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Test Code LAB5509 Lyme Disease, Molecular Detection, PCR, Blood

Important Note

Mayo's test code: PBORB

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Reporting Name

Lyme Disease PCR, B

Specimen Type

Whole Blood EDTA


Ordering Guidance


This assay does not detect Borrelia miyamotoi. If infection with this organism is suspected, order BMIPB / Borrelia miyamotoi Detection, PCR, Blood or BMIYC / Borrelia miyamotoi Detection, PCR, Spinal Fluid.



Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 mL

Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.


Reject Due To

Gross hemolysis OK

Specimen Stability Information

Specimen Type Temperature Time
Whole Blood EDTA Refrigerated (preferred) 7 days
  Frozen  7 days

Specimen Minimum Volume

0.3 mL

Day(s) Performed

Monday through Sunday

Specimen Retention Time

1 week

Report Available

1 to 4 days

Reference Values

Negative

Reference values apply to all ages.

Useful For

Supporting the diagnosis of Lyme disease in conjunction with serologic testing

 

This test should not be used to screen asymptomatic patients.

Testing Algorithm

For information see Acute Tick-borne Disease Testing Algorithm.

CPT Code Information

87476

87798 x 2

87801 (if appropriate for government payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBORB Lyme Disease PCR, B 90892-1

 

Result ID Test Result Name Result LOINC Value
56080 B. burgdorferi PCR, B 94247-4
38290 B. mayonii PCR, B 94248-2
38291 B. garinii/B. afzelii PCR, B 94249-0
38340 Lyme Disease PCR Comment 59464-8

Method Description

Nucleic acid is extracted from clinical specimens using the automated MagNA Pure LC instrument system. The extract is then transferred wells of a 96-well plate for amplification. The LightCycler is an automated instrument that amplifies and monitors the development of target nucleic acid (amplicon) after each cycle of polymerase chain reaction (PCR). The DNA target for PCR assay is the 283-base pairs plasminogen-binding protein gene (OppA2), which is present at a frequency of 1 copy per organism in all 4 confirmed pathogenic species of the Borrelia burgdorferi sensu lato genogroup (B burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii, and Borrelia mayonii). A specific base pair DNA target sequence is amplified by PCR. The detection of amplicon is based on fluorescence resonance energy transfer, which utilizes 1 hybridization probe with a donor fluorophore, fluorescein, at the 3' end, and a second hybridization probe with an acceptor fluorophore, LC-Red 610, at the 5' end. When the target amplicon is present, the LC-Red 610 emits a measurable and quantifiable light signal at a specific wavelength. Presence of the specific organism nucleic acid may be confirmed by performing a melting curve analysis of the amplicon. Using features of the melting curve analysis, the assay primers and specific hybridization probes are able to detect and differentiate B burgdorferi sensu stricto from B mayonii, B afzelii, and B garinii, although the melting curve analysis cannot differentiate between B afzelii and B garinii. Each assay run can be completed within 60 minutes.(Unpublished Mayo method)

Supportive Data

The following validation data supports the use of this assay for clinical testing.

 

Analytical Sensitivity/Limit of Detection:

The lower limit of detection is approximately 300 to 1000 genomic copies/mL in cerebrospinal fluid, tissue, blood, and synovial fluid.

 

Accuracy/Diagnostic Sensitivity and Specificity:

Spiking studies of whole organism in whole blood (spiked near the approximate limit of detection) showed 100% recovery.

 

Analytical Specificity:

No polymerase chain reaction signal was obtained from the extracts of 22 bacterial, viral, parasitic, and fungal isolates that can cause symptoms similar to Lyme disease, including Rickettsia rickettsii, Rickettsia typhi, Ehrlichia canis, Babesia microti, Plasmodium falciparum, Plasmodium vivax, Bartonella henselae, Bartonella quintana, herpes simplex virus, and Toxoplasma gondii. Relapsing fever borreliae (including Borrelia miyamotoi) are also not detected with this assay.

 

Precision:

Interassay precision was 100% and intra-assay precision was 100%.

 

Reference Range:

The reference range for this assay is negative. This assay is only to be used for patients with a clinical history and symptoms consistent with Lyme disease and must be interpreted in the context of serologic tests, which are the gold standard for diagnosis of Lyme disease.

 

Reportable Range:

This is a qualitative assay, and the results are reported as negative or positive for targeted Borrelia burgdorferi.

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.