title: Prevalence and diversity of Borrelia species in ticks that have bitten humans in Sweden.
abstract: Members of the genus Borrelia are among the most common infectious agents causing tick-borne disease in humans worldwide. Here, we developed a Light Upon eXtension (LUX) real-time PCR assay that can detect and quantify Borrelia species in ticks that have fed on humans, and we applied the assay to 399 such ticks. Borrelia PCR-positive ticks were identified to species level by sequencing the products of conventional PCR performed using Borrelia group-specific primers. There was a 19% prevalence of Borrelia spp. in the detached ticks, and the number of spirochetes per Borrelia PCR-positive tick ranged from 2.0 × 10(2) to 4.9 × 10(5), with a median of 7.8 × 10(3) spirochetes. Adult ticks had a significantly larger number of spirochetes, with a median of 8.4 × 10(3) compared to the median of nymphs of 4.4 × 10(3). [corrected] Adult ticks also exhibited a higher prevalence of Borrelia (33%) than nymphs (14%). Among the identified species, Borrelia afzelii was found to predominate (61%) and was followed by B. garinii (23%), B. valaisiana (13%), B. burgdorferi sensu stricto (1%), B. lusitaniae (1%), and B. miyamotoi-like (1%). Also, 3% of the ticks were coinfected with multiple strains of B. afzelii. Notably, this is the first report of B. lusitaniae being detected in ticks in Sweden. Our LUX real-time PCR assay proved to be more sensitive than a corresponding TaqMan assay. In conclusion, the novel LUX real-time PCR method is a rapid and sensitive tool for detection and quantification of Borrelia spp. in ticks.
authors.affiliation: Division of Medical Microbiology, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Wilhelmsson
authors.forename: Linda
authors.initials: L
authors.lastname: Fryland
authors.forename: Stefan
authors.initials: S
authors.lastname: Börjesson
authors.forename: Johan
authors.initials: J
authors.lastname: Nordgren
authors.forename: Sven
authors.initials: S
authors.lastname: Bergström
authors.forename: Jan
authors.initials: J
authors.lastname: Ernerudh
authors.forename: Pia
authors.initials: P
authors.lastname: Forsberg
authors.forename: Per-Eric
authors.initials: PE
authors.lastname: Lindgren
mesh_terms: D000818:Animals; D058491:Bacterial Load; D001431:Bacteriological Techniques / Q000379:methods*; D001898:Borrelia / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D004247:DNA / Q000737:chemistry / Q000235:genetics; D014644:Genetic Variation; D006801:Humans; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction / Q000379:methods*; D015995:Prevalence; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D013548:Sweden; D013987:Ticks / Q000235:genetics / Q000382:microbiology*
chemical_list: D004247:DNA