Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease

[duncan]

http://www.mdpi.com/2227-9032/6/2/33

[Psilociraptor]

So... given that post treatment culture failure is half the reason this debate spawned... what exactly did they do differently to make it work here? Seems like they didn't talk much about what they attributed their success to.

[duncan]

I suspect part of the answer lies in testing tissue.

[Martian]

Abstract of the publication:

Healthcare (Basel). 2018 Apr 14;6(2). pii: E33. doi: 10.3390/healthcare6020033.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease.

Middelveen MJ, Sapi E, Burke J, Filush KR, Franco A, Fesler MC, Stricker RB.

Abstract

INTRODUCTION: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borreliaburgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms.

METHODS: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner.

RESULTS: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borreliaburgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods.

CONCLUSIONS: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

KEYWORDS: Borrelia burgdorferi; Lyme disease; chronic infection; spirochete culture; tickborne disease

PMID: 29662016 PMCID: PMC6023324 DOI: 10.3390/healthcare6020033

Free full text available (follow link in first post).

[Psilociraptor]

I suspect part of the answer lies in testing tissue.

Maybe I missed something, but wasn't it mostly blood and genital secretions? Either way it seems worthy of a discussion since it will obviously be a point of contention for critics.