Direct Molecular Typing of Borrelia burgdorferi Sensu Lato Species in Synovial Samples from Patients with Lyme Arthritis

Since Lyme arthritis was first described in the United States, it has now been reported in many countries of Europe. However, very few strains of the causative bacterium, Borrelia burgdorferi, have been isolated from synovial samples. For this reason, different molecular direct typing methods were developed recently to assess which species could be involved in Lyme arthritis in Europe. We developed a simple oligonucleotide typing method with PCR fragments from the flagellin gene of B. burgdorferi sensu lato, which is able to differentiate seven different Borrelia species. Among 10 consecutive PCR-positive patients with Lyme arthritis from the northeastern France, two species were identified in synovial samples: B. burgdorferi sensu stricto in 9 cases and B. garinii in 1 case. Conversely, all B. burgdorferi sensu lato species detected in 10 consecutive PCR-positive biopsies from a second set of patients with erythema migrans from the same geographical area were identified as either B. afzelii or B. garinii (P < 0.001). These results indicate that B. burgdorferi sensu stricto is the principal but not the only Borrelia species involved in Lyme arthritis in northeastern France.

莱姆关节炎（Lyme arthritis）首次在美国被报道以来，目前已在欧洲多个国家均有病例报告。然而，从滑膜样本（synovial samples）中分离得到的致病病原菌伯氏疏螺旋体（Borrelia burgdorferi）菌株数量极少。为此，近年来研究人员开发了多种分子直接分型方法，以评估欧洲莱姆关节炎可能涉及的疏螺旋体菌种。
本研究开发了一种基于伯氏疏螺旋体广义群（B. burgdorferi sensu lato）鞭毛蛋白基因（flagellin gene）PCR扩增片段的简易寡核苷酸分型方法，可区分7种不同的疏螺旋体菌种。在法国东北部连续收治的10例莱姆关节炎PCR阳性患者中，滑膜样本中检出2种疏螺旋体：9例为伯氏疏螺旋体狭义群（B. burgdorferi sensu stricto），1例为伽氏疏螺旋体（B. garinii）。
与之相反，在同一地理区域纳入的第二组连续10例游走性红斑（erythema migrans）PCR阳性患者的活检样本中，检出的所有伯氏疏螺旋体广义群菌种均为阿弗西疏螺旋体（B. afzelii）或伽氏疏螺旋体（P < 0.001）。
上述结果表明，在法国东北部的莱姆关节炎病例中，伯氏疏螺旋体狭义群是主要致病疏螺旋体菌种，但并非唯一的致病菌种。