Borrelia burgdorferi detected by culture and PCR in clinical

Topics with information and discussion about published studies related to Lyme disease and other tick-borne diseases.
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tosho
Posts: 282
Joined: Sun 16 Dec 2007 0:54
Location: Poland

Borrelia burgdorferi detected by culture and PCR in clinical

Post by tosho » Thu 17 Nov 2011 22:02

http://www.ncbi.nlm.nih.gov/pubmed?term ... lapse%20of

Oksi J, Marjamäki M, Nikoskelainen J, Viljanen MK.

Borrelia burgdorferi detected by culture and PCR in clinical relapse of disseminated Lyme borreliosis.

Ann Med, 1999. 31(3):p.225-32
Abstract

A total of 165 patients with disseminated Lyme borreliosis (diagnosed in 1990-94, all seropositive except one culture-positive patient) were followed after antibiotic treatment, and 32 of them were regarded as having a clinically defined treatment failure. Of the 165 patients, 136 were tested by polymerase chain reaction (PCR) during the follow-up. PCR was positive from the plasma of 14 patients 0-30 months after discontinuation of the treatment, and 12 of these patients had a clinical relapse. In addition, Borrelia burgdorferi was cultured from the blood of three patients during the follow-up. All three patients belonged to the group with relapse, and two of them were also PCR positive. This report focuses on the 13 patients with clinical relapse and culture or PCR positivity. Eight of the patients had culture or PCR-proven initial diagnosis, the diagnosis of the remaining five patients was based on positive serology only. All 13 patients were primarily treated for more than 3 months with intravenous and/or oral antibiotics (11 of them received intravenous ceftriaxone, nine for 2 weeks, one for 3 weeks and one for 7 weeks, followed by oral antibiotics). The treatment caused only temporary relief in the symptoms of the patients. All but one of them had negative PCR results immediately after the first treatment. The patients were retreated usually with intravenous ceftriaxone for 4-6 weeks. None of them was PCR positive after the retreatment. The response to retreatment was considered good in nine patients. We conclude that the treatment of Lyme borreliosis with appropriate antibiotics for even more than 3 months may not always eradicate the spirochete. By using PCR, it is possible to avoid unnecessary retreatment of patients with 'post-Lyme syndrome' and those with 'serological scars' remaining detectable for months or years after infection.

PMID: 10442678
Last edited by tosho on Thu 17 Nov 2011 23:55, edited 1 time in total.

Martian
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Location: Friesland, the Netherlands

Re: Borrelia burgdorferi detected by culture and PCR in clin

Post by Martian » Thu 17 Nov 2011 23:26

Just a little off-topic remark again about the text formatting: it's much better to put the title on a separate line and increase its size. You can use the posts of rlstanley and me as standards.

For example:
http://www.lymeneteurope.org/forum/view ... f=5&t=3409
http://www.lymeneteurope.org/forum/view ... f=5&t=3423

ChuckG
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Joined: Thu 17 Mar 2011 23:45
Location: Berkeley

Re: Borrelia burgdorferi detected by culture and PCR in clin

Post by ChuckG » Fri 18 Nov 2011 3:28

I read all of these tosho postings. For me at least, insufficient data. Perhaps reading the whole papers would make a difference but none exist.

And so I maintain my agnostic opinion on the IDSA/ILADS "feud" regarding treatment. Same opinion applies to testing, about which I know a lot more.

tosho
Posts: 282
Joined: Sun 16 Dec 2007 0:54
Location: Poland

Re: Borrelia burgdorferi detected by culture and PCR in clin

Post by tosho » Fri 18 Nov 2011 12:05

I am sorry, I can't help when it comes to detailed interpretation, as I am not competent.

But, what I do is I use opinion of competent people (or people that I expect they are competent). For example here...

Stephen W. Barthold, Emir Hodzic, Denise M. Imai, Sunlian Feng, Xiaohua Yang, and Benjamin J. Luft

Ineffectiveness of Tigecycline against Persistent Borrelia burgdorferi

Antimicrob Agents Chemother. 2010 February; 54(2): 643–651.

http://www.ncbi.nlm.nih.gov/pmc/article ... ool=pubmed

... you can read that:
Management of Lyme disease patients with antibiotics is based upon evidence-based clinical guidelines (78). Clinical assumptions are complicated by the ephemeral, variably recurrent, and diverse nature of both objective clinical signs and subjective symptoms of Lyme borreliosis. What is not known is whether or not antibiotic treatment completely eradicates the infection, and this has generated debate among the medical and lay communities. Various Borrelia burgdorferi isolates have been shown to possess differences in susceptibility to antibiotics, including B. burgdorferi N40 resistance to erythromycin (60, 73), but there is no evidence of acquired antibiotic resistance by B. burgdorferi in response to treatment. It has recently been demonstrated that B. burgdorferi has a putative efflux system with significant homology to the tetracycline efflux protein and to a resistance-nodulation-division (RND) efflux system (AcrAB-TolC) (15). Treatment failures for human Lyme borreliosis have been documented with nearly every type of antimicrobial drug, based upon clinical relapse (22), culture (23, 28, 29, 48, 52, 55, 57, 62, 72), or PCR (48, 58).
Some of the studies that I posted yesterday on this forum are mentioned as a references in the bold sentence above.

And, from a layman point of view, I can only hope that study quoted above is valuable.

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