A recently published study has raised questions about long-standing assumptions in Lyme disease research, particularly regarding the presence of Borrelia burgdorferi in the bloodstream during the early stages of infection.
The study analyzed blood samples from 145 individuals living in areas of the United States where Lyme disease is common. Researchers used a modified diagnostic approach that involved separating platelet-rich plasma immediately after blood draw to prevent contamination and potential loss of spirochetes from the sample. They then employed highly sensitive PCR testing followed by Sanger sequencing to identify bacterial DNA.
Of 98 patients clinically suspected of having early localized Lyme disease, 33 (approximately 34%) showed detectable levels of B. burgdorferi DNA, challenging the prevailing belief that spirochetemia does not occur at this stage. Interestingly, 17% of 47 asymptomatic control participants also tested positive for the bacterium’s flaB gene.
The findings suggest that the flaB gene may serve as a more sensitive molecular marker than the commonly used 16S rRNA gene in early-stage detection, possibly because spirochetes either gain or retain multiple copies of the flaB gene during initial infection.