ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2013
Performance of United States serologic assays in the diagnosis of Lyme borreliosis acquired in Europe.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 5 of them syntheses that pooled it.
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40 citing papers in PubMed, 5 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society.German medical science : GMS e-journal · 2025Guideline
- Seroprevalence of Lyme Borreliosis in Europe: Results from a Systematic Literature Review (2005-2020).Vector borne and zoonotic diseases (Larchmont, N.Y.) · 2023Pooled it
- Cutaneous Lyme borreliosis: Guideline of the German Dermatology Society.German medical science : GMS e-journal · 2017Guideline
- The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis.BMC infectious diseases · 2016Pooled it
- The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research.PloS one · 2016Pooled it
- Clinical data on symptomatic cutaneous reinfections due to Borrelia burgdorferi sensu lato in Slovenia.Infection · 2026Article
- Prevalence and Risk Factors ofPathogens (Basel, Switzerland) · 2026Article
- A novel single-tier serologic test to diagnose all stages of Lyme disease.Journal of clinical microbiology · 2025Article
- Comparison of the Serodiagnostic Accuracy Tests for Lyme Disease in Adults and Children: A Network Meta-Analysis.Pathogens (Basel, Switzerland) · 2025Review
- Borrelia surface proteins: new horizons in Lyme disease diagnosis.Applied microbiology and biotechnology · 2025Review
- Borrelia spielmanii-Associated Neuroborreliosis in Patient Receiving Rituximab, Belgium.Emerging infectious diseases · 2025Article
- Synovial fluid alpha-defensins in Lyme arthritis-a useful marker.Folia microbiologica · 2024Article
- Lyme borreliosis diagnosis: state of the art of improvements and innovations.BMC microbiology · 2023Review
- Laboratory Diagnosis of Lyme Borreliosis.Clinical microbiology reviews · 2021Review
- Performance of a Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease in Nova Scotia.Journal of clinical microbiology · 2020Article
- Modified two-tiered testing algorithm for Lyme disease serology: the Canadian context.Canada communicable disease report = Releve des maladies transmissibles au Canada · 2020Review
- Immunoserological Diagnosis of Human Borrelioses: Current Knowledge and Perspectives.Frontiers in cellular and infection microbiology · 2020Review
- Geographical Features and Seroprevalence ofJournal of arthropod-borne diseases · 2018Article
- Pilot Study of Immunoblots with RecombinantHealthcare (Basel, Switzerland) · 2018Article
- A Community Study ofHealthcare (Basel, Switzerland) · 2018Article
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6 authors at 3 institutions in 2 countries.
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Abstract
backgroundPhysicians in the United States sometimes need to evaluate a patient for suspected Lyme borreliosis (LB) who may have acquired the infection in Europe. Using serum samples from European LB patients, we compared the performance of European and US serodiagnostic tests, including newer-generation assays containing Vmp-like sequence, expressed or its C6 peptide.
methodsThe sensitivity of each assay was determined using 64 serum samples from LB patients with early or late disease manifestations who acquired the infection in Europe. Specificity was measured using 100 sera from healthy subjects from a nonendemic area.
resultsFor the detection of European-acquired infection, conventional 2-tiered testing (enzyme-linked immunosorbent assay [ELISA] followed by immunoblotting) using US assays had an overall sensitivity and specificity of 52% and 100%, compared with 81% (P = .0007) and 99% (P = 1.00) using analogous European tests. The sensitivity of a US C6 ELISA used as a stand-alone test (88% overall) was statistically comparable to that of conventional 2-tiered testing using European tests (P = .47) and was 100% specific. Similarly, an alternative 2-tiered algorithm using a standard US ELISA followed by a C6 ELISA was comparably sensitive (84% overall) compared with conventional 2-tiered testing using European assays (P = .82), and specificity remained 100%.
conclusionsEuropean assays outperformed analogous US assays in a conventional 2-tiered testing algorithm. However, a C6 ELISA used as a stand-alone test or in the second tier of a 2-tiered algorithm performed comparably to conventional 2-tiered testing using European assays, and can be used for evaluation of any patient, regardless of travel history.
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