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Medientyp:
E-Artikel
Titel:
Antibodies to Borrelia burgdorferi and Bartonella species in serum and synovial fluid from people with rheumatic diseases
Beteiligte:
Kim, Lisa;
Lashnits, Erin;
Breitschwerdt, Edward B.;
Elam, Amanda;
Grade, Neenah;
Miller, Jennifer;
Shikhman, Alexander R.
Erschienen:
American Society for Microbiology, 2024
Erschienen in:Microbiology Spectrum
Sprache:
Englisch
DOI:
10.1128/spectrum.01653-23
ISSN:
2165-0497
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>ABSTRACT</jats:title>
<jats:sec>
<jats:title />
<jats:p>
Vector-borne infections may underlie some rheumatic diseases, particularly in people with joint effusions. This study aimed to compare serum and synovial fluid antibodies to
<jats:italic>B. burgdorferi</jats:italic>
and
<jats:italic>Bartonella</jats:italic>
spp. in patients with rheumatic diseases. This observational, cross-sectional study examined paired synovial fluid and serum specimens collected from 110 patients with joint effusion between October 2017 and January 2022. Testing for antibodies to
<jats:italic>B. burgdorferi</jats:italic>
(using CDC criteria) and
<jats:italic>Bartonella</jats:italic>
spp.
<jats:italic>via</jats:italic>
two indirect fluorescent antibody (IFA) assays was performed as part of routine patient care at the Institute for Specialized Medicine (San Diego, CA, USA). There were 30 participants (27%) with positive two-tier
<jats:italic>B. burgdorferi</jats:italic>
serology and 26 participants (24%) with IFA seroreactivity (≥1:256) to
<jats:italic>B. henselae</jats:italic>
and/or
<jats:italic>B. quintana</jats:italic>
. Both
<jats:italic>B. burgdorferi</jats:italic>
IgM and IgG were detected more frequently in synovial fluid than serum: 27% of patients were either IgM or IgG positive in synovial fluid, compared to 15.5% in serum (
<jats:italic>P</jats:italic>
= 0.048). Conversely,
<jats:italic>B. henselae</jats:italic>
and
<jats:italic>B. quintana</jats:italic>
antibodies were detected more frequently in serum than synovial fluid; overall only 2% of patients had positive IFA titers in synovial fluid, compared to 24% who had positive IFA titers in serum (
<jats:italic>P</jats:italic>
< 0.001). There were no significant associations between
<jats:italic>B. burgdorferi</jats:italic>
or
<jats:italic>Bartonella</jats:italic>
spp. seroreactivity with any of the clinical rheumatological diagnoses. This study provides preliminary support for the importance of synovial fluid antibody testing for documenting exposure to
<jats:italic>B. burgdorferi</jats:italic>
but not for documenting exposure to
<jats:italic>Bartonella</jats:italic>
spp.
</jats:p>
</jats:sec>
<jats:sec>
<jats:title>IMPORTANCE</jats:title>
<jats:p>
This study focuses on diagnostic testing for two common vector-borne diseases in an affected patient population. In it, we provide data showing that antibodies to
<jats:italic>B. burgdorferi</jats:italic>
, but not
<jats:italic>Bartonella</jats:italic>
spp., are more commonly found in synovial fluid than serum of patients with joint effusion. Since Lyme arthritis is a common—and sometimes difficult to diagnose—rheumatic disease, improving diagnostic capabilities is of utmost importance. While our findings are certainly not definitive for changes to practice, they do suggest that synovial fluid could be a useful sample for the clinical diagnosis of Lyme disease, and future prospective studies evaluating this claim are warranted.
</jats:p>
</jats:sec>