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Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
Li Y, Chen Z, Tong CH, Van K, Jones RS, Bare LA. Li Y, et al. PLoS One. 2025 Jun 30;20(6):e0327376. doi: 10.1371/journal.pone.0327376. eCollection 2025. PLoS One. 2025. PMID: 40587524 Free PMC article.
The modified two-tier test (MTTT) and standard two-tier test (STTT) protocols are being used for Lyme disease serology testing in the clinic. ...To this end, we obtained results of Lyme disease testing performed in a …
The modified two-tier test (MTTT) and standard two-tier test (STTT) protocols are being used for Lyme …
Performance of two modified two-tier algorithms for the serologic diagnosis of Lyme disease.
Landry ML, Hassan S, Rottmann BG, Pesak SJ, Ordazzo M, Skrzyniarz M, Deponte S, Peaper DR. Landry ML, et al. J Clin Microbiol. 2024 May 8;62(5):e0013924. doi: 10.1128/jcm.00139-24. Epub 2024 Apr 10. J Clin Microbiol. 2024. PMID: 38597655 Free PMC article.
We compared the performance of a new modified two-tier testing (MTTT) platform, the Diasorin Liaison chemiluminescent immunoassay (CLIA), to the Zeus enzyme-linked immunoassay (ELISA) MTTT and to Zeus ELISA/Viramed immunoblot standard two-tie …
We compared the performance of a new modified two-tier testing (MTTT) platform, the Diasorin Liaison chemilumine …
Diagnostic parameters of modified two-tier testing in European patients with early Lyme disease.
Baarsma ME, Schellekens J, Meijer BC, Brandenburg AH, Souilljee T, Hofhuis A, Hovius JW, van Dam AP. Baarsma ME, et al. Eur J Clin Microbiol Infect Dis. 2020 Nov;39(11):2143-2152. doi: 10.1007/s10096-020-03946-0. Epub 2020 Jul 6. Eur J Clin Microbiol Infect Dis. 2020. PMID: 32632699 Free PMC article.
Modified two-tier testing (MTTT) for Lyme borreliosis (i.e. confirmation with an EIA instead of an immunoblot) has been shown to have improved sensitivity compared with standard two-tier testing (STTT) in samples from Americ …
Modified two-tier testing (MTTT) for Lyme borreliosis (i.e. confirmation with an EIA instead of an immuno …
Evaluation of different standard and modified two-tier testing strategies for the laboratory diagnosis of lyme borreliosis in a European setting.
Hoeve-Bakker BJA, Kerkhof K, Heron M, Thijsen SFT, van Gorkom T. Hoeve-Bakker BJA, et al. Eur J Clin Microbiol Infect Dis. 2024 Dec;43(12):2397-2406. doi: 10.1007/s10096-024-04956-y. Epub 2024 Oct 7. Eur J Clin Microbiol Infect Dis. 2024. PMID: 39375250 Free PMC article.
Guidelines recommend a two-tier testing (TTT) strategy for disseminated LB: serological screening with a sensitive enzyme immunoassay (EIA) and confirmation with a specific immunoblot. Searching for the most sensitive and specific approach, this retrospective …
Guidelines recommend a two-tier testing (TTT) strategy for disseminated LB: serological screening with a sensitive enzy …
A novel single-tier serologic test to diagnose all stages of Lyme disease.
Levin AE, Wormser GP, Horn EJ, Karaseva N, Miller D, Kellogg H. Levin AE, et al. J Clin Microbiol. 2025 Sep 10;63(9):e0048325. doi: 10.1128/jcm.00483-25. Epub 2025 Aug 20. J Clin Microbiol. 2025. PMID: 40833084 Free PMC article.
This standard two-tier testing (STTT) approach provides high specificity, but at the cost of low sensitivity in early Lyme disease. Recent studies have shown that a modified two-tier (MTTT) testing approach, in which a secon …
This standard two-tier testing (STTT) approach provides high specificity, but at the cost of low sensitivity in early …
Tick-borne infections in children in North America.
