The Spirochetes that Cause LB Belong to the so-called B. Burgdorferi s.l.-complex : A Part from the Book Chapter : Antimicrobial Susceptibility of Borrelia burgdorferi Sensu Lato: An In vitro Study Approach

The spirochetes that cause LB belong to the so-called B. burgdorferi s.l.-complex. They are spiral-shaped bacteria of 4–30 µm in length and 0.2–0.3 µm in diameter. They are members of the Spirochaetaceae family and belong to the genus Borrelia which comprises both the relapsing fever borreliae and the closely related LB agents. Borrelia burgdorferi s.l. is transmitted by members of the Ixodes ricinus complex. These are predominantly I. ricinus and I. persulcatus in Europe and Asia, and I. scapularis and I. pacificus in North America. Once infected with borreliae, these three-host hard ticks (Ixodidae) can remain infected for the remainder of their lives, including through molts. Thus, they are able to effectively transmit spirochetes in the next feeding stage and potentially to their hosts. The geographical presence of the disease in the northern hemisphere mirrors the distribution of the Ixodes spp. ticks that transmit the LB agents. At present, the B. burgdorferi s.l.-complex includes 23 different genospecies. However, only B. burgdorferi sensu strictu, B. afzelii, B. spielmanii, B. garinii, and B. bavariensis have been definitively established to be pathogenic to humans. Very recently, B. bissettiae and B. mayonii have been described as causes of LB in clinically ill patients from Germany, the U.S.A. and Canada. Human pathogenicity is also very probable but remains a matter of debate for B. valaisiana and B. lusitaniae. All of the above-mentioned species that are assumed to be pathogenic to humans, with the exception of B. mayonii, are found in Europe. Borrelia burgdorferi s.s., B. mayonii and  the probable pathogen B. bissettiae are present in the U.S.A., and all species  listed here are distributed in Asia, except for B. burgdorferi s.s. and B. mayonii.

Author(s) Details:

Klaus-Peter Hunfeld
Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe-University Frankfurt, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Germany and INSTAND e.V., Gesellschaft zur Förderung der Qualitätssicherung in medizinischen Laboratorien e.V.,Ubierstraße 20, D-40223 Düsseldorf, Germany.

Peter Kraiczy
Institute for Medical Microbiology & Infection Control, University Hospital Frankfurt, Goethe-University Frankfurt, Paul-Ehrlich Str. 40, D-60596 Frankfurt am Main, Germany.

Douglas E. Norris
W. Harry Feinstone Department of Molecular Microbiology & Immunology, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205, USA.

Benedikt Lohr
Institute for Laboratory Medicine, Microbiology & Infection Control, Northwest Medical Centre, Academic Teaching Hospital, Medical Faculty, Goethe-University Frankfurt, Steinbacher Hohl 2-26, D-60488 Frankfurt am Main, Germany.

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Recent Global Research Developments in New Antimicrobials Against Borrelia burgdorferi

Systematic Review and Meta-analysis of Lyme Disease Data in China:

A systematic review of Chinese- and English-language journal articles published during 2005–2020 revealed that Lyme disease has been clinically diagnosed in 29 provinces in China.

The seropositivity point prevalence, measured using a diagnostic enzyme-linked assay (EIA), was approximately 9.1%.

A more conservative 2-tier testing approach (EIA plus a confirmatory Western immunoblot) yielded a seropositivity rate of 1.8%.

Seropositivity was higher in high-risk exposure populations (10.0%) compared to low-risk exposure populations (4.5%).

The northeastern and western provinces had the highest seropositivity rates [1] .

In Vitro Evaluation of Phytochemicals and Micronutrients:

Researchers tested the efficacy of 15 phytochemicals and micronutrients against different forms of Borrelia burgdorferi and Borrelia garinii, including spirochetes, latent rounded forms, and biofilms [2] .

Persistent Infection After Antibiotic Treatment:

A study reported persistent Borrelia burgdorferi sensu lato infection even after antibiotic treatment, highlighting the challenges in managing this pathogen [3] .

Advances in Studying Borrelia burgdorferi:

Over the years, Borrelia burgdorferi has become a valuable model for studying host-pathogen interactions. Researchers have made significant progress in developing culture methods, animal models, and other tools to better understand this microbe [4] .

References

1. Stark J, Li X, Zhang J, et al. Systematic Review and Meta-analysis of Lyme Disease Data and Seropositivity for Borrelia burgdorferi, China, 2005‒2020. Emerging Infectious Diseases. 2022;28(12):2389-2397. doi:10.3201/eid2812.212612.
2. Goc, A. Niedzwiecki, M. Rath, In vitro evaluation of antibacterial activity of phytochemicals and micronutrients against Borrelia burgdorferi and Borrelia garinii, Journal of Applied Microbiology, Volume 119, Issue 6, 1 December 2015, Pages 1561–1572, https://doi.org/10.1111/jam.12970
3. Verschoor YL,Vrijlandt A,Spijker R, van Hest RM, ter Hofstede H, van Kempen K, Henningsson AJ, Hovius JW, 2022. Persistent Borrelia burgdorferi Sensu Lato Infection after Antibiotic Treatment: Systematic Overview and Appraisal of the Current Evidence from Experimental Animal Models. Clin Microbiol Rev 35:e00074-22.
4. Goc, A., Niedzwiecki, A., & Rath, M. (2015). In vitro evaluation of antibacterial activity of phytochemicals and micronutrients against Borrelia burgdorferi and Borrelia garinii. Journal of applied microbiology, 119(6), 1561-1572.