CULTURE-CONFIRMED REINFECTION OF A PERSON WITH DIFFERENT STRAINS OF BORRELIA-BURGDORFERI SENSU-STRICTO

In recent years, the utility of serum-based diagnostic testing for Lym e disease has improved substantially; however, recovery by culture of the bacterium from skin biopsies of suspected patients is still the on ly definitive laboratory test. Reinfection of patients has been assume d to occur but as yet has not been documented by serial isolates from the same person, We present a case of culture-confirmed reinfection of a patient in Menominee County, Michigan, Borrelia burgdorferi was iso lated from the skin punch biopsy specimens during each episode of eryt hema migrans (EM) and was subjected to molecular strain typing, geneti c analysis of two outer surface protein genes, protein profile analysi s, and serum antibody response testing, Results show that these isolat es are distinct strains of the bacterium and that the two episodes of EM were caused by independent infections, This report describes the do cumented, culture-confirmed reinfection of a human by two different st rains of B. burgdorferi.