Gutiérrez J, Núñez F, Piédrola G, Maroto C
Departamento de Microbiología, Hospital Universitario San Cecilio, Universidad de Granada, España.
Rev Med Chil. 1998 Jun;126(6):629-36.
There is phenotypic and genetic variability among the species Borrelia burgdorferi that produces Lyme disease. Three gene species and seven serotypes have been defined.
To study the efficacy of two gene species in the serological diagnosis of Borrelia burgdorferi infections in Granada, Spain.
One thousand sixty nine sera coming from 1,251 subjects without Lyme borreliosis were analyzed. These subjects were studied for health or pregnancy controls, differential diagnosis of viral disease, diagnosis of syphilis, neurological or rheumatic diseases. In all samples, antibodies against Borrelia burgdorferi (B31 and Pko strains) and against Treponema pallidum were investigated. Screening tests (ELISA and hemagglutination) were followed by confirmations tests for positive samples (Western Blot IgG strain B31 and FTA-abs respectively). A clinical and laboratory follow up was done for subjects with positive serological tests.
The global rate of positive antibodies against Borrelia burgdorferi B31 was 8.31% and against the strain Pko was 0.64%. Western blot was negative in 36% of subjects with positive ELISA B31. The distribution of antibodies against the strain B31 was acute herpes virus infection in 16%, gestation in 3%, HIV infection in 6.4%, T pallidum infection in 36%, rheumatic diseases in 25%, neurological diseases in 17.5% and health controls in 7.4%. The percentage of positive Western Blot analyzes were 0.8, 2.1 and 0.4% respectively. A reversion of positive ELISA tests was observed in 6 subjects.
The disparity in rates of antibodies against Borrelia burgdorferi in different geographic regions may be due to differences in the serological tests used. The high rate of false positive ELISA tests underscores the need to use other serological tests.
引起莱姆病的伯氏疏螺旋体物种之间存在表型和基因变异性。已定义了三种基因种和七种血清型。
研究两种基因种在西班牙格拉纳达对伯氏疏螺旋体感染进行血清学诊断中的效能。
分析了来自1251名无莱姆病螺旋体病受试者的1069份血清。这些受试者因健康或妊娠对照、病毒病鉴别诊断、梅毒诊断、神经或风湿性疾病而接受研究。在所有样本中，检测了抗伯氏疏螺旋体（B31和Pko菌株）和抗梅毒螺旋体的抗体。筛查试验（酶联免疫吸附测定法和血凝试验）之后，对阳性样本进行确认试验（分别为B31菌株的免疫印迹IgG和荧光密螺旋体抗体吸收试验）。对血清学检测呈阳性的受试者进行临床和实验室随访。
抗伯氏疏螺旋体B31的抗体总体阳性率为8.31%，抗Pko菌株的为0.64%。在酶联免疫吸附测定法B31呈阳性的受试者中，36%的免疫印迹结果为阴性。抗B31菌株抗体的分布情况为：急性疱疹病毒感染占16%，妊娠占3%，艾滋病毒感染占6.4%，梅毒螺旋体感染占36%，风湿性疾病占25%，神经疾病占17.5%，健康对照占7.4%。免疫印迹分析的阳性百分比分别为0.8%、2.1%和0.4%。观察到6名受试者的酶联免疫吸附测定法阳性试验结果出现逆转。
不同地理区域抗伯氏疏螺旋体抗体率的差异可能是由于所用血清学检测方法的不同。酶联免疫吸附测定法的高假阳性率突出表明需要使用其他血清学检测方法。
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