@entity8831 ( @entity8831 ) develops at the site of the tick bite in 77-90% of @entity3001 ( @entity3001 ) @entity1 and is therefore a common manifestation of @entity66 . Clinical treatment failures have been reported in early @entity3001 cases for almost every suitable antimicrobial agent. The exact risk of resistance to antibiotic treatment in @entity1 with @entity8831 , however, is not known and there are few published cases of culture-proven treatment failure. Moreover, currently available diagnostic techniques cannot reliably discriminate between possible reinfection, true endogenous relapse and @entity325 with other tick-borne pathogens. These drawbacks together with the phenomenon of resistance to therapy in individual @entity1 undoubtedly contribute to the inconsistencies surrounding the optimal treatment regimens for @entity3001 and are often misinterpreted and misused to support prolonged antibiotic treatment regimens. The question for the underlying mechanisms of possible antimicrobial resistance in @entity2069 sensu lato remains unresolved but a better understanding of such genetic or phenotypic mechanisms would be helpful for the treatment of @entity3001 and other @entity66 . Investigations on this issue, at best, should start with borrelial isolates cultured from @entity1 before the start of antibiotic therapy and again after the conclusion of treatment. This task, however, remains challenging insofar, as culture is rarely successful under routine laboratory conditions after antimicrobial therapy. Here, we review recent clinical and experimental data on treatment resistance in @entity8831 @entity1 suggesting that, although rare, borrelial persistence does occur at the site of the infectious lesion after antibiotic treatment. Borrelial persistence, however, is unlikely to result from acquired resistance against antimicrobial agents that were used for initial specific chemotherapy.

Risk of culture-confirmed borrelial persistence in @entity1 treated for XXXX and possible mechanisms of resistance.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity3001 :: ('MESH:D008193', 'Disease') :: ['LB', 'Lyme borreliosis'] @entity66 :: ('MESH:D004194', 'Disease') :: ['early disease', 'spirochetal diseases'] @entity2069 :: ('139', 'Species') :: ['Borrelia burgdorferi'] @entity8831 :: ('MESH:C538499', 'Disease') :: ['EM', 'Erythema migrans'] @entity325 :: ('MESH:D060085', 'Disease') :: ['co-infection']
@entity8831 :: (MESH:C538499,Disease) :: ['erythema migrans']
