MILFORD, Conn.--(BUSINESS WIRE)--Patients with clinical Lyme disease may not be infected by the Lyme disease spirochete (bacteria), but in fact by other related bacteria, such as Borrelia miyamotoi and a new, as yet unnamed spirochete according to a paper just published this month in the International Journal of Molecular Sciences http://www.mdpi.com/1422-0067/15/3/4284/.
“The gateway to new DNA sequencing tests is proper polymerase chain reaction (PCR), and we have designed a pair of genus-specific PCR primers to detect all pathogenic spirochetes, including Borrelia burgdorferi, Borrelia miyamotoi and other related borreliae in this group and to prepare the templates for direct DNA sequencing,” said Sin Hang Lee, MD, a Milford Hospital pathologist and lead author of the paper. DNA sequencing is the accepted gold standard for all nucleic acid-based diagnostic tests.
While testing 12 serum samples from patients who had been treated for Lyme disease, residues of a new spirochete were detected in the archived serum sample from a patient who had been diagnosed with and treated for “neurologic Lyme disease” based on the information supplied by the Centers for Disease Control and Prevention (CDC). In fact, as Dr. Lee and his coauthors stated in the paper, the patient “might have a mixed infection by a B. burgdorferi and a novel relapsing fever borrelia of uncertain significance which was more resistant to the standard regimen of antibiotic treatment than the B. burgdorferi co-infectant. Alternatively, this novel bacterium as a sole infectious agent of this patient’s neuroborreliosis might have some common epitopes with the B. burgdorferi species, causing a positive Lyme disease 2-tier serology test result in the host’s serum.”
Among another 20 samples taken from untreated clinically suspect Lyme disease patients, residues of Borrelia miyamotoi were discovered in a serum which was negative for the standard 2-tier serology test, in addition to two isolates of Borrelia burgdorferi, the more common infectious agent for Lyme disease, according to the report just published by Lee and colleagues. Human Borrelia miyamotoi infections were only recently reported in 2013 in the United States, according to Dr. Lee.
In the paper, the authors concluded that, “The diagnoses of Lyme disease based on clinical manifestations, serological findings and detection of infectious agents often contradict each other…” Therefore, “a sensitive and reliable DNA-based test is needed to support the diagnosis of Lyme disease and Lyme disease-like borreliosis.”
The CDC at Fort Collins, CO supplied two panels of blind-coded serum samples under Material Transfer Agreements Reference Numbers NCEZID-R137154-00 and NCEZID-R147284-00 in support of this study, acknowledged the authors in the end of the article.
Dr. Lee is the director of Milford Hospital-affiliated Milford Medical Laboratory which is a licensed clinical laboratory to offer 16S rDNA sequencing-based tests for Lyme disease and related borreliosis (www.dnalymetest.com). Dr. Lee first introduced this method to diagnose spirochetemia during the early stage of Lyme disease. Now the improved test is sensitive enough to reliably diagnose off-season spirochetemia with low bacterial density, according to Dr. Lee.