Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease

Farhan Khan; Ziyad Allehebi; Yahya Shabi; Ian Davis; Jason LeBlanc; Robbin Lindsay; Todd Hatchette

doi:10.1093/ofid/ofac272

Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease

Open Forum Infect Dis. 2022 Jun 6;9(7):ofac272. doi: 10.1093/ofid/ofac272. eCollection 2022 Jul.

Authors

Farhan Khan¹, Ziyad Allehebi¹, Yahya Shabi¹, Ian Davis¹, Jason LeBlanc¹, Robbin Lindsay², Todd Hatchette¹

Affiliations

¹ Department of Pathology and Laboratory Medicine, Queen Elizabeth II Health Science Centre, Halifax, Nova Scotia, Canada.
² Zoonotic Diseases and Special Pathogens Division, National Microbiology Laboratory (NML), Public Health Agency of Canada (PHAC), Winnipeg, Manitoba, Canada.

Abstract

The modified 2-tier testing algorithm (MTTT) for Lyme disease (LD) has been approved by the US Food and Drug Administration. In this study, we show that the MTTT detected 28% more cases of early infection compared with the standard 2-tier algorithm while retaining high specificity in a region with a high incidence of LD.

Keywords: Borrelia burgdorferi; Lyme disease; diagnostics; modified two-tiered testing; serology.