Detection of Borrelia infection in ticks and humans

In Europe at least three different Borrelia species are known to be pathogenic for humans. An interesting aspect of species classification is their correlation with epidemiological observations and clinical manifestations. Therefore, simple and rapid methods which enable a species-specific differentiation are more and more important for research as well as for diagnostic purposes.In the first part of the thesis, the development of a method for quantification and simultaneous identification of different Borrelia species was carried out and its practical usefulness was tested by performing an epidemiological study in ticks.The prevalence of Borrelia infection in ticks is an essential component of risk assessment. In the second part of the thesis (i) Borrelia infection and (ii) species distribution in I. ricinus ticks in Europe was determined performing a metaanalysis.Serology, which is the main diagnostic tool for Lyme Borreliosis to date, has various disadvantages. Therefore, many efforts have been attempted to develop alternative methods, e.g., PCR, which enables a direct detection of the pathogen. Despite the lack of standardization and ambiguous results in various studies, urine PCR, which is regarded as a desirable diagnostic tool, is already used by many diagnostic laboratories. To clarify this unsatisfactory situation, in the third part of the thesis the method of urine PCR was analyzed quantitatively by use of a highly standardized protocol.In summary, we have developed a highly sensitive real-time PCR which enables not only species-specific differentiation of Borrelia genotypes, but also their quantification. This method was successfully employed in an epidemiological study on ticks, which was itself set into relation to the situation in Europe performing a metaanalysis. A critical evaluation with help of our method revealed that urine PCR as diagnostic tool for Lyme Borreliosis is not advisable at least for diagnosis of early stages of Lyme Borreliosis