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niedziela, 20 listopada 2016

Lyme Disease Transmission

Lyme Disease Transmission
 
  • Modes other than ticks
  • Blood-sucking insects, such as mosquitoes, flies, fleas and mites
  • Transplacental transmission
  • Contact with infected urine and other bodily fluids from infected animals
  • Transmission via blood, tissue and organ donation
  • Sexual transmission

Modes other than Ticks

Scientific studies support potential alternate modes of transmission; however these potential transmission sources have not been fully researched. A small selection of available research is offered below.
Blood-sucking insects, such as mosquitoes, flies, fleas and mites
Dr Steven Luger reported in The New England Journal of Medicine a case in which a patient was bitten by a large fly and presented 13 days later with Lyme symptoms. These were resolved via pharmaceutical treatment.

http://www.nejm.org/doi/full/10.1056/NEJM199006143222415

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http://www.nejm.org/doi/full/10.1056/NEJM199006143222415

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A German study of patients with Lyme arthritis identified evidence, through serological test for antibodies to the causative spirochete, that one patient had contracted the disease from a fly.‘Lyme arthritis: Clinical features, serological and radiographic findings of cases in Herzer P, Wilske B, Preac-Mursic V, G Schierz, Schattenkirchner M, & Zollner N. 1986, Lyme Arthritis: Clinical Features, Serological, and Radiographic Findings of Cases in Germany, Klinische Wochenschrift 64:206-215.

http://link.springer.com/article/10.1007/BF01711648#page-1

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http://www.ncbi.nlm.nih.gov/pubmed/26631488 -----------------------------------------------------------------------------http://www.aaem.pl/pdf/aaem0208.pdf -----------------------------------------------------------------------------dr Dietrich Klinghardt http://articles.mercola.com/sites/articles/archive/2012/10/13/under-our-skin-documentary.aspx -----------------------------------------------------------------------------Occurrence of Borrelia burgdorferi s.l. in different genera of mosquitoes (Culicidae) in Central Europe

http://www.sciencedirect.com/science/article/pii/S1877959X15300327
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A French study of four Lyme patients ascertained that only one was bitten by a tick; the researchers suggested that two of the patients may have contracted the disease from a mosquito or biting fly.Doby JM, Chastel C, Couatarmanac’h A, Cousanca C, Chevrant-Breton J, Martin A, Legay B & Guiquen C. 1985, Etiologic and epidemiologic questions posed by erythema chronicum migrans and Lyme disease, Bull Soc Pathol Exot Filiales 78(4):512-525.

https://www.ncbi.nlm.nih.gov/pubmed/4075471

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Borrelia burgdorferi was identified in 13 species of mites, 15 species of flies and two species fleas.Pokornỳ P. 1989, Incidence of the spirochete Borrelia burgdorferi in arthopods (Arthropoda) and antibodies in vertebrates (Vertebrata), Cesk Epidemiol Mikrobiol Imunol. 38(1):52-60.

https://www.ncbi.nlm.nih.gov/pubmed/2646031

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A study identified Borrelia spirochetes in mosquitoes and fleas.Hubálek Z, Halouzka J & Juřicová Z. 1998, Investigation of haematophagous arthropods for borreliae – summarised data 1988-1996, Folia Parasitologica 45: 67-72.

http://folia.paru.cas.cz/pdfs/fol/1998/01/11.pdf

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Borrelia burgdorferi spirochetes identifiedin mosquitoes and flies.Magnarelli LA & Anderson JF. 1988, Tick and biting insects infected with the etiologic agent of Lyme disease, Borrelia burgdorferi, J. Clin. Microbiol. 26(8):1482.

http://jcm.asm.org/content/26/8/1482.full.pdf

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Borrelia afzelii spirochetes identified in female mosquitoes of the genus Culex, Aedes and Anopheles.Zákovská A, Capková L, Serỳ O, Halouzka J & Dendis M. 2006,Isolation of Borrelia afzelii from Overwintering Culex Pipiens Biotype Molestus Mosquitoes, Ann Agric Environ Med. 13(2):345-348.

