ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2008
Effect of Borrelia burgdorferi genotype on the sensitivity of C6 and 2-tier testing in North American patients with culture-confirmed Lyme disease.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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29 citing papers in PubMed.
- Single-step immunoblot tests with recombinant protein antigens for detecting IgG and IgM antibodies in Lyme disease.Microbiology spectrum · 2026Article
- A novel single-tier serologic test to diagnose all stages of Lyme disease.Journal of clinical microbiology · 2025Article
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- Turning the needle into the haystack: Culture-independent amplification of complex microbial genomes directly from their native environment.PLoS pathogens · 2024Review
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- Laboratory Diagnosis of Lyme Borreliosis.Clinical microbiology reviews · 2021Review
- Lyme Disease in Humans.Current issues in molecular biology · 2021Article
- Performance of a Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease in Nova Scotia.Journal of clinical microbiology · 2020Article
- Multicenter Evaluation of the C6 Lyme ELISA Kit for the Diagnosis of Lyme Disease.Microorganisms · 2020Article
- Lyme Disease Frontiers: ReconcilingPathogens (Basel, Switzerland) · 2019Review
- Proposed Lyme Disease Guidelines and Psychiatric Illnesses.Healthcare (Basel, Switzerland) · 2019Review
- Under-Detection of Lyme Disease in Canada.Healthcare (Basel, Switzerland) · 2018Article
- Whole genome sequencing and phylogenetic analysis of strains of the agent of Lyme disease Borrelia burgdorferi from Canadian emergence zones.Scientific reports · 2018Article
- Relapsing feverInternational journal of general medicine · 2018Article
- Antibody responses to Borrelia burgdorferi detected by western blot vary geographically in Canada.PloS one · 2017Article
- Commercial test kits for detection of Lyme borreliosis: a meta-analysis of test accuracy.International journal of general medicine · 2016Article
- Similarities in murine infection and immune response to Borrelia bissettii and Borrelia burgdorferi sensu stricto.Microbiology (Reading, England) · 2015Article
- Evolutionary aspects of emerging Lyme disease in Canada.Applied and environmental microbiology · 2015Review
- Complex population structure of Borrelia burgdorferi in southeastern and south central Canada as revealed by phylogeographic analysis.Applied and environmental microbiology · 2015Article
- Simple objective detection of human lyme disease infection using immuno-PCR and a single recombinant hybrid antigen.Clinical and vaccine immunology : CVI · 2014Article
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11 authors.
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Abstract
backgroundA potential concern with any serologic test to detect antibodies to Borrelia burgdorferi is whether the epitopes incorporated in the test provide sufficient cross-reactivity to detect infection with all of the pathogenic strains of the species. This is a particular concern for the C6 test, which is based on reactivity to a single peptide.
methodsC6 testing and 2-tier testing were performed on acute-phase serum samples obtained from >158 patients with erythema migrans for whom the genotype of the borrelial isolate was defined on the basis of an analysis of the 16S-23S ribosomal DNA spacer region and/or on the genetic variation of the outer surface protein C gene (ospC). The sonicated whole cell-based enzyme-linked immunosorbent assay, the immunoblots used in the 2-tier testing, and the C6 assay all used antigens from B. burgdorferi sensu stricto strain B31.
resultsThe sensitivity of C6 testing (69.5%) was greater than that of 2-tier testing (38.9%) (P<.001); the difference in sensitivity, however, was statistically significant only for patients infected with 2 of the 3 ribosomal spacer type-defined genotypes. The lower sensitivity of 2-tier testing was attributable to the low sensitivity of the immunoblot tests, rather than the first-tier enzyme-linked immunosorbent assay. There was also a trend for the sensitivity of 2-tier testing to vary according to the ospC genotype for the 14 genotypes represented in the study (P=.07); this relationship was not observed with C6 testing.
conclusionsLack of sensitivity of the C6 test because of strain diversity seems less likely to be a limitation of this serologic test, compared with 2-tier testing in North American patients with early Lyme disease.
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