Serological Methods in the Diagnosis of Lyme Disease: A Challenge in Laboratory Practice

Lyme disease is caused by bacteria of the Borrelia burgdorferi sensu lato complex and is the most common tick-borne infection in Europe and North America. Serological methods are approved for laboratory diagnosis, and the CDC continues to recommend a two-step algorithm for their use. However, serological methods have significant limitations that must be considered when interpreting results. We reviewed literature sources with a focus on the standard two-tiered testing (STTT), which is applied in our country, and the modified two-tiered testing (MTTT).