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PubMed1988

Influence of antenatal screening on perinatal mortality caused by syphilis in Swaziland.

In a survey of 283 deliveries in Swaziland, active syphilis (positive results in the Treponema pallidum haemagglutination assay (TPHA) and the rapid plasma reagin (RPR) test) was found in 37 (13.1%) and possibly active infection (positive TPHA but negative RPR test results) in a further 87 (30.7%). The perinatal mortality of untreated mothers with active disease was 21.9% (7/32). The RPR test carried out antenatally by nurses had a sensitivity of 36% (13/36) and predictive accuracy of 48% (13/27). Awareness of this incidence of syphilis led to improved antenatal clinic measures and the prophylactic treatment of all newborn infants. More comprehensive serology is discussed and the prophylactic treatment of mothers considered. The need for health education aiming at safer sexual practices is of paramount importance in a society facing the arrival of the human immunodeficiency virus.

Adolescent↗
PubMed1979

Clinical evaluation of amoxycillin in the treatment of syphilis.

Following demonstration of in vitro activity of amoxycillin against Treponema pallidum, a clinical research group was set up to study the effects of amoxycillin against various stages of syphilitic infection in men. A total of eighty-nine cases, fifteen primary, twenty-nine secondary, thirty late and fifteen adult congenital patients have been investigated. One hundred per cent effectiveness was recorded for primary and secondary syphilis; 66.7% for late syphilis and 60% success for adult congenital syphilis. In 10.4% of cases there was a transient elevation of SGOT and SGPT although it is not certain whether this was a reaction to the drug itself. There were three incidences of drug-related rash and two other minor side-effects. Amoxycillin is thus a safe and effective oral agent for the treatment of all stages of syphilis in man.

Administration, Oral↗
PubMed2005

[Exogenous and endogenous infections of genital tract].

The paper is an overview of etiological factors, clinical manifestations, diagnostics and treatment of genital tract infections. Infections caused by Trichomonas vaginalis, fungi Candida, Saccharomyces and Geotrichum are discussed as well as syphilis, gonorrhea and infections with Chlamydia, mycoplasms and ureaplasms. The problem of vaginal dysbacteriosis and mixed infections is pointed out.

Animals↗
PubMed1985

Reinfection of chancre-immune rabbits with Treponema pallidum. I. Light and immunofluorescence studies.

Inoculation of infectious Treponema pallidum into the skin of chancre-immune rabbits results in a limited inflammatory response. Intact organisms are identifiable by immunofluorescence in the dermis of the infection site for 1-2 days. By Day 3 structurally intact T pallidum are seen localized in hair follicles, erector pili muscles, and cutaneous nerves, while inflammatory cells containing fluorescent (T pallidum) fragments are seen in the dermis. After Day 6 intact organisms are no longer found. It is proposed that hair follicles, erector pili muscles, and particularly nerves may provide relatively protected sites for T pallidum, and that T pallidum may migrate within nerves. Clearance of organisms from the infected site appears to be mediated by phagocytosis and digestion by macrophages as a result of an accelerated delayed hypersensitivity response, but antibody-mediated destruction and T pallidum migration may also be involved.

Animals↗
PubMed1980

Analysis of the anticomplementary activity in sera of three African patients with parasitic and bacteriological infections.

The sera of three different patients from Togo, Africa were investigated with respect to their complement profile. The three patients were suffering from parasitic (Onchocerca volvulus) and bacteriological (Treponema pertenue) diseases. The total hemolytic activity (50% hemolytic complement) was markedly depressed. The analysis of the individual complement components revealed the the titers of C1, C2, C3, and C4 were lowered up to 90%, indicating an activation of the classical pathway of complement. Addition of the patients' sera to normal human serum induced a temperature-dependent consumption of C4 and C2, whereas C3 was not affected. This activity in the patients' sera eluted from a Sephadex-G-200 column with the 19 S peak and could be identified as the activated form of the first component of the complement system. The reason for the presence of activated C1, C1 in the patients' sera resides in the absence of functionally active C1 inactivator.

Adult↗
PubMed1985

Radioimmunoassays for the detection of antibodies to treponemal polypeptide antigens in serum.

