scholarly journals Lyme disease: Modern approaches to prevention, diagnosis and treatment

2021 ◽  
Vol 59 (5) ◽  
pp. 547-554
Author(s):  
B. S. Belov ◽  
L. P. Ananyeva
Keyword(s):  
Lyme Disease ◽  
Laboratory Diagnosis ◽  
The United States ◽  
Cefuroxime Axetil ◽  
Diagnosis And Treatment ◽  
Common Disease ◽  
Serum Samples ◽  
Number Of Factors ◽  
Single Oral Administration

Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily the United States and Europe. In endemic areas, early LD is a common disease that requires high medical vigilance. Considering the extreme relevance of this problem for public health, in November 2020, the committee of experts of three American scientific societies published an updated version of the clinical guidelines for the prevention, diagnosis and treatment of LD, the main provisions of which are presented in this article. It is emphasized that in the absence of vaccines, the risk of LD and other diseases transmitted by ticks can be reduced by using personal protective equipment and repellents. Antibiotic prophylaxis is carried out by a single oral administration of doxycycline. In the laboratory diagnosis of LD, the determination of antibodies to B. burgdorfery in the blood serum is a first-line study. At the second stage, serum samples are examined using an immunoblot for IgM and IgG. The basis of treatment of LD is rational antibiotic therapy. The choice of an antibiotic depends on a number of factors, including the presence of extracutaneous manifestations of LD (neuroborreliosis, carditis, arthritis). The most commonly used are doxycycline, amoxicillin, cefuroxime-axetil and ceftriaxone.

scholarly journals Experimental determination of the pharmacokinetic properties of trimethoprim and sulfamethoxazole combination in the blood serum of broiler chickens

2021 ◽  
Author(s):  
K Putecova ◽  
K Nedbalcova ◽  
I Bartejsova ◽  
M Zouharova ◽  
K Matiaskova ◽  
...  
Keyword(s):  
Oral Administration ◽  
Broiler Chickens ◽  
Animal Health ◽  
Pharmacokinetic Parameters ◽  
Serum Samples ◽  
Commercial Preparation ◽  
Single Oral Administration ◽  
Thermo Fisher Scientific ◽  
Medicinal Substances

A rapid, simple and highly efficient analytical method for the targeted determination of trimethoprim and sulfamethoxazole in serum samples has been developed and used to measure the pharmacokinetic curve of these medicinal substances after administration to chicken broilers. The pharmacokinetics properties of trimethoprim and sulfamethoxazole were investigated in clinically healthy broiler chickens after the single oral administration of the commercial preparation Methoxasol (Eurovet Animal Health, B.V., The Netherlands) at a dose of 0.275 ml/kg b.w. After a single dose drug administration, the chickens were sacrificed by decapitation under general anaesthesia by Isoflurin 1 000 mg/g (Vetpharma AH, Spain) and the blood was collected at precisely defined intervals: 15, 30, 45, 60, 90, 120, 180, 360 and 720 min after the administration. The serum concentrations of amoxicillin were determined using Q Exactive tandem mass spectrometer (Thermo Fisher Scientific, USA) in conjunction with liquid chromatography. The detected pharmacokinetic parameters of trimethoprim after the oral administration were C<sub>max</sub> = 2.1 ± 1.0 µg/ml; T<sub>max</sub> = 1.5 h; t<sub>½</sub> = 0.88 h; k<sub>el</sub> = 0.009 3 ± 0.001 1 1/h; AUC<sub>t</sub> = 2.901 ± 1.4 µg.h/ml; AUC<sub>∞</sub> = 2.907 ± 1.5 µg.h/ml; V<sub>d</sub> = 2.632 l/kg; Cl = 2.7 l/h. The pharmacokinetic parameters of sulfamethoxazole after the oral administration were C<sub>max</sub> = 47.1 ± 15.3 µg/ml; T<sub>max</sub> = 1 h; t<sub>½</sub> = 1.92 h; k<sub>el</sub> = 0.004 6 ± 0.000 3 1/h; AUC<sub>t</sub> = 89.676 ± 26.9 µg.h/ml; AUC<sub>∞</sub> = 94.612 ± 28.4 µg.h/ml; V<sub>d</sub> = 0.584 l/kg; Cl = 0.21 l/h. To the best of our knowledge, this is the first pharmacokinetic study of the combination of sulfamethoxazole and trimethoprim in broiler chickens.

