German National Reference Center for Borrelia

Oberschleißheim, Germany

German National Reference Center for Borrelia

Oberschleißheim, Germany
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Waindok P.,University of Veterinary Medicine Hannover | Schicht S.,University of Veterinary Medicine Hannover | Fingerle V.,German National Reference Center for Borrelia | Strube C.,University of Veterinary Medicine Hannover
Ticks and Tick-borne Diseases | Year: 2017

Lyme borreliosis (LB) is the most important human tick-borne disease, but Borrelia genospecies cause different clinical manifestations. Ticks of the genus Ixodes removed from humans between 2006 and 2012 were analysed for Borrelia burgdorferi sensu lato (sl) infections. The majority of ticks originated from the Greater Hanover region in Northern Germany. The engorgement status varied over the entire spectrum from unengorged (no evidence of started blood feeding) to fully engorged. In the present study, prevalence data for B. burgdorferi sl 2011 and 2012 were obtained by quantitative real-time PCR and compared to those from a former study including years 2006-2010 (Strube et al., 2011) to evaluate B. burgdorferi sl infections in ticks affecting humans over a 7-year period. In 2011, 34.2% (70/205) of adult ticks, 22.2% (94/423) of nymphs, 8.3% of larvae (1/12) as well 3 of 6 not differentiated ticks were Borrelia positive. In 2012, 31.8% (41/129) of adult ticks, 20.4% of nymphs (69/337) as well as 1 of 4 of the not differentiated ticks were determined positive. Total Borrelia infection rates decreased significantly from 23.1% in 2006 to 17.1% in 2010, followed by a significant increase to 26.0% in 2011 and 23.4% in 2012. Furthermore, B. burgdorferi sl genospecies distribution in 2006-2012 was determined in the present study by applying Reverse Line Blot technique. Borrelia genospecies differentiation was successful in 641 (67.3%) out of 953 positive tick samples. The most frequently occurring genospecies was B. afzelii (40.5% of infected ticks), followed by B. garinii/. B. bavariensis (12.4%). Amongst the 641 ticks analysed for their genospecies, 74 (11.5%) carried more than one genospecies, of which 69 (10.7%) were double-infected and five (0.8%) were triple-infected. Comparison of genospecies distribution in ticks removed from humans with those from questing ticks flagged in the same geographical area revealed that ticks removed from humans were significantly more frequently infected with B. afzelii (p = 0.0004), but significantly less infected with B. burgdorferi sensu stricto (p = 0.0001). © 2017 Elsevier GmbH.

Wang G.,New York Medical College | Liveris D.,New York Medical College | Mukherjee P.,University of Calgary | Jungnick S.,German National Reference Center for Borrelia | And 2 more authors.
Current Protocols in Microbiology | Year: 2014

Borrelia burgdorferi sensu lato is a group of spirochetes belonging to the genus Borrelia in the family of Spirochaetaceae. The spirochete is transmitted between reservoirs and hosts by ticks of the family Ixodidae. Infection with B. burgdorferi in humans causes Lyme disease or Lyme borreliosis. Currently, 20 Lyme disease-associated Borrelia species and more than 20 relapsing fever-associated Borrelia species have been described. Identification and differentiation of different Borrelia species and strains is largely dependent on analyses of their genetic characteristics. Avariety of molecular techniques have been described for Borrelia isolate speciation, molecular epidemiology, and pathogenicity studies. In this unit, we focus on three basic protocols, PCR-RFLP-based typing of the rrs-rrlA and rrfA-rrlB ribosomal spacer, ospC typing, and MLST. These protocols can be employed alone or in combination for characterization of B. burgdorferi isolates or directly on uncultivated organisms in ticks, mammalian host reservoirs, and human clinical specimens. © 2014 by John Wiley & Sons, Inc.

Teegler A.,Paul Ehrlich Institute | Herzberger P.,Paul Ehrlich Institute | Margos G.,German National Reference Center for Borrelia | Fingerle V.,German National Reference Center for Borrelia | Kraiczy P.,Paul Ehrlich Institute
Ticks and Tick-borne Diseases | Year: 2014

Borrelia miyamotoi, a relapsing fever spirochete transmitted by ixodid ticks, is able to cause infections associated with systemic complaints, including malaise and fever, as well as meningoencephalitis in immunocompromised patients. In order to elucidate immune evasion of previously difficult to cultivate B. miyamotoi, we have examined the ability of this newly emerging human pathogen to escape the complement system. Growth inhibition assays revealed that B. miyamotoi is strongly resistant to complement-mediated bacteriolysis. Investigating complement activation, we found that B. miyamotoi showed reduced deposition of components C3, C5, C7, C8, C9 as well as the membrane attack complex (MAC) on the borrelial surface. In addition, no aberrations in cell morphology were observed after incubation of B. miyamotoi in active human serum, confirming the findings of the growth inhibition assay. The data presented here provide strong evidence that B. miyamotoi overcome human complement by affecting the central complement component C3, thereby inhibiting formation of the C3 convertase and downstream activation of the complement cascade. © 2014 Elsevier GmbH.