Cross-reacting treponemal antigens are potentially important candidates for serodiagnostic assays in syphilitic infections. Based on the idea that the organelles for locomotion in virulent and avirulent treponemes might be composed of similar subunits, we attempted to purify the flagellar antigens of Treponema phagedenis biotype Reiter and Treponema refringens for use in radioimmunoassays. With a combination of physical and chemical methods, the major protein subunit of purified flagellar preparations exhibited a mass of approximately 37 kilodaltons (kd) on sodium dodecyl sulfate-polyacrylamide gels. These 37-kd materials, with weight estimates comparable to those of other flagellin molecules, were further purified by preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electroelution. Human and rabbit sera, alone or subjected to DEAE Affi-Gel blue chromatography, were subsequently tested in radioimmunoassays employing each of the purified preparations. Even though sera from patients with secondary syphilis and from experimentally infected animals at 3 to 4 weeks postinfection were reactive in radioimmunoassays employing the 37-kd flagellar antigens, the assays were relatively insensitive for detection of immunoglobulin G responses in the early stages of human infection. Detection of immunoglobulin G antibodies in sera obtained early in the course of natural or experimental infection was possible with electroeluted 33- to 64-kd materials from both avirulent and virulent treponemes.

Animals↗
PubMed2005

Involvement of periodontopathic anaerobes in aspiration pneumonia.

Increasing evidence has linked the anaerobic bacteria forming periodontopathic biofilms with aspiration pneumonia in elderly persons. In experiments designed to eliminate the potent respiratory pathogens forming biofilms in the oral cavity, we have shown that the mechanical and chemical oral cleansing using povidone-iodine effectively reduced the detection rates and numbers of methicillin-sensitive Staphylococcus species, Streptococcus pneumoniae, and Haemophilus influenzae in patients scheduled to undergo oral surgery requiring endotracheal intubation. We confirmed the pathogenicity of periodontopathic anaerobic bacteria for aspiration pneumonia in an experimental mouse model. Based upon the finding of the coexistence of Porphyromonas gingivalis with Treponema denticola in chronic periodontitis lesions, we innoculated a mixed culture of P. gingivalis and T. denticola into the mouse trachea; the resulting infection induced inflammatory cytokine production and caused pneumonia. In another series of investigations, professional oral health care (POHC), mainly cleansing administered by dental hygienists once a week for 24 months to elderly persons requiring daily care, resulted in the reduction of the number of total anaerobes, Candida albicans, and Staphylococcus species and in the number of cases of fatal aspiration pneumonia. We also found that the POHC treatment of elderly persons for 6 months in the winter season reduced the salivary levels of protease, trypsin-like activity, and neuraminidase and also decreased the frequency of influenza cases.

Aged↗
PubMed2007

Phylogenetic analysis of bacterial and archaeal species in symptomatic and asymptomatic endodontic infections.

Phylogenetic analysis of bacterial and archaeal 16S rRNA was used to examine polymicrobial communities within infected root canals of 20 symptomatic and 14 asymptomatic patients. Nucleotide sequences from approximately 750 clones amplified from each patient group with universal bacterial primers were matched to the Ribosomal Database Project II database. Phylotypes from 37 genera representing Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria and Proteobacteria were identified. Results were compared to those obtained with species-specific primers designed to detect Prevotella intermedia, Porphyromonas gingivalis, Porphyromonas endodontalis, Peptostreptococcus micros, Enterococcus sp., Streptococcus sp., Fusobacterium nucleatum, Tannerella forsythensis and Treponema denticola. Since members of the domain Archaea have been implicated in the severity of periodontal disease, and a recent report confirms that archaea are present in endodontic infections, 16S archaeal primers were also used to detect which patients carried these prokaryotes, to determine if their presence correlated with severity of the clinical symptoms. A Methanobrevibacter oralis-like species was detected in one asymptomatic and one symptomatic patient. DNA from root canals of these two patients was further analysed using species-specific primers to determine bacterial cohabitants. Trep. denticola was detected in the asymptomatic but not the symptomatic patient. Conversely, Porph. endodontalis was found in the symptomatic but not the asymptomatic patient. All other species except enterococci were detected with the species-specific primers in both patients. These results confirm the presence of archaea in root canals and provide additional insights into the polymicrobial communities in endodontic infections associated with clinical symptoms.

Archaea↗
PubMed2004

Relapse of secondary syphilis after benzathine penicillin G: molecular analysis.

