Diagnostic Detection and Direct Genotyping of Borrelia burgdor feri

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Mol Diagn 1998 Sep;3(3):131-141

Diagnostic Detection and Direct Genotyping of Borrelia burgdor

feri Regular by Polymerase Chain Reaction in Cerebrospinal Fluid

in Lyme Neuroborreliosis.

Lebechdouble dagger AM, Hansendouble dagger K, Rutledge section

sign BJ, Kolbert section sign CP, Rys section sign PN, Persing

section sign DH

Borrelia Laboratory, Department of Clinical Bio - chemistry

Statens Seruminstitut, Copenhagen, Denmark

[Record supplied by publisher]

Background: A DNA target imbalance in favor of the plasmid-borne

outer surface protein A (OspA) versus chromosomal genes has been

thought to explain the relatively high diagnostic sensitivity of

an OspA-based polymerase chain reaction (PCR) on joint fluid from

patients with Lyme arthritis. The aim of this study was to

evaluate the diagnostic sensitivity of the OspA-based PCR on

cerebrospinal fluid (CSF) samples from patients with Lyme

neuroborreliosis and to perform DNA sequence analysis on the

amplicon to determine the genospecies of Borrelia present in the

CSF. Methods and Results: CSF from 150 consecutively diagnosed

European patients with untreated active neuroborreliosis was

investigated. Borrelia burgdorferi DNA was detected in 31 of 150

patients with Lyme neuroborreliosis (20.6%). Genotyping of the

amplicons was possible in 13 of the CSF samples and revealed that

11 of the 13 patients had been infected with Borrelia garinii, 1

with Borrelia afzelii, and 1 specimen showed evidence of a

mixture of B. garinii and B. afzelii sequences. Conclusions: The

diagnostic sensitivity of the OspA-based PCR for detection of B.

burgdorferi DNA in CSF was comparable to that found previously

using PCR assays based on genomic targets. The predominance of B.

garinii DNA (92%) found in CSF substantially supports the current

hypothesis that B. garinii is the principal agent of Lyme

neuroborreliosis in Europe. Mixed infections, comprising

different genospecies of B. burgdorferi sensu lato, seem to be

the exception.

PMID: 10089270