ABSTRACT
In recent years, the utility of serum-based diagnostic testing for Lyme disease has improved substantially; however, recovery by culture of the bacterium from skin biopsies of suspected patients is still the only definitive laboratory test. Reinfection of patients has been assumed to occur but as yet has not been documented by serial isolates from the same person. We present a case of culture-confirmed reinfection of a patient in Menominee County, Michigan. Borrelia burgdorferi was isolated from the skin punch biopsy specimens during each episode of erythema migrans (EM) and was subjected to molecular strain typing, genetic analysis of two outer surface protein genes, protein profile analysis, and serum antibody response testing. Results show that these isolates are distinct strains of the bacterium and that the two episodes of EM were caused by independent infections. This report describes the documented, culture-confirmed reinfection of a human by two different strains of B. burgdorferi.
Subject(s)
Borrelia burgdorferi , Lipoproteins , Lyme Disease/immunology , Antibodies, Bacterial/blood , Antigens, Surface/genetics , Bacterial Outer Membrane Proteins/genetics , Bacterial Proteins/analysis , Bacterial Vaccines , Borrelia burgdorferi Group/genetics , Borrelia burgdorferi Group/immunology , Humans , Immunoenzyme Techniques , Lyme Disease/diagnosis , Male , Middle Aged , RecurrenceABSTRACT
Borrelia burgdorferi was isolated from skin biopsy specimens of erythema chronicum migrans lesions on two individuals residing in Menominee County, Michigan, in 1992. To our knowledge, these are the first two cases of culture-confirmed Lyme disease in Michigan. In spite of prompt treatment and resolution of illness, antibodies to B. burgdorferi were detectable for at least 3 months in both patients. Both specimens were obtained at different rural medical practices, thus demonstrating that with adequate laboratory support it is feasible to confirm a diagnosis of acute Lyme disease by culture in rural health care settings.
Subject(s)
Borrelia burgdorferi Group/isolation & purification , Adult , Erythema Chronicum Migrans/microbiology , Humans , Male , Michigan , Middle Aged , Skin/microbiologyABSTRACT
A Legionella-like organism, strain 1677-MI-H, was isolated from the bronchoscopy washings of a patient with pneumonia who had a 2-year history of progressive, chronic lymphocytic leukemia. The growth characteristics, cellular fatty acids, and ubiquinone content of the isolate were consistent with those for Legionella spp. The isolate was serologically distinct in the slide agglutination test with absorbed antisera. DNA hybridization studies showed that strain 1677-MI-H (ATCC 49751) represents a new Legionella species which is named Legionella lansingensis.
Subject(s)
Legionella/isolation & purification , Leukemia, Lymphocytic, Chronic, B-Cell/microbiology , Pneumonia/microbiology , Agglutination Tests , DNA, Bacterial/genetics , Female , Humans , Legionella/classification , Legionella/physiology , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Middle Aged , Nucleic Acid Hybridization , Pneumonia/complications , Sequence HomologyABSTRACT
Sera with concurrent rises in titer to Legionella and mycoplasmal or chlamydial antigens were absorbed with whole Legionella organisms. Absorption removed Legionella reactivity only. No evidence of cross-reactivity between Legionella organisms and either Mycoplasma or Chlamydia organisms was found in studies of hyperimmune rabbit antisera.
Subject(s)
Legionella/classification , Absorption , Antigens, Bacterial/analysis , Chlamydia/classification , Mycoplasma/classification , SerotypingABSTRACT
An indirect hemagglutination test was used to determine the prevalence of antibody to serogroups 1-4 of Legionella pneumophila in sera from 1200 apparently healthy Michigan residents. Serogroup 1 was the most prevalent; 71 (11.8%) of 600 sera collected during the winter months (January-April, 1980) and 131 (21.8%) of 600 sera collected during the summer period (July-September, 1980) had serogroup 1 titers. This seasonal difference was independent of sex and was statistically significant in four of six age groups studied. A trend toward decreasing prevalence in the 50-59 years and 60 years or older age groups was noted in the winter sample and was statistically significant in the summer study. Prevalence of antibody to serogroups 2, 3, and 4 was significantly lower, and was associated with serogroup 1 reactivity.
Subject(s)
Legionnaires' Disease/immunology , Adolescent , Adult , Age Factors , Antibodies, Bacterial/immunology , Cross-Sectional Studies , Epidemiologic Methods , Female , Hemagglutination Tests , Humans , Male , Michigan , Middle Aged , SeasonsABSTRACT
Parallel testing of 895 sera by indirect hemagglutination and indirect fluorescent-antibody techniques showed 97.3% agreement. Although the indirect hemagglutination technique usually showed more cross-reactivity among serogroups than the indirect fluorescent-antibody technique with Formalin-fixed antigens and a conjugate which detected primarily immunoglobulin G antibodies, heterologous serogroup reactions were significantly lower than homologous serogroup titers and the etiological serogroup could be easily defined. The indirect hemagglutination techniques showed no cross-reactivity with a crude extract of Escherichia coli O13:K92:H4. Since the indirect hemagglutination technique was shown to detect both immunoglobulin M and immunoglobulin G antibodies and was found to be rapid, simple, and inexpensive, it appears to be an excellent alternative to the indirect fluorescent-antibody test for serodiagnosis of legionellosis.
Subject(s)
Hemagglutination Tests , Legionella/immunology , Antibodies, Bacterial/analysis , Cross Reactions , Escherichia coli/immunology , Fluorescent Antibody Technique , Humans , Immunodiffusion , Legionella/classification , Legionnaires' Disease/diagnosis , SerotypingABSTRACT
The indirect fluorescent antibody test and a microhemagglutination technique detected antibodies in human sera to Legionnaires' disease antigen about equally. Since the hemagglutination technique was simpler, more rapid, and less expensive, we used it to ascertain the prevalence of antibody in 1200 sera from apparently healthy, nonhospitalized Michigan residents. Prevalence was analyzed by age, sex, geographic location (county or residence), and season of the year. There was a significant difference in prevalence between seasons: 91 of 600 sera (15.2%) from February to March 1978 had a titer equal to or greater than 1.16, contrasted with 179 of 600 sera (29.8%) from August to September 1978. This difference was independent of age and sex. There was no significant difference by geographic location, sex, or age except for decreased prevalence for persons 60 years or older.
