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Journal of Clinical Microbiology, June 2000, p. 2097-2102, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

A European Multicenter Study of Immunoblotting in Serodiagnosis of Lyme Borreliosis

J. Robertson,1 E. Guy,2 N. Andrews,3 B. Wilske,4 P. Anda,5 M. Granström,6 U. Hauser,4 Y. Moosmann,7 V. Sambri,8 J. Schellekens,9 G. Stanek,10 and J. Gray11,*

Public Health Laboratory, Southampton General Hospital, Southampton,1 Public Health Laboratory, Singleton Hospital, Swansea,2 and Public Health Laboratory Service Statistics Unit, Colindale, London,3 United Kingdom; Pettenkofer Institute, University of Munich, Munich, Germany4; Centro Nacional de Microbiologia, Instituto de Salud Carlos III, Madrid, Spain5; Department of Clinical Microbiology, Karolinska Hospital, Stockholm, Sweden6; Diagnostic Parasitology, University of Neuchâtel, Neuchâtel, Switzerland7; Microbiology, St. Orsola Hospital, University of Bologna, Bologna, Italy8; Diagnostic Laboratory for Infectious Diseases, National Institute of Public Health, Bilthoven, The Netherlands9; Hygiene Institute, University of Vienna, Vienna, Austria10; and Department of Environmental Resource Management, University College Dublin, Dublin, Ireland11

Received 27 September 1999/Returned for modification 12 November 1999/Accepted 10 March 2000

A European multicenter study of immunoblotting for the serodiagnosis of Lyme borreliosis showed considerable variation in results obtained from tests with a panel of 227 serum samples. Six laboratories used different immunoblot methods, and a wide range of bands was detected in all the assays. Multivariable logistic regression analysis of data from individual laboratories was used to determine the most discriminatory bands for reliable detection of antibodies to Borrelia burgdorferi sensu lato. These bands were used to construct individual interpretation rules for the immunoblots used in the six laboratories. Further analysis identified a subset of eight bands, which were important in all the laboratories, although with variations in significance. Possible European rules, all closely related, were formulated from these bands, although there was no single rule that gave high levels of sensitivity and specificity for all the laboratories. This is a reflection of the wide range of methodologies used, especially the use of different species and strains of B. burgdorferi sensu lato. The panel of European rules provides a framework for immunoblot interpretation which may be adapted in relation to the characteristics of Lyme borreliosis in local areas.

* Corresponding author. Mailing address: Department of Environmental Resource Management, University College, Belfield, Dublin 4, Ireland. Phone: 00353-1-7067739. Fax: 00353-1-7061102. E-mail: jgray{at}macollamh.ucd.ie.

Journal of Clinical Microbiology, June 2000, p. 2097-2102, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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