title: Diagnosis of Lyme borreliosis using enzyme immunoanalysis.
abstract: BACKGROUND
  Antiborrelia antibodies in Lyme borreliosis (LB) are mostly detected by enzyme immunoassay (EIA), confirmed by immunoblot (the "two-step system"). In indicated cases, direct evidence of Borrelia burgdorferi is obtained with the PCR method, electron microscopy and cultivation. The "one-step system" of testing for IgM and IgG antibodies in LB is economically preferably, but it requires an EIA kit with more than 90% sensitivity and specificity.
  
  
  METHODS
  90 blood samples were collected, 54 from patients with clinically defined LB and 36 samples from individuals free of LB. IgM and IgG antibodies against Borrelia burgdorferi were detected in parallel with five different EIA kits from various producers. The results were verified clinically in all cases, in disputable cases with additional immunoblot (BAG-Med), and analyzed statistically.
  
  
  RESULTS
  Specificity and sensitivity were calculated from the measured values, and diagnostic efficiency was determined for each EIA kit. EIA kits for antiborrelia antibody assay with high specificity have low sensitivity and vice versa. In 9 samples from patients with clinical diagnoses (multiple sclerosis, Parkinson disease, epilepsy, rheumatoid arthritis) we found false positives in EIA and WB tests.
  
  
  CONCLUSIONS
  The best results for a "one-step system" of examinations for antiborrelia antibodies were obtained with the Abbot and Euroimmun EIA kits in our set. A "two-step system" of serological examination could be composed from the basic IgM and IgG examination with a high sensitivity EIA kit (Viroimmun, Test-Line) followed with confirmation of positives by specific immunoblot.
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine in Hradec Králové, Charles University of Prague, Czech Republic. cermakovaz@fnhk.cz
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Cermakova
authors.forename: Olga
authors.initials: O
authors.lastname: Ryskova
authors.forename: Karel
authors.initials: K
authors.lastname: Honegr
authors.forename: Eva
authors.initials: E
authors.lastname: Cermakova
authors.forename: Irena
authors.initials: I
authors.lastname: Hanovcova
mesh_terms: D025065:Borrelia burgdorferi / Q000235:genetics / Q000302:isolation & purification / Q000648:ultrastructure; D003429:Cross Reactions; D003937:Diagnosis, Differential; D006801:Humans; D007124:Immunoenzyme Techniques; D007075:Immunoglobulin M / Q000097:blood; D008193:Lyme Disease / Q000175:diagnosis* / Q000201:enzymology* / Q000276:immunology; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D007075:Immunoglobulin M; D011933:Reagent Kits, Diagnostic