Lenka Krbková

Detection of Borrelia burgdorferi sensu stricto ospC alleles associated with human lyme borreliosis worldwide in non-human-biting tick Ixodes affinis and rodent hosts in Southeastern United States.

ABSTRACT Comparative analysis of ospC genes from 127 Borrelia burgdorferi sensu stricto strains collected in European and North American regions where Lyme disease is endemic and where it is not endemic revealed a close relatedness of geographically distinct populations. ospC alleles A, B, and L were detected on both continents in vectors and hosts, including humans. Six ospC alleles, A, B, L, Q, R, and V, were prevalent in Europe; 4 of them were detected in samples of human origin. Ten ospC alleles, A, B, D, E3, F, G, H, H3, I3, and M, were identified in the far-western United States. Four ospC alleles, B, G, H, and L, were abundant in the southeastern United States. Here we present the first expanded analysis of ospC alleles of B. burgdorferi strains from the southeastern United States with respect to their relatedness to strains from other North American and European localities. We demonstrate that ospC genotypes commonly associated with human Lyme disease in European and North American regions where the disease is endemic were detected in B. burgdorferi strains isolated from the non-human-biting tick Ixodes affinis and rodent hosts in the southeastern United States. We discovered that some ospC alleles previously known only from Europe are widely distributed in the southeastern United States, a finding that confirms the hypothesis of transoceanic migration of Borrelia species.

Therapy of Lyme borreliosis in children

SummaryA retrospective open study was conducted to determine the efficacy of penicillin and ceftriaxone in children with skin manifestations of Lyme borreliosis (solitary erythema migrans, multiple erythemata, borrelial lymphocytoma) and neuroborreliosis, respectively. One hundred sixty children were treated with penicillin and 41 with ceftriaxone for an average of 12 days. Serum antibodies to borreliae were determined before therapy and 2–3 and 4–6 weeks thereafter. At admission 44%/26%, 8%/42%, and 40%/35% of erythema migrans, borrelial lymphocytoma and neuroborreliosis patients, respectively, were IgM/IgG positive. Four to 6 weeks after treatment the percentage of seropositives was 20%/15%, 8%/61%, and 21%/44%, respectively. A 3 months follow-up was completed with 151 children. No child showed clinical evidence of illness, nor were there abnormalities in laboratory parameters.ZusammenfassungIn einer offenen, retrospektiven Studie an Kindern wurde die Wirksamkeit von Penicillin bei der Behandlung von Hautmanifestationen der Lyme-Borreliose (Erythema migrans, n=160, Borrelien-Lymphozytom, n=26) und die Wirksamkeit von Ceftriaxon zur Behandlung der Neuroborreliose (n=41) untersucht. Die Therapiedauer betrug durchschnittlich 12 Tage. Serum-Antikörper wurden vor der antibiotischen Behandlung und 2–3 und 4–6 Wochen danach bestimmt. Zum Zeitpunkt der ersten Untersuchung waren 44%/26%, 8%/42% und 40%/35% der Erythema migrans-, Borrelien-Lymphozytom-bzw. Neuroborreliose-Patienten IgM/IgG positiv. Vier bis 6 Wochen nach Behandlung war der Anteil der Seropositiven 20%/15%, 8%/61% bzw. 21%/44%. Untersuchungen 3 Monate nach Behandlung konnten bei 151 Kindern (65%) durchgeführt werden. Keines der Kinder zeigte klinische Anzeichen einer Erkrankung oder einer chronischen Form der Lyme-Borreliose, ebenso gaben die Ergebnisse der Laboratoriumsuntersuchungen keinen Hinweis auf Anomalien.

Assessment of antibodies against surface and outer membrane proteins of Anaplasma phagocytophilum in Lyme borreliosis and tick-borne encephalitis paediatric patients.

To examine evidence of positive antibodies against immunogenic proteins of Anaplasma phagocytophilum in patients with other tick-borne infections and to diagnose possible co-infections, 412 serum specimens were tested by immunoblotting using three specific Anaplasma antigens: surface proteins p44 and Asp62 and outer membrane protein A (OmpA). In total, 284 serum samples from children with Lyme borreliosis and 12 serum samples from children with tick-borne encephalitis were tested. Sera from patients with viral aseptic meningitis (n = 47) and from blood donors (n = 69) were used as controls. Among all serum specimens from patients with tick-borne infections submitted for this study, six samples (2·0%) showed positive IgM reactions and seven samples (2·4%) were IgG positive for A. phagocytophilum by immunoblot. Borderline reactivity was found in 30 samples (10·14%) for IgM and 36 samples (12·2%) for IgG. The difference between patients and blood donors was statistically significant for IgM (P = 0·006) and for IgG (P = 0·0007) antibodies. A statistically significant result was obtained for IgG (P = 0·02) but not for IgM between patients and children with aseptic meningitis. Immunoblot using three specific antigens provides novel information about the positivity of antibodies to A. phagocytophilum in children with other tick-borne infections. Taking into account clinical and laboratory findings of children despite antibody positivity, no case of human granulocytic anaplasmosis was demonstrated.