Susceptibility of Borrelia afzelii strains to antimicrobial agents.

 Int J Antimicrob Agents. 2005 Jun;25,6:474-8. Susceptibility of Borrelia afzelii strains to 
antimicrobial agents. Ruzi·-Sablji· E, Podreka T, Maraspin V, Strle F.
Institute of Microbiology and Immunology, Medical Faculty Ljubljana, Slovenia. 
eva.ruzic-sabljic@mf.uni-lj.si
The aim of the present study was to determine the susceptibility of Borrelia afzelii strains to 
antibiotics, and to test the hypothesis that persistence of borrelia in skin, after therapy, is a 
consequence of resistance to the antibiotic used for treatment. Ten B. afzelii strains isolated 
from skin of seven adult patients, two with acrodermatitis chronica atrophicans, five with 
erythema migrans, were studied. In three patients B. afzelii was isolated from erythema 
65migrans lesion before antibiotic therapy and 2-3 months after treatment with cefuroxime
axetil, two patients, or with ceftriaxone, one patient. MICs and MBCs for amoxicillin, 
azithromycin, ceftriaxone, cefuroxime, doxycycline and amikacin were measured. There was total 
resistance to amikacin but isolates were susceptible to all other antibiotics except one isolate that 
was resistant to cefuroxime, MIC > 4 mg/L. Comparison of MBC values after 3 and 6 weeks' 
incubation revealed comparable results for azithromycin and ceftriaxone while for amoxicillin, 
cefuroxime and doxycycline, some differences were found. In one of the patients from whom 
there were borrelia isolated before and after treatment with cefuroxime axetil, both isolates 
were resistant to cefuroxime. In the other two patients, the paired isolates were susceptible to the 
antibiotic used for therap




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