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PubMed1975

Isolation and purification of Treponema pallidum from syphilitic lesions in rabbits.

Treponema pallidum were extracted from testicular syphilomas of corticosteroid-treated rabbits and purified by differential centrifugation. The steroid therapy allowed a longer holding time for infected rabbits, which produced greater treponeme yields, averaging 1.58 x 10(10) treponemes per rabbit. The treatment, which also diminished cellular infiltration and increased the extracellular mucoid material in lesions, produced much cleaner suspensions than preparations from nontreated animals. Most of the treponemes in the purified suspensions were still motile, and none carried demonstrable host immunoglobulin. The preparations were free of recognizable host tissue debris and they contained, on the average, 1.9 x 10(-7) mug of protein per treponeme.

Adrenal Cortex Hormones↗
PubMed2005

Bacterial vaginosis in female sex workers in Chennai, India.

Bacterial vaginosis (BV) causes obstetric and gynaecological complications and non-chlamydial/non-gonococcal pelvic inflammatory disease and has been shown to be associated with the risk of acquiring HIV and herpes simplex (HSV)-2 infections. This study investigated both the prevalence of BV and its association with STDs among 582 female sex workers living in Chennai, South India. Blood, vaginal and endocervical swabs were tested for HSV-2, HIV, Treponema pallidum, BV, Chlamydia trachomatis, Neisseria gonorrhoea and Trichomonas vaginalis. The vaginal swabs collected were Gram's stained and analysed for BV by Nugent's scoring criteria. Of the women studied, 45% (95% CI, 40.6-48.7) were positive, 39.5% (95% CI, 35.5-43.5) were negative and 16% (95% CI, 12.8-18.7) were intermediate for BV. Bacterial vaginosis positivity was directly related to concurrent infection with HSV-2 (RR 1.3, AR 12, P = 0.00), T vaginalis (RR 1.5, AR 10, P = 0.01) T. pallidum (RR 2.8, AR 16, P = 0.00) and HIV (RR 4.1, AR 52, P = 0.01). Future studies are needed to focus on the risk factors for BV.

Adult↗
PubMed2006

Antibiotic selection may contribute to increases in macrolide-resistant Treponema pallidum.

To determine whether the 23S rRNA mutation that confers macrolide resistance is present in >1 Treponema pallidum strain, 58 isolates collected between 2001 and 2005 were screened for this mutation and for an unrelated sequence that distinguishes between strains. The odds of identifying a macrolide-resistant strain increased over time (P=.006). In subjects who had received macrolides in the previous year, the relative risk of harboring a resistant strain was 2.2 (95% confidence interval, 1.1-4.4; P=.02). The macrolide-resistant strains were not identical. These findings suggest that macrolide resistance may be increasing in multiple strains in response to antibiotic pressure.

Drug Resistance, Bacterial↗
PubMed1996

A mgl-like operon in Treponema pallidum, the syphilis spirochete.

A 38-kDa lipoprotein of Treponema pallidum subsp. pallidum (T. pallidum), the syphilis spirochete, previously was identified as a putative homolog of E. coli MglB [Becker et al. (1994) Infect. Immun. 62, 1381-1391]. In the present study, genome walking in regions adjacent to the T. pallidum 38-kDa lipoprotein gene has identified three contiguous genes (tp-mglB [formerly tpp38], tp-mglA, and tp-mglC) which appear to comprise a mgl-like operon in T. pallidum. A prominent transcript corresponding to tp-mglB, the first gene of the operon which encodes the carbohydrate receptor, is synthesized by T. pallidum along with lesser abundant transcript(s) corresponding to the entire T. pallidum mgl operon. An active promoter 135 bp upstream of tp-mglB is believed to direct mRNA synthesis for the operon. This is the first membrane protein-encoding operon of T. pallidum for which a putative function (glucose import) has been assigned. Furthermore, by analogy with E. coli MglB which interacts with the sensory transducer Trg to induce a chemotactic response, it is possible that T. pallidum also contains a homolog of E. coli Trg or other methyl-accepting chemotaxis proteins. The existence of a mgl operon in T. pallidum thus may have important implications with respect to T. pallidum survival, tissue dissemination, and sensory transduction during virulence expression.

Amino Acid Sequence↗
PubMed2003

Use of PCR in the diagnosis of early syphilis in the United Kingdom.

