Since culture of Borrelia burgdorferi from patients with chronic Lyme disease has been an extraordinarily rare event, clarification of the nature of the illness and proving its etiology as infectious have been difficult. A method for reliably and reproducibly culturing B. burgdorferi from the blood of patients with chronic Lyme disease was therefore sought by making a controlled blood culture trial studying 47 patients with chronic Lyme disease. All had relapsed after long-term oral and intravenous antibiotics. 23 patients with other chronic illness formed the control group. Positive cultures were confirmed by fluorescent antibody immuno-electron microscopy using monoclonal antibody directed against Osp A, and Osp A PCR. 43/47 patients (91%) cultured positive. 23/23 controls (100%) cultured negative. Although persistent infection has been, to date, strongly suggested in chronic Lyme disease by positive PCR and antigen capture, there are major problems with these tests. This new method for culturing B. burgdorferi from patients with chronic Lyme disease certainly defines the nature of the illness and establishes that it is of chronic infectious etiology. This discovery should help to reestablish the gold standard in laboratory diagnosis of Lyme disease.

• MeSH
• Bacteremia diagnosis   drug therapy   microbiology   MeSH
• Bacteriological Techniques standards   MeSH
• Borrelia burgdorferi Group isolation & purification   ultrastructure   MeSH
• Chronic Disease MeSH
• Diagnosis, Differential MeSH
• Humans MeSH
• Lyme Disease diagnosis   drug therapy   microbiology   MeSH
• Treatment Failure MeSH
• Predictive Value of Tests MeSH
• Recurrence MeSH
• Reproducibility of Results MeSH
• Case-Control Studies MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Geographicals
• Czech Republic MeSH
• New York City MeSH
• Connecticut MeSH
• Texas MeSH

The survey is based on a total of 1263 records (738 isolations and 525 molecular DNA detections) of five Borrelia burgdorferi s.l. genomic groups available from 26 European countries: B. burgdorferi sensu stricto, B. afzelii, B. garinii, B. valaisiana (= VS116) and B. lusitaniae (= PoTiB2). It shows the geographic distribution, the source (ixodid ticks 802 records, fleas 2 records, mosquitoes 2 records, wild mammals 66 records, human patients 391 records) and the association of the genomic groups with particular clinical manifestations of Lyme borreliosis in humans (B. afzelii significantly prevails in skin lesions whereas B. garinii is more often associated with neuroborreliosis). The most frequent genomic groups in Europe are B. garinii (501 records) and B. afzelii (469 records). They occur across the continent and islands, whereas the third frequent genomic group, B. burgdorferi s.s. (201 records), has only rarely been isolated in eastern Europe. The remaining genomic groups, i.e. B. valaisiana (85 records) and B. lusitaniae (7 records) have only been isolated from, or detected in, Ixodes ricinus ticks in a few European countries.

• MeSH
• Skin Diseases, Bacterial microbiology   MeSH
• Borrelia burgdorferi Group classification   genetics   isolation & purification   MeSH
• Culicidae microbiology   MeSH
• DNA, Bacterial analysis   MeSH
• Genome, Bacterial * MeSH
• Ticks microbiology   MeSH
• Humans MeSH
• Lyme Disease microbiology   MeSH
• Peripheral Nervous System Diseases microbiology   MeSH
• Mammals microbiology   MeSH
• Siphonaptera microbiology   MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Europe MeSH
• Europe, Eastern MeSH
• Names of Substances
• DNA, Bacterial MeSH

A total of 35 patients with late stage Lyme borreliosis with involvement of the joints was followed up until 3 years after a 14 day course of 2 g ceftriaxone once daily i.v. Diagnosis was confirmed by indirect and direct microbiological methods as well as clinical signs and symptoms. Long term clinical results in 26 patients at 36 months were complete response or marked improvement in 19, relapse in six and new manifestations in four of the cases, respectively. Possible mechanisms for non-responding to therapy are discussed. Therapy was well tolerated; in no case discontinuation of treatment was necessary due to adverse drug reactions. The treatment results in this group of 35 patients with Lyme arthritis are considered successful. The data obtained are consistent with expectations based on the published experiences with ceftriaxone in this indication.

• MeSH
• Borrelia burgdorferi Group immunology   isolation & purification   MeSH
• Time Factors MeSH
• Ceftriaxone therapeutic use   MeSH
• Adult MeSH
• Arthritis, Infectious complications   drug therapy   immunology   pathology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Lyme Disease complications   drug therapy   immunology   pathology   MeSH
• Follow-Up Studies MeSH
• Antibodies, Bacterial blood   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Consumer Product Safety MeSH
• Treatment Outcome MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Ceftriaxone MeSH
• Antibodies, Bacterial MeSH

In an open non-comparative clinical trial with the aim of evaluating the clinical efficacy and safety of a 14 day course of 2 g ceftriaxone once daily, 46 patients with neuroborreliosis were entered at the Infectious Diseases Teaching Hospital in Prague 8. In 39 patients the diagnosis was early Lyme neuroborreliosis. Seven patients suffered from late stage disease. Clinical results were 30% of patients cured at the end of treatment and 85% after 9 months in early stage disease. In late stage disease two patients out of seven were cured and four had improved after 12 months. One patient died because of cardiac infarction. In no patient had treatment to be discontinued because of adverse reactions to antibiotics.

• MeSH
• Borrelia burgdorferi Group immunology   isolation & purification   ultrastructure   MeSH
• Ceftriaxone therapeutic use   MeSH
• Child MeSH
• Adult MeSH
• Ticks MeSH
• Humans MeSH
• Lyme Disease drug therapy   immunology   microbiology   pathology   MeSH
• Nervous System Diseases drug therapy   immunology   microbiology   pathology   MeSH
• Antibodies, Bacterial blood   MeSH
• Treatment Outcome MeSH
• Animals MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Clinical Trial MeSH
• Names of Substances
• Ceftriaxone MeSH
• Antibodies, Bacterial MeSH