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

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 the16S rRNA gene were evaluated (TaqMan ® and LUX™). Among patients classified as LNB cases (n = 102), five children (5%) wereBorrelia PCR-positive in CSF with the TaqMan ® assay. In the Non-LNB group (n = 131), one patient wasBorrelia PCR positive with the TaqMan ® assay. Among controls (n = 59), all CSF samples were PCR negative. When amplifying and sequencingospA, we foundB. 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) ofB. 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.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research