scholarly journals Diagnostic Performance of Five Assays for Anti-Hepatitis E Virus IgG and IgM in a Large Cohort Study

2015 ◽  
Vol 54 (3) ◽  
pp. 549-555 ◽  
Author(s):  
Heléne Norder ◽  
Marie Karlsson ◽  
Åsa Mellgren ◽  
Jan Konar ◽  
Elisabeth Sandberg ◽  
...  
Keyword(s):  
Gold Standard ◽  
Diagnostic Performance ◽  
Hepatitis E Virus ◽  
Blood Donors ◽  
Laboratory Diagnosis ◽  
Hepatitis E ◽  
Serum Samples ◽  
Large Cohort Study ◽  
No Gold Standard

Determination of anti-hepatitis E virus (anti-HEV) antibodies is still enigmatic. There is no gold standard, and results obtained with different assays often diverge. Herein, five assays were compared for detection of anti-HEV IgM and IgG. Serum samples from 500 Swedish blood donors and 316 patients, of whom 136 had suspected HEV infection, were analyzed. Concordant results for IgM and IgG with all assays were obtained only for 71% and 70% of patients with suspected hepatitis E, respectively. The range of sensitivity for anti-HEV detection was broad (42% to 96%); this was reflected in the detection limit, which varied up to 19-fold for IgM and 17-fold for IgG between assays. HEV RNA was analyzed in all patients and in those blood donors reactive for anti-HEV in any assay, and it was found in 26 individuals. Among all of the assays, both anti-HEV IgG and IgM were detected in 10 of those individuals. Twelve had only IgG and, in 7 of those 12, IgG was only detected with the two most sensitive assays. Three of the HEV-RNA-positive samples were negative for anti-HEV IgM and IgG in all assays. With the two most sensitive assays, anti-HEV IgG was identified in 16% of the blood donor samples and in 66% of patients with suspected HEV infection. Because several HEV-RNA-positive samples had only anti-HEV IgG without anti-HEV IgM or lacked anti-HEV antibodies, analysis for HEV RNA may be warranted as a complement in the laboratory diagnosis of ongoing HEV infection.

Angiostrongylus costaricensis egg antigen for the immunodiagnosis of abdominal angiostrongyliasis

2008 ◽  
Vol 82 (3) ◽  
pp. 251-254 ◽  
Author(s):  
P. Mesén-Ramírez ◽  
E. Abrahams-Sandí ◽  
K. Fernández-Quesada ◽  
P. Morera
Keyword(s):  
The United States ◽  
Enzyme Linked Immunosorbent Assay ◽  
Histopathological Diagnosis ◽  
Parasitic Disease ◽  
Serum Samples ◽  
Widespread Occurrence ◽  
Specific Igg ◽  
Egg Antigen ◽  
Specific Diagnostic Test

AbstractAngiostrongylus costaricensis is the aetiological agent of human abdominal angiostrongyliasis, a parasitic disease reported from the United States to Argentina, with a widespread occurrence of the nematode throughout Central and South America. This study assesses the performance of A. costaricensis eggs as antigen in an enzyme-linked immunosorbent assay (ELISA), for the determination of parasite-specific IgG1 antibodies. The specificity and the sensitivity of the method were 87% and 90.5%, respectively. Through this test it was possible to demonstrate a sharp and early decline in IgG1 antibody in serum samples taken from patients with histopathological diagnosis of abdominal angiostrongyliasis at different time points after surgical treatment. The present work demonstrated the usefulness of the egg antigen in the development of a specific diagnostic test for abdominal angiostrongylosis.

scholarly journals Evaluation of Modified Two-Tiered Testing Algorithms for Lyme Disease Laboratory Diagnosis Using Well-Characterized Serum Samples