BACKGROUND AND OBJECTIVES: It is difficult to distinguish between relapse and reinfection in patients who develop a second episode of syphilis after treatment. GOAL: The goal of this study was to use molecular methods to distinguish between relapse and reinfection in a patient with recurrent secondary syphilis. STUDY DESIGN: Treponema pallidum tprK sequences were amplified from cerebrospinal fluid (CSF), skin, and blood from the initial presentation and from blood from the second presentation. Neighbor-joining clustering analysis was performed for deduced tprK sequences from the case patient and for sequences derived from blood and CSF of a different patient with secondary syphilis. RESULTS: The case patient's tprK sequences from both episodes of syphilis clustered together with a high degree of similarity. CONCLUSION: Our patient likely relapsed despite treatment.

Adult↗
PubMed1980

Coronavirus infection in a litter of pups.

An outbreak of a coronavirus infection in a litter of 10-week-old poodle pups from a commercial kennel is described. Coronavirus-like particles were demonstrated by electron microscopy in the intestinal contents and in the colonic mucosa. Treponemas and campylobacters were excreted in great numbers in the faeces. The gastrointestinal disturbances were complicated by hepatic and renal degeneration and severe bronchopneumonia.

Animals↗
PubMed1982

Expression of Treponema pallidum antigens in Escherichia coli K-12.

A colony bank of recombinant plasmids harboring Treponema pallidum DNA inserts has been established in Escherichia coli K-12. By using an in situ immunoassay, we identified four E. coli clones that expressed T. pallidum antigens. Thus, recombinant DNA technology may provide powerful new tools for studying the pathogenesis of T. pallidum infection.

Animals↗
PubMed2004

Secondary syphilis: a histologic and immunohistochemical evaluation.

The usual method for detecting spirochetes in tissue sections is the silver stain; however, they are often difficult to detect due to marked background staining commonly seen with this technique. In certain clinical settings, such as neurosyphilis, congenital syphilis, and immunosuppressive conditions including human immunodeficiency virus (HIV) infection, a better method of detecting spirochetes in tissue sections is needed. We compare immunohistochemistry (IHC) with a monoclonal antibody to Treponema pallidum to silver staining in 19 biopsies from 17 patients with serologic evidence of secondary syphilis. IHC demonstrated a sensitivity of 71%, which was superior to the 41% sensitivity of the silver stain (p = 0.084). Furthermore, specificity was improved with IHC, as background artifacts were markedly reduced. Dermal spirochetes were visualized in all 12 positive cases, while epidermal organisms were seen in only eight cases. This finding lies contrary to accepted teaching that organisms are most commonly seen at the dermal epidermal junction. Of interest, perineural plasmacellular infiltrates were frequently seen in our cases (74%). Spirochetes were not seen in any of 14 control cases with similar histopathologic patterns. Although serologic studies remain the gold standard, IHC is more sensitive and specific than silver stain for detecting T. pallidum in biopsies of secondary syphilis.

Adult↗
PubMed2004

[Seroprevalence of hepatitis B and C virus, human immunodeficiency virus and syphilis in the blood donors].

Transfusion-transmitted infections are the most commonly encountered complications in transfusion practice. Serological markers for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV) and Treponema pallidum were screened in blood banks routinely. These tests are obligatory for transfusion safety and may give an idea about the seropositivity rates of a specific region. In this study, the results of 29,049 volunteer blood donors who were admitted to Blood Center of Kocaeli University Hospital between January 1999 to January 2004, have been retrospectively evaluated. HBsAg, anti-HCV and anti-HIV-1/2 were screened by microparticle enzyme immunoassay (MEIA), and syphilis antibodies were screened by rapid plasma reagin (RPR) test in the Blood Center Laboratory. The seropositivity rates for HBsAg, anti-HCV and RPR were found as 2.3%, 0.37% and 0.02%, respectively. Eight donors were found seropositive for anti-HIV-1/2, but they were all accepted as false positive results, since the western blot confirmation tests were all negative.

Antibodies, Bacterial↗
PubMed1983

Relationship between neurological features and intrathecal synthesis of IgG antibodies to Treponema pallidum in untreated and treated human neurosyphilis.

In syphilitic patients with or without CNS involvement the correlation of Treponema-specific IgG titre per milligram total IgG in CSF and serum (ITPA index) is a dependable source of information on the synthesis of treponemal IgG antibodies in the CNS. This index also provides a more reliable definition of asymptomatic neurosyphilis. Further, a discrimination between Treponema-specific and Treponema-non-specific IgG synthesis in the CNS is possible. Of 261 patients with clinical symptoms of neurosyphilis, 82% had a local production of treponemal IgG antibodies as shown by an elevated ITPA index. In patients with neurosyphilis and intrathecal synthesis of Treponema-specific IgG antibodies, 94% had oligoclonal IgG in the CSF. Comparison of different CSF protein alteration groups in untreated and treated neurosyphilitic patients showed that early diagnosis (and early treatment) led to improvement of the impairment of the blood-CSF barrier and reduction of the immune reaction in the CNS. However, synthesis of treponemal IgG antibodies in the CNS could persist as a 'scar syndrome' even after adequately cured infection.

