One of the most common questions I receive after reviewing a DNA Connexions Superfloss Lyme Panel is:
"What do these results actually mean?"
Patients often understand that the test is looking for Lyme disease and other vector-borne infections, but they are understandably confused by terms such as IND, NPS, and why some organisms appear as straightforward positives while others do not.
If you're looking for a more detailed explanation of how the DNA Connexions test works and how it differs from conventional Lyme testing, I recommend reading our previous article:
DNA Connexions Superfloss Lyme Panel: Direct Evidence in a World of Indirect Tests
For this article, let's focus specifically on interpreting the results.
Understanding Positive, IND, and NPS Results
The first thing many patients notice is that not all positive findings look the same.
Positive (No Qualifier)
When an organism appears on the report without any additional qualifier, the laboratory has identified DNA from that organism at a level meeting its criteria for a positive result.
In simple terms:
The laboratory found genetic material from that organism in the sample.
This is the strongest level of detection reported on the test.
IND (Indeterminate)
An IND result means the laboratory detected a signal suggestive of that organism, but the amount of DNA identified did not meet the threshold required for a definitive positive result.
Think of it as:
"Something was detected, but not enough to call it fully positive."
An IND result should not automatically be interpreted as negative. Rather, it represents a weaker signal that may still be clinically relevant depending on the patient's symptoms, history, and overall presentation.
NPS
NPS results are similar in that they indicate the laboratory identified evidence suggestive of the organism but that the finding did not satisfy all criteria necessary for a definitive positive report.
Patients often ask whether IND or NPS should simply be ignored.
My answer is generally no.
These findings should not be interpreted in isolation, but neither should they automatically be dismissed. They are pieces of information that must be considered alongside the patient's symptoms, exposure history, physical examination, and other laboratory findings.
Why False Negatives Are More Common Than False Positives
No test is perfect, and the DNA Connexions panel is no exception.
One of the most important concepts for patients to understand is that this test is generally more likely to miss an infection than to falsely identify one.
Vector-borne organisms are biologically complex. They are not continuously active, continuously circulating, or continuously shedding detectable DNA.
As a result, there may be times when an organism is present but little or no detectable DNA is captured in the sample.
For this reason, a negative result does not necessarily mean an infection is absent.
It means:
"No detectable DNA from that organism was identified in this sample."
That is an important distinction.
In contrast, false positives are generally considered less likely because the test is looking for specific genetic sequences associated with the organism itself.
The Best Test We Have Is Still Not a Perfect Test
Patients are sometimes surprised when I explain that even this test has limitations.
The reality is that no currently available Lyme or vector-borne infection test is perfect.
The DNA Connexions Superfloss Panel evaluates a limited number of organisms. While it covers several important vector-borne pathogens, there are hundreds of known vector-borne organisms worldwide and likely many more that remain poorly characterized.
A negative result does not rule out every possible vector-borne infection.
What makes this test valuable is not that it is perfect.
What makes it valuable is that it provides some of the best direct evidence currently available when evaluating potential vector-borne infections.
"My Organism Only Exists in South America"
Another common concern occurs when patients receive a positive result and immediately begin researching the organism online.
Often they find statements such as:
"This organism is found primarily in South America."
or
"This infection is only found in Europe."
At first glance, this can make the result seem impossible.
However, there is an important limitation in how we often think about infectious diseases.
Medicine frequently assumes that where an organism was first identified is where it remains forever.
History has shown this assumption is often incorrect.
Organisms spread. Animal hosts migrate. Vectors expand their geographic range. Human travel increases exposure opportunities. Most importantly, many lesser-known vector-borne infections receive very little research funding or surveillance.
For organisms such as Borrelia burgdorferi, Bartonella henselae, and Babesia microti, we have extensive research and monitoring.
For lesser-known organisms such as Borrelia recurrentis, Bartonella bacilliformis, Babesia divergens, and others, the reality is that much less research has been performed.
In many cases, we simply do not know their true geographic distribution because few researchers are actively looking for them.
This remains an important blind spot in modern medicine and one that will hopefully receive greater attention in the coming years.
The absence of extensive surveillance data should not automatically be interpreted as proof that an organism cannot exist in a particular region.
How Is This Different From Conventional Testing?
Another question I hear frequently is:
"Couldn't I just get tested through my regular doctor's office?"
In most cases, conventional testing focuses on a relatively small number of organisms and relies primarily on antibody testing.
Typically, conventional laboratories evaluate organisms such as:
- Borrelia burgdorferi
- Bartonella henselae
- Bartonella quintana
- Babesia microti
- Occasionally Babesia duncani
More importantly, these tests generally look for the body's immune response rather than direct evidence of the organism itself.
For many patients, Lyme testing consists solely of an ELISA screening test. If that test is negative, the investigation often ends there.
The DNA Connexions panel provides a fundamentally different type of information because it is searching for microbial DNA rather than antibodies.
That does not make it perfect. It simply means it answers a different question.
The Bottom Line
The DNA Connexions Superfloss Lyme Panel is best viewed as one important piece of a larger clinical puzzle.
A positive result provides direct evidence that DNA from a particular organism was identified in the sample.
IND and NPS findings may represent weaker signals that deserve thoughtful interpretation rather than automatic dismissal.
A negative result does not completely exclude the possibility of infection, particularly given the complex and often intermittent nature of vector-borne organisms.
Most importantly, this test provides a type of information that conventional testing often cannot: direct evidence of microbial DNA rather than simply measuring the immune system's response.
While not perfect, it remains one of the most useful tools currently available for evaluating potential vector-borne infections and helping patients and clinicians make more informed decisions about the next steps in care.