Lack of Borrelia burgdorferi DNA in synovial samples from patients with antibiotic treatment-resistant Lyme arthritis

Arthritis Rheum. 1999 Dec;42(12):2705-9. doi: 10.1002/1529-0131(199912)42:12<2705::AID-ANR29>3.0.CO;2-H.

Abstract

Objective: To determine whether Borrelia burgdorferi DNA may be detected in synovial tissue from patients with Lyme arthritis who have persistent synovial inflammation after antibiotic treatment.

Methods: Synovial specimens obtained at synovectomy from 26 patients with antibiotic treatment-resistant Lyme arthritis and from 10 control subjects were tested for B burgdorferi DNA using 3 primer-probe sets that target genes encoding outer surface proteins A or B or a flagellar protein (P41) of the spirochete.

Results: The 26 patients with Lyme arthritis, who had received antibiotic therapy for a mean total duration of 8 weeks prior to synovectomy, and the 10 control subjects each had negative polymerase chain reaction (PCR) results in synovial samples. When the samples were spiked with approximately 1-10 B burgdorferi, all but 1 had positive PCR results, suggesting that spirochetal DNA could have been detected in most of the unspiked samples if it had been present.

Conclusion: These results indicate that synovial inflammation may persist in some patients with Lyme arthritis after the apparent eradication of the spirochete from the joint with antibiotic therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Arthritis, Infectious / genetics*
  • Arthritis, Infectious / surgery
  • Borrelia burgdorferi Group / genetics*
  • Child
  • DNA Primers / analysis
  • DNA, Bacterial / analysis*
  • Drug Resistance, Microbial
  • Female
  • Humans
  • Lyme Disease / genetics*
  • Lyme Disease / surgery
  • Male
  • Middle Aged
  • Polymerase Chain Reaction

Substances

  • DNA Primers
  • DNA, Bacterial