2018 ◽  
Vol 56 (8) ◽  
Author(s):  
Adoracion Pegalajar-Jurado ◽  
Martin E. Schriefer ◽  
Ryan J. Welch ◽  
Marc R. Couturier ◽  
Tiffany MacKenzie ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Laboratory Testing ◽  
Laboratory Diagnosis ◽  
Serum Samples ◽  
Chemiluminescence Immunoassay ◽  
Testing Algorithms ◽  
Second Tier ◽  
Testing Algorithm ◽  
Low Sensitivity ◽  
Recommended Algorithm

ABSTRACTStandard two-tiered testing (STTT) is the recommended algorithm for laboratory diagnosis of Lyme disease (LD). Several limitations are associated with STTT that include low sensitivity in the early stages of disease, as well as technical complexity and subjectivity associated with second-tier immunoblotting; therefore, modified two-tiered testing (MTTT) algorithms that utilize two sequential first-tier tests and eliminate immunoblotting have been evaluated. Recently, a novel MTTT that uses a VlsE chemiluminescence immunoassay followed by a C6 enzyme immunoassay has been proposed. The purpose of this study was to evaluate the performance of the VlsE/C6 MTTT using well-characterized serum samples. Serum samples from the CDC Lyme Serum Repository were tested using three MTTTs, VlsE/C6, whole-cell sonicate (WCS)/C6, and WCS/VlsE, and three STTTs (immunoblotting preceded by three different first-tier assays: VlsE, C6, and WCS). Significant differences were not observed between the results of the MTTTs assessed; however, the VlsE/C6 MTTT resulted in the highest specificity (100%) when other diseases were tested and the lowest sensitivity (75%) for LD samples. Significant differences were present between the results for various MTTTs and STTTs evaluated. Specifically, all MTTTs resulted in higher sensitivities than the STTTs for all LD groups combined and were significantly more accurate (i.e., higher proportion of correct classifications) for this group, with the exception of the WCS/ViraStripe STTT. Additionally, when other diseases were tested, only the results of the VlsE/C6 MTTT differed significantly from those of the WCS/ViraStripe STTT, with the VlsE/C6 MTTT resulting in a 6.2% higher accuracy. Overall, the VlsE/C6 MTTT offers an additional laboratory testing algorithm for LD with equivalent or enhanced performance compared to that of the other MTTTs and STTTs evaluated in this study.

scholarly journals Lyme Disease: Diversity of Borrelia Species in California and Mexico Detected Using a Novel Immunoblot Assay

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 97 ◽  
Author(s):  
Melissa C. Fesler ◽  
Jyotsna S. Shah ◽  
Marianne J. Middelveen ◽  
Iris Du Cruz ◽  
Joseph J. Burrascano ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
The United States ◽  
Immunoglobulin M ◽  
Health Concern ◽  
Borrelia Burgdorferi Sensu Lato ◽  
Serum Samples ◽  
Group 2 ◽  
Immunoblot Technique ◽  
Group 1

Background: With more than 300,000 new cases reported each year in the United States of America (USA), Lyme disease is a major public health concern. Borrelia burgdorferi sensu stricto (Bbss) is considered the primary agent of Lyme disease in North America. However, multiple genetically diverse Borrelia species encompassing the Borrelia burgdorferi sensu lato (Bbsl) complex and the Relapsing Fever Borrelia (RFB) group are capable of causing tickborne disease. We report preliminary results of a serological survey of previously undetected species of Bbsl and RFB in California and Mexico using a novel immunoblot technique. Methods: Serum samples were tested for seroreactivity to specific species of Bbsl and RFB using an immunoblot method based on recombinant Borrelia membrane proteins, as previously described. A sample was recorded as seropositive if it showed immunoglobulin M (IgM) and/or IgG reactivity with at least two proteins from a specific Borrelia species. Results: The patient cohort consisted of 90 patients residing in California or Mexico who met the clinical case definition of chronic Lyme disease. Immunoblot testing revealed that 42 patients were seropositive for Bbsl (Group 1), while 56 patients were seropositive for RFB (Group 2). Eight patients were seropositive for both Bbsl and RFB species. Group 1 included patients who were seropositive for Bbss (14), B. californiensis (eight), B. spielmanii (10), B. afzelii/B. garinii (10), and mixed infections that included B. mayonii (three). Group 2 included patients who were seropositive for B. hermsii (nine), B. miyamotoi (seven), B. turicatae (nine), and B. turcica (two). In the remaining Group 1 and Group 2 patients, the exact Borrelia species could not be identified using the immunoblot technique. Conclusions: Lyme disease is associated with a diverse group of Borrelia species in California and Mexico. Current testing for Lyme disease focuses on detection of Bbss, possibly resulting in missed diagnoses and failure to administer appropriate antibiotic therapy in a timely manner. The genetic diversity of Borrelia spirochetes must be considered in future Lyme disease test development.

