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Lyme borreliosis (LB) is a multisystemic disease caused by  Borrelia burgdorferi sensu lato  ( sl ) complex transmitted to humans by  Ixodes  ticks.  B .  burgdorferi sl  complex, currently comprising at least 19 genospecies, includes the main pathogenic species responsible for human disease in Europe:  B .  burgdorferi sensu stricto  ( ss ),  B .  afzelii , and  B .  garinii . In this study, for the first time, MALDI-TOF MS was applied to  Borrelia  spp., supplementing the existing database, limited to the species  B .  burgdorferi ss ,  B   .   spielmanii  and  B .  garinii , with the species  B .  afzelii , in order to enable the identification of all the species potentially implicated in LB in Europe. Moreover, we supplemented the database also with  B .  hermsii , which is the primary cause of tick-borne relapsing fever in western North America,  B .  japonica , circulating in Asia, and another reference strain of  B .  burgdorferi ss  (B31 strain). The dendrogram obtained by analyzing the protein profiles of the different  Borrelia  species reflected  Borrelia  taxonomy, showing that all the species included in the  Borrelia sl  complex clustered in a unique branch, while  Borrelia hermsii  clustered separately. In conclusion, in this study MALDI-TOF MS proved a useful tool suitable for identification of  Borrelia  spp. both for diagnostic purpose and epidemiological surveillance.

Identification of Borrelia Species after Creation of an In-House MALDI-TOF MS Database