Figueroa R, Bracero L A, Aguero-Rosenfeld M, Beneck D, Coleman J, Schwartz I
Department of Obstetrics and Gynecology, New York Medical College, Westchester County Medical Center, Valhalla, USA.
Gynecol Obstet Invest. 1996;41(4):240-3. doi: 10.1159/000292277.
The purpose of our study was to determine whether Borrelia burgdorferi spirochetes were present in placentas of asymptomatic women with reactive Lyme serology using a silver stain, and to confirm the identity of the spirochetes by polymerase chain reaction (PCR). Sixty placentas of asymptomatic women with ELISA-positive or-equivocal serology for Lyme antibodies during pregnancy were examined for spirochetes using a silver stain. The results of the ELISA serology were confirmed by Western blot analysis. PCR amplification for B. burgdorferi was performed on placentas identified to have spirochetes and on a group of placentas negative for spirochetes. Spirochetes were identified by silver staining in 3 (5%) of the 60 placentas. PCR confirmed B. burgdorferi nucleotide sequences in 2 of the placentas. The 5 women had equivocal Lyme ELISA and negative syphilis serology. The results of the Western blot analysis were negative in 2 cases and indeterminate in 1 case. Six controls were negative for spirochetes by silver staining and PCR. A normal perinatal outcome was observed in all cases. Spirochetes identified in placental tissue of pregnancies with reactive Lyme serology were confirmed by PCR to be B. burgdorferi. There was no relationship between the presence of placental spirochetes and the results of Lyme serology or the pregnancy outcome.
我们研究的目的是使用银染色法确定莱姆血清学反应阳性的无症状孕妇的胎盘内是否存在伯氏疏螺旋体，并通过聚合酶链反应（PCR）确认螺旋体的身份。对60例孕期莱姆抗体ELISA检测呈阳性或可疑阳性的无症状孕妇的胎盘进行银染色，以检查螺旋体。ELISA血清学检测结果通过蛋白质印迹分析进行确认。对鉴定出有螺旋体的胎盘以及一组螺旋体检测呈阴性的胎盘进行伯氏疏螺旋体的PCR扩增。在60个胎盘中，有3个（5%）通过银染色鉴定出螺旋体。PCR在2个胎盘中确认了伯氏疏螺旋体的核苷酸序列。这5名女性的莱姆ELISA检测结果可疑，梅毒血清学检测呈阴性。蛋白质印迹分析结果在2例中为阴性，1例为不确定。6个对照通过银染色和PCR检测螺旋体均为阴性。所有病例均观察到正常的围产期结局。PCR确认，在莱姆血清学反应阳性妊娠的胎盘组织中鉴定出的螺旋体为伯氏疏螺旋体。胎盘螺旋体的存在与莱姆血清学检测结果或妊娠结局之间没有关联。
