All Posts Tagged With: "infectious disease"

Int J Infect Dis. 2009 Nov 17. [Epub ahead of print]

Lakos A, Solymosi N.

The Center for Tick-borne Diseases, Visegrádi 14, Budapest, H-1132, Hungary.

BACKGROUND: There is disagreement regarding whether Lyme borreliosis is associated with adverse pregnancy outcome.

METHODS: We performed a review of the data from 95 women with Lyme borreliosis during pregnancy, evaluated at the Center for Tick-borne Diseases, Budapest over the past 22 years.

RESULTS: Treatment was administered parenterally to 66 (69.5%) women and orally to 19 (20%). Infection remained untreated in 10 (10.5%) pregnancies.

Adverse outcomes were seen in 8/66 (12.1%) parentally treated women, 6/19 (31.6%) orally treated women, and 6/10 (60%) untreated women. In comparison to patients treated with antibiotics, untreated women had a significantly higher risk of adverse pregnancy outcome (odds ratio (OR) 7.61, p=0.004).

While mothers treated orally had an increased chance (OR 3.35) of having an adverse outcome compared to those treated parenterally, this difference was not statistically significant (p=0.052). Erythema migrans did not resolve by the end of the first antibiotic course in 17 patients.

Adverse pregnancy outcome was more frequent among these ‘slow responder’ mothers (OR 2.69), but this was not statistically significant (p=0.1425). Loss of the pregnancy (n=7) and cavernous hemangioma (n=4) were the most prevalent adverse outcomes in our series.
The other complications were heterogeneous.

CONCLUSION: Our results indicate that an untreated maternal Borrelia burgdorferi s.l. infection may be associated with an adverse outcome, although bacterial invasion of the fetus cannot be proven.

It appears that a specific syndrome representing ‘congenital Lyme borreliosis’ is unlikely.

PMID: 19926325 [PubMed – as supplied by publisher]

To delineate the inflammatory potential of the 3 pathogenic species of Borrelia burgdorferi sensu lato, we stimulated monocyte-derived macrophages from healthy human donors with 10 isolates each of B. burgdorferi, Borrelia afzelii, or Borrelia garinii recovered from erythema migrans skin lesions of patients with Lyme borreliosis from the United States or Slovenia. B. burgdorferi isolates from the United States induced macrophages to secrete significantly higher levels of interleukin (IL)-8, CCL3, CCL4, IL-6, IL-10, and tumor necrosis factor than B. garinii or B. afzelii isolates. Consistent with this response in cultured macrophages, chemokine and cytokine levels in serum samples of patients from whom the isolates were obtained were significantly greater in B. burgdorferi-infected patients than in B. afzelii- or B. garinii-infected patients. These results demonstrate in vitro and in vivo that B. burgdorferi has greater inflammatory potential than B. afzelii and B. garinii, which may account in part for variations in the clinical manifestations of Lyme borreliosis. Continued