Rheumatology Medical News about lyme arthritis;Borrelia burgdorferi genotypes

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Analysis of Borrelia burgdorferi genotypes in patients with lyme arthritis: High frequency of ribosomal RNA intergenic spacer type 1 strains in antibiotic-refractory arthritis
Arthritis & Rheumatism, 07/09/09

Jones KL et al. – Study reports that most of the B burgdorferi genotypes, particularly OspC type K (RST2), were identified in the joint fluid of patients with Lyme arthritis, and the genotype frequencies found in joints reflected those in EM skin lesions. However, RST1 strains were most frequent in patients with antibiotic-refractory arthritis.

Methods

Aim was to determine the B burgdorferi genotypes in the joints of pts with Lyme arthritis
Joint fluid samples from 124 ps seen over a 30-yr period analyzed for:
- OspC types by semi-nested PCR and sequencing
- RSTs by nested PCR and restriction fragment length polymorphism analysis
These results were correlated with clinical outcome

Results

OspC and RST genotypes were identified in 40% joint fluid samples
In these samples, OspC type K strains (RST2) were identified in 43%, OspC type A strains (RST1) were identified in 22%
8 other OspC types and all 3 RSTs were identified among the remaining 35%
However, among 17 pts who had been treated with antibiotics all 7 pts who were infected with RST1 strains had antibiotic-refractory arthritis, vs 4/6 pts infected with RST2 strains and only 1/4 infected with RST3 strains

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