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Background  Lyme borreliosis is a tick-borne disease caused by  Borrelia burgdorferi  sensu lato. The variety of characteristic and non-specific clinical manifestations is partially explained by its genetic diversity. We investigated the ability of  B .  burgdorferi  sl isolates to cause erythema migrans.    Methods  The genetic constellation of isolates from ticks was compared to isolates found in erythema migrans. PCR and sequence analysis was performed on the plasmid-encoded  ospC  and the chromosomal 5S-23S rDNA spacer region (IGS).    Results  Seven different  B .  burgdorferi  sl genospecies were identified in 152 borrelia isolates from ticks and erythema migrans biopsies.  B afzelii  (51%) and  B .  garinii  (27%) were the most common in ticks. From the 44 sequences obtained from erythema migrans samples 42 were  B .  afzelii , one  B .  garinii  and one  B .  bavariensis . Significant associations with erythema migrans formation were found for four IGS and two  ospC  types. Five from 45  ospC  types were associated with more than one genospecies.    Conclusions   B .  burgdorferi  sl isolates differ in their propensity to cause erythema migrans. These differences were also found within genospecies. In other words, although  B .  afzelii  was mostly associated with erythema migrans, some  B .  afzelii  isolates had a low ability to cause erythema migrans. Our data further support the occurrence of plasmid exchange between borrelia genospecies under natural conditions.

Ability to cause erythema migrans differs between Borrelia burgdorferi sensu lato isolates