http://link.springer.com/article/10.1007/s150100050029#page-1

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Transplacental transmission
 The issue of transplacental (mother to child in utero) transmission is raised in the LDAA’s formal response to DoH Scoping Study on Lyme disease (page 16) from Gardner T. 2001, ‘Lyme disease’ in J Remington & JO Klein (eds), Infectious Diseases of the Fetus and Newborn Infant, 5th edn. Philidelphia, WB Saunders; 519-641
http://www.lymedisease.org.au/wp-content/uploads/2010/11/20140129LDAAScopingStudyResponse.pdf

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A compilation of peer-reviewed journal articles indicating that Lyme could be contracted in utero is available on the LDAA website.

http://www.lymedisease.org.au/wp-content/uploads/2012/07/peer-reviewed-journal-articles-regarding-transplacental-transmission-of-lyme.pdf

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Contact with urine and other bodily fluids from infected animals
The potential for humans to contract Lyme disease via an infected mammal is an area that has yet to be fully researched, however remains of concern to the LDAA and Lyme patients.

There is ample evidence of Borrelia in mammals reported in Australian and overseas research:


An Australian study found Borrelia spirochetes in cattle, rodents, kangaroos and bandicoots. Mackerras MJ. 1959, The haematozoa of Australian mammals. Aust J Zool. vol. 7: 105-135.

http://www.publish.csiro.au/zo/ZO9590105

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An Australian study identified a new species of Borrelia (B. queenslandica), in the blood of rats. Carley JG & Pope JH. 1962, A new species of Borrelia (B. queenslandica) from Rattus Villosissimus in Queensland, Aust J Exp Biol. Vol. 40:255-262.

http://www.readcube.com/articles/10.1038/icb.1962.29

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Borrelia antibodies were identified in 22 mammalian species, including carnivores and rodents.



Pokornỳ P. 1989, Incidence of the spirochete Borrelia burgdorferi in arthopods (Arthropoda) and antibodies in vertebrates (Vertebrata), Cesk Epidemiol Mikrobiol Imunol. 38(1):52-60.

https://www.ncbi.nlm.nih.gov/pubmed/2646031

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Evidence of Borrelia found in systemically ill cats and dogs in the UK. Shaw SE, BInns SH, Birtles RJ, Day MJ, Smithson R & Kenny MJ. 2005, Molecular evidence of tick-transmitted infections in dogs and cats in the United Kingdom, Vet Rec Nov 19; 157(21): 645-648.

https://www.ncbi.nlm.nih.gov/pubmed/16299364%20

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Positive ELISA results for Borrelia antibodies in horses. Sorensen K, Neely DP, Grappell PM & Reed W. 1990, Lyme disease antibodies in thoroughbred broodmares, correlation to early pregnancy failure, Equine Vet J, 10(3): 166-168.

http://www.sciencedirect.com/science/article/pii/S073708060680153X

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Transmission of Borrelia from animals to humans could theoretically occur via exposure to their urine, blood, semen, colostrums or synovial fluid, as detailed below.

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The LDAA Australian patient report (2012), page 12, Table 2 and page 14, Table 4 included respondents nominating other suspected modes of transmission via animals including, urine, saliva and milk.

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Live Borrelia burgdorferi was isolated in the blood and urine of white-footed mice. The authors reported that "Spirochetes remained viable for 18-24 hours in urine." Bosler EM & Schulze TL. 1986, The prevalence and significance of Borrelia burgdorferi in the urine of feral reservoir hosts, Zentralbl Bakteriol Mikroboil Hyg A., Dec; 263(1-2): 40-44.

https://www.ncbi.nlm.nih.gov/pubmed/3577491

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Borrelia burgdorferi was isolated in the blood of a dog three and four weeks post infection. Cerri D, Farina R, Andreani E, Nuvoloni R, Pedrini A & Cardini G. 1994, Experimental infection of dogs with Borrelia burgdorferi, Res Vet Sci, 57(2): 256-258.

https://www.ncbi.nlm.nih.gov/pubmed/7817018

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Horse and cow blood, cow colostrums, cow urine and cow synovial fluids found to be Borrelia burgdorferi culture positive. Burgess EC. 1998, Borrelia burgdorferi infection in Wisconsin horses and cows, Ann N Y Acad Sci, 539:235-243.

https://www.ncbi.nlm.nih.gov/pubmed/3190095

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The West Australian Lyme Association's submission in response to the DoH Scoping Study on Lyme Disease explores the potential role of livestock and their reproductive products in transporting (and possibly transmitting) Lyme disease, including:



Limited screening of imported livestock through quarantine process (Pages 5-6).



