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Journal of Clinical Microbiology, April 2001, p. 1294-1298, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1294-1298.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Characterization of Lyme Borreliosis Isolates from Patients with Erythema Migrans and Neuroborreliosis in Southern Sweden

Katharina Ornstein,1 Johan Berglund,1 Ingrid Nilsson,1 Ragnar Norrby,1 and Sven Bergström2,*

Department of Infectious Diseases and Medical Microbiology, Lund University, Lund,1 and Department of Microbiology, Umeå University, Umeå,2 Sweden

Received 16 August 2000/Returned for modification 11 November 2000/Accepted 11 January 2001

Southern Sweden is an area of Lyme borreliosis (LB) endemicity, with an incidence of 69 cases per 100,000 inhabitants. The most frequent clinical manifestations are erythema migrans (77%) and neuroborreliosis (16%). There was no record of human Borrelia strains being isolated from patients in this region before the prospective study reported here. Borrelia spirochetes were isolated from skin and cerebrospinal fluid (CSF) from LB patients living in the region. A total of 39 strains were characterized by OspA serotype analysis, species-specific PCR, and signature nucleotide analysis of the 16S rRNA gene. Of 33 skin isolates, 31 (93.9%) were Borrelia afzelii strains and 2 (6.1%) were Borrelia garinii strains. Of six CSF isolates, five (83.3%) were B. garinii and one (16.7%) was B. afzelii. Neither Borrelia burgdorferi sensu stricto strains nor multiple infections were observed. The B. afzelii isolates were of OspA serotype 2. Three B. garinii strains were of OspA serotype 5, and the remaining four strains were of OspA serotype 6. All of the B. garinii strains belonged to the same 16S ribosomal DNA ribotype class. Our findings agree with earlier findings from other geographic regions in Europe where B. afzelii and B. garinii have been recovered predominately from skin and CSF cultures, respectively. To further study the possible presence in Sweden of the genotype B. burgdorferi sensu stricto, which is known to be present in Europe and to occur predominately in patients with Lyme arthritis, molecular detection of Borrelia-specific DNA in synovial samples from Lyme arthritis patients should be performed.

* Corresponding author. Mailing address: Department of Microbiology, Umeå University, S-901 87 Umeå, Sweden. Phone: 46-(0)90-7856726. Fax: 46-(0)90-772630. E-mail: sven.bergstrom{at}micro.umu.se.

Journal of Clinical Microbiology, April 2001, p. 1294-1298, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1294-1298.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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