The isolation of B. burgdorferi sensu lato requires the use of complex cultivation media. The aim of the study was to compare the usefulness of BSK-H (a commercial medium produced by HiMedia, India) and MKP medium. MKP and BSK-H media were prepared in accordance with the relevant protocols. Borrelia strains and skin culture biopsies were simultaneously inoculated into both media, incubated and checked for growth. Borrelial growth characteristics, isolation rates and characteristics of the isolated borreliae were analysed and compared. Initially, numbers of spirochaetes were higher in BSK-H than in MKP; however, in comparison with MKP, the strains subcultured in BSK-H medium were more frequently irregular, thin and non-motile, and rapidly died. In addition, the borrelial isolation rate from erythema migrans skin samples was higher in MKP than in BSK-H medium (108/171, 63.2% versus 70/171, 40.9%; p(0.0001). The far most frequently isolated species was Borrelia afzelii (92.9% and 97.2% strains isolated from BSK-H and MKP, respectively). Comparison of strains cultured from individual patients in both media showed differences in plasmid contents in 9/46 (19.6%) strain pairs, and protein profiles differed in 30/43 (69.8%) strain pairs, most often in the expression of OspC (in 27/28 patients OspC was expressed only in strains growing in MKP). BSK-H medium supports the growth of borrelial strains but MKP is superior with regard to the isolation rate, morphology and motility of strains. BSK-H medium supports fast initial growth of borreliae but this is followed by rapid deformation and death of the spirochaetes.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 33088985In older studies, a chronic distal symmetric sensory neuropathy was reported as a relatively common manifestation of late Lyme disease in the United States. However, the original papers describing this entity had notable inconsistencies and certain inexplicable findings, such as reports that this condition developed in patients despite prior antibiotic treatment known to be highly effective for other manifestations of Lyme disease. More recent literature suggests that this entity is seen rarely, if at all. A chronic distal symmetric sensory neuropathy as a manifestation of late Lyme disease in North America should be regarded as controversial and in need of rigorous validation studies before acceptance as a documented clinical entity.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 3427756Background. The pathogenesis of acrodermatitis chronica atrophicans (ACA) is not well understood. Objective. The purpose of this study was to gain a better understanding of ACA by utilizing a large data set of adult Slovenian patients with Lyme borreliosis. Methods. The age of 590 ACA patients was compared with that of patients with other manifestations of Lyme borreliosis. The location of the ACA lesion on the body was compared with that of erythema migrans (EM). Results. Patients diagnosed with ACA were on average 14.3 years older than patients with EM (p ( 0.001). ACA patients were also significantly older than patients with Lyme neuroborreliosis or Lyme arthritis (p ( 0.001). The average delay in diagnosis of ACA was 1.6 years (range 0.1–20 years). For 572 (96.9%) of the ACA patients, the site of the skin lesion(s) was confined to an extremity vs. 79.6% for patients with EM, p ( 0.001. For the 20 ACA patients who reported a preceding untreated EM lesion at the same body site, the mean time between the development of the EM and the onset of ACA was 3.0 ± 4.4 (median 1.3, range 0.1–15.0) years. Conclusions. ACA is more likely to be diagnosed in older individuals than any other manifestation of Lyme borreliosis. ACA is more likely than EM to be localized anatomically to the extremities. Available data favor the hypothesis that ACA occurs most often on the extremities of older individuals because of predisposing age-related anatomic or physiologic changes, but more data are needed to define the latency period and other aspects of the pathogenesis of this skin condition.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 3428012Human granulocytic anaplasmosis (HGA) is a rare disease in Europe, caused by Anaplasma phagocytophilum and transmitted by Ixodes ricinus ticks. Till the present article, only 2 cases of HGA in European children (15 years old were reported.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 2814124In Slovenia, a small Central European country, where tularemia cases are very rare and mostly sporadic, six cases of ulceroglandular tularemia were recognised in 2012-2013 in patients residing in or visiting a small geographical area of (6 km2. Epidemiological data indicated transmission by a tick bite in at least 3/6 patients.
F.02 Acquisition of new scientific knowledge
COBISS.SI-ID: 3252652