Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026
Xenodiagnosis to Search for Borrelia burgdorferi After Antibiotic Treatment of Lyme Disease: A Prospective Cohort Study.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02446626 (Xenodiagnosis After Antibiotic Treatment for Lyme Disease - Phase II Study), which is not on this map. Cited by 3 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Xenodiagnosis After Antibiotic Treatment for Lyme Disease - Phase II Study
Who cites it
3 citing papers in PubMed.
- Curiouser and curiouser: understanding the intersection of inter- and intra-specific diversity during theInfection and immunity · 2026Review
- Vectors Are Not Just Culture Vessels.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Evidence-domain translation in the Lyme disease controversy over persistent post-treatment symptoms.Frontiers in cellular and infection microbiology · 2026Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
backgroundSome patients report nonspecific symptoms after antibiotic therapy for Lyme disease (LD), raising questions about ongoing infection, despite no compelling evidence. We investigated whether xenodiagnosis could detect Borrelia burgdorferi in such patients and if positive results correlated with symptoms.
methodsParticipants were adults who completed antibiotic treatment for LD 3-12 months earlier (posttherapy, n = 40) or had persistent symptoms for ≥12 months after treatment, (posttreatment LD symptoms [PTLDS], n = 20). Controls included 1 patient with erythema migrans (EM), 1 patient with untreated Lyme arthritis (LA), and 9 healthy volunteers (HV). Participants had 25-30 larval Ixodes scapularis ticks placed; ticks were collected 3-6 days later and tested for B. burgdorferi. The primary analysis evaluated if B. burgdorferi detection by xenodiagnosis was associated with persistence of symptoms in patients during the first year after treatment. This trial is registered with ClinicalTrials.gov, NCT02446626.
resultsRecovered ticks included 402 from posttherapy, 314 from PTLDS, 30 from the EM patient, 11 from the LA patient, and 80 from HV. All ticks tested negative for B. burgdorferi except for 1 tick from a recovered patient. An unplanned interim analysis led to the early termination of the study for futility.
conclusionsXenodiagnosis with larval I. scapularis ticks showed no evidence of B. burgdorferi in most patients after treatment, irrespective of symptoms. This may be due to the absence of bacteria or to the low sensitivity of the technique in humans. This method is unlikely to detect persistent B. burgdorferi infection in humans, and further research on the use of xenodiagnosis is unwarranted.
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