Phillips S E, Mattman L H, Hulínská D, Moayad H
Greenwich Hospital, CT 06830, USA.
Infection. 1998 Nov-Dec;26(6):364-7. doi: 10.1007/BF02770837.
Since culture of Borrelia burgdorferi from patients with chronic Lyme disease has been an extraordinarily rare event, clarification of the nature of the illness and proving its etiology as infectious have been difficult. A method for reliably and reproducibly culturing B. burgdorferi from the blood of patients with chronic Lyme disease was therefore sought by making a controlled blood culture trial studying 47 patients with chronic Lyme disease. All had relapsed after long-term oral and intravenous antibiotics. 23 patients with other chronic illness formed the control group. Positive cultures were confirmed by fluorescent antibody immuno-electron microscopy using monoclonal antibody directed against Osp A, and Osp A PCR. 43/47 patients (91%) cultured positive. 23/23 controls (100%) cultured negative. Although persistent infection has been, to date, strongly suggested in chronic Lyme disease by positive PCR and antigen capture, there are major problems with these tests. This new method for culturing B. burgdorferi from patients with chronic Lyme disease certainly defines the nature of the illness and establishes that it is of chronic infectious etiology. This discovery should help to reestablish the gold standard in laboratory diagnosis of Lyme disease.
由于从慢性莱姆病患者中培养出伯氏疏螺旋体的情况极为罕见，因此明确该疾病的本质并证明其病因具有传染性一直很困难。为此，通过对47例慢性莱姆病患者进行对照血培养试验，寻找一种能可靠且可重复地从慢性莱姆病患者血液中培养伯氏疏螺旋体的方法。所有患者在长期口服和静脉使用抗生素后均复发。23例患有其他慢性疾病的患者组成对照组。通过使用针对Osp A的单克隆抗体的荧光抗体免疫电子显微镜和Osp A PCR确认培养阳性。47例患者中有43例（91%）培养阳性。23例对照组患者（100%）培养阴性。尽管迄今为止，通过阳性PCR和抗原捕获在慢性莱姆病中强烈提示存在持续性感染，但这些检测存在重大问题。这种从慢性莱姆病患者中培养伯氏疏螺旋体的新方法无疑明确了该疾病的本质，并确定其病因是慢性感染性的。这一发现应有助于重新确立莱姆病实验室诊断的金标准。
