PDF(Pubmed)
Abstract：
Human Lyme borreliosis (LB) represents a multisystem disorder that can progress in stages. The causative agents are transmitted by hard ticks of the Ixodes ricinus complex that have been infected with the spirochete Borrelia burgdorferi sensu lato. Today, LB is considered the most important human tick-borne illness in the Northern Hemisphere. The causative agent was identified and successfully isolated in 1982 and, shortly thereafter, antibiotic treatment was found to be safe and efficacious. Since then, various in vitro studies have been conducted in order to improve our knowledge of the activity of antimicrobial agents against B. burgdorferi s. l. The full spectrum of in vitro antibiotic susceptibility has still not been defined for some of the more recently developed compounds. Moreover, our current understanding of the in vitro interactions between B. burgdorferi s. l. and antimicrobial agents, and their possible mechanisms of resistance remains very limited and is largely based on in vitro susceptibility experiments on only a few isolates of Borrelia. Even less is known about the possible mechanisms of the in vitro persistence of spirochetes exposed to antimicrobial agents in the presence of human and animal cell lines. Only a relatively small number of laboratory studies and cell culture experiments have been conducted. This review summarizes what is and what is not known about the in vitro susceptibility of B. burgdorferi s. l. It aims to shed light on the known unknowns that continue to fuel current debates on possible treatment resistance and mechanisms of persistence of Lyme disease spirochetes in the presence of antimicrobial agents.
摘要：
人类莱姆病（LB）代表了一种可以分阶段发展的多系统疾病。病原体是由已感染螺旋体BorreliaBurgdorferisensulato的Ixodes蓖麻复合体的硬蜱传播的。今天,LB被认为是北半球最重要的人类蜱传疾病。病原体于1982年被鉴定并成功分离，此后不久,抗生素治疗被认为是安全有效的.从那以后,为了提高我们对抗菌药物对B.burgdorferis.l的活性的认识，已经进行了各种体外研究。此外，我们目前对B.burgdorferis.l.和抗菌剂之间的体外相互作用的理解，它们可能的抗性机制仍然非常有限，并且主要基于仅对少数疏螺旋体分离株的体外敏感性实验。对于在人和动物细胞系存在下暴露于抗微生物剂的螺旋体在体外持续存在的可能机制知之甚少。仅进行了相对少量的实验室研究和细胞培养实验。这篇综述总结了关于B.burgdorferis.l的体外易感性的未知和未知。它旨在阐明已知的未知因素，这些未知因素继续推动当前关于在存在抗微生物剂的情况下莱姆病螺旋体可能的治疗抗性和持续存在机制的辩论。
