Projects / Programmes
Bolezni in povzročitelji, ki jih v Sloveniji prenašajo členonožci (Slovene)
January 1, 2009
- December 31, 2014
| Code |
Science |
Field |
Subfield |
| 3.01.00 |
Medical sciences |
Microbiology and immunology |
|
| Code |
Science |
Field |
| B510 |
Biomedical sciences |
Infections |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
Researchers (32)
Organisations (1)
Significance for science
The aims in this programme were set to fill the void in knowledge on the etiology, course of disease, pathogenic mechanisms, and treatment efficacy for Lyme borreliosis. Since this programme was based in a human system, the knowledge gained might and did influence clinical practice. Moreover, we anticipate that the generated data will foster new areas of investigation to potentially include studies of new spirochetal genotypes, etiology of new tick-borne diseases, factors in acute versus chronic Borrelia infection, and immune mechanisms of post-treatment symptoms. Ad 1. and 2. The obtained data enabled a rational choice of antibiotics for treatment of erythema migrans and rational decisions on duration of the treatment. Ad 3. Acquisition of data not published previously. Since our findings indicate that persistence of borreliae in skin after treatment with antibiotics for 14 days is an extremely rare event, there is no need for prolonged treatment that was used by some clinicians due to the fear of persistance. Ad 4. Completition of very limited data. Our findings indicate that in comparison to immunocompetent patients those with an underlying immunocompromised condition more often have complicated course of early Lyme borreliosis and more frequently need additional antibiotic treatment but as a rule have favourable final outcome. Ad 5. Completition of very limited data. Differences found by comparison of patients with early Lyme borreliosis according to age suggest the role of immune mechanisms in the pathogenesis of the disease and are a stimulus for further studies. Ad 6 and 7. Acquisition of data not published previously. Ad 8 in 9. Comparison of demonstration of intrathecal production of Borrelia antibodies and isolation of Borreliae from cerebrospinal fluid enabled the assessment of sensitivity of intrathecal production of Borrelia antibodies for the diagnosis of Lyme nuroborreliosis. The findings are of substantial parctical value. Additional evaluation of diagnostic value of serological testing of central nervous system infections with different Borrelia species would be needed. Ad 10 and 11. The assessment of the efficacy of the two treatment approaches enables rational antibiotic choice. Because no differences were found, future treatment of patients with suspected chronic Lyme borreliosis will consist of doxycycline, which is a much less expensive drug in comparison to ceftriaxone. Similar approach will be used also for patients with acrodermatitis chronica atrophicans. Ad 12. Acquisition of data not published previously. The obtained data will be of importance for the development of vaccine against Lyme borreliosis. Ad 13. Completition of data that are very limited in European literature. Ad 14. In patients with Borrelia skin culture proven erythema migrans, who had leukopenia and/or thrombocytopenia, concomittant infections with Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum and/or tick-borne encephalitis virus were not found. The findings have influece on the management of patients in everyday clinical practice. Ad 15 in 16. The causes of post-Lyme disease symptoms are unclear. We evaluated the frequency of new or increased symptoms after treatment of erythema migrans with antibiotics and assessed immune characteristics of patients with sustained symptoms. Our results indicate that incomplete improvement is at least partly associated with distinct immune reactivity. These findings provide a new paradigm for the study of postinfectious symptoms in patients with Lyme borreliosis. We have been using similar approaches also for patients with Lyme neuroborreliosis.
Significance for the country
All studies of the research programme (1.-16.) are of indirect importance for the society due to the promotion of the country through new knowledge. Studies with a potential of pronounced direct influence on health care and/or management of patients are listed herein: Ad 1 and 2. The obtained data will enable rational choice of antibiotics for treatment of erythema migrans and rational decisions on duration of the treatment. Ad 4. Our findings indicate that in comparison to immunocompetent patients those with an underlying immunocompromised condition more often have complicated course of early Lyme borreliosis and more frequently need additional antibiotic treatment but as a rule have favourable final outcome. The findings enable a rational treatment approach in immunocompromised patients who develop Lyme borreliosis. Ad 8 in 9. Comparison of demonstration of intrathecal production of Borrelia antibodies and isolation of Borreliae from cerebrospinal fluid enabled the assessment of sensitivity of intrathecal production of Borrelia antibodies for the diagnosis of Lyme nuroborreliosis. The findings are of substantial value for clinical practice. Ad 10. and 11. The assessment of the efficacy of the two treatment approaches will enable rational antibiotic choice. Because no differences were found, future treatment of patients with suspected chronic Lyme borreliosis will consist of doxycycline, which is much less expensive drug in comparison to ceftriaxone. Similar approach will be used also for patients with acrodermatitis chronica atrophicans.
Most important scientific results
Annual report
2009,
2010,
2011,
2012,
2013,
final report,
complete report on dLib.si
Most important socioeconomically and culturally relevant results
Annual report
2009,
2010,
2011,
2012,
2013,
final report,
complete report on dLib.si