Koedel U.,Ludwig Maximilians University of Munich | Fingerle V.,German National Reference Center for Borrelia | Pfister H.-W.,Ludwig Maximilians University of Munich
Nature Reviews Neurology | Year: 2015

Lyme disease, caused by the Borrelia burgdorferi bacterium, is the most common vector-borne disease in the northern hemisphere. The clinical presentation varies with disease stage, and neurological manifestations (often referred to as Lyme neuroborreliosis) are reported in up to 12% of patients with Lyme disease. Most aspects of the epidemiology, clinical manifestation and treatment of Lyme neuroborreliosis are well known and accepted; only the management of so-called chronic Lyme disease is surrounded by considerable controversy. This term is used for disparate patient groups, including those who have untreated late-stage infection (for example, late neuroborreliosis), those with subjective symptoms that persist after treatment (termed 'post-Treatment Lyme disease syndrome' [PTLDS]), and those with unexplained subjective complaints that may or may not be accompanied by positive test results for B. burgdorferi infection in serum (here called 'chronic Lyme disease'). The incidence of PTLDS is still a matter of debate, and its pathogenesis is unclear, but there is evidence that these patients do not have ongoing B. burgdorferi infection and, thus, do not benefit from additional antibiotic therapy. Chronic Lyme disease lacks an accepted clinical definition, and most patients who receive this diagnosis have other illnesses. Thus, a careful diagnostic work-up is needed to ensure proper treatment. © 2015 Macmillan Publishers Limited.

Tappe J.,University of Veterinary Medicine Hannover | Jordan D.,University of Veterinary Medicine Hannover | Janecek E.,University of Veterinary Medicine Hannover | Fingerle V.,German National Reference Center for Borrelia | Strube C.,University of Veterinary Medicine Hannover
Parasites and Vectors | Year: 2014

Background: The present study investigated the prevalence of Borrelia burgdorferi sensu lato (s.l.) genospecies in Ixodes ricinus ticks collected in Hanover, Northern Germany, in 2010. At the same time the study served as fifth-year-follow-up study for data comparison with 2005. Methods: A total of 2100 questing ticks were collected and analysed by quantitative real-time PCR (qPCR) with subsequent species differentiation via Reverse Line Blot and Sanger sequencing. Simultaneously, results obtained in 2010 were compared to infection rates from 2005 to evaluate the development of B. burgdorferi s.l. infection rates in Hanoverian ticks. Results: Overall, 22.7% (476/2,100) of collected ticks were tested positive for B. burgdorferi s.l. infections. Adult ticks showed an infection rate of 33.3% (124/372), subdivided into 29.6% (58/196) positive males and 37.5% (66/176) positive females. Nymph and larvae infection rates were found to be 20.3% (344/1,697) and 25.8% (8/31), respectively. Species identification was successful for 59.2% (282/476) of positive ticks with B. afzelii as the most frequently detected genospecies, followed by B. garinii (including B. bavariensis) and B. spielmanii. B. burgdorferi sensu stricto (s.s.), B. bissettii, B. valaisiana and B. lusitaniae were also identified. Significant differences concerning seasonal fluctuations as well as local differences were observed. Comparing infection rates of Hanoverian ticks between years, a significant increase (P = 0.002) could be observed for larvae with 1.7% positives (2/60) in 2005 and 25.8% positives (8/31) in 2010. In the latter year, coinfections with Borrelia and Rickettsiales were detected in a total of 7.8% (163/2,100) of collected ticks. Of these, 7.3% (153/2,100) were coinfected with Rickettsia spp., 0.3% (7/2,100) with A. phagocytophilum and 0.1% (3/2,100) were coinfected with all three pathogens. Between years 2005 and 2010, no statistically significant differences in coinfection rates were found. Conclusions: Comparing B. burgdorferi s.l. infections in Hanoverian I. ricinus ticks in 2010 with data from 2005, a statistically significant increase of infected larvae was noted, whereas the other stages revealed no statistically significant differences. Whether the increased larvae infection rate is an isolated event or results from factual circumstances, e.g. increasing effectiveness of transovarial transmission due to unknown factors, has to be evaluated in further studies. © 2014 Tappe et al.; licensee BioMed Central Ltd.

Ogden N.H.,Public Health Agency of Canada | Mechai S.,University of Montréal | Margos G.,Ludwig Maximilians University of Munich | Margos G.,German National Reference Center for Borrelia
Frontiers in Cellular and Infection Microbiology | Year: 2013

The geographic ranges of ticks and tick-borne pathogens are changing due to global and local environmental (including climatic) changes. In this review we explore current knowledge of the drivers for changes in the ranges of ticks and tick-borne pathogen species and strains via effects on their basic reproduction number (R0), and the mechanisms of dispersal that allow ticks and tick-borne pathogens to invade suitable environments. Using the expanding geographic distribution of the vectors and agent of Lyme disease as an example we then investigate what could be expected of the diversity of tick-borne pathogens during the process of range expansion, and compare this with what is currently being observed. Lastly we explore how historic population and range expansions and contractions could be reflected in the phylogeography of ticks and tick-borne pathogens seen in recent years, and conclude that combined study of currently changing tick and tick-borne pathogen ranges and diversity, with phylogeographic analysis, may help us better predict future patterns of invasion and diversity. © 2013 Ogden, Mechai and Margos.

