, Harf-Monteil C, Hasanjani RMR, Hasler P, Hatchette T, Hauser P, He Q, Hedges A, Helbig J, Hennequin C, Herrmann B, Hezode C, Higgins P, Hoesli I, Hoiby N, Hope W, Houvinen P, Hsu LY, Huard R, Humphreys H, Icardi M, Imoehl M, Ivanova K, Iwamoto T, Izopet J, Jackson Y, Jacobsen K, Jang TN, Jasir A, Jaulhac B, Jaureguy F, Jefferies JM, Jehl F, Johnstone J, Joly-Guillou ML, Jonas M, Jones M, Joukhadar C, Kahl B, Kaier K, Kaiser L, Kato H, Katragkou A, Kearns A, Kern W, Kerr K, Kessin R, Kibbler C, Kimberlin D, Kittang B, Klaassen C, Kluytmans J, Ko WC, Koh WJ, Kostrzewa M, Kourbeti I, Krause R, Krcmery V, Krizova P, Kuijper E, Kullberg BJ, Kumar G, Kunin CM, La Scola B, Lagging M, Lagrou K, Lamagni T, Landini P, Landman D, Larsen A, Lass-Floerl C, Laupland K, Lavigne JP, Leblebicioglu H, Lee B, Lee CH, Leggat P, Lehours P, Leibovici L, Leon L, Leonard N, Leone M, Lescure X, Lesprit P, Levy PY, Lew D, Lexau CA, Li SY, Li W, Lieberman D, Lina B, Lina G, Lindsay JA, Livermore D, Lorente L, Lortholary O, Lucet JC, Lund B, Lütticken R, MacLeod C, Madhi S, Maertens J, Maggi F, Maiden M, Maillard JY, Maira-Litran T, Maltezou H, Manian FA, Mantadakis E, Maragakis L, Marcelin AG, Marchaim D, Marchetti O, Marcos M, Markotic A, Martina B, Martínez J, Martinez JL, Marty F, Maurin M, McGee L, Mediannikov O, Meersseman W, Megraud F, Meletiadis J, Mellmann A, Meyer E, Meyer W, Meylan P, Michalopoulos A, Micol R, Midulla F, Mikami Y, Miller RF, Miragaia M, Miriagou V, Mitchell TJ, Miyakis S, Mokrousov I, Monecke S, Mönkemüller K, Monno L, Monod M, Morales G, Moriarty F, Morosini I, Mortensen E, Mubarak K, Mueller B, Mühlemann K, Muñoz Bellido JL, Murray P, Muscillo M, Mylotte J, Naessens A, Nagy E, Nahm MH, Nassif X, Navarro D, Navarro F, Neofytos D, Nes I, Ní Eidhin D, Nicolle L, Niederman MS, Nigro G, Nimmo G, Nordmann P, Nougairède A, Novais A, Nygard K, Oliveira D, Orth D, Ortiz JR, Osherov N, Österblad M, Ostrosky-Zeichner L, Pagano L, Palamara AT, Pallares R, Panagopoulou P, Pandey P, Panepinto J, Pappas G, Parkins M, Parola P, Pasqualotto A, Pasteran F, Paul M, Pawlotsky JM, Peeters M, Peixe L, Pepin J, Peralta G, Pereyre S, Perfect JR, Petinaki E, Petric M, Pettigrew M, Pfaller M, Philipp M, Phillips G, Pichichero M, Pierangeli A, Pierard D, Pigrau C, Pilishvili T, Pinto F, Pistello M, Pitout J, Poirel L, Poli G, Poppert S, Posfay-Barbe K, Pothier P, Poxton I, Poyart C, Pozzetto B, Pujol M, Pulcini C, Punyadeera C, Ramirez M, Ranque S, Raoult D, Rasigade JP, Re MC, Reilly JS, Reinert R, Renaud B, Rice L, Rich S, Richet H, Rigouts L, Riva E, Rizzo C, Robotham J, Rodicio MR, Rodriguez J, Rodriguez-Bano J, Rogier C, Roilides E, Rolain JM, Rooijakkers S, Rooney P, Rossi F, Rotimi V, Rottman M, Roux V, Ruhe J, Russo G, Sadowy E, Sagel U, Said SI, Saijo M, Sak B, Sa-Leao R, Sanders EAM, Sanguinetti M, Sarrazin C, Savelkoul P, Scheifele D, Schmidt WP, Schønheyder H, Schönrich G, Schrenzel J, Schubert