Isolation of Borrelia burgdorferi Sensu Lato from Blood of Patients with Erythema Migrans

Maraspin, Vera; Ružić‐Sabljić, Eva; Cimperman, J; Lotrič‐Furlan, Stanka; Jurca, Tomaž; Picken, Roger N.; Strle, Franc

doi:10.1007/s15010-001-0154-6

Cited by 32 publications

(39 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We had expected to isolate more borrelia strains, although, in Europe, the recovery rate has generally been low (Ͻ10% in patients with early Lyme borreliosis manifested by erythema migrans) using volumes of blood similar to those in the present study (1,19). The explanations for the low recovery rate could be the same as those for the low proportion of positive PCR findings in blood (4,12,13).…”

Section: Discussionmentioning

confidence: 50%

Validation of Cultivation and PCR Methods for Diagnosis of Lyme Neuroborreliosis

et al. 2008

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 50%

Validation of Cultivation and PCR Methods for Diagnosis of Lyme Neuroborreliosis

et al. 2008

View full text Add to dashboard Cite

“…Borrelia species of the corresponding isolate pairs were identical in 47 out of 50 (94%) patients, while in 3/50 (6%) patients the species were divergent. The concurrent presence of various Borrelia species in an individual host has been described previously (15,21,30,47,49). The majority of such mixed infections were demonstrated by PCR, which directly amplifies borrelial DNA in the sample, while as a rule only one species appeared after culturing the sample (18, 24, 25, 29-31, 47, 49).…”

Section: Discussionmentioning

confidence: 67%

“…A large majority of these 50 patients with Lyme borreliosis included in the study presented with solitary or multiple erythema migrans (39/50, 78%), which are two main clinical signs of Borrelia infection in Slovenia (1, 40, 41) and elsewhere (3,19,21,38,39,47 (15,21,31,47). In order to analyze the isolated Borrelia strains and to determine the degree of similarity between and within the isolated strain pairs, several typing methods were used in this study, including PFGE for species identification and plasmid profile determination and protein profile electrophoresis for the assessment of the molecular masses of separated proteins.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Borrelia burgdorferi Sensu Lato Strains Isolated from Specimens Obtained Simultaneously from Two Different Sites of Infection in Individual Patients

et al. 2005

View full text Add to dashboard Cite

The aim of the present study was to analyze and compare Borrelia strains isolated from two different specimens obtained simultaneously from individual patients with Lyme borreliosis. Fifty such patients and 50 corresponding pairs of Borrelia isolates (100 low-propagated strains) were subjected to genotypic and phenotypic analysis, including pulsed-field gel electrophoresis for species identification and plasmid profile determination and protein profile electrophoresis for the assessment of the presence and molecular masses of separated proteins. The strains were isolated from two distinct skin lesions (12 patients), skin and blood (28 patients), skin and cerebrospinal fluid (8 patients), and blood and cerebrospinal fluid (2 patients). Out of 100 isolates, 63 were typed as B. afzelii and 37 as B. garinii. From each individual specimen only a single Borrelia species was cultured. Comparison of 50 Borrelia strain pairs isolated from two different specimens of an individual patient revealed that 12/50 (24%) patients were simultaneously infected with two different Borrelia strains; in 3/50 (6%) patients strains differed at the species level, in 4 out of the remaining 47 (9%) patients a strain difference in plasmid profile was established, while 5 out of the remaining 43 (11%) patient strain pairs differed in regard to the protein profiles of the two concurrently isolated strains. The results of the present study indicate that human patients with Lyme borreliosis may simultaneously harbor different B. burgdorferi sensu lato strains.

