Kersten A, Poitschek C, Rauch S, Aberer E
Department of Dermatology, University of Vienna, Austria.
Antimicrob Agents Chemother. 1995 May;39(5):1127-33. doi: 10.1128/AAC.39.5.1127.
Antibiotic therapy with penicillin, doxycycline, and ceftriaxone has proven to be effective for the treatment of Lyme borreliosis. In some patients, however, it was noticed that borreliae can survival in the tissues in spite of seemingly adequate therapy. For a better understanding of this phenomenon, we investigated the different modes of degeneration of Borrelia burgdorferi suspensions during a 96-h exposure to various antibiotics. By dark-field microscopy and ultrastructural investigations, increasing blebbing and the gradual formation of granular and cystic structures could be followed during the exposure time. Although antibiotic concentrations at the MIC at which 90% of organisms are inhibited after 72 h were 80% or even greater, motile organisms were still present after incubation with penicillin and doxycycline but not after incubation with ceftriaxone. By transmission electron microscopy, intact spirochetal parts, mostly situated in cysts, were seen up to 96 h after exposure with all three antibiotics tested. According to experiences from studies with other spirochetes it is suggested that encysted borreliae, granules, and the remaining blebs might be responsible for the ongoing antigenic stimulus leading to complaints of chronic Lyme borreliosis.
青霉素、强力霉素和头孢曲松的抗生素疗法已被证明对莱姆病螺旋体病的治疗有效。然而，在一些患者中，人们注意到尽管进行了看似充分的治疗，螺旋体仍能在组织中存活。为了更好地理解这一现象，我们研究了伯氏疏螺旋体悬浮液在96小时内暴露于各种抗生素期间的不同退化模式。通过暗视野显微镜和超微结构研究，在暴露期间可以观察到气泡增加以及颗粒状和囊状结构的逐渐形成。尽管在72小时后抑制90%生物体生长的最低抑菌浓度（MIC）的抗生素浓度为80%甚至更高，但与青霉素和强力霉素孵育后仍有活动的生物体存在，而与头孢曲松孵育后则没有。通过透射电子显微镜观察，在使用所有三种测试抗生素暴露96小时后，仍可见完整的螺旋体部分，大多位于囊肿中。根据对其他螺旋体的研究经验，有人提出，被包裹的螺旋体、颗粒和剩余的气泡可能是导致慢性莱姆病螺旋体病症状的持续抗原刺激的原因。
