Bil-Lula Iwona, Matuszek Patryk, Pfeiffer Thomas, Woźniak Mieczysław
Department of Clinical Chemistry, Wroclaw Medical University, Poland.
Euroimmun, Wrocław, Poland.
Adv Clin Exp Med. 2015 Jul-Aug;24(4):663-70. doi: 10.17219/acem/28625.
Infections of Borrelia burgdorferi sensu lato reveal clinical manifestations affecting numerous organs and tissues. The standard diagnostic procedure of these infections is quite simple if a positive history of tick exposure or typical erythema migrans appears. Lack of unequivocal clinical symptoms creates the necessity for further evaluation with laboratory tests.
This study discusses the utility of a novel, improved, well-optimized, sensitive and highly specific quantitative real-time PCR assay for the diagnostics of infections caused by Borrelia burgdorferi sensu lato.
We designed an improved, specific, highly sensitive real-time quantitative polymerase chain reaction (RQ-PCR) assay for the detection and quantification of all Borrelia burgdorferi genotypes. A wide validation effort was undertaken to ensure confidence in the highly sensitive and specific detection of B. burgdorferi.
Due to high sensitivity and great specificity, as low as 1.6×10² copies of Borrelia per mL of whole blood could be detected. As much as 12 (3%) negative ELISA IgM results, 14 (2.8%) negative results of Line blot IgM, 11 (3.1%) and 7 (2.7%) of negative ELISA IgG and Line blot IgG results, respectively, were positive in real-time PCR.
The data in this study confirms the high positive predictive value of real-time PCR test in the detection of Borrelia infections.
伯氏疏螺旋体复合群感染可引发影响多个器官和组织的临床表现。如果有蜱虫叮咬暴露史或出现典型的游走性红斑，这些感染的标准诊断程序相当简单。缺乏明确的临床症状使得有必要通过实验室检测进行进一步评估。
本研究探讨一种新型、改进、优化良好、灵敏且高度特异的定量实时PCR检测方法在诊断伯氏疏螺旋体复合群感染中的应用价值。
我们设计了一种改进的、特异的、高度灵敏的实时定量聚合酶链反应（RQ-PCR）检测方法，用于检测和定量所有伯氏疏螺旋体基因型。进行了广泛的验证工作，以确保对伯氏疏螺旋体的高灵敏和特异检测有信心。
由于高灵敏度和高特异性，每毫升全血中低至1.6×10²份伯氏疏螺旋体拷贝都能被检测到。实时PCR检测显示，分别有12份（3%）ELISA IgM阴性结果、14份（2.8%）线性印迹IgM阴性结果、11份（3.1%）ELISA IgG阴性结果和7份（2.7%）线性印迹IgG阴性结果呈阳性。
本研究数据证实了实时PCR检测在伯氏疏螺旋体感染检测中的高阳性预测值。
