Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection

Here is the much-awaited persistence study out of Emory, in rhesus monkeys. This study was commissioned to accompany the Klempner study on persistence in humans, by the National Institute of Health (NIH). Possibly the most important findings on persistence ever, considering who the authors are. This study does demonstrate live spirochete survival after standard treatment, and indicates that there may be brain inflammation in some after treatment.

Persistence of Borrelia burgdorferi in Rhesus Macaques following Antibiotic Treatment of Disseminated Infection.
Embers ME, Barthold SW, Borda JT, Bowers L, Doyle L, et al.
(2012) PLoS ONE 7(1): e29914.

http://dx.doi.org/10.1371/journal.pone.0029914

Abstract

The persistence of symptoms in Lyme disease patients following antibiotic therapy, and their causes, continue to be a matter of intense controversy. The studies presented here explore antibiotic efficacy using nonhuman primates.

Rhesus macaques were infected with B. burgdorferi and a portion received aggressive antibiotic therapy 4-6 months later. Multiple methods were utilized for detection of residual organisms, including the feeding of lab-reared ticks on monkeys (xenodiagnosis), culture, immunofluorescence and PCR. Antibody responses to the B. burgdorferi-specific C6 diagnostic peptide were measured longitudinally and declined in all treated animals. B.
burgdorferi antigen, DNA and RNA were detected in the tissues of treated animals. Finally, small numbers of intact spirochetes were recovered by xenodiagnosis from treated monkeys.

These results demonstrate that B. burgdorferi can withstand antibiotic treatment, administered post-dissemination, in a primate host. Though B. burgdorferi is not known to possess resistance mechanisms and is susceptible to the standard antibiotics (doxycycline, ceftriaxone) in vitro, it appears to become tolerant post-dissemination in the primate host. This finding raises important questions about the pathogenicity of antibiotic-tolerant persisters and whether or not they can contribute to symptoms post-treatment.

Free, full text of this open-access article:
http://dx.doi.org/10.1371/journal.pone.0029914

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