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Journal of Clinical Microbiology, December 2006, p. 4407-4413, Vol. 44, No. 12
0095-1137/06/$08.00+0     doi:10.1128/JCM.01077-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Borrelia burgdorferi Genetic Markers and Disseminated Disease in Patients with Early Lyme Disease

Division of Rheumatology, Allergy, and Immunology, Center for Immunology and Inflammatory Disease, Harvard Medical School, Massachusetts General Hospital, 55 Fruit St., CNY 149/8301, Boston, Massachusetts 02114

Received 24 May 2006/ Returned for modification 17 September 2006/ Accepted 3 October 2006

Three genetic markers of Borrelia burgdorferi have been associated with disseminated disease: the OspC type, the 16S-23S rRNA intergenic spacer type (RST), and vlsE. Here, we modified previous methods so as to identify the three markers by PCR and restriction fragment length polymorphism in parallel, analyzed B. burgdorferi isolates from erythema migrans (EM) skin lesions in 91 patients, and correlated the results with evidence of dissemination. OspC type A was found approximately twice as frequently in patients with disseminated disease, whereas type K was identified approximately twice as often in those without evidence of dissemination, but these trends were not statistically significant. The remaining seven types identified were found nearly equally in patients with or without evidence of dissemination. RST 1 strains were significantly associated with dissemination (P = 0.03), whereas RST 2 and RST 3 strains tended to have an inverse association with this outcome. The vlsE gene was identified in all 91 cases, using primer sets specific for an N-terminal sequence of B. burgdorferi strain B31 (vlsE^B31) or strain 297 (vlsE²⁹⁷), but neither marker was associated with dissemination. Specific combinations of the three genetic markers usually occurred together. OspC type A was always found with RST 1 and vlsE^B31, type K was always identified with RST 2 and more often with vlsE²⁹⁷, and types E and I were almost always found with RST 3 and equally often with vlsE^B31 and vlsE²⁹⁷. We conclude that B. burgdorferi strains vary in their capacity to disseminate, but almost all strains isolated from EM lesions sometimes caused disseminated disease.

Published ahead of print on 11 October 2006.

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