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Consult a qualified Lyme ( Borreliosis ) Disease literate doctor for medical advice if Lyme Disease is suspect.
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Antimicrob Agents Chemother. 2005 Apr;49(4):1294-301
In Vitro Susceptibility Testing of Borrelia burgdorferi Sensu Lato
Isolates Cultured from Patients with Erythema Migrans before and
after Antimicrobial Chemotherapy.
Hunfeld KP, Ruzic-Sabljic E, Norris DE, Kraiczy P, Strle F.
Institute of Medical Microbiology, University Hospital of Frankfurt,
Paul-Ehrlich Str. 40, D-60596 Frankfurt/Main, Germany.
K.Hunfeld@em.uni-frankfurt.de.
Clinical treatment failures have been reported to occur in early
Lyme borreliosis (LB) for many suitable antimicrobial agents.
Investigations of possible resistance mechanisms of the Borrelia
burgdorferi complex must analyze clinical isolates obtained from LB
patients, despite their receiving antibiotic treatment. Here,
borrelial isolates obtained from five patients with erythema migrans
(EM) before the start of antibiotic therapy and again after the
conclusion of treatment were investigated.
The 10 isolates were
characterized by restriction fragment length polymorphism analysis
and plasmid profile analysis and subjected to susceptability testing
against a variety of antimicrobial agents including those used for
initial chemotherapy.
Four out of five patients were infected by the
same genospecies (Borrelia afzelii, n = 3; Borrelia garinii, n = 1)
at the site of the EM lesion before and after antimicrobial therapy.
In one patient the genospecies of the initial isolate (B. afzelii)
differed from that of the follow-up isolate (B. garinii). No
significant changes in the in vitro susceptabilities became obvious
for corresponding clinical isolates before the start and after the
conclusion of antimicrobial therapy. This holds true for the
antimicrobial agents used for specific chemotherapy of the patients,
as well as for any of the additional agents tested in vitro.
Our
study substantiates borrelial persistence in some EM patients at the
site of the infectious lesion despite antibiotic treatment over a
reasonable time period. Borrelial persistence, however, was not
caused by increasing MICs or minimal borreliacidal concentrations in
these isolates.
Therefore, resistance mechanisms other than acquired
resistance to antimicrobial agents should be considered in patients
with LB resistant to treatment.
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