LYME BORRELIOSIS Detection and identification of the infecting genotype

Research output: ThesisDoctoral Thesis (compilation)


Lyme borreliosis is caused by the spirochete Borrelia burgdorferi sensu lato, a bacterium with a parasitic life-style, which is transmitted between hosts by the Ixodes tick-vector. Humans will incidentally become infected. The resulting illness can involve the skin, nervous system, joints and heart. Southern Sweden has been identified as an area endemic for Lyme borreliosis. The most common clinical manifestations are erythema migrans and neuroborreliosis. Three major species have been associated with Lyme borreliosis in Europe, B. burgdorferi sensu stricto (s. s.), B. afzelii and B. garinii. The presence of the two latter species was indicated in a seroepidemiological study where a Lyme borreliosis infected population, living in southern Sweden, showed preferential seroreactivity to the species-specific loop of the surface membrane protein P66 originating from B. afzelii and B. garinii. In parallel, a study was performed using culture-based analytical method. Subsequently determination of the OspA serotype (protein-based), and the 16S rDNA genotype, indicated that, B. afzelii (OspA serotype 2) and B. garinii (OspA serotype 5 and 6) were present in skin and cerebrospinal fluid from patients in the region. Using a direct molecular method, that combines nested OspA PCR and sequence analysis, the third major species, B. burgdorferi s. s., was identified in a clinical specimen for the first time in Sweden. In order to further improve the sensitivity and quantification of Borrelia spirochetes, we designed a RT real-time PCR assay directed against 16S rRNA, a method providing both excellent sensitivity and reproducibility. In conclusion, the three major Lyme Borrelia species, B. burgdorferi s. s., B. afzelii and B. garinii, have been found to be associated with Lyme borreliosis in southern Sweden.


  • Katharina Ornstein
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Infectious Medicine


  • Parasitologi (människa och djur), Parasitology (human and animal), Infektioner, Infections, PCR, genospecies, Lyme borreliosis, Borrelia burgdorferi, Microbiology, bacteriology, virology, mycology, Mikrobiologi, bakteriologi, virologi, mykologi
Original languageEnglish
Awarding Institution
Supervisors/Assistant supervisor
  • [unknown], [unknown], Supervisor, External person
Award date2002 May 29
  • Katharina Ornstein, Dep of Infectious Diseases, University Hospital, 221 85 Lund,
Print ISBNs91-628-5192-6
Publication statusPublished - 2002
Publication categoryResearch

Bibliographic note

Defence details Date: 2002-05-29 Time: 10:00 Place: Segerfalksalen, Wallenberg Neurocentrum, Lund External reviewer(s) Name: Stanek, Gerold Title: Professor Affiliation: Medical Faculty,Institute of Hygiene, University of Vienna, Austria --- Article: Berglund J., R. Eitrem, K. Ornstein, A. Lindberg, Å. Ringnér, H. Elmrud, M. Carlsson, A. Runehagen, C. Svanborg, and R. Norrby. 1995. An epidemiological study of Lyme disease in southern Sweden. N. Engl. J. of Med. 333:1319-1324.Ornstein, K., J. Berglund, I. Nilsson, R. Norrby, and S. Bergstrom. 2001. Characterization of Lyme borreliosis isolates from patients with erythema migrans and neuroborreliosis in Southern Sweden. J.Clin.Microbiol. 39:1294-1298.Ornstein, K., J. Berglund, S. Bergström, R. Norrby, and A. G. Barbour. 2002. Three major Lyme Borrelia species (B. burgdorferi sensu stricto, B. afzelii and B. garinii) identified by polymerase chain reaction in cerebrospinal fluid from patients with neuroborreliosis in Sweden. Manuscript . Scand. J. Inf. Dis. 34:341-346.Ornstein Katharina, Yngve Östberg, Jonas Bunikis, Laila Noppa, Johan Berglund , Ragnar Norrby, and Sven Bergström. Differential immune response to the variable surface loop antigen of P66 of Borrelia burgdorferi sensu lato species in geographically diverse Lyme borreliosis patient populations. 2002. Submitted.Ornstein Katharina, Hossein Mirian, Durland Fish and Alan G. Barbour. Quantification of spirochete burden in Borrelia burgdorferi infected ticks by reverse transcriptase real-time polymerase chain reaction with the small-subunit ribosomal RNA. Manuscript.