Microbiological and serological diagnosis of Lyme borreliosis

Abstract

In Europe, Lyme borreliosis is caused by Borrelia burgdorferi sensu stricto, B. afzelii, B. garinii and the recently described species B. spielmanii. For the development of diagnostic tools, the heterogeneity of the causative agents must be considered. The serological diagnosis should follow the principle of a two-step procedure: a sensitive enzyme-linked immunosorbent analysis as the first step, followed by immunoblot (IgM and IgG) if reactive. The sensitivity and standardization of immunoblots have been enhanced by the use of recombinant antigens instead of whole cell lysates. Improved sensitivity has resulted from the use of recombinant proteins primarily expressed in vivo (e.g. VlsE) and the combination of homologous proteins from different strains (e.g. DbpA). At present, detection rates for serum antibodies are 20-50% in localized, 70-90% in disseminated early and nearly 100% in late disease. Detection of the borreliae by culture or PCR should be confined to specific indications. The best results are obtained from skin biopsies (50-70% with culture or PCR) and synovial tissue or fluid (50-70% with PCR). Cerebrospinal fluid is positive in only 10-30%. Methods that are not recommended for diagnostic purposes include antigen tests in body fluids, PCR of urine and lymphocyte transformation tests.

Chronic Lyme Disease: A Review

“…It should be noted however, that B. burgdorferi culture and PCR have low sensitivity in most body fluids from patients with Lyme disease [56,57]. The initial report claiming frequent isolation of B. burgdorferi from patients with post-Lyme disease syndrome using MPM media [58] has not been reproduced by other researchers [49,59,60].…”

Prevalence of antibodies to Borrelia burgdorferi sensu stricto in humans from a Cuban village

“…5 Therefore, in our study, people with positive blots suggest previous contact with the infectious agent, since antibodies persist long time after the original infection. The estimated seroprevalence interval in the studied population is relatively low.…”

Part I. Zoonozis – Tick-Borne Diseases Tick-Borne Bacterial Diseases in Poland

“…So far, the role of only OspA, OspB, OspC, and decorin binding proteins DbpA and DbpB, which also occur on the outer membrane, has been described. All these proteins are encoded on plasmids, and their expression depends on the conditions in which the bacterium is located [4,5,6].…”

“…In 2000, an international group of experts published recommendations for proper laboratory diagnostics of Lyme borreliosis (www. dghm.org/red/index.html?cname=MIQ), which are regularly reviewed and updated [4,5,6 ].…”