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. 2021 May;40(5):1003-1012.
doi: 10.1007/s10096-020-04129-7. Epub 2021 Jan 2.

Lyme neuroborreliosis in Swedish children-PCR as a complementary diagnostic method for detection of Borrelia burgdorferi sensu lato in cerebrospinal fluid

Barbro H Skogman  1   2 , Peter Wilhelmsson  3   4 , Stephanie Atallah  5 , Ann-Cathrine Petersson  6 , Katarina Ornstein  7 , Per-Eric Lindgren  3   8
Affiliations

Lyme neuroborreliosis in Swedish children-PCR as a complementary diagnostic method for detection of Borrelia burgdorferi sensu lato in cerebrospinal fluid

Barbro H Skogman et al. Eur J Clin Microbiol Infect Dis. 2021 May.

Abstract

The aim of this study was to evaluate polymerase chain reaction (PCR) as a diagnostic method for the detection of Borrelia burgdorferi s.l. in CSF of Swedish children with LNB. This study was performed retrospectively on CSF and serum samples collected from children evaluated for LNB (n = 233) and controls with other specific neurological disorders (n = 59) in a Swedish Lyme endemic area. For anti-Borrelia antibody index, the IDEIA Lyme Neuroborreliosis kit (Oxoid) was used. Two in-house real-time PCR assays targeting the 16S rRNA gene were evaluated (TaqMan® and LUX™). Among patients classified as LNB cases (n = 102), five children (5%) were Borrelia PCR-positive in CSF with the TaqMan® assay. In the Non-LNB group (n = 131), one patient was Borrelia PCR positive with the TaqMan® assay. Among controls (n = 59), all CSF samples were PCR negative. When amplifying and sequencing ospA, we found B. garinii (n = 2), B. afzelii (n = 2), B. bavariensis (n = 1), and one untypable (n = 1). With the LUX™ technology, all CSF samples were PCR negative. The TaqMan® assay could detect only few cases (n = 6) of B. burgdorferi s.l. in CSF among children with LNB and the sensitivity was very low (5%). However, using larger CSF volumes and centrifugation of samples, the PCR technique could still be useful as a complementary diagnostic method when evaluating LNB. Furthermore, detection of spirochete DNA in clinical matrices, including CSF, is the method of choice for studying epidemiological aspects of LNB, a tick-borne emerging disease.

Keywords: Children; Diagnosis; Diagnostic test; Lyme neuroborreliosis; PCR.

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Conflict of interest statement

PL has been an external scientific expert to Valneva Austria GmbH, Vienna, Austria. The other authors declare that they have no financial or non-financial competing interest.

Figures

Fig. 1
Fig. 1
Map of the Lyme endemic region in Sweden where the study was conducted
See this image and copyright information in PMC

References

    1. Lindgren E, Talleklint L, Polfeldt T. Impact of climatic change on the northern latitude limit and population density of the disease-transmitting European tick Ixodes ricinus. Environ Health Perspect. 2000;108(2):119–123. doi: 10.1289/ehp.00108119. - DOI - PMC - PubMed
    1. Ripoche M, Gasmi S, Adam-Poupart A, Koffi JK, Lindsay LR, Ludwig A, Milord F, Ogden NH, Thivierge K, Leighton PA. Passive tick surveillance provides an accurate early signal of emerging Lyme disease risk and human cases in southern Canada. J Med Entomol. 2018;55(4):1016–1026. doi: 10.1093/jme/tjy030. - DOI - PubMed
    1. Rizzoli A, Hauffe H, Carpi G, Vourc HG, Neteler M, Rosa R (2011) Lyme borreliosis in Europe. Euro Surveill 16(27):19906 - PubMed
    1. Cartter ML, Lynfield R, Feldman KA, Hook SA, Hinckley AF. Lyme disease surveillance in the United States: looking for ways to cut the Gordian knot. Zoonoses Public Health. 2018;65(2):227–229. doi: 10.1111/zph.12448. - DOI - PMC - PubMed
    1. Greig JD, Young I, Harding S, Mascarenhas M, Waddell LA. A scoping review of Lyme disease research relevant to public health. Can Commun Dis Rep. 2018;44(10):243–256. doi: 10.14745/ccdr.v44i10a03. - DOI - PMC - PubMed