Physician preferences in the diagnosis and treatment of Lyme disease in the United States

Infection ◽  
1996 ◽  
Vol 24 (2) ◽  
pp. 182-186 ◽  
Author(s):  
Martina H. Ziska ◽  
S. T. Donta ◽  
F. C. Demarest
Keyword(s):  
United States ◽  
Lyme Disease ◽  
The United States ◽  
Diagnosis And Treatment

scholarly journals Borrelia burgdorferi Complement Regulator-Acquiring Surface Protein 2 (CspZ) as a Serological Marker of Human Lyme Disease

2007 ◽  
Vol 15 (3) ◽  
pp. 484-491 ◽  
Author(s):  
Peter Kraiczy ◽  
Annekatrin Seling ◽  
Catherine A. Brissette ◽  
Evelyn Rossmann ◽  
Klaus-Peter Hunfeld ◽  
...  
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Type Strain ◽  
Surface Protein ◽  
The United States ◽  
Sensu Stricto ◽  
Serum Samples ◽  
Genes Encoding ◽  
Complement Regulator ◽  
Infecting Organisms

ABSTRACT Serological diagnosis of Lyme disease may be complicated by antigenic differences between infecting organisms and those used as test references. Accordingly, it would be helpful to include antigens whose sequences are well conserved by a broad range of Lyme disease spirochetes. In the present study, line blot analyses were performed using recombinant complement regulator-acquiring surface protein 2 (BbCRASP-2) from Borrelia burgdorferi sensu stricto strain B31 and serum samples from human Lyme disease patients from throughout the United States and Germany. The results indicated that a large proportion of the patients had produced antibodies recognizing recombinant BbCRASP-2. In addition, Lyme disease spirochetes isolated from across North America and Europe were found to contain genes encoding proteins with high degrees of similarity to the B. burgdorferi type strain B31 BbCRASP-2, consistent with the high percentage of serologically positive patients. These data indicate that BbCRASP-2 may be valuable for use in a widely effective serological assay.

scholarly journals Evaluation of the Recombinant VlsE-Based Liaison Chemiluminescence Immunoassay for Detection of Borrelia burgdorferi and Diagnosis of Lyme Disease

2008 ◽  
Vol 15 (12) ◽  
pp. 1796-1804 ◽  
Author(s):  
Thomas B. Ledue ◽  
Marilyn F. Collins ◽  
John Young ◽  
Martin E. Schriefer
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Viral Infections ◽  
Relative Sensitivity ◽  
The United States ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Chemiluminescence Immunoassay ◽  
Variable Surface ◽  
Relative Specificity

ABSTRACT Recent efforts to improve the serologic diagnosis of Lyme disease have included the use of a synthetic peptide (C6) that reproduces the sequence of invariable region 6 of VlsE, the variable surface antigen of Borrelia burgdorferi. In the present study, the diagnostic performance of DiaSorin's recombinant VlsE-based chemiluminescence immunoassay in 1,947 human serum samples was evaluated. Sensitivity was determined using two serum panels from the CDC. For panel I, we observed sensitivities of 68.4% and 75.6% for subjects with early, localized (n = 19) or disseminated (n = 41) disease, respectively. For panel II, we observed sensitivities of 61.5% and 100% for subjects with early (n = 26) or late-stage (n = 11) disease, respectively. We observed a specificity of 99.5% for healthy donors (n = 600) living either in regions of the United States where the disease is endemic or in regions where it is not endemic. Overall, specificity among 207 potentially cross-reactive sera from subjects who had other spirochetal infections, nonspirochetal infections including bacterial and viral infections, or autoimmune or neurologic disease; who were positive for rheumatoid factor or anti-mouse antibodies; or who had been previously vaccinated for Lyme disease was 93.7%. In a direct comparison of 1,038 prospectively collected samples for Lyme disease testing we observed a relative sensitivity of 70%, a relative specificity of 99.1%, and an overall agreement of 97.1% between the DiaSorin recombinant VlsE chemiluminescence immunoassay and the Immunetics peptide-based C6 enzyme-linked immunosorbent assay.

