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At least 73 records · Page 4Linked to original sources
PubMed1999

Clinical comparison of the Treponema pallidum CAPTIA syphilis-G enzyme immunoassay with the fluorescent treponemal antibody absorption immunoglobulin G assay for syphilis testing.

Recently, a treponema-specific immunoglobulin G (IgG) enzyme immunoassay (EIA), the CAPTIA Syphilis-G (Trinity Biotech, Jamestown, N.Y.), has become available as a diagnostic test for syphilis. A total of 89 stored sera previously tested by the fluorescent treponemal antibody absorption (FTA-ABS) IgG assay were evaluated by the CAPTIA EIA. The FTA-ABS IgG procedure was performed by technologists unblinded to results of rapid plasmid reagin (RPR) testing of the same specimens. Borderline CAPTIA-positive samples (antibody indices of >/=0.650 and </=0.900) were retested; if the second analysis produced an index of >0.900, the sample was considered positive. Thirteen of 89 (15%) samples had discrepant results. Compared to the FTA-ABS assay, the CAPTIA EIA had a sensitivity and specificity and positive and negative predictive values of 70.7, 97.9, 96.7, and 79.7%, respectively. In another analysis, discrepancies between results were resolved by repeated FTA-ABS testing (technologists were blinded to previous RPR results) and patient chart reviews. Seven CAPTIA-negative samples which were previously interpreted (unblinded) as minimally reactive by the FTA method were subsequently interpreted (blinded) as nonreactive. One other discrepant sample (CAPTIA negative and FTA-ABS positive [at an intensity of 3+], unblinded) was FTA negative with repeated testing (blinded). For the five remaining discrepant samples, chart reviews indicated that one patient (CAPTIA negative and FTA-ABS positive [minimally reactive], blinded) had possible syphilis. These five samples were also evaluated and found to be negative by another treponema-specific test, the Treponema pallidum microhemagglutination assay. Therefore, after repeated testing and chart reviews, 2 of the 89 (2%) samples had discrepant results; the adjusted sensitivity, specificity, and positive and negative predictive values were 96.7, 98.3, 96.7, and 98.3%, respectively. This study demonstrates that the CAPTIA IgG EIA is a reliable method for syphilis testing and that personnel performing tests which require subjective interpretation, like the FTA-ABS test, may be biased by RPR test results.

Adult↗
PubMed2002

Syphilis epidemic in Slovenia influenced by syphilis epidemic in the Russian Federation and other newly independent states.

In 1994 an 18-fold increase in the annually reported incidence rate of early syphilis (to 1.81 cases per 100,000 total population) in comparison to the preceding year was observed in Slovenia. The reported incidence rates remained elevated for a period of five years. The possible link between the evolving syphilis epidemic in the Russian Federation and newly independent States (NIS) during the 1990s and the observed increases in the reported early syphilis incidence rates in Slovenia, was explored. Surveillance data obtained by mandatory reporting of all newly diagnosed syphilis cases between 1994 and 1999 were analysed according to the information on sexual partners, the country of probable source of infection, and occupation. More than half of all reported cases (62%) were directly or indirectly linked to a source of infection abroad. Among these, the majority of cases (73%) were linked to the Russian Federation or NIS. Of these, 68% occurred in males, a high proportion being long-distance lorry drivers.

Adult↗
PubMed2006

Inadequate syphilis screening among women with prenatal care in a community with a high syphilis incidence.

OBJECTIVES AND GOAL: This study was designed to evaluate the extent to which pregnant women in a community with a high syphilis incidence were screened for syphilis according to standard recommendations of twice during prenatal care and at labor and delivery. STUDY DESIGN: Labor and delivery records from 4 hospitals in Miami-Dade County, Florida, were abstracted to obtain maternal and prenatal care characteristics and syphilis screening practices. RESULTS: Of the 1991 women, records indicated that 1655 (83%) were screened at least once during prenatal care, 220 (11%) were screened twice during prenatal care before delivery, and 184 (9%) were screened twice during prenatal care and at delivery. Attending a private clinic, having more than adequate prenatal care and having private insurance were associated with not being screened at least twice before delivery. CONCLUSIONS: Few women were screened according to standard recommendations, and provider or institutional-related factors affected adequacy of screening.

