Borrelia Defeats Antibiotics

The Infectious Diseases Society of America (IDSA) asserts that Borrelia burgdorferi (the tick-transmitted spirochete that causes Lyme disease) readily succumbs to antibiotic treatment. Microbiologists who have studied the organism disagree. It survives assaults from drugs and the immune system by hiding in biofilms and by changing form (See Townsend Letter, July 2009; 312:30–31). Norwegian researchers øystein Brorson and Sverre-Henning Brorson say: “B.burgdorferi has the ability to convert (and reconvert) to cystic forms both in vivo and in vitro” when exposed to the antibiotics ceftriaxone, doxycyclin, ciprofloxacin, and vancomycin. When the environment is safe for growth, the bacteria returns to its motile form.

Recent studies involving the use of the new antibiotic tigecycline show the difficulty of finding a treatment for Borrelia. In vitrolaboratory tests found that tigecycline inhibited and destroyed the cyst and motile forms of B. burgdorferi. Unfortunately, in vitroresearch does not always match the results of in vivo research. Researchers at University of California-Davis tested this antibiotic on mice with different stages of Borrelia infection (1 week, 3 weeks, or 4 months) in a controlled study. Three months after treatment, infection status was evaluated by culture, quantitative OspA (outer surface protein A) real-time polymerase chain reaction (PCR), and subcutaneous transplantation of joint and heart tissue into other mice. Not surprisingly, tissue from the saline-treated control mice were culture- and PCR-positive for Borrelia. Some tissues from the antibiotic-treated mice were also PCR-positive, although the DNA markers were greatly reduced compared with the controls. Antibiotic treatment at the 1-week stage appeared to be more effective than treatment that began at the later stages.

All of the antibiotic-treated mice were culture-negative. Even though the spirochetes could not be cultured, mice that received transplants from the antibiotic-treated mice developed spirochetal DNA in multiple tissues. Moreover, ticks that fed on the antibiotic-treated mice acquired Borrelia and were then able to transmit the infection to other mice. Clearly, negative cultures do not mean that Borrelia is absent. The researchers conclude: “… antibiotic treatment [with tigecycline] is unable to clear persisting spirochetes, which remain viable and infectious, but are nondividing or slowly dividing.”

Unfortunately, tigecycline is not the only failure. The UC-Davis researchers state: “Treatment failures have been documented with nearly every type of antimicrobial drug, based upon clinical relapse, culture, or PCR.” Studies such as this one support the view that the IDSA’s treatment  guidelines are inadequate. They also show how challenging this infection is.

Barthold SW, Hodzic E, Imai DM, Feng S, et al. Ineffectiveness of tigecycline against persistent Borrelia burgdorferi [abstract]. Antimicrob Agents Chemother. February 2010;54(2):643–651.Available at: www.ncbi.nlm.nih.gov/pubmed/19995919.
Brorson ø, Brorson S-H. An in vitro study of the susceptibility of mobile and cystic forms of Borrelia burgdorferi to tinidazole. Int Microbiol. 2004;7:139–142. Available at www.im.microbios.org. Accessed April 21, 2010.
Brorson ø, Brorson SH, Scythes J, MacAllister J, et al. Destruction of spirochete Borrelia burgdorferi round-body propagules (RBs) by the antibiotic tigecycline [abstract]. Proc Natl Acad Sci U.S.A. November 3, 2009;106(44):18656-61. Available at: www.ncbi.nlm.nih.gov/pubmed/19843691. Accessed April 21, 2010.
Johnson L. LYMEPOLICYWONK: Barthold and Luft – persistence and integrity in science [blog]. December 15, 2009. www.lymedisease.org/news/lymepolicywonk/290.html. Accessed April 27, 2010.

Lyme Disease: An American Problem or Worldwide Plague?

For some reason, Americans tend to assume that Lyme Disease is isolated to the United States. It is understood that other diseases, such as cancer, diabetes, and hepatitis, are prevalent throughout the world – but Lyme Disease is perceived to be an exclusively American disease. The reality is that Lyme Disease is a major problem all around the globe.  (more…)

Saving Our Children: Evaluation and Management of Pediatric Tick-Borne Diseases

Dr. Ann Corson had nearly 20 years of experience as a primary care doctor when she was faced with one of her most complex and challenging medical cases: her only child was literally dying from an unidentified illness without clear answers. It took three years for her to more fully understand the illness that was ravaging her son’s body. It was then that Dr. Corson realized “how totally inadequate my ‘ivory-tower’ medical education had been regarding tick-borne diseases.” As a result of her own son’s personal struggles with Lyme disease, Dr. Corson has emerged as one of the most respected Lyme-literate medical doctors in the field.

After discovering the etiology of her child’s mysterious illness, Dr. Corson feverishly read the scientific literature and studied with respected Lyme clinicians Joseph Burrascano, MD, and Charles Ray Jones, MD. She started her own practice devoted solely to the treatment of tick-borne diseases (TBDs). Her mission has become to help “those mothers who otherwise would have to watch their children slowly decay without knowledgeable doctors.”

Dr. Corson quickly recognized that the clinical challenges presented by chronic tick-borne disease patients are incredibly complex and require a multidisciplinary, holistic approach. Over the years, it became apparent that allopathic medicine did not offer a complete solution. As a result, she has incorporated treatment strategies into her practice from many different healing disciplines. Helping patients attain the improvements they are striving for requires a willingness to think beyond the boundaries of that which is understood today. Consideration must be given to those things that will only be more widely accepted in the future.

In her presentation at the LIA Foundation “From Roadblocks to Recovery” event in June 2009, Dr. Corson shared her approach to the evaluation and management of pediatric tick-borne diseases.

“Ticks are cesspools of disease,” she noted. Besides Borrelia burgdorferi, ticks harbor numerous other organisms that are pathogenic and result in considerable health challenges in humans. Some of these include other Borrelia species, Babesia microti, Babesia duncani, Ehrlichia chaffeensis, Anaplasma phago­cytophilum, Bartonella henselae, Bartonella quintana, Mycoplasma fermentans and other Mycoplasma species, Rickettsia rickettsii, Coxiella burnetii, Francisella tularensis, viruses such as HHV-6,nematodes, and possibly many other organisms. These are just the ones that are known today; in reality, the list may be much longer. (more…)

Diagnostic Dilemmas in Lyme Disease

Sparse evidence of Lyme disease has been documented in the US for at least 90 years, but in 1975 it suddenly exploded onto the human population with an undeniable presence never witnessed before, with numerous children and adults displaying a multitude of debilitating neurologic, psychiatric, and physical symptoms. The original outbreak was investigated by a team of Yale physicians and misdiagnosed as juvenile rheumatoid arthritis. All this took place in Old Lyme, Connecticut. The condition was later named Lyme disease. The causative agent, a thin spirochete found to reside in the salivary glands and ovaries of the deer tick, was eventually identified by Dr. Wally Burgdorfer in 1982 and named in his honor, Borrelia burgdorferi (Bb). From that time on, there have been considerable diagnostic challenges and controversy in the treatment of the disease. (more…)