The Performance of Nine Commercial Serological Screening Assays for the Diagnosis of Lyme Borreliosis: a Multicenter Modified Two-Gate Design Study

Hoeve-Bakker, B. J. A.; Jonker, M.; Brandenburg, A. H.; Reijer, P Martijn den; Stelma, F.F.; Dam, Alje P. van; Gorkom, Tamara van; Kerkhof, Karen; Thijsen, Steven; Kremer, Kristin

doi:10.1128/spectrum.00510-22

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…Additionally, although IgG is generally the isotype tested for in seroprevalence studies [6,24], immunoblot confirmation using IgM was also included in this study. The inevitably observed IgM-only seropositive results may be explained by (i) early infection at the time of sampling, (ii) abrogated isotype-switching due to spirochetal clearance from effective antibiotic treatment [26,27], (iii) persistent IgM response [28] or (iv) false-positive reaction due to cross-reacting IgM antibodies [23,29].…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence and Risk Factors of Lyme Borreliosis in The Netherlands: A Population-Based Cross-Sectional Study

et al. 2023

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Lyme borreliosis (LB) is not notifiable in many European countries, and accurate data on the incidence are often lacking. This study aimed to determine the seroprevalence of Borrelia burgdorferi sensu lato (s.l.)-specific antibodies in the general population of The Netherlands, and to determine risk factors associated with seropositivity. Sera and questionnaires were obtained from participants (n = 5592, aged 0–88 years) enrolled in a nationwide serosurveillance study. The sera were tested for B. burgdorferi s.l.-specific IgM and IgG antibodies using ELISA and immunoblot. Seroprevalence was estimated controlling for the survey design. Risk factors for seropositivity were analyzed using a generalized linear mixed-effect model. In 2016/2017, the seroprevalence in The Netherlands was 4.4% (95% CI 3.5–5.2). Estimates were higher in men (5.7% [95% CI 4.4–7.2]) than in women (3.1% [95% CI 2.0–4.0]), and increased with age from 2.6% (95% CI 1.4–4.4) in children to 7.7% (95% CI 5.9–7.9) in 60- to 88-year-olds. The seroprevalence for B. burgdorferi s.l. in the general population in The Netherlands was comparable to rates reported in European countries. The main risk factors for seropositivity were increasing age, being male and the tick bite frequency. The dynamics of LB infection are complex and involve variables from various disciplines. This could be further elucidated using infectious disease modelling.

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Section: Discussionmentioning

confidence: 99%

Seroprevalence and Risk Factors of Lyme Borreliosis in The Netherlands: A Population-Based Cross-Sectional Study

et al. 2023

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“…The results of CLIA were expressed using the antibody index calculated as the ratio between the sample Relative Light Unit (RLU) and the calibrator RLU. The VirClia ® IgG assay showed sensitivity ranging from 79% to 95.9% and specificity from 93.8% to 97.9% on C. burnetii , B. henselae and Borrelia spp., agreeing when compared with both ELISA and IFA testing [ 28 – 30 ]. Results were interpreted according to the manufacturer’s instructions.…”

Section: Methodsmentioning

confidence: 84%

Seroprevalence of vector-borne pathogens in outdoor workers from southern Italy and associated occupational risk factors

et al. 2022

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Background Vector-borne diseases (VBDs) represent an emerging global threat to public health due to the geographical expansion of arthropod vectors. The study aims to assess the seroprevalence of selected vector-borne pathogens (VBPs) in different groups of outdoor workers and the occupational risk factors for exposure to arthropod bites. Methods A cross-sectional study was conducted on 170 workers recruited in two different regions of southern Italy, including farmers, forestry workers, veterinarians, geologists/agronomists and administrative employees, and tested for IgG antibodies against Bartonella henselae, Borrelia spp. Coxiella burnetii and Rickettsia conorii, using a chemiluminescent immunoassay (CLIA). The relationship among job characteristics, tick exposure and the prevalence of seropositive subjects for each pathogen was investigated by applying categorical principal component analysis (CATPCA). Results A high seroprevalence for C. burnetii (30.0%) and R. conorii (15.3%) was reported, mainly in farmers (67.7% and 54.8%, respectively) and forestry workers (29.0% and 16.1%, respectively), while a low prevalence was observed for B. henselae and Borrelia spp. (8.8% and 4.1%, respectively). The regression equation by CATPCA was significant for C. burnetii and R. conorii (P < 0.001), showing a positive association with job, tick bite exposure, working area and contact with animals. Conclusions These findings highlight the need of activating an appropriate occupational health response for minimizing the risk of arthropod vector exposure in workplaces, considering specific preventive measures in particular in high-risk job categories. Graphical Abstract

