Polymerase chain response (PCR) testing for Lyme illness produces low positivity, solely nominally informs medical resolution making, and represents substantial healthcare prices in endemic areas, per a brand new research in Open Discussion board Infectious Ailments.
The research authors, from the State College of New York Upstate Medical College, say the findings favor reliance on serologic testing for the tick-borne illness and help initiatives to restrict pointless PCR use.
Attributable to the spirochete bacterium Borrelia burgdorferi carried by black-legged (deer) ticks, Lyme illness is the most typical vector-borne sickness in america. Diagnostic pointers advocate serologic testing over PCR as a result of it’s extra delicate. However each assessments have limitations, the researchers be aware.
The one-center research of all B burgdorferi PCR outcomes was carried out in Upstate New York from January 2024 via June 2026.
Potential diagnostic stewardship alternative
In the course of the research interval, 885 B burgdorferi PCR assessments have been carried out. Half of the specimens have been cerebrospinal fluid (CSF; 50.1%), adopted by synovial fluid (35.6%) and blood (14.4%). General positivity was 1.9%.
By specimen, positivity was 5.4% for synovial fluid and 0 for CSF and blood. The PCR assessments value $401,790 complete ($201,122, $143,010, and $57,658 for CSF, synovial fluid, and blood specimens, respectively).
These findings spotlight an essential diagnostic stewardship alternative to scale back pointless PCR utilization whereas offering clinician schooling on selling adherence to evidence-based diagnostic suggestions for Lyme illness.
Of the 17 optimistic B burgdorferi PCRs, 64.7% didn’t have an effect on remedy, as a result of antibiotics had already been began based mostly optimistic serologic outcomes and medical presentation. The median time from assortment to PCR end result was 7.2 days as a result of must ship samples to a lab.
Thus, six optimistic PCRs (36.3%) helped information medical resolution making, however 5 of these sufferers had not undergone serologic testing concurrently PCR. Of the 17 optimistic PCRs, an infectious illness seek the advice of was made in solely three instances.
“These findings spotlight an essential diagnostic stewardship alternative to scale back pointless PCR utilization whereas offering clinician schooling on selling adherence to evidence-based diagnostic suggestions for Lyme illness,” the researchers wrote.
It needs to be famous that the senior creator on the research reported a possible battle of curiosity associated to DiaSorin, maker of a Lyme illness serologic take a look at.
