Uusi borreliatesti jossa bakteeri viljellään verestä. Nykyisin käytetään epäluotettavaa vasta-aineiden muodostumiseen perustuvaa testiä joka antaa usein virheellisiä negatiivisia tai raja-arvoisia testituloksia.
Uuden testin kehittäneen laboratorion mukaan: "Borreliatestit ovat tunnettuja epäluotettavuudestaan. Sen seurauksena on esiintynyt runsaasti virheellisiä diagnooseja ja hoitoja. Nyt laboratorio, "Advanced Laboratory Services Inc. ", on kehittänyt borrelia-testin bakteerin viljelemiseksi verestä. Nykyiset seulonnoissa käytettävät edulliset vastainetatestit kertovat ainoastaan mahdollisesta tartunnasta jossakin vaiheessa elämää ja elimistön kyvystä tunnistaa ja muodostaa vasta-aineita. Tutkimusten mukaan nämä testit jättävät havaitsematta 30 - 70% borreliatapauksista.
Uusi testi kertoo näytteenottohetken tilanteen. Testi voi olla positiivinen myös sellaisissa tapauksissa joissa vasta-ainetesti on negatiivinen."
Alla myös erään amerikkalaisen Borrelioosiin erikoistuneen lääkärin näkemyksiä uudesta testistä. "Borrelia-bakteeri hakeutuu kudoksiin mutta ilmestyy aika ajoin verenkiertoon. Mahdollisimman luotettavan tuloksen saamiseksi verinäytteen tulle olla laboratoriossa 24 tunnin sisällä. Kuljetuksen aikana lämpötila ei saa vaihdella suuresti. Näistä syistä testi on tällä hetkellä käytössä vain USA:ssa. Näyte on parasta ottaa varhain iltapäivällä sillä suurin osa sairastuneista saa silloin oireita esim. kasvojen punoitus, lämmön lievä nousu, uupumus jne. Antibiootteja ei tule käyttää 4 viikkoon ennen näytteenottoa. Koska testitulos kertoo todellisen tilanteen juuri sillä hetkellä, hoitava lääkäri ei voi kieltää tilannetta. Borrelia-tartunta on tosiasia."
Sharon Hill, PA, September 5, 2011
BORRELIA CULTURE NOW AVAILABLE TO EVALUATE
LYME DISEASE PATIENTS
Research breakthrough promises a new Gold Standard in Lyme Disease testing
Lyme Disease blood testing has been notorious for its unreliability This has been responsible for misdiagnoses and inappropriate patient care, as well as confusion on the part of both patient and physician alike. Now, as a result of intensive research, Advanced Laboratory Services Inc. is able to offer what will rapidly become the new gold standard of Lyme tests, the Borrelia Culture.
Until now, the most widely used confirmatory tests for Lyme disease have been serologies. Being indirect tests, at best they can only indicate possible exposure to this organism at some previous point in time. It has been variously reported that the sensitivity of these assays is low and may miss anywhere from 30% to as many as 70% of cases of Lyme. Once positive, these serologic tests tend to remain positive for variable periods, even years, even after treatment. Therefore they do not and cannot be used as a marker for progress during treatment or for success of treatment. In addition, some acute viral infections may potentially give a false positive result.
How are most other infectious diseases diagnosed? Traditionally, a culture is taken to see if an infection is present, and if so, what specific bacterium is causing it. Unfortunately, because Lyme Borrelia are symbionts, meaning that they need a living host to survive, trying to get them to thrive in vitro has been a nearly impossible task. In addition, they are noted for their very slow growth. Because of these difficulties, Borrelia culture until now has not been available to clinicians.
Advanced Laboratory Services Inc. is proud to announce that they have overcome many of these technical difficulties and is able to offer Borrelia cultures. While still considered investigational, the new methods employed allow these advantages:
By definition, culture is a direct test and if positive, indicates that an infection was present at the time the specimen was taken
Cultures may be positive even in a patient who is seronegative
In theory, any fluid or tissue that is infected can be cultured
All known strains of Borrelia burgdorferi sensu lato can be detected
When combined with PCR and DNA sequencing, the exact identity of the Borrelia can be ascertained
Advanced methods have the promise to increase yield and decrease turn-around time
Culture positivity fulfills even the strict CDC surveillance case definition
Will become the new Gold Standard for laboratory testing
Currently, Advanced Labs is offering two Borrelia blood culture panels. The Basic Panel consists of culturing, with confirmation of identity by histology and by specific immunostaining. The report, if positive, will include a picture of the actual immunostained culture result. The expected turnaround time for this is approximately ten to fourteen days. However, some do grow more slowly, so all cultures will be held in the lab for a minimum of six weeks.
We also offer the Extended Panel. In addition to histology and immunostaining, the identity of all positive cultures will be further studied by polymerase chain reaction (PCR) and by nucleic acid sequencing. These extra steps will generally require an additional ten to fourteen days. However, if the initial histology with immunostaining is positive, a preliminary report will be issued while the nucleic acid studies are pending.
Bb culture nuts and bolts
Sensitivity exceeds 80% if the patient is symptomatic at the time of blood draw and not on antibiotics for at least four weeks
All negative controls have remained negative so far
As with all blood cultures, may need several sets to be sure
Any positive test is significant, even if it is the only positive out of a set of three
We have found that the success of culturing Borrelia can be increased by following these simple recommendations:
The patient should not have been exposed to any antibiotics, even those not known to affect this organism, for a minimum of four weeks prior to the blood sample being drawn.
Borrelia are more likely to be recovered from patients who are symptomatic at the time of blood sampling.
A higher yield may be seen if the blood is drawn in the early afternoon, when most infected patients feel especially ill.
Advanced Laboratory Services is continually refining its processes, so we welcome your feedback! Please feel free to share your ideas with us.
Advanced Laboratory Services, Inc. 501 Elmwood Avenue - Sharon Hill, PA 19079
Web: www.advanced-lab.com email: firstname.lastname@example.org
Toll Free- 855-238-4949 Fax- 855-238-4946
.....the biology of Bb in people is quite complex and still not fully understood.
Bb do seek out and persist in deep tissues, but they regularly transit through the circulation throughout the infection. I have seen some very impressive vital videos of this, and my extensive experience with MacDonald's blood Bb cultures 25 years ago confirmed this.
To assure maximal test sensitivity, the patient must have been off antibiotics for four weeks, be symptomatic from Lyme, and if at all possible, have the blood drawn in the early afternoon. I have observed that in active Lyme, many of not most patients get a wave of fatigue, increased symptoms, flushed face, and slightly elevated temperature at that time of day. If blood is drawn then, MacDonald was able to get a positive culture in nearly every one of my patients (probably about 100 cultures were done then). So I have to assume that that is when the spirochetemia seems most likely to be present.
Current lab experiments have revealed growth of Borrelia from many different patients from all across the USA. Because the ability to culture Borrelia is broad, the test is not reported as positive for Bb unless it is identified by growth characteristics, histology and at a minimum direct immunostaining by monoclonal and polyclonal antibodies.
Further testing is optional, and consists of PCR testing by a variety of primers and then by nucleic acid sequencing.
If a non-Borrelia spirochete is seen, it will be reoorted as such.
---What I specifically mean is that the lab has tested people who do not have Lyme and they never got a positive culture from any of them. In other words, if a patient has a positive culture, it is real, and not a contaminant etc. Therefore a positive culture cannot be dismissed, just as, for example, one would not ignore a positive culture of meningococcus on a spinal tap.
In other words, this data indicates that a doc should not dismiss a positive culture. It is real.