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Infection and Immunity, July 1999, p. 3518-3524, Vol. 67, No. 7
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Four Clones of Borrelia burgdorferi Sensu Stricto Cause Invasive Infection in Humans

Gerald Seinost,1 Daniel E. Dykhuizen,2 Raymond J. Dattwyler,1,* William T. Golde,1 John J. Dunn,3 Ing-Nang Wang,2 Gary P. Wormser,4 Martin E. Schriefer,5 and Benjamin J. Luft1

Department of Medicine1 and Department of Ecology and Evolution,2 State University of New York at Stony Brook, Stony Brook, New York 11794; Biology Department, Brookhaven National Laboratory, Upton, New York 119733; Department of Medicine, New York Medical College, Valhalla, New York 105954; and Centers for Disease Control, Fort Collins, Colorado 805225

Received 20 October 1998/Returned for modification 6 December 1998/Accepted 14 April 1999

Lyme disease begins at the site of a tick bite, producing a primary infection with spread of the organism to secondary sites occurring early in the course of infection. A major outer surface protein expressed by the spirochete early in infection is outer surface protein C (OspC). In Borrelia burgdorferi sensu stricto, OspC is highly variable. Based on sequence divergence, alleles of ospC can be divided into 21 major groups. To assess whether strain differences defined by ospC group are linked to invasiveness and pathogenicity, we compared the frequency distributions of major ospC groups from ticks, from the primary erythema migrans skin lesion, and from secondary sites, principally from blood and spinal fluid. The frequency distribution of ospC groups from ticks is significantly different from that from primary sites, which in turn is significantly different from that from secondary sites. The major groups A, B, I, and K had higher frequencies in the primary sites than in ticks and were the only groups found in secondary sites. We define three categories of major ospC groups: one that is common in ticks but very rarely if ever causes human disease, a second that causes only local infection at the tick bite site, and a third that causes systemic disease. The finding that all systemic B. burgdorferi sensu stricto infections are associated with four ospC groups has importance in the diagnosis, treatment, and prevention of Lyme disease.

* Corresponding author. Mailing address: Division of Clinical Immunology/Allergy, Department of Medicine, State University of New York at Stony Brook, Health Sciences Center, Stony Brook, NY 11794-8161. Phone: (516) 444-2348. Fax: (516) 444-3475. E-mail: Rayd{at}epo.som.sunysb.edu.

Infection and Immunity, July 1999, p. 3518-3524, Vol. 67, No. 7
0019-9567/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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