Demonstration of Borrelia burgdorferi DNA in urine samples from healthy humans whose sera contain B. burgdorferi-specific antibodies

Abstract

Since the possibility of asymptomatic infection with Borrelia burgdorferi has been suggested by a positive serology found in healthy subjects, we hypothesized that these subjects might excrete borrelial DNA sequences in urine as happens in patients with Lyme borreliosis. We found borrelial sequences by nested PCR in the urine samples from 3 of 13 healthy B. burgdorferi antibody-positive adults but not in urine samples from 79 antibody-negative healthy controls. After therapy with doxycycline, the urine samples were repeatedly negative for B. burgdorferi DNA. We conclude that urinary excretion of borrelial DNA sequences may occur in seropositive healthy subjects during asymptomatic infection. Demonstration of such sequences in urine must be interpreted cautiously and may not necessarily prove a borrelial cause of disease.

PCR in laboratory diagnosis of human Borrelia burgdorferi infections

“…The effect of treatment correlates well with a PCR study of blood donors (79). Three patients with urine positive in PCR were found among 13 seropositive healthy adult blood donors.…”

“…In addition to reports summarized in Table 7, B. burgdorferi DNA was detected by PCR in blood (189), SF (140,165), CSF (101), and urine (52,79,105,155,189) of patients with LA. Maiwald et al (105) found that 11 of 15 patients with LA (1 with arthralgia and a typical history of a tick bite and EM, 9 with arthritis as a major symptom with other etiologies ruled out, and 5 with arthritis in combination with other manifestations) were reactive on tests of urine by a PCR that amplified a 259-bp fragment of the 23S rRNA gene (161).…”

“…Maiwald et al (105) found that 11 of 15 patients with LA (1 with arthralgia and a typical history of a tick bite and EM, 9 with arthritis as a major symptom with other etiologies ruled out, and 5 with arthritis in combination with other manifestations) were reactive on tests of urine by a PCR that amplified a 259-bp fragment of the 23S rRNA gene (161). A flagellinspecific DNA could be amplified in urine from 9 of 24 (37.5%) patients with LA, but no further details of the patients are given (79).…”

Diagnostic Value of PCR for Detection ofBorrelia burgdorferiin Skin Biopsy and Urine Samples from Patients with Skin Borreliosis

“…In different studies, the rates of detection of borrelial DNA by PCR have ranged from 11 to 100% for urine samples from patients with neuroborreliosis (2,6,18,19,22,34), from 38 to 60% for patients with Lyme arthritis (19,34), and from 44 to 49% for patients with active LB (11,23). We were not able to confirm the presence of borrelial DNA in the urine of patients with early-stage localized or late-stage skin borreliosis.…”

“…Recently, promising results were published about the detection of borrelial DNA in the urine of patients with neuroborreliosis and Lyme arthritis (2,6,34,42). However, the diagnostic value of urine PCR in early infection is still unclear, and published results are controversial (18,19,22,23).…”