Screening process in interstate transport of livestock is not always adequate (Page 6).


Potential for Borrelia to survive in imported frozen semen and ova (P 9-10). Borrelia burgdorferi spirochetes were found to have a mean viability of 90%+ after being frozen at minus-196 Celsius for 12 weeks. ‘Viability of Borrelia burgdorferi in Stored Semen’, Kumi-Diaka, J. and Harris, O, (1995) British Veterinary Journal, Mar/Apr 1995. v. 151 (2)


Lack of facilities in Australia to test livestock suspected of infection with Lyme disease (Page 11).

The submission can be found here.

http://www.lymedisease.org.au/wp-content/uploads/2010/11/WALAScopingStudySubmission.pdf

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An extensive collection of research regarding the role birds in the transmission cycle of Lyme disease has been compiled on the website of Australian researcher (and Lyme patient), Karen Smith.

Transmission via blood, tissue and organ donations
The LDAA has repeatedly raised concerns about the lack of screening of Australian blood supplies for Borrelia and known co-infections.

http://www.donateblood.com.au/faq/the-donation-process/what-tests-do-the-blood-service-perform-on-donated-blood%20

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At this time, public safety relies on voluntary,,'opting out,, of blood and organ donation programs by those who are aware they are infected with Lyme disease and co-infections. This is of major concern, given the number of people in the Australian population likely to be undiagnosed with these infections.


The LDAA again raised the concerns in the formal response to the DoH Scoping Study (pages 39-40) in relation to public risk through blood transfusions.

http://www.donateblood.com.au/faq/the-donation-process/what-tests-do-the-blood-service-perform-on-donated-blood%20

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The LDAA's Patient-Focused Action Plan, appended to the Scoping Study Response, called for:

http://www.lymedisease.org.au/part-2-lyme-politics/#wants

Screening of blood for Borrelia, Babesia, and other known co-infections.

Notification to organ donors to withdraw from program after suspected tick bites.

Research supporting concerns about potential transmission through blood include:


US studies have found Borrelia “may survive storage under blood banking conditions and that transfusion-related Lyme disease is theoretically possible”
Nadelman RB, Sherer C, Mack L, Pavia CS & Wormser GP. 1990, Survival of Borrelia burgdorferi in human blood stored under blood banking conditions , Transfusion, 30(4):298-301.

https://www.ncbi.nlm.nih.gov/pubmed/2349627

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An article raising concerns about the transfusion-based transfusion was published.

Leiby DA. 2011, Transfusion-associated babesiosis: shouldn't we be ticked off? Annals of internal medicine 155(8), 556-557.

http://annals.org/aim/article/475003/transfusion-associated-babesiosis-shouldn-t-we-ticked-off

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Sexual transmission

There is a growing body of anecdotal evidence among the Australian Lyme community indicating that Lyme disease may be sexually transmitted. This anecdotal evidence is supported, at this stage, by limited scientific research; however Lyme patients are urged to practice safe sex as a precaution.


A 2001 study found that sexual partners of Lyme patients were likely to carry Borrelia themselves. Bach G. 2001 April, ‘Recovery of Lyme spirochetes by PCR in semen samples of previously diagnosed Lyme disease patients’, International Scientific Conference on Lyme disease.

http://www.anapsid.org/lyme/bach.html

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Newly published research provides evidence that Borrelia burgdorferi may be transmissible through both vaginal secretions and seminal fluid, again suggesting sexual transmission.
Middelveen, MJ, Bandoski, C, Burke J, Sapi E, Mayne PJ, Stricker RB, 2104, ‘Isolation and Detection of Borrelia burgdorferi from Human Vaginal and Seminal Secretions’, Presented at the Western Regional Meeting of the American Federation for Medical Research, Carmel, CA, January 25, 2014.