show abstract

“…B. burgdorferi sensu lato can be recovered from various tissues and body fluids of patients with LB, including biopsy (14,25,31,140,165,178,200,204,209,214,221,227,237,256,267,303,327,333,342,369) and lavage (369) specimens of EM skin lesions, biopsy specimens of ACA skin lesions (14,258,267,342), biopsy specimens of borrelial lymphocytoma skin lesions (188), cerebrospinal fluid specimens (60,147,237,267,342), and blood specimens (13,22,189,216,221,322,367,368,374). Anecdotally, recovery of B. burgdorferi sensu lato from other tissue or fluid specimens (189), such as synovial fluid (289), cardiac tissue (312), and iris (265), has also been reported.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…Unfortunately, high-volume plasma cultures are not appropriate for young children, since obtaining such a large quantity of blood would be unacceptable. Reported rates of recovery from blood of patients with EM in Europe have been Ͻ10% (13,189). This may be due to a low frequency of hematogenous dissemination of B. afzelii, the principal cause of EM in Europe (351), or to culturing an inadequate volume of blood.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Diagnosis of Lyme Borreliosis

et al. 2005

View full text Add to dashboard Cite

A large amount of knowledge has been acquired since the original descriptions of Lyme borreliosis (LB) and of its causative agent, Borrelia burgdorferi sensu stricto. The complexity of the organism and the variations in the clinical manifestations of LB caused by the different B. burgdorferi sensu lato species were not then anticipated. Considerable improvement has been achieved in detection of B. burgdorferi sensu lato by culture, particularly of blood specimens during early stages of disease. Culturing plasma and increasing the volume of material cultured have accomplished this. Further improvements might be obtained if molecular methods are used for detection of growth in culture and if culture methods are automated. Unfortunately, culture is insensitive in extracutaneous manifestations of LB. PCR and culture have high sensitivity on skin samples of patients with EM whose diagnosis is based mostly on clinical recognition of the lesion. PCR on material obtained from extracutaneous sites is in general of low sensitivity, with the exception of synovial fluid. PCR on synovial fluid has shown a sensitivity of up to >90% (when using four different primer sets) in patients with untreated or partially treated Lyme arthritis, making it a helpful confirmatory test in these patients. Currently, the best use of PCR is for confirmation of the clinical diagnosis of suspected Lyme arthritis in patients who are IgG immunoblot positive. PCR should not be used as the sole laboratory modality to support a clinical diagnosis of extracutaneous LB. PCR positivity in seronegative patients suspected of having late manifestations of LB most likely represents a false-positive result. Because of difficulties in direct methods of detection, laboratory tests currently in use are mainly those detecting antibodies to B. burgdorferi sensu lato. Tests used to detect antibodies to B. burgdorferi sensu lato have evolved from the initial formats as more knowledge on the immunodominant antigens has been collected. The recommendation for two-tier testing was an attempt to standardize testing and improve specificity in the United States. First-tier assays using whole-cell sonicates of B. burgdorferi sensu lato need to be standardized in terms of antigen composition and detection threshold of specific immunoglobulin classes. The search for improved serologic tests has stimulated the development of recombinant protein antigens and the synthesis of specific peptides from immunodominant antigens. The use of these materials alone or in combination as the source of antigen in a single-tier immunoassay may someday replace the currently recommended two-tier testing strategy. Evaluation of these assays is currently being done, and there is evidence that certain of these antigens may be broadly cross-reactive with the B. burgdorferi sensu lato species causing LB in Europe

show abstract

Isolation of Borrelia burgdorferi Sensu Lato from Blood of Patients with Erythema Migrans

Abstract: In European patients with erythema migrans the yield of blood culturing was low, spirochetemia was often clinically silent and the course and outcome of the illness were favorable; the predominantly isolated strain was B. afzelii.

Cited by 32 publications

References 27 publications

Validation of Cultivation and PCR Methods for Diagnosis of Lyme Neuroborreliosis

Validation of Cultivation and PCR Methods for Diagnosis of Lyme Neuroborreliosis

Comparison of Borrelia burgdorferi Sensu Lato Strains Isolated from Specimens Obtained Simultaneously from Two Different Sites of Infection in Individual Patients

Diagnosis of Lyme Borreliosis

Contact Info

Product

Resources

About