S, Schwarz K, Schwarz S, Sefton A, Segondy M, Seifert H, Seng P, Senneville E, Sexton D, Shafer RW, Shalit I, Shankar N, Shata TM, Shields J, Sibley C, Sicinschi L, Siljander T, Simitsopoulou M, Simoons-Smit AM, Sissoko D, Sjögren J, Skiada A, Skoczynska A, Skov R, Slack M, Sogaard M, Sola C, Soriano A, Sotto A, Sougakoff W, Sougakoff W, Souli M, Spelberg B, Spelman D, Spiliopoulou I, Springer B, Stefani S, Stein A, Steinbach WJ, Steinbakk M, Strakova L, Strenger V, Sturm P, Sullivan P, Sutton D, Symmons D, Tacconelli E, Tamalet C, Tang JW, Tang YW, Tattevin P, Thibault V, Thomsen RW, Thuny F, Tong S, Torres C, Townsend R, Tristan A, Trouillet JL, Tsai HC, Tsitsopoulos P, Tuerlinckx D, Tulkens P, Tumbarello M, Tureen J, Turnidge JD, Turriziani O, Tutuian R, Uçkay I, Upton M, Vabret A, Vamvakas EC, van den Boom D, Van Eldere J, van Leeuwen W, van Strijp J, Van Veen S, Vandamme P, Vandenesch F, Vayssier M, Velin D, Venditti M, Venter M, Venuti A, Vergnaud G, Verheij T, Verhofstede C, Viscoli C, Vizza CD, Vogel U, Waller A, Wang YF, Warn P, Warris A, Wauters G, Weidmann M, Weill FX, Weinberger M, Welch D, Wellinghausen N, Wheat J, Widmer A, Wild F, Willems R, Willinger B, Winstanley C, Witte W, Wolff M, Wong F, Wootton M, Wyllie D, Xu W, Yamamoto S, Yaron S, Yildirim I, Zaoutis T, Zazzi M, Zbinden R, Zehender GG, Zemlickova H, Zerbini ML, Zhang L, Zhang Y, Zhao YD, Zhu Z, Zimmerli W. ACKNOWLEDGEMENT OF REVIEWERS. Clin Microbiol Infect 2011. [DOI: 10.1111/j.1469-0691.2010.03428.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Neuroborreliosis is easily diagnosed by means of clinical symptoms and laboratory findings. Guiding symptoms are radicular pain and pareses of the extremities and the facial nerve. There is a great number of further less frequently occurring neurological symptoms, which can be attributed to a borrelial infection only by appropriate investigations of the CSF. Radiculitis is cured adequately by oral doxycycline while symptoms of the central nervous system are probably better treated intravenously by ceftriaxone, cefotaxime or penicillin G. Post-Lyme syndrome is a diffuse description of non-specific complaints, which are not the explicit result of a former infection with B. burgdorferi. As further antibiotics do not help and the CSF is unremarkable in most patients, a persistent infection with B. burgdorferi s.l. in all probability can be excluded.
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Affiliation(s)
- R Kaiser
- Neurologische Klinik, Klinikum Pforzheim, Kanzlerstrasse 2-6, 75175, Pforzheim, Deutschland.
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Mygland A, Ljøstad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol 2009; 17:8-16, e1-4. [PMID: 19930447 DOI: 10.1111/j.1468-1331.2009.02862.x] [Citation(s) in RCA: 410] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- A Mygland
- Department of Neurology, Sorlandet Sykehus, Kristiansand, Norway.