In an interview regarding this research, Australia’s Dr Peter Mayne said, “...the presence of the Lyme spirochete in genital secretions and identical strains in married couples strongly suggests that sexual transmission of the disease occurs.”

http://www.prweb.com/releases/2014/01/prweb11506441.htm

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dr.Kurkiewicz
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Recent study suggests that Lyme disease can be sexually transmitted

https://www.lymedisease.org/lyme-sexual-transmission-2/

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A 2001 study found that sexual partners of Lyme patients were likely to carry Borrelia themselves. Bach G. 2001 April, ‘Recovery of Lyme spirochetes by PCR in semen samples of previously diagnosed Lyme disease patients’, International Scientific Conference on Lyme disease.

http://www.anapsid.org/lyme/bach.html

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Lyme disease can be transmitted sexually
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Lyme spirochetes recovered in semen of Lyme positive patients
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The presence of the Lyme spirochete in genital secretions and identical strains in married couples strongly suggests that sexual transmission of the disease occurs
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Lyme transmitted through sexual contact and from mother to child congenitally
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Laboratory studies confirm the existence of Lyme spirochetes in semen/vaginal secretions.
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Video newscast Lyme can be sexually transmitted
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http://safersex.education/can-lyme-disease-be-sexually-transmitted/

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http://www.livingwithlyme.com/images/Lyme_Disease_The_Unknown_Epidemic.pdf

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If Lyme disease is sexually transmitted, what are the implications for the general population? An editorial published online on August 21, 2015, in the prominent infectious disease journal Expert Review of Anti-infective Therapy explores what happens if Lyme disease morphs from a tickborne illness into a sexually transmitted disease

http://informahealthcare.com/doi/abs/10.1586/14787210.2015.1081056

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The authors point out that contact and/or sexual transmission of Borrelia burgdorferi was demonstrated in mouse and dog models more than 25 years ago. Around the same time, sexual transmission of the Lyme spirochete was demonstrated by Russian researchers in ticks that transmit the disease to humans. Those studies have never been repeated.

http://www.prohealth.com/library/showarticle.cfm?libid=21170

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The study — presented at the annual Western Regional Meeting of the American Federation for Medical Research — a collaborative effort by an international team of scientists — tested semen samples and vaginal secretions of three groups of patients to investigate whether passing Lyme disease to a partner through unprotected sex is a possibility. The study observed control subjects without evidence of Lyme disease, random subjects who tested positive for Lyme disease, and married heterosexual couples engaging in unprotected sex who tested positive for the disease. The presence of B. burgdorferi and identical strains of the bacterium were of particular interest to the researchers in unprotected sex in spouses.
 
The control subjects were found to test negative for the bacterium in semen samples or vaginal secretions, as expected by the researchers. The researchers found traces of B. burgdorferi in the vaginal secretions of all women with Lyme disease. In contrast, approximately half of the men with the disease tested positive for the bacterium in semen samples. In addition, one of the heterosexual couples with Lyme disease were found to have identical strains of the bacterium in their genital secretions

http://www.collective-evolution.com/2015/04/16/lyme-disease-the-cdcs-greatest-coverup-what-they-dont-want-you-to-know/

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Abstract

Lyme disease caused by the spirochete Borrelia burgdorferi has become a major worldwide epidemic. In this article, we explore the clinical, epidemiological and experimental evidence for sexual transmission of Lyme disease in animal models and humans. Although the likelihood of sexual transmission of the Lyme spirochete remains speculative, the possibility of Lyme disease transmission via intimate human contact merits further study

http://www.ncbi.nlm.nih.gov/pubmed/26489537

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A new study suggests that Lyme disease may be sexually transmitted. The study was presented at the annual Western Regional Meeting of the American Federation for Medical Research, and an abstract of the research was published in the January issue of the Journal of Investigative Medicine.
Lyme disease is a tickborne infection caused by Borrelia burgdorferi, a type of corkscrew-shaped bacteria known as a spirochete (pronounced spiro’keet). The Lyme spirochete resembles the agent of syphilis, long recognized as the epitome of sexually transmitted diseases. Last summer the Centers for Disease Control and Prevention (CDC) announced that Lyme disease is much more common than previously thought, with over 300,000 new cases diagnosed each year in the United States. That makes Lyme disease almost twice as common as breast cancer and six times more common than HIV/AIDS.
“Our findings will change the way Lyme disease is viewed by doctors and patients,” said Marianne Middelveen, lead author of the study presented in Carmel. “It explains why the disease is more common than one would think if only ticks were involved in transmission.”

