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Order Code LYMPV Lyme Disease, Molecular Detection, PCR, Varies

Additional Codes

EPIC Order Code: LABLYMPC


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.



Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Spinal fluid

Container/Tube: Sterile vial

Specimen Volume: 1 mL

Collection Instructions: Label specimen as spinal fluid.

 

Specimen Type: Synovial fluid

Container/Tube: Sterile vial

Specimen Volume: 1 mL

Collection Instructions: Label specimen as synovial fluid.

 

Specimen Type: Tissue (fresh only)

Sources: Skin or synovial biopsy

Container/Tube: Sterile container with normal saline

Specimen Volume: Approximately 4 mm(3)

Collection Instructions:

1. Submit only fresh tissue.

2. Skin biopsies:

a. Wash biopsy site with an antiseptic soap. Thoroughly rinse area with sterile water. Do not use alcohol or iodine preparations. A local anesthetic may be used.

b. Biopsy specimens are best taken by punch biopsy to include full thickness of dermis.

3. Label specimen with source of tissue.


Useful For

Supporting the diagnosis of Lyme disease in conjunction with serologic testing

 

Specific indications including testing skin biopsies when a rash lesion is not characteristic of erythema migrans and testing synovial fluid or synovium to support the diagnosis of Lyme arthritis

 

This test should not be used to screen asymptomatic patients.

Testing Algorithm

The following algorithms are available:

-Acute Tick-Borne Disease Testing Algorithm

-Meningitis/Encephalitis Panel Algorithm

Method Name

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Reporting Name

Lyme Disease, PCR, Varies

Specimen Type

Varies

Specimen Minimum Volume

Spinal fluid: 0.3 mL; Synovial fluid: 0.5 mL; Tissue: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Reference Values

Negative

Reference values apply to all ages.

Method Description

Nucleic acid is extracted from clinical specimens using the automated MagNA Pure LC instrument system. The extract is then transferred to individual 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)

Day(s) Performed

Monday through Sunday

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

87476

87798 x 2

87801 (if appropriate for government payers)

Forms

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