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Wormser GP, Shapiro ED, Halperin JJ, Porwancher RB, O'Connell S, Nadelman RB, Strle F, Radolf JD, Hovius JWR, Baker PJ, Fingerle V, Dattwyler R. Analysis of a flawed double-blind, placebo-controlled, clinical trial of patients claimed to have persistent Lyme disease following treatment. Minerva Med 2009; 100:171-172. [PMID: 19390504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Fingerle V. [What is the value of a rapid tick test for borrelia (interview by Dr. Judith Neumaier)]. MMW Fortschr Med 2008; 150:6. [PMID: 19006886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Fingerle V, Huppertz HI. Lyme-Borreliose im Kindes- und Jugendalter. Hautarzt 2007; 58:541-50, quiz 551-2. [PMID: 17729432 DOI: 10.1007/s00105-007-1350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In Europe, Lyme borreliosis is the most common disease communicated by ticks and especially affects the skin, nervous system, joints, and heart. It is caused by at least four species of the spirochete Borrelia burgdorferi. The various pathologies are classified as early forms (erythema migrans, borrelia lymphocytom, early neuroborreliosis, carditis) or late forms (arthritis, acrodermatitis chronica atrophicans, chronic neuroborreliosis). The accuracy of serodiagnosis is 20-50% with erythema migrans, 70-90% with early neuroborreliosis, and nearly 100% with Lyme arthritis. Following special indications, the agent is confirmed by skin biopsy or spinal or joint puncture. Oral therapy is performed with amoxicillin, doxycycline, and cefuroxime, and intravenous therapy uses ceftriaxone, cefotaxime, or penicillin G. All in all, the prognosis of treated Lyme borreliosis is good. In childhood permanent defects are extremely rare, even following long-term manifestation at an early age.
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Affiliation(s)
- V Fingerle
- Nationales Referenzzentrum für Borrelien, Max-von-Pettenkofer-Institut, Ludwig-Maxmillians-Universität München.
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Fingerle V, Schulte-Spechtel U, Ruzic-Sabljic E, Strle F, Leonhard S, Hoffmann H, Weber K, Pfister K, Wilske B. P1502 Epidemiological aspects of Borrelia spielmanii from Germany with special respect to its genetic heterogeneity. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71341-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rupprecht T, Fingerle V, Kirschning C, Koedel U, Pfister HW. Das Chemokin CXCL13 als Biomarker für die Neuroborreliose. Akt Neurol 2007. [DOI: 10.1055/s-2007-987467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
The definitive diagnosis of acute neuroborreliosis (NB) is based upon the presence of lymphomonocytic CSF pleocytosis and intrathecal Borrelia burgdorferi (B.b.)-specific antibody production (expressed by an antibody index of >2). However, the latter might be absent in early stages of the disease. Now a recently discovered additional CSF marker-the cytokine CXCL13-was found to be positive in every initial CSF sample from patients with NB and therefore could be a valuable tool for early diagnosis and initiation of antibiotic therapy. We report an unusual case of NB in a patient with a history of metastatic carcinoma of the prostate and unilateral polyradiculitis. While no intrathecal B.b.-specific antibody production could be demonstrated initially, the CSF CXCL13 level was high (>500 ng/g vs <1.7 ng/g in healthy controls). During the course of the disease, the antibody index turned positive (4.8) and the patient responded to antibiotic therapy, thus confirming the diagnosis. In this case, measuring CXCL13 in the CSF would have led to earlier diagnosis and treatment of NB.