OBJECTIVES: To evaluate a Treponema pallidum polymerase chain reaction (PCR) test in the laboratory diagnosis of early syphilis in the United Kingdom. SUBJECTS AND SETTING: Men and women attending genitourinary medicine clinics in England. METHODS: A trial PCR service was offered for the analysis of swabs of ano-genital or oral ulcers suspected to be syphilitic in origin. Clinical details, results of treponemal serology, and other relevant laboratory tests carried out by the sending laboratories were obtained retrospectively by questionnaire. RESULTS: Data from 98 patients, representing 100 episodes of ulceration, were analysed. The majority of patients (70) attended clinics in the Greater Manchester area. Eighty six patients were male and 58 were men who have sex with men (MSM), of whom 24 were HIV positive. PCR results agreed with the clinical diagnosis for 95 patients; samples from 26 patients were PCR positive and serologically diagnosed as primary (18) or secondary (8) syphilis, whereas 70 patients had PCR negative samples and were not diagnosed as having active syphilis. These data include two HIV positive patients who were PCR positive 12 and 21 days before their treponemal seroconversion. One positive PCR result was not supported by positive treponemal serology (this patient coincidentally received a 10 day course of co-amoxiclav 1 week after sampling). Three patients had negative PCR results but positive syphilis serology. The sensitivity, specificity, positive and negative predictive value for primary syphilis were 94.7%, 98.6%, 94.7%, and 98.6%, respectively, and for secondary syphilis these were 80.0%, 98.6%, 88.9%, and 97.2%, respectively. CONCLUSION: PCR is a sensitive and specific test for T pallidum, and an important adjunct to dark ground microscopy and treponemal serology in diagnosing infectious syphilis in the United Kingdom.

DNA, Bacterial↗
PubMed1990

Syphilis, gonorrhoea and genital chlamydial infection in a Somali village.

A total of 767 sera were collected from 187 men, 200 women and 380 children in a Somali village, Jambaluul. All sera were tested for syphilis serological markers by Venereal Diseases Research Laboratory (VDRL) and Treponema pallidum Haemagglutination Assay (TPHA). Sera positive for both or either of these tests were further analysed for the presence of specific IgM antibodies by Solid Phase Haemadsorption Assay (SPHA). A high and almost equal prevalence of TPHA positivity was found in men and women; 24% and 22.5%, respectively, and IgM antibodies were found in 3% and 4%, respectively. TPHA positivity significantly increased with age. Thus more than half of the villagers at the age of 45 years or more were TPHA positive. One percent of the children were TPHA positive. From all adults aged 15 years and above urogenital specimens were also taken for Chlamydia trachomatis antigen detection with an enzyme-amplified immunoassay (IDEIA) and Neisseria gonorrhoeae culture. Chlamydial genital infection was found in 6% of the men and 18% of the women. All gonococcal cultures were negative.

Adolescent↗
PubMedDate not supplied

Immunization of rabbits with Spirochaeta aurantia does not induce resistance to Treponema pallidum.

Rabbits were immunized with viable Spirochaeta aurantia, a free-living, facultative anaerobic spirochete that is similar in some biochemical characteristics to Treponema pallidum, a parasitic, microaerophilic spirochete. Single and multiple immunizations with living S. aurantia, with or without Freund's incomplete adjuvant, Freund's complete adjuvant, or heat-killed T. pallidum, were carried out over a four-month period. Living S. aurantia was neither toxic nor virulent for rabbits. Immunized rabbits produced a high level of agglutinating antibody to S. aurantia but no antibody to T. pallidum, as determined by the T. pallidum hemagglutination test. Immunized rabbits were challenged with multiple intradermal inoculations of 100 viable T. pallidum (Nichols strain) and compared to unimmunized rabbits similarly infected. Immunization with S. aurantia did not protect against T. pallidum infection. Thus S. aurantia appears not to be suitable as a potential vaccine against infection with T. pallidum.

Animals↗
PubMed1988

Anaerobic infections in the head and neck region.