Antibody Formation↗
PubMed2004

Present characteristics of symptomatic Entamoeba histolytica infection in the big cities of Japan.

Medical records, for 2000 and 2001, of symptomatic amoebic patients who were treated at our hospitals in Tokyo, Yokohama and Osaka were studied retrospectively for the purpose of gathering epidemiological data on symptomatic Entamoeba histolytica infection. A total of 58 patients were treated. Fifty-five of them were male, and 96% of the male patients were Japanese. The mean age of patients was 44.9 years old, and 91% of patients contracted the disease in Japan. Fifty-six per cent of the male patients indicated that they were practising homosexuals, and 44% of the male patients denied these practices or left the question unanswered. The serum Treponema pallidum haemagglutination test was positive in 45% of the patients, and antibody to human immunodeficiency virus (HIV) was positive in 45%. Our study revealed that recent symptomatic E. histolytica infection almost exclusively afflicted middle-aged males in the big cities of Japan, that a majority of the patients were probably exposed to the causative organism during homosexual activity, and that an increasing number of patients will be co-infected with HIV.

AIDS Serodiagnosis↗
PubMed2004

Transmission of herpes simplex virus Type 2 among factory workers in Ethiopia.

The herpes simplex virus type 2 (HSV-2) and human immunodeficiency virus (HIV) epidemics are believed to fuel each other, especially in sub-Saharan countries. In Ethiopia during 1997-2002, a retrospective study was conducted to examine risk factors for infection and transmission of HSV-2, in a cohort of 1612 factory workers. Prevalence of HSV-2 seropositivity at enrollment was 40.9%, and incidence of seroconversion was 1.8 seroconversions/100 person-years (PY), which decreased over time. Independent risk factors for seropositivity were having an HSV-2-seropositive partner, female sex, HIV antibodies, positive Treponema pallidum particle agglutination assay result, older age, low education level, and orthodox religion. These same factors were independent risk factors for HSV-2 seroconversion, with the exception of the latter 3. Most HSV-2-infected persons did not report symptoms. Among 41 monogamous HSV-2-serodiscordant heterosexual couples, incidence of HSV-2 seroconversion was 20.75 seroconversions/100 PY for women and 4.93 seroconversions/100 PY for men. The high burden of both HSV-2 and HIV infection in Ethiopia warrants stringent control measures.

Adult↗
PubMed1991

Identification of Treponema pallidum in amniotic fluid and fetal blood from pregnancies complicated by congenital syphilis.

Two pregnant women with secondary syphilis underwent amniocentesis and evaluation for fetal syphilis. In both cases, motile spirochetes, typical of Treponema pallidum, were observed during dark-field microscopic examination of the amniotic fluid. The presence of T pallidum was confirmed by antitreponemal monoclonal antibody immunofluorescence assays and by rabbit infectivity tests using the amniotic fluid. In the first case, an infant at 35 weeks' gestation delivered within 24 hours of amniocentesis had hepatosplenomegaly, osteochondritis, and neurosyphilis. In the second case, a fetus at 24 weeks' gestation was hydropic and a fetal blood sample showed anemia, thrombocytopenia, and elevated liver enzymes. Fetal syphilis was confirmed by rabbit infectivity testing using fetal blood obtained by funipuncture. This is the first report of the diagnosis of fetal syphilis by funipuncture and confirmation of the presence of virulent T pallidum in the blood of a human fetus. The mother was treated for secondary syphilis, but the infant had residual signs of congenital infection at birth 14 weeks later. Neonatal serum from the first case and fetal serum from the second case showed specific immunoglobulin M reactivity with the 47-kd antigen of T pallidum by Western blot assays. A new wild-type strain of T pallidum, designated DAL-1, was isolated from the amniotic fluid of the first case and is available for future studies. We conclude that the presence of T pallidum in amniotic fluid or fetal blood indicates fetal-placental infection. Further investigation is necessary to determine the pathogenesis of amniotic fluid infection and its role in the prenatal diagnosis of congenital syphilis.

Adult↗
PubMed1984

Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.

One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I.

Adolescent↗