Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis

Schmidt, B; Aberer, Elisabeth; Stockenhuber, C; Klade, H; Breier, Friedrich; Luger, A.

doi:10.1016/0732-8893(95)00027-8

Cited by 64 publications

(69 citation statements)

References 36 publications

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“…By using specially designed outer primers, up to 10 3 -fold-lower concentrations of B. burgdorferi DNA could be detected, compared with those detected by standard PCR methods (97). Using this nested PCR on urine specimens, 27 of 36 untreated patients with EM (75%) were found to have reactive specimens (156).…”

Section: Target Selectionmentioning

confidence: 97%

“…Contamination problems can be overcome by strictly following published precautions for avoiding false-positive results (90,155). However, one must consider that all published studies with nested PCR have been performed in specialized, mostly research laboratories, and up to now companies selling PCR kits for the detection of pathogens have avoided using this technique in their assays.…”

Section: Selection Of the Pcr Methodsmentioning

confidence: 99%

“…Most researchers in the United States have used the genes coding for the outer surface proteins, the ospA and ospB genes, which are located on a linear plasmid (Table 1). These genes are known to be highly variable (191) and have been found not to amplify all strains isolated in Europe (31,84,122,137,156). Although more than 20 different gene segments were amplified, only a few direct comparisons have been published.…”

Section: Target Selectionmentioning

confidence: 99%

“…Direct comparison of PCR results with different primers are given in a few studies with SF (22,78,107,123,134), CSF (32,101), urine (32,156), and skin biopsy (35,186) specimens. PCR results with chromosomal primers in SF were less sensitive than were results with plasmid primers, despite a similar analytical sensitivity (123,134).…”

Section: Primer Selectionmentioning

confidence: 99%

“…An increased sensitivity of PCR in clinical samples has always been achieved with a nested PCR assay. By carefully following guidelines (see the section on primer selection below), the annealing temperature could be increased from 52ЊC (155) to 55ЊC (158), resulting in a better performance. A chromosomal gene (clone 2H1) has been found to be conserved in American strains (146).…”

Section: Target Selectionmentioning

confidence: 99%

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Methodological Aspects

1985

Journal of Internal Medicine

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Section: Target Selectionmentioning

confidence: 97%

Section: Selection Of the Pcr Methodsmentioning

confidence: 99%

Section: Target Selectionmentioning

confidence: 99%

Section: Primer Selectionmentioning

confidence: 99%

Section: Target Selectionmentioning

confidence: 99%

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Methodological Aspects

1985

Journal of Internal Medicine

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Amplification of DNA of Borrelia burgdorferi in Urine Samples of Patients With Granuloma Annulare and Lichen Sclerosus et Atrophicus

Aberer¹

1999

Archives of Dermatology

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Efficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme Borreliosis

et al. 2018

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IMPORTANCE Controversies about the choice of antibiotic agent and treatment modality exist in the management of erythema migrans in early cutaneous Lyme borreliosis (LB). OBJECTIVE To conduct a network meta-analysis (NMA) of all randomized clinical trials on various antibiotic agents and treatment modalities in early cutaneous LB. DATA SOURCES Electronic searches in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were conducted from inception until July 2017. The reference lists of the included studies were hand searched, authors were contacted, and ongoing trials were searched at ClinicalTrials.gov. STUDY SELECTION One reviewer screened the titles and abstracts of the 9975 reports identified by the electronic searches. Full-text copies of 161 potentially relevant articles were obtained, and 2 reviewers independently assessed those articles for inclusion. Adults with a physician-confirmed early localized skin infection who were treated with antibiotics of any dose or duration were included. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data on study, patient, and intervention characteristics. Network meta-analyses on treatment effects and adverse outcomes were calculated with a frequentist approach using the R package netmeta. The Grading of Recommendations Assessment, Development and Evaluation guidance for NMA was used to assess the certainty of evidence. MAIN OUTCOMES AND MEASURES Treatment effects for response to treatment (resolution of symptoms) and treatment-related adverse events. RESULTS Overall, 19 studies (2532 patients) were included. The mean patient age ranged between 37 and 56 years, and the percentage of female patients ranged from 36% to 60%. The antibiotics investigated were doxycycline, cefuroxime axetil, ceftriaxone, amoxicillin, azithromycin, penicillin V, and minocycline. Pooled effect sizes from NMAs did not suggest any significant differences in treatment response by antibiotic agent (eg, amoxicillin vs doxycycline odds ratio, 1.26; 95% CI, 0.41-3.87), dose, or duration (eg, doxycycline, 200 mg/d for 3 weeks, vs doxycycline, 200 mg/d for 2 weeks, odds ratio, 1.28; 95% CI, 0.49-3.34). Treatment failures were rare at both 2 months (4%; 95% CI, 2%-5%) and 12 months (2%, 95% CI, 1%-3%) after treatment initiation. There were also no differences in the effect sizes among antibiotic agents and treatment modalities for treatment-related adverse outcomes, which were generally mild to moderate. Certainty of evidence was categorized as low and very low mostly because of imprecision, indirectness, and study limitations (high risk of bias) of the included studies. CONCLUSIONS AND RELEVANCE This NMA suggests that neither the antibiotic agent nor treatment modality contributed to comparative effectiveness or drug-related adverse outcomes. This finding is relevant for physicians treating patients with LB and for patient decision making.

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Detection of Borrelia burgdorferi DNA by polymerase chain reaction in the urine and breast milk of patients with Lyme borreliosis

Cited by 64 publications

References 36 publications

Methodological Aspects

Methodological Aspects

Amplification of DNA of Borrelia burgdorferi in Urine Samples of Patients With Granuloma Annulare and Lichen Sclerosus et Atrophicus

Efficacy and Safety of Antibiotic Therapy in Early Cutaneous Lyme Borreliosis

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