Glatz M.,Medical University of Graz | Glatz M.,University of Zürich | Mullegger R.R.,Medical University of Graz | Mullegger R.R.,State Hospital Wiener Neustadt | And 5 more authors.
Ticks and Tick-borne Diseases | Year: 2014

Candidatus Neoehrlichia mikurensis DNA was discovered in Ixodes ricinus ticks in 1999 and is referred to as an emerging human pathogen since its first detection in patients with febrile illness reported in 2010. In recent years, Ca. Neoehrlichia mikurensis has been detected in ticks from several European, Asian, and African countries. However, no epidemiological data exist for Austria, which is a highly endemic region for tick-transmitted diseases. To assess the geographic spread and prevalence of Ca. Neoehrlichia mikurensis sympatric with other tick-transmitted pathogens, we analysed 518 I. ricinus ticks collected in 2002 and 2003 in Graz, Austria. The prevalence of Ca. Neoehrlichia mikurensis was 4.2%, that of Borrelia burgdorferi sensu lato 25.7%, and that of Anaplasma phagocytophilum 1%. Coinfections with Ca. Neoehrlichia mikurensis and B. burgdorferi sensu lato were found in 2.3% of all ticks. Thus, the results show a relatively high prevalence of Ca. Neoehrlichia mikurensis in Austrian ticks suggesting a high probability for the occurrence of undiagnosed human infections in Austria. © 2013 Elsevier GmbH.

Wilking H.,Robert Koch Institute | Fingerle V.,German National Reference Center for Borrelia | Klier C.,German National Reference Center for Borrelia | Thamm M.,Robert Koch Institute | Stark K.,Robert Koch Institute
Emerging Infectious Diseases | Year: 2015

To assess Borrelia burgdorferi sensu lato (the cause of Lyme borreliosis) seropositivity in Germany, we tested serum samples from health survey (2008–2011) participants. Seroprevalence was 5.8% among women and 13.0% among men; infection risk was highest among persons ≥60 years of age. Public health interventions, including education about risk factors and preventive measures, are needed. © 2015, Centers for Disease Control and Prevention (CDC). All rights reserved.

PubMed | University of Veterinary And Pharmaceutical Sciences Brno, German National Reference Center for Borrelia, Slovak Academy of Sciences, Bavarian Health and Food Safety Authority and 2 more.
Type: Evaluation Studies | Journal: Infection | Year: 2016

For simultaneous detection of Borrelia miyamotoi (relapsing fever spirochete) and Borrelia burgdorferi sensu lato, we have developed a duplex real-time PCR targeting the flagellin gene (flaB; p41), a locus frequently used in routine diagnostic PCR for B. burgdorferi s.l. detection.Primers and probes were designed using multiple alignments of flaB sequences of B. miyamotoi and B. burgdorferi s.l. species. The sensitivity and specificity of primers and probes were determined using serial dilutions (ranging from 10(4) to 10(-1)) of B. miyamotoi and B. burgdorferi s.l. DNA and of several species of relapsing fever spirochetes. Conventional PCR on recG and glpQ and sequencing of p41 PCR products were used to confirm the species assignment.The detection limit of both singleplex and duplex PCR was 10 genome equivalents except for B. spielmanii and two B. garinii genotypes which showed a detection limit of 10(2) genome equivalents. There was no cross reactivity of the B. miyamotoi primers/probes with B. burgdorferi s.l. DNA, while the B. burgdorferi s.l. primer/probe generated a signal with B. hermsii DNA. Out of 2341 Ixodes ricinus ticks from Germany and Slovakia that were screened simultaneously for the presence of B. miyamotoi and B. burgdorferi s.l., 52 were positive for B. miyamotoi and 276 for B. burgdorferi s.l., denoting an average prevalence of 2.2% for B. miyamotoi and 11.8% for B. burgdorferi s.l., and B. miyamotoi DNA was also detectable by PCR using artificial clinical samples.The duplex real-time PCR developed here represents a method that permits simultaneous detection and differentiation of B. burgdorferi s.l. and B. miyamotoi in environmental and potentially clinical samples.

PubMed | University of Amsterdam, Centers for Disease Control and Prevention, Medical University of Vienna, Laboratory for Infectious Diseases and 12 more.
Type: | Journal: BMC infectious diseases | Year: 2016

Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe.We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy.Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50% (95% CI 40% to 61%); neuroborreliosis 77% (95% CI 67% to 85%); acrodermatitis chronica atrophicans 97% (95% CI 94% to 99%); unspecified Lyme borreliosis 73% (95% CI 53% to 87%). Specificity was around 95% in studies with healthy controls, but around 80% in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches.The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.

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