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“…The specific IgM class antibody is present in the blood of the infected individual from 3 weeks to 6 months after a tick bite, while the IgG class antibody appears after 6 weeks and can appear in the blood of the infected individual after recovery [ 4 ]. In a retrospective analysis that included 74 cases of patients with Lyme borreliosis and 122 controls, Hoeve-Bakker et al showed that there was little diagnostic value of IgM class antibody determination in screening for Lyme disease [ 12 ]. Therefore, positive IgM results for the diagnosis of Lyme disease should be approached with caution [ 12 ].…”

Section: Backgrondmentioning

confidence: 99%

“…In a retrospective analysis that included 74 cases of patients with Lyme borreliosis and 122 controls, Hoeve-Bakker et al showed that there was little diagnostic value of IgM class antibody determination in screening for Lyme disease [ 12 ]. Therefore, positive IgM results for the diagnosis of Lyme disease should be approached with caution [ 12 ]. The multiplicity of B. burgdorferi that resides in the middle intestine of the tick and the multitude of symptoms caused by it in patients, in addition to the lack of uniform diagnostic tests, lead to a delay in the initiation of treatment that can transition to chronic Lyme borreliosis, which in turn leads to a multi-organ and multi-system disease [ 13 ].…”

Section: Backgrondmentioning

confidence: 99%

High Prevalence of Borrelia burgdorferi Antibodies in Jaworzno, Poland: A Retrospective Study Revealing Endemic Lyme Borreliosis

Koleżyńska,

Solarz,

Wieczorek

et al. 2023

Med Sci Monit

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Background This retrospective study of 704 adult residents of Jaworzno, Poland, aimed to evaluate medical personnel awareness of episodes of Lyme borreliosis and serum antibody levels for Borrelia burgdorferi sensu lato. Material/Methods This study included 704 residents of Jaworzno, Poland, who had no more than 12 months between tick bite and screening. The study consisted of a self-designed questionnaire survey and an analysis of IgG and IgM antibodies against B . burgdorferi sensu lato using an enzyme-linked assay (ELISA) and Western blot analysis, when necessary, to confirm the results. Results A total of 558 residents (79.3%) confirmed having contact with a tick, 84 (11.9%) responded that they did not remember having contact with a tick, and 62 (8.8%) denied having contact with a tick. Regarding IgG, the ELISA showed 183 (25.99%) positive, 440 (62.5%) negative, and 81 (11.5%) equivocal results. Regarding IgM, the ELISA showed 180 (25.57%) positive, 435 (61.79%) negative, and 89 (12.64%) equivocal results. Positive and equivocal results for the IgG and IgM classes using the ELISA test were confirmed in 36 cases (13.64%) for IgG and in 53 cases (19.70%) for IgM using Western blot analysis. Conclusions The ELISA method obtained similar values for positive, negative, and equivocal results in the serological test. This was reflected in the survey conducted on residents who reported a tick bite and later received a positive result in the ELISA test as well as an approximate time between the bite and removal of the tick.

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The Performance of Nine Commercial Serological Screening Assays for the Diagnosis of Lyme Borreliosis: a Multicenter Modified Two-Gate Design Study

Abstract: Serology plays an important role in the diagnosis of Lyme borreliosis. Guidelines prescribe a two-tier testing algorithm in which a highly sensitive screening assay is used for screening and reactive sera are retested with an immunoblot to reduce false positivity rates.

Cited by 6 publications

References 27 publications

Seroprevalence and Risk Factors of Lyme Borreliosis in The Netherlands: A Population-Based Cross-Sectional Study

Seroprevalence and Risk Factors of Lyme Borreliosis in The Netherlands: A Population-Based Cross-Sectional Study

Seroprevalence of vector-borne pathogens in outdoor workers from southern Italy and associated occupational risk factors

High Prevalence of Borrelia burgdorferi Antibodies in Jaworzno, Poland: A Retrospective Study Revealing Endemic Lyme Borreliosis

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