Anaerobic bacteria form the predominant flora of the oral cavity, outnumbering facultative organisms by 10-1,000: 1. The type of anaerobic bacteria and their concentration depend on the anatomical site and the degree of anaerobiosis in the different sites in the mouth. Three groups of anaerobic bacteria inhabit the oral cavity; the strict anaerobes, the moderate anaerobes, and the microaerophilic group of organisms. The majority of anaerobic bacterial infections occurring in the region of the mouth, head and neck are caused by the commensal flora. These infections include dental and periodontal disease where the predominant organisms are Bacteroides species, Veillonella, Bifidobacteria, Peptococcus, Peptostreptococcus and Propionibacterium species. More recently, Bacteroides endontalis has been isolated from a periapical abscess of endodontal origin and B. gingivalis, B. intermedius, Haemophilus actinomycetemcomitans and Wollinella species in chronic periodontal disease. Treponema species and other strict anaerobes are seen in smears of severe periodontal disease and acute necrotising gingivitis, but have not yet been isolated in pure culture. Until such time, their role in disease remains uncertain. Fusobacterium nucleatum is specially associated with severe orofacial infections which may extend into the mediastinum. Other anaerobic infections include chronic otitis media, chronic sinusitis and mastoiditis, and brain abscess. Treatment of these conditions should include the use of beta-lactamase resistant antimicrobials, such as clindamycin or one of the nitroimidazoles with penicillin.

Abscess↗
PubMed1996

Aspects of adherence of oral spirochetes.

Oral spirochetes are present in the oral cavity in various numbers and forms and have been strongly implicated as playing a role in the etiology of periodontal disease. Because adherence to host tissues is a critical first step in establishing a bacterial infection, reports on the attachment of oral spirochetes to host tissues and matrix components were reviewed. The great bulk of the literature concerns Treponema denticola; however, where there is information regarding other oral spirochete species, it will be noted.

Adhesins, Bacterial↗
PubMed2001

Toll-like receptor 2-dependent inhibition of macrophage class II MHC expression and antigen processing by 19-kDa lipoprotein of Mycobacterium tuberculosis.

Mycobacterium tuberculosis (MTB) induces vigorous immune responses, yet persists inside macrophages, evading host immunity. MTB bacilli or lysate was found to inhibit macrophage expression of class II MHC (MHC-II) molecules and MHC-II Ag processing. This report characterizes and identifies a specific component of MTB that mediates these inhibitory effects. The inhibitor was extracted from MTB lysate with Triton X-114, isolated by gel electroelution, and identified with Abs to be MTB 19-kDa lipoprotein. Electroelution- or immunoaffinity-purified MTB 19-kDa lipoprotein inhibited MHC-II expression and processing of both soluble Ags and Ag 85B from intact MTB bacilli. Inhibition of MHC-II Ag processing by either MTB bacilli or purified MTB 19-kDa lipoprotein was dependent on Toll-like receptor (TLR) 2 and independent of TLR 4. Synthetic analogs of lipopeptides from Treponema pallidum also inhibited Ag processing. Despite the ability of MTB 19-kDa lipoprotein to activate microbicidal and innate immune functions early in infection, TLR 2-dependent inhibition of MHC-II expression and Ag processing by MTB 19-kDa lipoprotein during later phases of macrophage infection may prevent presentation of MTB Ags and decrease recognition by T cells. This mechanism may allow intracellular MTB to evade immune surveillance and maintain chronic infection.

Acyltransferases↗
PubMedDate not supplied

Solid-hase hemadsorption: a method for rapid detection of Treponema pallidum-specific IgM.

A solid-phase hemadsorption (SPHA) technique for the rapid detection of Treponema pallidum-specific IgM antibodies is described. The demonstration of these immunoglobulins permits differentiation between a recent and a long-lasting infection and facilitates the decision as to whether or not a patient should receive therapy for syphilis. Errors that occur in the fluorescent treponemal antibody-absorbed test with IgM conjugate (IgM-FTA-Abs test) because of high titers of T. pallidum-specific IgG (competitive inhibition), rheumatoid factors, or 7S IgM do not occur with the SPHA technique. This test is easy to perform; it requires only microtiter plates coated with antisera to human IgM in addition to the standard T. pallidum hemagglutination reagents. As compared with the Veneral Disease Research Laboratory (vdrl) test, SPHA test has the advantage of being specific for T. pallidum; furthermore, IgM antibodies can be demonstrated earlier after infection and disappear sooner after adequate treatment of syphilis.

Antibody Specificity↗
PubMed2003

Susceptibility of Treponema pallidum to host-derived antimicrobial peptides.

