In addition, microscopic examination for diagnosis of anaplasmosis and babesiosis is both time-consuming and labor intensive making them quite expensive. Hence, there is a desperate need to develop efficient tests for detection of the presence of these pathogens in a cost-effective and efficient manner. The presence of nucleases in serum and in other body fluids ensures clearance of nucleic acids when pathogens are eliminated by treatment with antimicrobials [50, 75, 76]. Therefore, nucleic acid based tests are now becoming

popular for diagnosis of various infectious diseases [51, 52, 77]. Indeed, these assays are ideal as the tests of cure for various diseases. Early selleck inhibitor detection of infection by Borrelia species, A. phagocytophilum and Babesia species using nucleic acid based techniques can lead to successful treatment of the illnesses in a timely manner. We previously developed a sensitive and accurate quantitative selleck kinase inhibitor real-time PCR assay using molecular beacons for mouse tissues [61]. MassTag PCR has been employed to detect coinfection of ticks collected from different sites in New York with B. burgdorferi, A. phagocytophilum and B. microti[6, 78] and quantitative PCR has also been employed recently for patient samples [79]. A pilot study, using the patient blood samples used multi-locus PCR and electrospray ionization

mass spectrometry, showed 90% efficiency in detection of early Lyme disease and could often distinguish pentoxifylline different strains/genotypes involved [80]. Recently, a real-time PCR test using 18S rRNA gene of B. microti was successfully used by employing SU5402 mouse small DNA groove probe for specific detection of the presence of this parasite with a sensitivity

of ~100 gene copies per 5 μl of the patients’ blood [53]. However, all these tests have yet to be fully refined to employ them for diagnosis purpose in a cost-effective manner. In this study, we have expanded the use of specific molecular beacon probes in real-time PCR for either simultaneous detection of three Lyme spirochete species and distinguishing them using the denaturation profile analysis or detection of the presence of A. phagocytophilum and B. microti along with B. burgdorferi in the sample using a single assay. Use of our duplex versus a multiplex assay according to need will be efficient and less expensive assay for diagnosis of multiple tick-borne diseases. Our optimized multiplex assay could accurately detect and quantify a single spirochete recA gene copy spiked in the human DNA. The presence of high concentrations of human genomic DNA (containing 105 copies of ACTA1 gene) did not affect accuracy of the assay (Figure 2) as also shown by almost perfect coefficient of correlation (r2 = 0.999) between threshold cycle and copy number of B. burgdorferi DNA. In addition, an asymmetric PCR was able to detect B. burgdorferi, B. afzelii and B.