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Yield of large-volume blood cultures in patients with early Lyme disease
G P Wormser1, S Bittker, D Cooper
1Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, New York, NY, USA.
Abstract:
To improve yield, 6 3-mL plasma cultures (18 mL total) were established for adult patients with early Lyme disease associated with erythema migrans. Borrelia burgdorferi was recovered from the blood of 22 (44.0%) of 50 evaluable patients. The recovery rate per plasma culture and the frequency of positive results for plasma cultures for individual patients were consistent with a level of spirochetemia of approximately 0.1 cultivable cell/mL of whole blood. Our findings suggest that, if further improvements in the yield of blood cultures are possible, they probably will depend on enhancing the sensitivity of the culture method rather than increasing the volume of material cultured.
Insights
Culturing Borrelia burgdorferi from blood is challenging in early Lyme disease. Improving culture sensitivity, not volume, is key for better spirochetemia detection in patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Bacteriology
Background:
- Early Lyme disease diagnosis relies on clinical signs like erythema migrans.
- Detecting Borrelia burgdorferi via blood culture is crucial for understanding disease dynamics.
- Optimizing culture yield is essential for accurate spirochetemia assessment.
Purpose of the Study:
- To evaluate Borrelia burgdorferi recovery rates from plasma cultures in early Lyme disease patients.
- To determine the optimal volume of blood culture for detecting spirochetemia.
- To assess the feasibility of improving diagnostic yield through enhanced culture sensitivity.
Main Methods:
- Established 6 x 3-mL plasma cultures (18 mL total) for 50 adult patients with early Lyme disease.
- Cultured blood samples for Borrelia burgdorferi recovery.
- Calculated recovery rates per plasma culture and frequency of positive results.
Main Results:
- Borrelia burgdorferi was recovered from 44.0% (22/50) of patients.
- Spirochetemia levels were estimated at approximately 0.1 cultivable cell/mL of whole blood.
- Recovery rates were consistent across plasma cultures, suggesting limited impact of increased volume.
Conclusions:
- Current plasma culture volumes yield limited Borrelia burgdorferi recovery.
- Enhancing culture method sensitivity is more critical than increasing blood volume for improved yield.
- Further research should focus on optimizing culture techniques for better spirochetemia detection.
