First name
Laura
Last name
Chapman

Title

Multiplex High-Definition Polymerase Chain Reaction Assay for the Diagnosis of Tick-borne Infections in Children.

Year of Publication

2023

Number of Pages

ofad121

Date Published

04/2023

ISSN Number

2328-8957

Abstract

BACKGROUND: ticks can carry species as well as other pathogens that cause human disease. The frequency of tick-borne infections and coinfections in children with suspected Lyme disease is unknown, creating clinical uncertainty about the optimal approach to diagnosis.

METHODS: We enrolled children aged 1-21 years presenting to 1 of 8 Pedi Lyme Net emergency departments for evaluation of Lyme disease. We selected cases with serologically or clinically diagnosed Lyme disease (erythema migrans or early neurologic disease) matched by symptoms, age, gender, and center to control subjects without Lyme disease. We tested whole blood samples collected at the time of diagnosis using a multiplex high-definition polymerase chain reaction (HDPCR) panel to identify 9 bacterial or protozoan pathogens associated with human disease. We compared the frequency of tick-borne coinfections in children with Lyme disease to matched controls.

RESULTS: Of the 612 selected samples, 594 (97.1%) had an interpretable multiplex HDPCR result. We identified the following non- tick-borne infections: (2), (1), and (12). Children with Lyme disease were more likely to have another tick-borne pathogen identified than matched controls (15/297 [5.1%] Lyme cases vs 0/297 [0%]; difference, 5.1% [95% confidence interval, 2.7%-8.2%]).

CONCLUSIONS: Although a substantial minority of children with Lyme disease had another tick-borne pathogen identified, either first-line Lyme disease antibiotics provided adequate treatment or the coinfection was subclinical and did not require specific treatment. Further studies are needed to establish the optimal approach to testing for tick-borne coinfections in children.

DOI

10.1093/ofid/ofad121

Alternate Title

Open Forum Infect Dis

PMID

37089773
Featured Publication
No

Title

Racial Differences in the Diagnosis of Lyme Disease in Children.

Year of Publication

2023

Number of Pages

1129-1131

Date Published

03/2023

ISSN Number

1537-6591

Abstract

Black children with Lyme disease compared with children of other races were less likely to have an erythema migrans lesion diagnosed (adjusted odds ratio, 0.34; 95% confidence interval, .14-.79) but more likely to have a swollen joint (adjusted odds ratio, 3.68; 95% confidence interval, 2.13-6.36) after adjustment for age and local Lyme incidence.

DOI

10.1093/cid/ciac863

Alternate Title

Clin Infect Dis

PMID

36314085
Featured Publication
No

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