Gene Sequencing and Cases of Chronic Lyme Disease —Reply

In Reply We appreciate the Letter in Reply from Dr Lee highlighting his research on the detection of persistent borreliosis by novel gene-sequencing methods. However, we contend that persistent polymerase chain reaction (PCR) positivity forBorrelia burgdorferi does not signify the presence of active infection or bacteremia that merits prolonged antibiotic treatment. To this point, Marques et al tested a cohort of patients with treated Lyme disease and posttreatment Lyme disease syndrome (PLTDS) for the presence of viableB burgdorferi. Using a xenodiagnostic technique wherein laboratory-raisedIxodes scapularis ticks fed on patients and subsequently attempted to infect immunodeficient mice, both ticks and mice were tested for the presence ofB burgdorferi by PCR and culture. Despite detectingB burgdorferi DNA by PCR amplification in a single patient with PLTDS on 2 separate occasions, the investigators were unable to cultureB burgdorferi. This supports current evidence that the association between microbiological data —especially PCR—and symptoms in patients with reported persistent Lyme disease remains unproven.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research