Examination of specific DNA by PCR in patients with different forms of Lyme borreliosis.
BACKGROUND
Borrelial specific DNA was examined in a group of 62 patients with different forms of Lyme borreliosis (LB) (32 patients suffered from neuroborreliosis, 19 manifested erythema migrans, and 11 joint involvement).


METHODS
Nested-PCR system with five newly derived primers was used in parallel. The study was organized prospectively, the presence of DNA was tested for plasma, CSF, joint fluid and urine before treatment, and plasma, joint fluid and urine were examined after treatment.


RESULTS
Before therapy, 36 patients (58.1%) were DNA positive on the whole; 21 positive patients (65.6%) were found in the group of neuroborreliosis, 8 (42.1%) showed signs of skin involvement, and 7 (63.6%) were positive in arthritis. After treatment, 11 patients (36.7%) were positive in neuroborreliosis, 3 (17.6%) in skin form, and 6 (54.5%) in joint form of LB. Among 97 positive amplifications the most frequent target was found in primer corresponding with 16S rDNA (50 samples, 51.5%). Lower but very similar results were obtained with primers for OspA (18 positive amplifications; 18.6%), OspC (13 positive amplifications; 13.4%), and flagellin (13 positive amplifications; 13.4%). There were 11 patients in whom only DNA and no specific antibodies were found.


CONCLUSIONS
Specific DNA was found in all clinical groups of LB with similar sensitivity. Examination of the borrelial DNA in urine displayed the same sensitivity as in CSF and had a two times higher sensitivity than in plasma.
Pícha
Dusan
D
Charles University, 2nd Medical School, 1st Clinic for Infectious Diseases, Teaching Hospital Bulovka, Prague, Czech Republic. dusan.picha@fnb.cz
Moravcová
Lenka
L
Holecková
Daniela
D
Zd'árský
Emanuel
E
Valesová
Marie
M
Maresová
Vilma
V
Hercogová
Jana
J
Vanousová
Daniela
D
D000907:Antibodies, Bacterial / Q000032:analysis; D001170:Arthritis, Infectious / Q000382:microbiology; D015748:Borrelia burgdorferi Group / Q000235:genetics*; D017931:DNA Primers; D004269:DNA, Bacterial / Q000032:analysis / Q000235:genetics*; D006801:Humans; D008193:Lyme Disease / Q000235:genetics* / Q000276:immunology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012867:Skin / Q000382:microbiology
D000907:Antibodies, Bacterial; D017931:DNA Primers; D004269:DNA, Bacterial