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Kowalski J, Hopfenmüller W, Fingerle V, Malberg H, Eisenblätter M, Wagner J, Miksits K, Hahn H, Ignatius R. Seroprevalence of human granulocytic anaplasmosis in Berlin/Brandenburg, Germany: an 8-year survey. Clin Microbiol Infect 2006; 12:924-7. [PMID: 16882301 DOI: 10.1111/j.1469-0691.2006.01490.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigated the seroprevalence of antibodies against Anaplasma phagocytophilum in Berlin/Brandenburg, north-eastern Germany. During 1994-2001, 422 sera from patients with proven tick-exposure (specimens with antibodies against Borrelia burgdorferi) were compared with 249 control sera. Using indirect fluorescent antibody testing, significantly more positive samples were detected among Borrelia antibody-positive specimens (4.5%, 95% CI 2.5-6.5%) than among controls (1.2%, 95% CI 0.5-1.9%; p < 0.05). While six (2.2%, 95% CI 1.3-3.1%) samples were positive among Borrelia antibody-positive sera between 1994 and 1997, 13 (8.7%, 95% CI 6.9-10.5%) were positive between 1998 and 2001 (p < 0.01), indicating an uneven annual seroprevalence.
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Affiliation(s)
- J Kowalski
- Department of Medical Microbiology and Infection Immunology, Charité-University Medicine, Berlin, Germany
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Abstract
As a rule, the tick, Ixodes ricinus, is picked up when its victim walks through low vegetation and brushes it off a leaf or blade of grass. Often hours later, the tick scores the skin at the site it selects and then pushes its barbed hypostome into the tiny wound to anchor itself to its victim with the aid of a cement-like substance and the barbs. While it sucks up blood, Borrelia burgdorferi spirochetes pass out of the tick's intestine into its salivary glands and thence into the host. It is therefore of decisive importance that the tick be removed with a special forceps as early as possible. The use of such substances as glue, alcohol or nail varnish to remove the tick must be discouraged. Currently, antibiotic prophylaxis, examination of the tick for the presence of B. burgdorferi, or serological follow-up tests are not recommended.
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Affiliation(s)
- V Fingerle
- Nationales Referenzzentrum für Borrelien, Max v. Pettenkofer Institut, LMU München.
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Fingerle V, Wilske B. [Stage-oriented treatment of Lyme borreliosis]. MMW Fortschr Med 2006; 148:39-41. [PMID: 16859159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Every manifestation of Lyme borreliosis needs to be treated with antibiotics. The type of antibiotic applied and duration of treatment will depend on the stage and severity of the disease. Erythema migrans, Borrelia lymphocytoma, Lyme arthritis and acrodermatitis chronica atrophicans are primarily treated orally. If neurological symptoms, severe Lyme carditis or eye manifestations are present, intravenous treatment is initially recommended. For oral therapy, doxycycline, amoxicillin, cefuroxime and, if intolerance is shown, azithromycin, are available. For intravenous treatment ceftriaxone, cefotaxime or penicillin G is employed. The overall prognosis for treated Lyme borreliosis is good. However, in particular when manifestations with substantial organic injury have persisted, incomplete healing must be expected. With the exception of erythema migrans, every manifestation should be subjected to a careful diagnostic work-up prior to the start of treatment, because premature antibiotic administration is not only associated with an elevated risk for the patient, but can also mask important diagnostic signs.
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Affiliation(s)
- V Fingerle
- Nationales Referenzzentrum für Borrelien, Max v. Pettenkofer Institut, LMU München.
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Fingerle V. IXODES RICINUS: CHARACTERISTICS, ECOLOGY, AND DYNAMICS OF THE POPULATIONS IN CONNECTION WITH CLIMATIC CHANGES. Microbiol Med 2005. [DOI: 10.4081/mm.2005.3408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Fingerle V, Michel H, Hettche G, Hizo-Teufel C, Wilske B. Borrelia burgdorferi s.l. OspA-types are widespread in Bavaria but show distinct local patterns. Int J Med Microbiol 2004; 293 Suppl 37:165-6. [PMID: 15147001 DOI: 10.1016/s1433-1128(04)80032-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- V Fingerle
- Max von Pettenkofer Institut, LMU Munich, Germany.
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