scholarly journals Lyme disease: modern approaches to treatment and prevention (based on international recommendations of 2020)

2022 ◽  
Vol 66 (9-10) ◽  
pp. 57-63
Author(s):  
B. S. Belov ◽  
L. P. Ananyeva
Keyword(s):  
Lyme Disease ◽  
Erythema Migrans ◽  
Clinical Manifestations ◽  
The United States ◽  
Cefuroxime Axetil ◽  
Duration Of Treatment ◽  
American College Of Rheumatology ◽  
Treatment And Prevention ◽  
Medical Importance ◽  
American Academy Of Neurology

Lyme disease (LD) or tick-borne borreliosis affects thousands of people every year in different regions of the world, primarily in the United States and Europe. Given the great social and medical importance of this problem, an updated version of the clinical guidelines for the prevention, diagnosis and treatment of PD was published in November 2020 by a committee of experts of the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN) and the American College of Rheumatology (ACR). This article discusses the main issues of the use of antibacterial drugs in LD. The most commonly used medications are doxycycline, amoxicillin, cefuroxime axetil, and ceftriaxone. Patients with erythema migrans receive appropriate antibiotics for 7–14 days, depending on the medication used. In case of other clinical manifestations of LD, the duration of treatment is extended to 14–28 days. Antibiotic prophylaxis is carried out using a single oral dose of 200 mg doxycycline for adults and 4.4 mg/kg (with a maximum of 200 mg) for children. This treatment scheme is highly efficient, easy to administer, and has a relatively low risk of adverse events.

scholarly journals Detection of Immune Complexes Is Not Independent of Detection of Antibodies in Lyme Disease Patients and Does Not Confirm Active Infection with Borrelia burgdorferi

2005 ◽  
Vol 12 (9) ◽  
pp. 1036-1040 ◽  
Author(s):  
Adriana R. Marques ◽  
Ronald L. Hornung ◽  
Len Dally ◽  
Mario T. Philipp
Keyword(s):  
Lyme Disease ◽  
Borrelia Burgdorferi ◽  
Rhesus Macaques ◽  
Protein A ◽  
Surface Protein ◽  
Laboratory Diagnosis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Active Infection ◽  
Serum Samples ◽  
Outer Surface Protein A

ABSTRACT The Borrelia burgdorferi-specific immune complex (IC) test, which uses polyethylene glycol (PEG) precipitation to isolate ICs from serum, has been used as a research test in the laboratory diagnosis of early Lyme disease (LD) and has been proposed as a marker of active infection. We examined whether B. burgdorferi-specific antibodies were present within PEG-precipitated ICs (PEG-ICs) in patients with LD, posttreatment Lyme disease syndrome, and controls, including individuals who received the outer surface protein A (OspA) vaccine. Using a B. burgdorferi whole-cell enzyme-linked immunosorbent assay (ELISA), we obtained positive PEG-IC results not only in patients with a history of LD, but also in individuals vaccinated with OspA vaccine. The frequency of positive PEG-IC ELISAs in OspA vaccinees was significantly higher with ELISA-reactive than with ELISA-negative unprocessed serum samples (P = 0.001), demonstrating dependency between the tests. Similar results were found using samples from rhesus macaques infected with B. burgdorferi, uninfected macaques vaccinated with OspA, and controls. Therefore, testing for the presence of antibodies against B. burgdorferi in PEG-IC preparations is not more likely to reflect active infection than testing in unprocessed serum and should not be used in individuals who received the OspA vaccine.

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