Adolescent↗
PubMed2000

Comparison of the Serodia Treponema pallidum particle agglutination, Captia Syphilis-G, and SpiroTek Reagin II tests with standard test techniques for diagnosis of syphilis.

We compared the microhemagglutination assay for Treponema pallidum (MHA-TP), a treponemal test, with two other treponemal tests, the Serodia Treponema pallidum particle agglutination (TP-PA) assay and the Captia Syphilis-G enzyme immunoassay, using 390 clinical serum samples. We also compared two nontreponemal tests, the rapid plasma Reagin (RPR) card test and the SpiroTek Reagin II test. Agreements of the MHA-TP with the TP-PA test and the Syphilis-G test were 97.4 and 97.7%, respectively. There was 89.2% agreement between the RPR and Reagin II tests. The Reagin II test was more apt to be reactive if the treponemal test was also reactive. We conclude that either the Serodia TP-PA test or the Captia Syphilis-G test is an appropriate substitute for the MHA-TP and that the Spirotek Reagin II test could substitute for the RPR test as a screening test.

Antibodies, Bacterial↗
PubMed1963

ON THE ORIGIN OF THE HUMAN TREPONEMATOSES (PINTA, YAWS, ENDEMIC SYPHILIS AND VENEREAL SYPHILIS).

A close relationship between the four human treponematoses is suggested by their clinical and epidemiological characteristics and by such limited knowledge of the treponemes as there is at present. No treponeme of this group (except for that of the rabbit) is known other than in man, but the human treponemes probably arose long ago from an animal infection. The long period of infectiousness of pinta suggests that it may have been the earliest human treponematosis. It may have been spread throughout the world by about 15 000 B.C., being subsequently isolated in the Americas when the Bering Strait was flooded. About 10 000 B.C. in the Afro-Asian land mass environmental conditions might have favoured treponeme mutants leading to yaws; from these, about 7000 B.C., endemic syphilis perhaps developed, to give rise to venereal syphilis about 3000 B.C. in south-west Asia as big cities developed there. Towards the end of the fifteenth century A.D. a further mutation may have resulted in a more severe venereal syphilis in Europe which, with European exploration and geographical expansion, was subsequently carried throughout the then treponemally uncommitted world. These suggestions find some tentative support in climatic changes which might have influenced the selection of those treponemes which still survive in humid or arid climates. Venereal transmission would presumably remove the treponeme from the direct influence of climate. The author makes a plea for further investigation of many aspects of this subject while this is still possible.

Americas↗
PubMed2006

Epidemiology of syphilis in pregnant women and congenital syphilis in Belarus.

In Belarus the spread of syphilis has been on the increase since 1988, and the incidence reached its peak in 1996 with 209.7 cases per 100 000 inhabitants. During the following years the incidence has reduced, but still remains high with 41 cases in 2004. In the years 1996-2004 all together 4239 pregnant women infected with syphilis were registered in Dermatovenereological Dispensaries in Belarus, giving birth to 116 children with congenital syphilis. The social end economic background of these events is reviewed.

Adolescent↗
PubMed1982

Meningovascular syphilis after 'appropriate' treatment of primary syphilis.

Meningovascular syphilis developed in a patient two years after the treatment of primary syphilis with a single intramuscular injection of 2.4 million units of penicillin G benzathine as recommended by the Centers for Disease Control. Although it could not be established with certainty whether this infection represented a reinfection or a treatment failure, the case emphasizes the necessity for serologic follow-up examination in all patients treated for primary syphilis.

Adult↗
PubMed2006

Symptomatic relapse of neurologic syphilis after benzathine penicillin G therapy for primary or secondary syphilis in HIV-infected patients.

We describe 3 symptomatic cases of neurologic syphilis that occurred after the administration of the usual therapy for primary or secondary syphilis in human immunodeficiency virus (HIV)-infected patients. We discuss the difficulty of diagnosing neurosyphilis, the need for lumbar puncture, and risk factors of relapse. Because HIV infection may alter the natural history and response of neurologic syphilis to treatment, scrupulous follow-up and repeated cycles of therapy are warranted.