LL-37 displays potent broad-spectrum activity against a number of pathogenic bacteria and is the only cathelicidin thus far identified in humans. In this study, we examined the capacity of human LL-37 and the similar CAP-18-derived peptide from rabbits to exert antimicrobial activity against the causative agent of syphilis, Treponema pallidum. We found that both peptides, as well as a truncated version of human LL-37 that contains its bactericidal domain, could exert rapid, but salt-sensitive antimicrobial activity against T. pallidum. Infectivity of T. pallidum in a rabbit model could effectively be blocked with the synthetic truncated LL-37-derived peptide WS22-N-amide.

Animals↗
PubMed1984

Syphilis, hepatitis A and hepatitis B seromarkers in homosexual men.

Two hundred homosexual men were investigated for prevalence rates of syphilis, hepatitis A (HAV) and hepatitis B (HBV). A reactive Treponema pallidum haemagglutination test (TPHA) was found in 56.3% of the participants. In 81.7% HBV seromarkers were detected. Hepatitis B surface antigen (HBsAG) was present in 6.6%. Anti-HAV was found in 51.0%. Risk factors for acquisition of these infections are discussed.

Berlin↗
PubMed1991

Neurosyphilis in human immunodeficiency virus type 1-seropositive individuals. A prospective study.

The prevalence of neurosyphilis in human immunodeficiency virus type 1 (HIV-1)-seropositive (HIV+) persons was assessed during the course of a study of the neurological complications of HIV-1 infection. One hundred sixty-six asymptomatic HIV+ subjects, 63 neurologically symptomatic HIV+ subjects, and six at-risk HIV-1-seronegative (HIV-) control subjects underwent cerebrospinal fluid (CSF) analysis on entry into this longitudinal study. Three (1.8%) of the asymptomatic HIV+ subjects had both a reactive CSF VDRL test and a reactive CSF fluorescent treponemal antibody-absorption (FTA-ABS) test. Two of these three subjects had a history of appropriately treated early syphilis, and all had a reactive serum rapid plasma reagin test. Of the 63 neurologically symptomatic HIV+ subjects, one patient with dementia had both a reactive CSF VDRL test and a fluorescent treponemal antibody-absorption test. Subjective improvement in cognitive skills followed high-dose, intravenous penicillin therapy. Another subject had a penicillin-responsive myelopathy accompanied by a reactive CSF fluorescent treponemal antibody-absorption test result, but a nonreactive CSF VDRL. Unsuspected neurosyphilis is relatively common in our population of asymptomatic HIV+ subjects and may be responsible for neurological disease in a significant minority of neurologically symptomatic HIV+ persons. Cerebrospinal fluid examination should be performed in all HIV+ persons with a history of syphilis or serological evidence of syphilis, regardless of prior treatment. Additionally, neurosyphilis should be considered in the differential diagnosis of neurological disease in any HIV+ person.

Adult↗
PubMed1997

Heterosexual transmission of hepatitis C virus among married couples in southwestern Japan.

The heterosexual transmission of hepatitis C virus (HCV) remains controversial, and data from general populations are scanty. In this cross-sectional study, we assessed the seroprevalence of antibodies to hepatitis C virus (anti-HCV) and the presence and genotype of HCV-RNA among 109 married couples within an endemic, community-based Japanese population. Overall, 25% of the husbands and 32% of the wives had anti-HCV. Spouses with anti-HCV-positive partners were around 2 times more likely to have anti-HCV than spouses with anti-HCV-negative partners (p = 0.01). Of 6 couples in which both spouses had HCV-RNA, however, 3 presented discordant HCV genotypes (type 1b vs. 2b). The couples' anti-HCV concordance status was not significantly influenced by the presence or absence of HCV-RNA among anti-HCV-positive partners (odds ratio [OR]: 0.8 for wives, 0.6 for husbands), nor by the length of marriage, the number of pregnancies or the use of contraceptives. No significant associations with anti-HCV were observed for serum markers of sexually transmitted agents, including human T-lymphotropic virus (OR = 1.1, 95% confidence interval [CI] 0.5-2.3), Treponema pallidum (OR = 0.7; CI 0.1-6.1) and hepatitis B virus (OR = 1.6; CI 0.9-3.0). Our results suggest that the clustering of HCV infection among specific couples within this endemic population may not be attributable to heterosexual transmission. Follow-up studies are necessary to determine the risk of heterosexual transmission of HCV in endemic areas.

Adult↗