Improving Lyme Disease Direct Detection: Identification of a Novel Method to Enrich for Borrelia in Blood, and Comparing Surveys and Serology in a Chronically Ill Patient Cohort

Abstract

Lyme disease is a multi-system disease caused by the spirochetal bacterium, Borrelia, an obligate parasite transmitted to humans by Ixodes ticks. The laboratory test for Lyme is reliant on the adaptive immune response which limits early diagnosis and is unable to distinguish between active and resolved infection. There is interest in tools that directly detect the microorganism and its associated biomarkers. However, there is no consensus regarding the methodologies used to process blood for this purpose. Our findings show sodium citrate anticoagulant is superior to commonly used EDTA for direct Borrelia detection in blood. Additionally, a mock-infected blood model demonstrates that serum and plasma lose the majority of Borrelia during processing, while the platelet fraction is enriched. Serostatus and surveys were analyzed for a 70-participant cohort of chronically ill patients and healthy controls to compare existing diagnostic techniques. This research provides foundational work informing future avenues of direct detection research.