Characterization of Lyme borreliosis isolates from patients with erythema migrans and neuroborreliosis in southern Sweden.
Southern Sweden is an area of Lyme borreliosis (LB) endemicity, with an incidence of 69 cases per 100,000 inhabitants. The most frequent clinical manifestations are erythema migrans (77%) and neuroborreliosis (16%). There was no record of human Borrelia strains being isolated from patients in this region before the prospective study reported here. Borrelia spirochetes were isolated from skin and cerebrospinal fluid (CSF) from LB patients living in the region. A total of 39 strains were characterized by OspA serotype analysis, species-specific PCR, and signature nucleotide analysis of the 16S rRNA gene. Of 33 skin isolates, 31 (93.9%) were Borrelia afzelii strains and 2 (6.1%) were Borrelia garinii strains. Of six CSF isolates, five (83.3%) were B. garinii and one (16.7%) was B. afzelii. Neither Borrelia burgdorferi sensu stricto strains nor multiple infections were observed. The B. afzelii isolates were of OspA serotype 2. Three B. garinii strains were of OspA serotype 5, and the remaining four strains were of OspA serotype 6. All of the B. garinii strains belonged to the same 16S ribosomal DNA ribotype class. Our findings agree with earlier findings from other geographic regions in Europe where B. afzelii and B. garinii have been recovered predominantly from skin and CSF cultures, respectively. To further study the possible presence in Sweden of the genotype B. burgdorferi sensu stricto, which is known to be present in Europe and to occur predominantly in patients with Lyme arthritis, molecular detection of Borrelia-specific DNA in synovial samples from Lyme arthritis patients should be performed.
Department of Infectious Diseases and Medical Microbiology, Lund University, Lund, Sweden.
K
K
Ornstein
J
J
Berglund
I
I
Nilsson
R
R
Norrby
S
S
Bergström
D000954:Antigens, Surface / Q000276:immunology; D001425:Bacterial Outer Membrane Proteins / Q000276:immunology; D001428:Bacterial Vaccines; D001898:Borrelia / Q000145:classification* / Q000302:isolation & purification*; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004275:DNA, Ribosomal / Q000032:analysis; D015787:Erythema Chronicum Migrans / Q000382:microbiology*; D020459:Genes, rRNA; D006801:Humans; D008074:Lipoproteins; D008193:Lyme Disease / Q000382:microbiology*; D022123:Lyme Disease Vaccines / Q000276:immunology; D020852:Lyme Neuroborreliosis / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000379:methods; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA; D012703:Serotyping; D012867:Skin / Q000382:microbiology; D013045:Species Specificity; D013548:Sweden
D000954:Antigens, Surface; D001425:Bacterial Outer Membrane Proteins; D001428:Bacterial Vaccines; D004275:DNA, Ribosomal; D008074:Lipoproteins; D022123:Lyme Disease Vaccines; C072045:OspA protein; D012336:RNA, Ribosomal, 16S