Off Topic (OT): FW: [LymeInfo] [sci] Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

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I'm sharing the info/links below in case they are of interest. El

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From: LymeInfo [mailto:LymeInfo ] On Behalf

Of Rick Laferriere

Sent: Wednesday, November 03, 2010 12:33 PM

LymeInfo

Subject: [LymeInfo] [sci] Early Lyme disease with spirochetemia - diagnosed

by DNA sequencing

Early Lyme disease with spirochetemia - diagnosed by DNA

sequencing.

Lee SH, Vigliotti VS, Vigliotti JS, W, J,

Walshon J.

BioMed Central Research Notes, 3(1):273. Epub ahead of print

1 November 2010.

http://www.biomedcentral.com/1756-0500/3/273/abstract

Abstract (provisional)

Background

A sensitive and analytically specific nucleic acid

amplification test (NAAT) is valuable in confirming the

diagnosis of early Lyme disease at the stage of spirochetemia.

Findings

Venous blood drawn from patients with clinical presentations

of Lyme disease was tested for the standard 2-tier screen

and Western Blot serology assay for Lyme disease, and also

by a nested polymerase chain reaction (PCR) for B.

burgdorferi sensu lato 16S ribosomal DNA. The PCR amplicon

was sequenced for B. burgdorferi genomic DNA validation. A

total of 130 patients visiting emergency room (ER) or

Walk-in clinic (WALKIN), and 333 patients referred through

the private physicians' offices were studied. While 5.4% of

the ER/WALKIN patients showed DNA evidence of spirochetemia,

none (0%) of the patients referred from private physicians'

offices were DNA-positive. In contrast, while 8.4% of the

patients referred from private physicians' offices were

positive for the 2-tier Lyme serology assay, only 1.5% of

the ER/ WALKIN patients were positive for this antibody

test. The 2-tier serology assay missed 85.7% of the cases of

early Lyme disease with spirochetemia. The latter diagnosis

was confirmed by DNA sequencing.

Conclusion

Nested PCR followed by automated DNA sequencing is a

valuable supplement to the standard 2-tier antibody assay in

the diagnosis of early Lyme disease with spirochetemia. The

best time to test for Lyme spirochetemia is when the

patients living in the Lyme disease endemic areas develop

unexplained symptoms or clinical manifestations that are

consistent with Lyme disease early in the course of their

illness.

http://www.biomedcentral.com/1756-0500/3/273/abstract

The complete, open source article is available as a

provisional pdf file here:

http://www.biomedcentral.com/content/pdf/1756-0500-3-273.pdf