A LightCycler-based PCR protocol was developed which targets the ospA gene for the identification and quantification of the different Borrelia burgdorferi sensu lato species in culture and in ticks, based on the use of a fluorescently labeled probe (HybProbe) and an internally labeled primer. The detection limit of the PCR was 1 to 10 spirochetes. A melting temperature determined from the melting curve of the amplified product immediately after thermal cycling allowed the differentiation of the three different B. burgdorferi sensu lato genospecies (B. burgdorferi sensu stricto, Borrelia garinii, and Borrelia afzelii) that are clinically relevant in Europe in a single PCR run. This method represents a simplified approach to study the association of different Borrelia species in ticks, the risk of Lyme borreliosis, and the putatively species-specific clinical sequelae. To determine the reliability of the real-time PCR protocol, we studied the prevalence of B. burgdorferi sensu lato infection in Ixodes ricinus ticks. A total of 1,055 ticks were collected by flagging vegetation in five different sites in the region of Konstanz (south Germany) and were examined for the distribution of B. burgdorferi species by real-time PCR. The mean infection rate was 35%. Of 548 adult ticks, 40% were positive, and of 507 nymphs, 30% were positive. The predominant genospecies (with 18% mixed infections) in the examined areas was B. afzelii (53%), followed by B. garinii (18%) and B. burgdorferi sensu stricto (11%); 0.8% of the infecting Borrelia could not be identified. (24) and the United States (25)-is a complex multisystem disorder caused by Borrelia burgdorferi sensu lato, a group of genetically diverse spirochetes. The principal vectors of these spirochetes are ticks belonging to the genus Ixodes (2).
Lyme borreliosis (LB)-the most common arthropod-borne infection in EuropeThe development of an erythema migrans rash at the site of the tick bite often characterizes the onset of LB. If left untreated, the infection can persist for years and may result in a range of clinical symptoms, which vary depending on the duration of the infection and the organs affected.Isolates of B. burgdorferi sensu lato can be classified into different genomic species (1, 11). Only one of them, B. burgdorferi sensu stricto, has been implicated as the cause of disease in North America, but in Europe three genospecies, Borrelia afzelii, Borrelia garinii, and B. burgdorferi sensu stricto, are known to be pathogenic, and still others, such as Borrelia valaisiana and Borrelia lusitaniae, have been identified but are of unknown pathogenicity (7). Coinfections by two or more genomic groups of B. burgdorferi sensu lato have been found in ticks (13,14) and patients with LB (5).There is strong evidence that different species are involved in distinct clinical manifestations of the disease (28). Different studies have presented indirect evidence for the association of B. garinii with predominantly neurological symptoms (5), while infections by B. burgdorferi sensu ...