Am. Lebech et al., DIAGNOSTIC-DETECTION AND DIRECT GENOTYPING OF BORRELIA-BURGDORFERI BYPOLYMERASE-CHAIN-REACTION IN CEREBROSPINAL-FLUID IN LYME NEUROBORRELIOSIS, Molecular diagnosis, 3(3), 1998, pp. 131-141
Citations number
38
Categorie Soggetti
Medical Laboratory Technology","Medicine, Research & Experimental","Biothechnology & Applied Migrobiology
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 p
olymerase chain reaction (PCR) on joint fluid from patients with Lyme
arthritis. The aim of this study was to evaluate the diagnostic sensit
ivity of the OspA-based PCR on cerebrospinal fluid (CSF) samples from
patients with Lyme neuroborreliosis and to perform DNA sequence analys
is on the amplicon to determine the genospecies of Borrelia present in
the CSF. Methods and Results: CSF from 150 consecutively diagnosed Eu
ropean patients with untreated active neuroborreliosis was investigate
d. Borrelia burgdorferi DNA was detected in 31 of 150 patients with Ly
me neuroborreliosis (20.6%). Genotyping of the amplicons was possible
in 13 of the CSF samples and revealed that 11 of the 13 patients had b
een infected with Borrelia garinii, 1 with Borrelia afzelii, and 1 spe
cimen showed evidence of a mixture of B. garinii and B. afzelii sequen
ces. Conclusions: The diagnostic sensitivity of the OspA-based PCR for
detection of B. burgdorferi DNA in CSF was comparable to that found p
reviously using PCR assays based on genomic targets. The predominance
of B. garinii DNA (92%) found in CSF substantially supports the curren
t hypothesis that B. garinii is the principal agent of Lyme neuroborre
liosis in Europe. Mixed infections, comprising different genospecies o
f B. burgdorferi sensu late, seem to be the exception.