1. Comparison of five diagnostic modalities for direct detection of Borrelia burgdorferi in patients with early Lyme disease
- Author
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Joseph DeMarco, Ira Schwartz, Gary P. Wormser, Diane Holmgren, Dionysios Liveris, Donna McKenna, Radha Iyer, Susan Bittker, John Nowakowski, Denise Cooper, and Robert B. Nadelman
- Subjects
Adult ,Male ,Microbiology (medical) ,Pathology ,medicine.medical_specialty ,Sensitivity and Specificity ,Article ,Lyme disease ,medicine ,Humans ,Blood culture ,Borrelia burgdorferi ,Aged ,Aged, 80 and over ,Bacteriological Techniques ,Lyme Disease ,integumentary system ,biology ,medicine.diagnostic_test ,General Medicine ,Middle Aged ,biology.organism_classification ,Molecular diagnostics ,medicine.disease ,Early Diagnosis ,Infectious Diseases ,Real-time polymerase chain reaction ,Molecular Diagnostic Techniques ,Skin biopsy ,Erythema migrans ,Female ,Nested polymerase chain reaction - Abstract
Lyme disease, the most commonly reported tick-borne infection in North America, is caused by infection with the spirochete Borrelia burgdorferi. Although an accurate clinical diagnosis can often be made based on the presence of erythema migrans, in research studies microbiologic or molecular microbiologic confirmation of the diagnosis may be required. In this study, we evaluated the sensitivity of 5 direct diagnostic methods (culture and nested polymerase chain reaction [PCR] of a 2-mm skin biopsy specimen, nested PCR and quantitative PCR (qPCR) performed on the same 1-mL aliquot of plasma and a novel qPCR-blood culture method) in 66 untreated adult patients with erythema migrans. Results of one or more of these tests were positive in 93.9% of the patients. Culture was more sensitive than PCR for both skin and blood, but the difference was only statistically significant for blood samples (P
- Published
- 2012