OBJECTIVE: We show that significant interlaboratory and intralaboratory variations exist in Lyme disease proficiency testing. DESIGN: Six case-defined Lyme serum samples and three serum samples from individuals with no history of Lyme disease were randomized in four shipments and distributed to 45 participating laboratories. RESULTS: Interlaboratory and intralaboratory performances were highly variable. Approximately 4% to 21% of laboratories failed to identify correctly positive serum samples with titers of 512 or more using polyvalent serum or immunoglobulin G conjugates. With lower levels of anti-Borrelia burgdorferi antibody in the serum sample, approximately 55% of participating laboratories did not identify a case-defined serum. There was also a striking inability of many laboratories to reproduce their results on split samples from the same individual. In addition, 2% to 7% of laboratories identified serum samples from individuals with no known exposure to B burgdorferi as positive using polyvalent serum. The false positivity rate increased to 27% with the use of immunoglobulin G conjugate. CONCLUSIONS: Our results indicate that there is an urgent need for standardization of current testing methodologies. Until a national commitment is made, serological testing for Lyme disease will be of questionable value for the diagnosis of the disease.
OBJECTIVE: We show that significant interlaboratory and intralaboratory variations exist in Lyme disease proficiency testing. DESIGN: Six case-defined Lyme serum samples and three serum samples from individuals with no history of Lyme disease were randomized in four shipments and distributed to 45 participating laboratories. RESULTS: Interlaboratory and intralaboratory performances were highly variable. Approximately 4% to 21% of laboratories failed to identify correctly positive serum samples with titers of 512 or more using polyvalent serum or immunoglobulin G conjugates. With lower levels of anti-Borrelia burgdorferi antibody in the serum sample, approximately 55% of participating laboratories did not identify a case-defined serum. There was also a striking inability of many laboratories to reproduce their results on split samples from the same individual. In addition, 2% to 7% of laboratories identified serum samples from individuals with no known exposure to B burgdorferi as positive using polyvalent serum. The false positivity rate increased to 27% with the use of immunoglobulin G conjugate. CONCLUSIONS: Our results indicate that there is an urgent need for standardization of current testing methodologies. Until a national commitment is made, serological testing for Lyme disease will be of questionable value for the diagnosis of the disease.
Authors: A A Reilly; I F Salkin; M R McGinnis; S Gromadzki; L Pasarell; M Kemna; N Higgins; M Salfinger Journal: J Clin Microbiol Date: 1999-07 Impact factor: 5.948
Authors: Susan C Lipsett; John A Branda; Alexander J McAdam; Louis Vernacchio; Caroline D Gordon; Catherine R Gordon; Lise E Nigrovic Journal: Clin Infect Dis Date: 2016-06-28 Impact factor: 9.079
Authors: P M Rath; B Ibershoff; A Mohnhaupt; J Albig; B Eljaschewitsch; D Jürgens; I Horbach; F J Fehrenbach Journal: Eur J Clin Microbiol Infect Dis Date: 1996-05 Impact factor: 3.267