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Chapter 56 :

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Abstract:

, in the form of louse-borne relapsing fever (LBRF), has been the cause of massive epidemics as recently as the early 1900s. Tick-borne relapsing fever (TBRF) and Lyme borreliosis (LB) are caused by over a dozen species and were first described about 100 years ago. There is a high prevalence of B. among human skin isolates from Europe, whereas isolates from cerebrospinal fluid (CSF) in Europe are most often B.. A few studies have reported the detection of species (B., B., and B. ) in patient samples in Europe. The genomes of the borreliae are unusual among prokaryotes in having a small linear chromosome of approximately 1,000 kb and both linear and circular plasmids. Two colinear plasmids (lp54 and cp26) seem to belong to the basic genome inventory of the species that causes Lyme disease. The ecological components that maintain species in nature are quite diverse and are spread throughout the world. This chapter talks about collection, transport, and storage of specimens. Direct microscopic visualization of borreliae in clinical samples is applicable only to cases of relapsing fever. The chapter describes molecular techniques and immunological techniques for identifying species, and explains about the serologic test. The antimicrobial susceptibility of species has been studied intensively in vitro. Standard methods for the determination of the minimal bactericidal concentration have not been established. Clinical criteria (case history and clinical findings) are decisive factors in the diagnosis and ordering of microbiological laboratory testing.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56

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Nucleic Acid Amplification Techniques
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Acute Respiratory Distress Syndrome
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Restriction Fragment Length Polymorphism
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Antimicrobial Susceptibility Testing
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0.5016682
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FIGURE 1

Two genera of ticks are vectors for relapsing fever and LB: (a) and (b).

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
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Image of FIGURE 2
FIGURE 2

Scanning electron micrograph of (provided by Gerhard Wanner, Munich, Germany).

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
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Image of FIGURE 3
FIGURE 3

spirochetes. (A) in a thin smear of patient blood (bright-field microscopy, Giemsa stain); (B) culture (dark-field microscopy).

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
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Image of FIGURE 4
FIGURE 4

Two-step approach for serodiagnosis.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
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Image of FIGURE 5
FIGURE 5

Whole-cell immunoblot for identification of diagnostic bands with MAbs. The antigen used is strain PKo. Lanes: G, IgG blot from a patient with late disease; M, IgM blot from a patient with early disease; 1 to 11, different MAbs against the respective reactive proteins. (Modified from reference )

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
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Tables

Generic image for table
TABLE 1

Characteristics of arthropod-borne borreliae

Modified from reference .

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
Generic image for table
TABLE 2

Distribution of species of sensu lato in European isolates from CSF, skin, and synovial fluid specimens

Data from references , and .

sensu lato species identifications from CSF and skin are based on culture; species identification from synovial fluid samples is based on PCR results. Culture isolates from synovial fluid are too few to estimate species distribution.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
Generic image for table
TABLE 3

Specimen types used for the diagnosis of LB

From the same day for AI determination.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
Generic image for table
TABLE 4

Sensitivity of methods for pathogen detection (PCR and culture) in LB

Up to 50% in patients with disease duration of less than 2 weeks compared with only 13% in patients for whom the illness duration was greater than 2 weeks.

Higher sensitivity of direct pathogen detection from synovial biopsy specimen.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56
Generic image for table
TABLE 5

Sensitivity of antibody detection methods in the diagnosis of Lyme disease

Negative only for patients with a very short duration of symptoms.

Citation: Schriefer M. 2011. , p 924-940. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch56

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