Reference: http://journals.lww.com/jinvestigativemed/Citation/2014/01000/Western_Regional_Meeting_Abstracts.18.aspx
The Journal of Investigative Medicine 2014;62:280-281
Presented at the Western Regional Meeting of the American Federation for Medical Research, Carmel, CA, January 25, 2014.
http://afmr.org/Western/
Additional information: officemanager(at)usmamed(dot)com

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http://www.treatlyme.net/treat-lyme-book/can-lyme-be-sexually-transmitted-yes

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Newly published research provides evidence that Borrelia burgdorferi may be transmissible through both vaginal secretions and seminal fluid, again suggesting sexual transmission.
Middelveen, MJ, Bandoski, C, Burke J, Sapi E, Mayne PJ, Stricker RB, 2104, ‘Isolation and Detection of Borrelia burgdorferi from Human Vaginal and Seminal Secretions’, Presented at the Western Regional Meeting of the American Federation for Medical Research, Carmel, CA, January 25, 2014.




persister cells

Kim Lewis over persister cells:

https://www.youtube.com/watch?v=qXTPiJWhtDg

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Northeastern University Antimicrobial Discovery Center

Kim Lewis, "The Paradox of Chronic Infections"

All bacterial populations stochastically produce a small number of dormant persister cells tolerant to antibiotics. Persisters are not mutants but phenotypic variants of the wild type.

We are interested in discovering the mechanism of persister formation. Using cell sorting and transcriptome analysis, we find that chromosomally-encoded “toxin” genes act to shut down cellular functions, creating a dormant state. Examples include HipA, which encodes a protein kinase that phosphorylates elongation factor Ef-Tu, blocking protein synthesis, and TisB, a small peptide that inserts in the membrane, causing a drop in pmf and ATP levels. Interestingly, TisB synthesis is induced by DNA damaging agents, including fluoroquinolone antibiotics. This means that persisters can be formed not only stochastically, but through stress response mechanisms.

We find that in chronic infections such as cystic fibrosis, antibiotic treatment selects for high-persister mutants. Whole genome sequencing indicates the mechanism for increased production of persisters.

Current projects involve the study of the molecular mechanisms of persister formation governed by HipA and TisB in E. coli; the search for persister genes in P. aeruginosa, S. aureus and M. tuberculosis; and characterization of high-persister mutants from clinical isolates of these pathogens. A related project is discovery of compounds capable of eliminating persisters. The work of the persister group is supported by a Transformative Award from the NIH, and with grants from ARO and CF Foundation.
 
 
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Lyme disease, caused by the spirochete Borrelia burgdorferi, is the most common vector-borne infection in North America and Europe. In 10-20% of cases, patients develop chronic Lyme disease after completing antibiotic treatment. The cause of these chronic symptoms is, however, poorly understood. We have previously shown that high-persister mutants are selected for over the course of relapsing chronic infections of Pseudomonas aeruginosa in cystic fibrosis patients and Candida albicans in oral thrush patients. It seems likely that these high persister mutants may contribute to the recalcitrance of the infection. Persister cells are drug-tolerant phenotypic variants of normal cells and may cause recurrent bacterial infections by resuming growth once antibiotic treatment has ceased. We hypothesize that persister cells play a role in the treatment failure that leads to chronic Lyme disease. Here, using time-dependent and dose dependent survival assays, we show that B. burgdorferi forms persister cells to the antibiotics commonly used for treatment of Lyme disease. Our results indicate that in a B.burgdorferi population, 0.001% to 1% of the cells can survive lethal doses of various antibiotics in vitro. These persister cells may contribute to treatment failure in chronic Lyme patients. Future experiments are aimed at screening for a better antimicrobial therapy to eradicate persisters in B. burgdorferi.

http://www.abstractsonline.com/Plan/ViewAbstract.aspx?mID=3475&sKey=ddd2449f-2f20-40f0-b4e3-23d73fdf5fae&cKey=6420d060-6ac4-4246-b649-bf393a7997df&mKey=673511f0-c86b-432f-a387-058032b8500b

