Borrelia burgdorferi DNA in the urine of treated patients with chronic Lyme disease symptoms.

 Infection. 1996 Sep-Oct;24,5:347-53.Borrelia burgdorferi DNA in the urine of treated 
patients with chronic Lyme disease symptoms. A PCR study of 97 cases.
Bayer ME, Zhang L, Bayer MH. Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
The presence of Borrelia burgdorferi DNA was established by PCR from urine samples of 97 
patients clinically diagnosed as presenting with symptoms of chronic Lyme disease. All patients 
had shown erythema chronica migrans following a deer tick bite. Most of the patients had been 
antibiotic-treated for extended periods of time. We used three sets of primer pairs with DNA 
sequences for the gene coding of outer surface protein A, OspA, and of a genomic sequence of B. 
burgdorferi to study samples of physician-referred patients from the mideastern USA. Controls 
from 62 healthy volunteers of the same geographic areas were routinely carried through the 
procedures in parallel with patients' samples.Of th e 97 patients, 72, 74.2%, were found with 
positive PCR and the rest with negative PCR. The 62 healthy volunteers were PCR negative. It 
is proposed that a sizeable group of patients diagnosed on clinical grounds as having chronic 
Lyme disease may still excrete Borrelia DNA, and may do so in spite of intensive antibiotic 
The urine of 74.2% of patients previously treated with antibiotics for Lyme disease was found 
to be positive for B. burgdorferi DNA using PCR testing. All patients, n=97, had prior 
documented EM rash and had received a minimum of 3 weeks to 2 months oral or intravenous 
antibiotics. In 4 patients, PCR results were temporarily negative after treatment, but became 
positive again 4-6 weeks later. All patients suffered continuing, often gradually worsening 
Lyme disease-like symptoms. seems to be characteristic for most of the patients in our 
study that, after antibiotic-free periods of a few months, they had again become increasingly 
ill with neurological and arthritic symptoms, so that treatment had been resumed

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