Adult↗
PubMedDate not supplied

Acquired syphilis in a patient with late congenital syphilis.

Late congenital syphilis was diagnosed in a 22-year-old woman on the basis of clinical, serologic and epidemiologic features. Clinical examination showed the "saddle-nose" deformity, Hutchinson's teeth, high-arched palate, Dubois little-finger sign, and small maxillae resulting in shallow depression of the central part of the face. Two years after receiving adequate treatment for late congenital syphilis, she presented with a primary syphilitic chancre; thus it was concluded that the woman had no immunity to reinfection with Treponema pallidum.

Adult↗
PubMed1991

Syphilis serology in patients with primary syphilis and non-treponemal sexually transmitted diseases in southern Africa.

The reactivity of a non-specific reagin (RPR) test and a specific treponemal (FTA-ABS) test were determined in 21 patients with primary syphilis, 430 patients with proven non-treponemal genital ulcerations and 719 patients with acute urethritis presenting at a clinic for sexually transmitted diseases in southern Africa. Excluding those 21 cases of primary syphilis, 358 of 1149 tests performed (31%) were found to be reactive by at least one test. The rate of false positive RPR tests was very low (0.02%). Significantly higher rates of seropositivity were detected in patients with genital ulcerations than in patients with acute urethritis. The highest rates were detected among patients with proven lymphogranuloma venereum (34% RPR positive, FTA-ABS positive; 19% RPR negative, FTA-ABS positive). The geometric mean titres (GMT) of positive RPR tests in non-treponemal infections were found to be lower than in darkfield positive cases of genital ulcer disease.

Acute Disease↗
PubMed2006

Audit of the use of benzathine penicillin, post-treatment syphilis serology and partner notification of patients with early infectious syphilis.

Recent increases in the incidence of early infectious syphilis have been particularly noted in men who have sex with men (MSM). Case-notes of 40 consecutive patients with infectious syphilis and follow-up data for one year were audited. Of the 40 patients, six were HIV co-infected. In all, 31 men received benzathine penicillin as first line while the remaining had other treatments. About 17 (42.5%) failed to attend for any post-treatment serological tests. Of the remainder, 17 (42.5%) attended for the first appointment and only 13 (32.5%) attended for the full one year follow-up. In all, 40 men in the study had 362 sexual contacts of which only 44 (12.2%) elected to be screened. This study illustrates the successful use of benzathine penicillin as first-line treatment, lack of patient compliance with post-treatment serological follow-up and difficulty with partner notification.

Adolescent↗
PubMed1998

Impact of a mandatory syphilis delivery test on reported cases of congenital syphilis in Upstate New York.

A regulation mandating a syphilis serology test at delivery was implemented on December 6, 1989. To assess any impact on congenital syphilis reporting, we compared all cases reported in Upstate New York for the year directly preceding the regulation (n = 69) to those born in the three-year period following its implementation (n = 239). After implementation, the percentage of cases not tested at delivery decreased from 10 percent to 1 percent and reports of syphilitic stillbirths tripled. Asymptomatic infection of both mothers and babies increased significantly and at-birth detection of cases in women with negative prenatal serologies increased by 43 percent. Delivery screening failed to identify seven cases due to incubating maternal infection.

Adolescent↗
PubMed1979

[Results of modern syphilis serology in blood donors, at the same time a contribution to spontaneous healing of syphilis].

261 out of 336 845 blood donors have been shown to had undergone a syphilitic infection. About 52 per cent of these donors have had knowledge of their infection and of specific treatment of the disease. In about 43 per cent of the investigated cases the T. pallidum infection has had probably an inapparent course and healed without treatment, that means spontaneously. In times with an increasing number of infections by T. pallidum blood banks have to look intensively for donors which are in the first stage of primary syphilis. For identification of these people and for the differentiation between antibodies against T. pallidum and apathogenic treponemes the use of a TPHA-ABS test is discussed.

Antibodies↗