The diagnostic value of serum Borrelia burgdorferi antibodies and seroconversion after Lyme neuroborreliosis, a nationwide observational study

被引：11

作者：

Tetens, Malte M. ^{[1
,14
]}

Dessau, Ram ^{[2
,3
]}

Ellermann-Eriksen, Svend ^{[4
]}

Andersen, Nanna S. ^{[5
]}

Jorgensen, Charlotte Svaerke ^{[6
]}

Ostergaard, Christian ^{[7
]}

Bodilsen, Jacob ^{[8
,9
]}

Damgaard, David F. ^{[8
]}

Bangsborg, Jette ^{[10
]}

Nielsen, Alex Christian ^{[11
]}

Moller, Jens Kjolseth ^{[12
]}

Omland, Lars Haukali ^{[1
]}

Obel, Niels ^{[1
,13
]}

Lebech, Anne-Mette ^{[13
]}

机构：

[1] Copenhagen Univ Hosp, Dept Infect Dis, Rigshospitalet, Copenhagen, Denmark

[2] Slagelse Hosp, Dept Clin Microbiol, Slagelse, Denmark

[3] Univ Southern Denmark, Dept Reg Hlth Res, Odense, Denmark

[4] Aarhus Univ Hosp, Dept Clin Microbiol, Aarhus, Denmark

[5] Odense Univ Hosp, Clin Ctr Emerging & Vector borne Infect, Dept Clin Microbiol, Odense, Denmark

[6] Statens Serum Inst, Dept Virus & Microbiol Special Diagnost, Copenhagen, Denmark

[7] Copenhagen Univ Hosp, Hvidovre Hosp, Dept Clin Microbiol, Copenhagen, Denmark

[8] Aalborg Univ Hosp, Dept Clin Microbiol, Aalborg, Denmark

[9] Aalborg Univ Hosp, Dept Infect Dis, Aalborg, Denmark

[10] Copenhagen Univ Hosp, Herlev Hosp, Dept Clin Microbiol, Copenhagen, Denmark

[11] Copenhagen Univ Hosp, Dept Clin Microbiol, Rigshospitalet, Copenhagen, Denmark

[12] Univ Hosp Southern Denmark, Vejle Hosp, Dept Clin Microbiol, Vejle, Denmark

[13] Univ Copenhagen, Fac Hlth & Med Sci, Copenhagen, Denmark

[14] Copenhagen Univ Hosp, Dept Infect Dis, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2022年 / 28卷 / 11期

关键词：

Borrelia burgdorferi intrathecal antibody; index test; Diagnostics; Lyme neuroborreliosis; Predictive value; Seroconversion; Serum antibody test; Serum serology; LUMBAR PUNCTURE; RISK; SEROPREVALENCE; PREVENTION; GUIDELINES; MANAGEMENT; DISEASES; IGG;

D O I：

10.1016/j.cmi.2022.06.001

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Objectives: Clinical guidelines disagree on the diagnostic usefulness of Borrelia burgdorferi (Bb) serum antibodies (serum-Bb) in investigation of Lyme neuroborreliosis (LNB). We investigated the association between serum-Bb and Bb intrathecal antibody index (Bb-AI) and rates of seroconversion and seroreversion after LNB. Methods: Danish residents who had a Bb-AI and corresponding serum-Bb measured between 1994 and 2020 were identified at all Danish departments of clinical microbiology. We used descriptive statistics to examine the proportions of positive Bb-AI combined with positive or negative serum-Bb antibody tests. Next, the rate of seroconversion and seroreversion among those with positive Bb-AI and either an initial negative or positive serum-Bb was estimated. Results: We included 34 609 individuals with a Bb-AI and corresponding serum-Bb. The proportion of individuals with positive Bb-AI who had negative serum-Bb was 16.8% (95% CI, 15.1-18.6). The proportion of individuals with positive serum-Bb IgM, serum-Bb IgG, or serum-Bb IgM and IgG antibodies who had positive Bb-AI was 10.6% (95% CI, 9.5-11.8), 24.7% (95% CI, 23.0-26.4), and 45.0% (95% CI, 42.4-48.0), respectively. The proportion of children (<18 years) with positive serum-Bb IgM and IgG antibodies who had a positive Bb-AI was 59.7% (95% CI, 53.4-65.8). The proportion of individuals with positive Bb-AI with initial negative or positive serum-Bb antibodies who seroconverted or seroreverted within 2 years was 17.3% (95% CI, 6.9-27.8) and 23.2% (95% CI, 19.1-27.7), respectively. Conclusions: Serum-Bb antibodies could not predict results of Bb-AI. A fifth of both seronegative and seropositive individuals with positive Bb-AI seroconverted or seroreverted within 2 years. Malte M. Tetens, Clin Microbiol Infect 2022;28:1500.e1-1500.e6 (c) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：1500.e1 / 1500.e6

页数：6

共 9 条

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