Clark Kerry L, Leydet Brian F, Threlkeld Clifford
Department of Public Health, University of North Florida, 1 UNF Drive, Jacksonville, FL 32224, USA.
Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA.
J Med Microbiol. 2014 May;63(Pt 5):674-684. doi: 10.1099/jmm.0.073122-0. Epub 2014 Feb 25.
The present study investigated the cause of illness in human patients primarily in the southern USA with suspected Lyme disease based on erythema migrans-like skin lesions and/or symptoms consistent with early localized or late disseminated Lyme borreliosis. The study also included some patients from other states throughout the USA. Several PCR assays specific for either members of the genus Borrelia or only for Lyme group Borrelia spp. (Borrelia burgdorferi sensu lato), and DNA sequence analysis, were used to identify Borrelia spp. DNA in blood and skin biopsy samples from human patients. B. burgdorferi sensu lato DNA was found in both blood and skin biopsy samples from patients residing in the southern states and elsewhere in the USA, but no evidence of DNA from other Borrelia spp. was detected. Based on phylogenetic analysis of partial flagellin (flaB) gene sequences, strains that clustered separately with B. burgdorferi sensu stricto, Borrelia americana or Borrelia andersonii were associated with Lyme disease-like signs and symptoms in patients from the southern states, as well as from some other areas of the country. Strains most similar to B. burgdorferi sensu stricto and B. americana were found most commonly and appeared to be widely distributed among patients residing throughout the USA. The study findings suggest that human cases of Lyme disease in the southern USA may be more common than previously recognized and may also be caused by more than one species of B. burgdorferi sensu lato. This study provides further evidence that B. burgdorferi sensu stricto is not the only species associated with signs and/or symptoms consistent with Lyme borreliosis in the USA.
本研究调查了美国南部主要因疑似莱姆病的游走性红斑样皮肤病变和/或与早期局限性或晚期播散性莱姆疏螺旋体病相符的症状而患病的人类患者的病因。该研究还纳入了来自美国其他州的一些患者。使用了几种针对疏螺旋体属成员或仅针对莱姆病组疏螺旋体（狭义伯氏疏螺旋体）的聚合酶链反应（PCR）检测方法以及DNA序列分析，以鉴定人类患者血液和皮肤活检样本中的疏螺旋体DNA。在居住于美国南部各州及其他地区患者的血液和皮肤活检样本中均发现了狭义伯氏疏螺旋体DNA，但未检测到来自其他疏螺旋体的DNA证据。基于部分鞭毛蛋白（flaB）基因序列的系统发育分析，与狭义伯氏疏螺旋体、美洲疏螺旋体或安德森疏螺旋体分别聚类的菌株，与来自美国南部各州以及该国其他一些地区患者的莱姆病样体征和症状相关。与狭义伯氏疏螺旋体和美洲疏螺旋体最相似的菌株最为常见，且似乎广泛分布于居住在美国各地的患者中。研究结果表明，美国南部的人类莱姆病病例可能比之前认为的更为常见，并且可能由不止一种狭义伯氏疏螺旋体引起。本研究进一步证明，狭义伯氏疏螺旋体并非美国唯一与莱姆疏螺旋体病体征和/或症状相关的物种。
