Comparison of different diagnostic assays for the detection of Borrelia burgdorferi-specific antibodies in dogs

Background: Antibody tests are frequently used in the diagnosis of canine Lyme borreliosis, including immunofluorescence assay (IFA) for immunoglobulin G (IgG) and M (IgM) antibodies, kinetic enzyme-linked immunosorbent assay (KELA), and Western blotting (WB). Recently, the SNAP4Dx, an in-house test using C6 technology has become available. Objectives: The aim of this study was to compare IFA, KELA, and SNAP4Dx assay results, and to determine their sensitivity and specificity when compared with the WB, used as gold standard in this study. Methods: Two hundred canine sera were tested for the presence of specific antibodies against Borrelia spp. using the above-mentioned tests. Results: The sensitivity and specificity of IFA-IgG was 76.6% (95% confidence interval [CI] 46.87-86.72) and 87.1% (95% CI 80.06-91.90), and 26.3% (95% CI 11.81-48.79) and 81.0% (95% CI 73.64-86.71) for IFA-IgM, respectively. KELA was 100% (95% CI 83.18-100) sensitive and 75.4% (95% CI 67.02-82.09) specific, and the SNAP4Dx was 84.2% (95% CI 62.43-94.48) sensitive and 98.5% (95% CI 94.83-99.60) specific. Conclusions: Both IFAs had very low sensitivity and specificity and cannot be recommended for screening purposes. In contrast, KELA showed excellent sensitivity, but positive results always need to be confirmed by WB to differentiate the source of antibody formation. The SNAP4Dx had a high sensitivity and specificity, and thus can potentially replace the more labor-intensive WB, at least in untreated dogs.