Effect of Borrelia burgdorferi genotype on the sensitivity of C6 and 2-tier testing in North American patients with culture-confirmed Lyme disease.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
G P WormserIra Schwartz

Abstract

A potential concern with any serologic test to detect antibodies to Borrelia burgdorferi is whether the epitopes incorporated in the test provide sufficient cross-reactivity to detect infection with all of the pathogenic strains of the species. This is a particular concern for the C6 test, which is based on reactivity to a single peptide. C6 testing and 2-tier testing were performed on acute-phase serum samples obtained from >158 patients with erythema migrans for whom the genotype of the borrelial isolate was defined on the basis of an analysis of the 16S-23S ribosomal DNA spacer region and/or on the genetic variation of the outer surface protein C gene (ospC). The sonicated whole cell-based enzyme-linked immunosorbent assay, the immunoblots used in the 2-tier testing, and the C6 assay all used antigens from B. burgdorferi sensu stricto strain B31. The sensitivity of C6 testing (69.5%) was greater than that of 2-tier testing (38.9%) (P<.001); the difference in sensitivity, however, was statistically significant only for patients infected with 2 of the 3 ribosomal spacer type-defined genotypes. The lower sensitivity of 2-tier testing was attributable to the low sensitivity of the immunoblot tests, rather than the first-tier enz...Continue Reading

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Citations

Apr 29, 2010·Current Allergy and Asthma Reports·Adriana R Marques
Mar 18, 2011·Clinical and Vaccine Immunology : CVI·Abhishek ChandraArmin Alaedini
Sep 6, 2015·International Journal of Medical Microbiology : IJMM·Sabrina JungnickVolker Fingerle
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Sep 12, 2019·Healthcare·Robert C BransfieldDouglas R Bransfield
Jan 1, 2020·Pathogens·Vladimir V BammMelanie K B Wills
Jan 29, 2021·Clinical Microbiology Reviews·John A Branda, Allen C Steere

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