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Borrelia burgdorferi, the causative agent of Lyme disease, forms drug-tolerant persister cells.
Bijaya Sharma, Autumn V. Brown, Nicole E. Matluck, Linden T. Hu and Kim Lewis

In this study, we examined the ability of B. burgdorferi to form persisters. Killing of growing cultures of B. burgdorferi with antibiotics used to treat the disease was distinctly biphasic, with a small subpopulation of surviving cells. Upon regrowth, these cells formed a new subpopulation of antibiotic-tolerant cells, indicating that these are persisters rather than resistant mutants. The level of persisters increased sharply as the culture transitioned from exponential to stationary phase. Combinations of antibiotics did not improve killing. Daptomycin, a membrane-active bactericidal antibiotic, killed stationary phase cells, but not persisters. Mitomycin C, an anti-cancer agent that forms adducts with DNA, killed persisters and eradicated both growing and stationary cultures of B. burgdorferi. Finally, we examined the ability of pulse-dosing an antibiotic to eliminate persisters. After addition of ceftriaxone, the antibiotic was washed away, surviving persisters were allowed to resuscitate, and antibiotic was added again. Four pulse-doses of ceftriaxone killed persisters, eradicating all live bacteria in the culture.

http://aac.asm.org/content/early/2015/05/20/AAC.00864-15
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What everyone was waiting for – Possible Lyme Disease Cure on Horizon

Gepubliceerd op 13 nov. 2014
All the lies are starting to come out folks, breaking news has just surfaced that Ying Zhang, MD, PhD developed a test that can identify persister cells in Chronic Lyme Disease. Borrelia burgdorferi persister cells neither die nor grow in the presence of an antibiotic. Rather, they exist in a dormant state that allows them to survive antibiotic treatment, only to awaken later and start a new wave of infection. This new test will be able to quantify how many Borrelia burgdorferi are alive and how many are dead after each drug was added to the bacteria. The method stains the living bacteria green and the dead or dying bacteria red in a way that filters out the noise that can corrupt existing tests. So now, it's only a matter of time till the CDC changes their protocol and week can seek immediate antibitiotic treatment.

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EFFECTIVENESS OF STEVIA REBAUDIANA WHOLE LEAF EXTRACT AGAINST THE VARIOUS MORPHOLOGICAL FORMS OF BORRELIA BURGDORFERI IN VITRO
P. A. S. Theophilus, M. J. Victoria, K. M. Socarras, K. R. Filush, K. Gupta, D. F. Luecke, E. Sapi*
Department of Biology and Environmental Science, University of New Haven, West Haven, CT, USA
Received: September 7, 2015; Accepted: October 26, 2015 | European Journal of Microbiology and Immunology (2015) | DOI: 10.1556/1886.2015.00031

Lyme disease is a tick-borne multisystemic disease caused by Borrelia burgdorferi. Administering antibiotics is the primary treatment for this disease; however, relapse often occurs when antibiotic treatment is discontinued. The reason for relapse remains unknown, but recent studies suggested the possibilities of the presence of antibiotic resistant Borrelia persister cells and biofilms.

In this study, we evaluated the effectiveness of whole leaf Stevia extract against B. burgdorferi spirochetes, persisters, and biofilm forms in vitro. The susceptibility of the different forms was evaluated by various quantitative techniques in addition to different microscopy methods. The effectiveness of Stevia was compared to doxycycline, cefoperazone, daptomycin, and their combinations. Our results demonstrated that Stevia had significant effect in eliminating B. burgdorferi spirochetes and persisters. Subculture experiments with Stevia and antibiotics treated cells were established for 7 and 14 days yielding, no and 10% viable cells, respectively compared to the above-mentioned antibiotics and antibiotic combination. When Stevia and the three antibiotics were tested against attached biofilms, Stevia significantly reduced B. burgdorferi forms. Results from this study suggest that a natural product such as Stevia leaf extract could be considered as an effective agent against B. burgdorferi.
 
