The aim of this study was to evaluate polymerase chain reaction (PCR) as a diagnostic method for the detection of Borrelia burgdorferi s.l. in CSF of Swedish children with LNB. This study was performed retrospectively on CSF and serum samples collected from children evaluated for LNB (n = 233) and controls with other specific neurological disorders (n = 59) in a Swedish Lyme endemic area. For anti-Borrelia antibody index, the IDEIA Lyme Neuroborreliosis kit (Oxoid) was used. Two in-house real-time PCR assays targeting the 16S rRNA gene were evaluated (TaqMan® and LUX™). Among patients classified as LNB cases (n = 102), five children (5%) were Borrelia PCR-positive in CSF with the TaqMan® assay. In the Non-LNB group (n = 131), one patient was Borrelia PCR positive with the TaqMan® assay. Among controls (n = 59), all CSF samples were PCR negative. When amplifying and sequencing ospA, we found B. garinii (n = 2), B. afzelii (n = 2), B. bavariensis (n = 1), and one untypable (n = 1). With the LUX™ technology, all CSF samples were PCR negative. The TaqMan® assay could detect only few cases (n = 6) of B. burgdorferi s.l. in CSF among children with LNB and the sensitivity was very low (5%). However, using larger CSF volumes and centrifugation of samples, the PCR technique could still be useful as a complementary diagnostic method when evaluating LNB. Furthermore, detection of spirochete DNA in clinical matrices, including CSF, is the method of choice for studying epidemiological aspects of LNB, a tick-borne emerging disease.

本研究的目的是评估聚合酶链式反应 (PCR) 作为检测瑞典 LNB 儿童脑脊液中伯氏疏螺旋体sl 的诊断方法。本研究回顾性地对瑞典莱姆病流行地区儿童的脑脊液和血清样本进行了 LNB 评估（n  = 233）和其他特定神经系统疾病的对照（n  = 59）。对于抗疏螺旋体抗体指数，使用 IDEIA 莱姆神经疏螺旋体病试剂盒 (Oxoid)。评估了两种针对16S rRNA 基因的内部实时 PCR 分析（TaqMan® 和 LUX™）。在归类为 LNB 病例 ( n  = 102) 的患者中，五名儿童 (5%) 是疏螺旋体TaqMan® 检测在 CSF 中呈 PCR 阳性。在非 LNB 组 ( n  = 131) 中，一名患者的 TaqMan® 检测结果为疏螺旋体PCR 阳性。在对照组 ( n  = 59) 中，所有 CSF 样本均为 PCR 阴性。在对ospA进行扩增和测序时，我们发现了B. garinii ( n  = 2)、B. afzelii ( n  = 2)、B. bavariensis ( n  = 1) 和一个不可分型 ( n  = 1)。使用 LUX™ 技术，所有 CSF 样本均为 PCR 阴性。TaqMan® 检测只能检测到少数情况下 ( n  = 6) 的B. burgdorferiLNB 儿童脑脊液中的 sl 和敏感性非常低 (5%)。然而，使用更大的 CSF 体积和样品离心，PCR 技术在评估 LNB 时仍可用作补充诊断方法。此外，在临床基质（包括 CSF）中检测螺旋体 DNA 是研究 LNB（一种蜱传新发疾病）流行病学方面的首选方法。