Taylor-Salmon E, Shapiro ED. Taylor-Salmon E, et al. Curr Opin Pediatr. 2024 Apr 1;36(2):156-163. doi: 10.1097/MOP.0000000000001326. Epub 2024 Jan 3. Curr Opin Pediatr. 2024. PMID: 38167816 Free PMC article. Review.
RECENT FINDINGS: A new algorithm, termed modified two-tier testing, for testing for antibodies to Borrelia burgdorferi , the cause of Lyme disease, has been approved and may replace traditional two-tier testing. In ad …
RECENT FINDINGS: A new algorithm, termed modified two-tier testing, for testing for antibodies to Borreli …
The Performance of Nine Commercial Serological Screening Assays for the Diagnosis of Lyme Borreliosis: a Multicenter Modified Two-Gate Design Study.
Hoeve-Bakker BJA, Jonker M, Brandenburg AH, den Reijer PM, Stelma FF, van Dam AP, van Gorkom T, Kerkhof K, Thijsen SFT, Kremer K. Hoeve-Bakker BJA, et al. Microbiol Spectr. 2022 Apr 27;10(2):e0051022. doi: 10.1128/spectrum.00510-22. Epub 2022 Mar 17. Microbiol Spectr. 2022. PMID: 35297658 Free PMC article.
The LB cases were diagnosed with erythema migrans (EM; n = 11), Lyme neuroborreliosis (LNB; n = 35), Lyme arthritis (LA; n = 20), or acrodermatitis chronica atrophicans (ACA; n = 8). ...Guidelines prescribe a two-tier testing algorithm in which …
The LB cases were diagnosed with erythema migrans (EM; n = 11), Lyme neuroborreliosis (LNB; n = 35), Lyme arthritis (LA; n = 2 …
The multiplexed single-tier InBios Lyme Detect Multiplex ELISA is more sensitive than standard two-tier tests in the early stages of Lyme disease.
Hickman AF, Weber AF, Horn EJ, Gwynne PJ. Hickman AF, et al. J Clin Microbiol. 2025 Nov 12;63(11):e0062925. doi: 10.1128/jcm.00629-25. Epub 2025 Oct 9. J Clin Microbiol. 2025. PMID: 41065377 Free PMC article.
Existing standardized and modified two-tier tests (STT/MTT) suffer from poor detection rates in the first weeks of infection, where the antibody response, the basis of diagnosis, is developing but is not robust enough for detection. ...The assay perfor …
Existing standardized and modified two-tier tests (STT/MTT) suffer from poor detection rates in the first weeks …
When a patient suspected with juvenile idiopathic arthritis turns out to be diagnosed with an infectious disease - a review of Lyme arthritis in children.
Orczyk K, Świdrowska-Jaros J, Smolewska E. Orczyk K, et al. Pediatr Rheumatol Online J. 2017 May 8;15(1):35. doi: 10.1186/s12969-017-0166-0. Pediatr Rheumatol Online J. 2017. PMID: 28482848 Free PMC article. Review.
The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. ...The current diagnostic standard is based on a 2-step testing: ELISA screening and immunoblot confirmation. Other suggested methods contain modified two- …
The Lyme arthritis is a common manifestation of infection with Borrelia burgdorferi spirochete. ...The current diagnostic standard is …
Pediatric decision limits for serologic screening of Lyme disease.
Lopez-Nunez O, Srivastava P, Wheeler BJ, Oakes N, Thomas H, Nowalk A, Wheeler S. Lopez-Nunez O, et al. Clin Biochem. 2021 May;91:59-62. doi: 10.1016/j.clinbiochem.2021.02.005. Epub 2021 Feb 20. Clin Biochem. 2021. PMID: 33617846
BACKGROUND: Laboratory diagnosis of Lyme disease (LD) relies on a two-tier protocol. We have observed disproportionate equivocal serologies in children requiring reflex western blot (WB) using manufacturer-provided ranges based on adult studies. ...METHODS: W …
BACKGROUND: Laboratory diagnosis of Lyme disease (LD) relies on a two-tier protocol. We have observed disproportionate …
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