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Peer Reviewed Evidence of Persistence of Lyme Disease Spirochete Borrelia burgdorferi and Tick-Borne Diseases
The following is a list of over 700 peer reviewed articles that support the evidence of persistence of Lyme and other tick-borne diseases. It is organized into different categories—general, psychiatric, dementia, autism and congenital transmission.


http://www.ilads.org/ilads_news/wp-cont ... nce-V2.pdf
 
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Researchers investigate four promising new treatments for Lyme disease
March 29, 2016 by Thea Singer

A new regimen

Lewis and his col­leagues are pro­viding that focus. A sub­pop­u­la­tion of B. burgdor­feri cells, they dis­cov­ered ear­lier, are “per­sister” cells—they are alive but lie dor­mant, in a spore­like state. Because antibi­otics attack only actively func­tioning bac­te­rial cells, per­sis­ters escape the onslaught. How­ever, once the antibi­otic has been flushed from the system, the per­sis­ters “wake up,” says Lewis, dividing and mul­ti­plying until an army of progeny infect the host.

That’s where “pulse dosing” comes in. Lewis’ team, in col­lab­o­ra­tion with researchers studying B. burgdor­feri in mice at Tufts University’s School of Med­i­cine, has been ana­lyzing the effect of giving the mice an antibi­otic that kills all the actively func­tioning bac­te­rial cells and then—using the timing that erad­i­cated the pathogen in the test tube—giving addi­tional doses to quash the per­sister cells as they begin to wake up but before they reproduce.

Plans are in the works for the first pulse-​​dosing human trials with med­ical schools.

Drugs com­bined and discovered

Doxy­cy­cline may be stan­dard first-​​line treat­ment for Lyme, but, says Lewis, it doesn’t even kill B. burgdor­feri, it just sup­presses its growth, leaving the rest of the work to the immune system. “We simply asked the ques­tion: ‘Is it pos­sible to com­bine existing antibi­otics to treat not only chronic Lyme but any stage of Lyme if the diag­nosis is unambiguous?”
The researchers have already found com­bi­na­tions that are effec­tive against the B. burgdor­feri in the test tube and will move on to animal studies next.
They are tack­ling new-​​drug dis­covery on two fronts: Plumbing the 200,000-plus com­pounds in their col­lec­tion at North­eastern to find the ones that act solely against B. burgdor­feri to avoid unwanted side effects and, in col­lab­o­ra­tion with Novo­bi­otic Phar­ma­ceu­ti­cals, extracting drugs from bac­teria that live in soil using the iChip, a device devel­oped by Slava Epstein, Dis­tin­guished Pro­fessor at North­eastern, in col­lab­o­ra­tion with Lewis. The iChip pro­vides access to the 99 per­cent of microbes in the envi­ron­ment that hereto­fore could not be grown in the lab.
“So far we have iden­ti­fied two lead com­pounds that kill B. burgdor­feri and have no activity against other bac­teria,” says Lewis.
The researchers are also exploring whether the micro­biome has “shifted” in those with PTLDS, to see whether intro­ducing cer­tain microor­gan­isms might shift it back. Animal studies have shown that manip­u­lating the micro­biome com­po­si­tion alle­vi­ates symp­toms of autoim­mune dis­eases such as rheuma­toid arthritis, which share many char­ac­ter­is­tics with PTLDS.

“We are going at Lyme dis­ease with every­thing we have,” says Lewis.
 
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WATCH: Bacteria Invade Antibiotics And Transform Into SuperbugsSeptember 8, 2016
If you've ever wanted to watch a superbug evolve before your very eyes, you're in luck. Researchers filmed an experiment that created bacteria a thousand times more drug-resistant than their ancestors. In the time-lapse video, a white bacterial colony creeps across an enormous black petri dish plated with vertical bands of successively higher doses of antibiotic.
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And if scientists can see it, maybe they can start to study it. Using something as simple as a giant petri dish like this could help scientists open up that spatial dimension that has been missing from the lab, says Pamela Yeh, a microbiologist at UCLA who was not involved in the experiment. "Hopefully this will put back in people's minds how important the spatial element can be."
 
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A. baumannii is evolving rapidly.........
Erythromycin was an early example; introduced as an alternative to penicillin for the treatment of S. aureus in Boston City Hospital in the early 1950s, it was completely withdrawn after less than a year because 70% of all the S. aureus isolates were found to have become erythromycin resistant. The same was observed with chlortetracycline and chloramphenicol and, subsequently, with other antibiotics
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