Borrelia - serology

Detection of IgG and IgM antibodies for Borrelia species (Lyme disease)
Microbiology
Serology
○ Whole blood ○ Serum ○ CSF (should always be submitted with serum)
Other Information
○ Acute and convalescent serum specimens may be required for serodiagnosis.
○ Specimens should be collected before administration of antimicrobial therapy.
○ Serological testing of asymptomatic patients, including following a tick bite and for individuals with erythema migrans (acute phase) is not recommended.

○ Serological testing should not be used to assess treatment response as antibodies persist for a long period after treatment.

○ Paired serum and CSF should be collected within 1h of each other, up to a maximum of 24h. Absolute values for total albumin and total IgG concentrations of both the serum and CSF specimens must be submitted in order to perform interpretive calculations for this test.

○ If European Lyme is suspected, indicate travel history on electronic order.
○ Serum separator tube (clotted blood) (min volume 5 mL)
○ CSF: sterile container (0,5 mL)

○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood
○ CSF by lumbar puncture: Decontaminate skin, collect at least 0,5mL of CSF by lumbar puncture into a sterile container; collect more CSF if additional cultures are requested (AFB, fungal, etc.). If more than one tube can be successfully collected, the microbiology laboratory should receive the second or third tubes (whichever is less bloody) to avoid contamination by skin flora or blood.

Refer to section Sample Processing / Delivery
PHOL
○ B. burgdorferi serology on blood: 5 to 7 days upon receipt by PHOL
○ CSF serology and European Lyme testing: up to 21 days upon receipt by NML
416-586-4800 extension 4432
NO
○ Label specimen container. Place specimens in biohazard bag and seal.

○ Transport specimens to the UHN/SH Microbiology Laboratory ASAP after collection at refrigeration temperature (2-8˚C).

○ The specimen will be referred to the Public Health Ontario Laboratory for testing