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Lyme arthritis : Demographic characteristics and Borrelia ospA genospecies in synovial fluid. A 17-year cohort study in Sweden

Ornstein, Katharina LU ; Broholm, Camilla ; Dessau, Ram B. and Petersson, Ann Cathrine LU (2026) In Ticks and Tick-borne Diseases 17(1).
Abstract

Lyme arthritis (LA) is a recognized manifestation of Lyme borreliosis in Sweden, but data on the causative Borrelia species are limited. This study aimed to describe the demographics of LA and identify Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) genospecies present in synovial fluid (SF). Patient data were collected from the test requisition form accompanying consecutive SF samples submitted to the Clinical Microbiology Laboratory in Lund, Sweden, for Borrelia DNA detection between 2007 and 2023. Detection was performed using 16S rDNA PCR, and genospecies were determined through ospA PCR followed by sequencing. Borrelia DNA was detected in 323 samples, corresponding to 283 unique patients, from a total of 2353 samples. Species... (More)

Lyme arthritis (LA) is a recognized manifestation of Lyme borreliosis in Sweden, but data on the causative Borrelia species are limited. This study aimed to describe the demographics of LA and identify Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) genospecies present in synovial fluid (SF). Patient data were collected from the test requisition form accompanying consecutive SF samples submitted to the Clinical Microbiology Laboratory in Lund, Sweden, for Borrelia DNA detection between 2007 and 2023. Detection was performed using 16S rDNA PCR, and genospecies were determined through ospA PCR followed by sequencing. Borrelia DNA was detected in 323 samples, corresponding to 283 unique patients, from a total of 2353 samples. Species characterization was successful in 213 cases. LA was diagnosed year-round, with approximately half of the cases occurring in youth (0–19 years). Males predominated among adults (≥20 years), though less so among youth. Two species were most common: B. afzelii (104 cases, 49 %) and B. burgdorferi sensu stricto (s.s.) (70 cases, 33 %). B. garinii, B. bavariensis, and B. spielmanii were identified in 21 (9 %), 14 (7 %), and 4 (2 %) cases, respectively. In conclusion, B. afzelii was the predominant species in SF. B. burgdorferi s.s. accounted for one-third of LA cases, despite being rarely found in ticks or humans in Sweden. B. spielmanii was detected in four cases, representing the first identification of this species in humans in Sweden and, more broadly, in synovial fluid.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
16S, Borrelia species, Lyme arthritis, OspA, PCR, Synovial fluid
in
Ticks and Tick-borne Diseases
volume
17
issue
1
article number
102582
publisher
Elsevier
external identifiers
  • scopus:105024338224
  • pmid:41386202
ISSN
1877-959X
DOI
10.1016/j.ttbdis.2025.102582
language
English
LU publication?
no
additional info
Publisher Copyright: © 2025
id
24521e31-eab2-4d9a-aab4-63525f2caf69
date added to LUP
2026-03-31 13:16:55
date last changed
2026-04-02 13:35:55
@article{24521e31-eab2-4d9a-aab4-63525f2caf69,
  abstract     = {{<p>Lyme arthritis (LA) is a recognized manifestation of Lyme borreliosis in Sweden, but data on the causative Borrelia species are limited. This study aimed to describe the demographics of LA and identify Borrelia burgdorferi sensu lato (B. burgdorferi s.l.) genospecies present in synovial fluid (SF). Patient data were collected from the test requisition form accompanying consecutive SF samples submitted to the Clinical Microbiology Laboratory in Lund, Sweden, for Borrelia DNA detection between 2007 and 2023. Detection was performed using 16S rDNA PCR, and genospecies were determined through ospA PCR followed by sequencing. Borrelia DNA was detected in 323 samples, corresponding to 283 unique patients, from a total of 2353 samples. Species characterization was successful in 213 cases. LA was diagnosed year-round, with approximately half of the cases occurring in youth (0–19 years). Males predominated among adults (≥20 years), though less so among youth. Two species were most common: B. afzelii (104 cases, 49 %) and B. burgdorferi sensu stricto (s.s.) (70 cases, 33 %). B. garinii, B. bavariensis, and B. spielmanii were identified in 21 (9 %), 14 (7 %), and 4 (2 %) cases, respectively. In conclusion, B. afzelii was the predominant species in SF. B. burgdorferi s.s. accounted for one-third of LA cases, despite being rarely found in ticks or humans in Sweden. B. spielmanii was detected in four cases, representing the first identification of this species in humans in Sweden and, more broadly, in synovial fluid.</p>}},
  author       = {{Ornstein, Katharina and Broholm, Camilla and Dessau, Ram B. and Petersson, Ann Cathrine}},
  issn         = {{1877-959X}},
  keywords     = {{16S; Borrelia species; Lyme arthritis; OspA; PCR; Synovial fluid}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Elsevier}},
  series       = {{Ticks and Tick-borne Diseases}},
  title        = {{Lyme arthritis : Demographic characteristics and Borrelia ospA genospecies in synovial fluid. A 17-year cohort study in Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.ttbdis.2025.102582}},
  doi          = {{10.1016/j.ttbdis.2025.102582}},
  volume       = {{17}},
  year         = {{2026}},
}