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Kill kinetics ofBorrelia burgdorferi and bacterial findings in relation to the treatment of lyme borreliosis

Abtötungskinetik derBorrelia burgdorferi s.l. — bakteriologische und klinische Befunde

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Summary

For a better understanding of the persistence ofBorrelia burgdorferi sensu lato (s.l.) after antibiotic therapy the kinetics of killingB. burgdorferi s.l. under amoxicillin, doxycycline, cefotaxime, ceftriaxone, azithromycin and penicillin G were determined. The killing effect was investigated in MKP medium and human serum during a 72 h exposure to antibiotics. Twenty clinical isolates were used, including ten strains ofBorrelia afzelii and ten strains ofBorrelia garinii. The results show that the kinetics of killing borreliae differ from antibiotic to antibiotic. The killing rate of a given antibiotic is less dependent on the concentration of the antibiotic than on the reaction time. Furthermore, the data show that the strains ofB. afzelii andB. garinii have a different reaction to antibiotics used in the treatment of Lyme borreliosis and that different reactions to given antibiotics also exist within one species. TheB. garinii strains appear to be more sensitive to antibiotics used in therapy. Furthermore, the persistence ofB. burgdorferi s.l. and clinical recurrences in patients despite seemingly adequate antibiotic treatment is described. The patients had clinical disease with or without diagnostic antibody titers toB. burgdorferi.

Zusammenfassung

Die bakterizide Aktivität von Amoxicillin, Doxycyclin, Cefotaxim, Ceftriaxon, Azithromycin und Penicillin G gegenBorrelia burgdorferi s.l. Stämme wurde in MKP-Medium und Humanserum während der 72 Stunden Einwirkungszeit untersucht. Die Antiborrelienwirkung der Antibiotika wurde an 20 Patientenisolaten, zehnBorrelia afzelii und zehnBorrelia garinii Stämmen, getestet. Der Abtötungseffekt der einzelnen Antibiotika auf getestete Stämme ist sehr unterschiedlich. Die Unterschiede hinsichtlich der Keimreduktion bestehen zwischen den Stämmen derB. afzelii undB. garinii species als auch zwischen den Stämmen innerhalb einer Spezies. Der Anteil der abgetöteten Borrelien ist weniger abhängig von der Konzentration des Antibiotikums als von der Einwirkungszeit. DieB. garinii Stämme sind offensichtlich empfindlicher gegen die in der Therapie eingesetzten Antibiotika. Die Persistenz vonB. burgdorferi s.l. und Rezidive der Erkrankung nach der Antibiotikatherapie werden diskutiert.

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Authors and Affiliations

  1. Max v. Pettenkofer Institut, Ludwig-Maximilians-Universität München, Pettenkoferstr. 9a, D-80336, München

    Vera Preac Mursic Ph. D. & U. Busch Dipl.-Biol.

  2. Kinderklinik, Ludwig-Maximilians-Universität München, Lindwurmstr. 4, D-80337, München, Germany

    W. Marget M. D.

  3. Dept. of Infectious Diseases, University Ljubljana, Japljeva 2, 61000, Ljubljana, Slovenia

    Dusica Pleterski Rigler M. D.

  4. Chirurgische Klinik, RK-Universität Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany

    S. Hagl M. D.

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  1. Vera Preac Mursic Ph. D.
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  2. U. Busch Dipl.-Biol.
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This article is the expanded version of a lecture delivered in Portoroz on 14 May 1995. See also page 59.

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Mursic, V.P., Busch, U., Marget, W. et al. Kill kinetics ofBorrelia burgdorferi and bacterial findings in relation to the treatment of lyme borreliosis. Infection 24, 9–16 (1996). https://doi.org/10.1007/BF01780643

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