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PubMed1995

Spirochetes isolated from dairy cattle with papillomatous digital dermatitis and interdigital dermatitis.

Two groups of spirochetes were isolated from papillomatous digital dermatitis (PDD) lesions in dairy cattle. The two groups could be readily differentiated on the basis of morphologic and immunologic characteristics and enzymatic activity. A spirochete isolated from an interdigital dermatitis (IDD) lesion appeared morphologically and antigenically similar to spirochetes in one of the PDD groups and exhibited an identical enzyme activity pattern. The two groups of PDD spirochetes had characteristics most consistent with the genus Treponema. The PDD and IDD isolates differed morphologically from previously described bovine Treponema spp. Although spirochetes have been observed to be one of the predominant bacterial morphotypes in PDD and IDD and are found invading the stratum spinosum and dermal papillae in PDD lesions, the significance of these spirochetes in the etiopathogenesis of PDD and IDD is presently unknown.

Animals↗
PubMed1978

Laboratory support in the management of syphilis.

Recent developments in syphilis serology are set down. The approach today is more rational as it has some basis in immunological understandings. In spite of improvements, syphilis serology continues to have limitations, and differentiating active from inactive cases remains taxing. In primary and secondary syphilis, dark-ground microscopy is still the quickest and surest way to make the diagnosis. In latent syphilis and in late and congenital cases, as well as in instances of other treponemal infections, serological evidence of disease needs to be considered along with each patient's medical, social and sexual history, when and why they may have been given antibiotic treatment, and the results of radiological studies and cerebrospinal fluid examination. For some syphilitics, the decision to treat or not to treat remains a matter of art rather than science.

Adolescent↗
PubMed2001

Serum phenytoin concentration and IgG antibody titre to periodontal bacteria in patients with phenytoin-induced gingival overgrowth.

Epileptic patients taking phenytoin with gingival-overgrowth and those without gingival-overgrowth were compared for daily drug dose, plasma total phenytoin concentration, plasma free-phenytoin concentration and serum IgG antibody titre against 13 periodontal bacteria. Significantly higher daily drug dose was noted in patients with gingival overgrowth (P < 0.05) when compared with those without overgrowth. In addition, both total and free forms of plasma phenytoin concentration were significantly higher in sera of patients with gingival growth than of those without overgrowth (P < 0.01). Strong positive correlation was found between daily drug dose and serum phenytoin concentration in patients with gingival overgrowth, while weak correlation was found in patients without gingival overgrowth, suggesting a difference in drug metabolism in these two groups. However, no differences were found in serum IgG antibody titres to 13 periodontal bacteria examined between two groups. These results suggest that metabolic ability of phenytoin is one of the factors for developing gingival overgrowth, and that periodontal infection may not be a primary causative factor for gingival overgrowth but act as an additive factor which increase tissue mass for this unwanted side effect.

Administration, Oral↗
PubMed1983

[Recent progress in syphilis serology].

Serological investigations for the diagnosis of syphilis have been performed in a special subunit at the Department of Dermatology to Lainz Hospital, Vienna, since 70 years. At present 80,000 to 100,000 sera are tested annually. The classical test systems VDRL, TPHA, AMHA-TP and FTA-ABS demonstrate, in particular, the presence of IgG antibodies and are, thus, suitable for the diagnosis of the disease, but do not permit conclusions on the activity of the disease and the actual need for antisyphilitic treatment. The newly developed IgM diagnosis of syphilis with the IgM-SPHA- and the 19S-IgM-FTA-ABS test solve these problems and can be performed even under routine conditions using the methods of solid phase haemadsorption and computerized high pressure liquid chromatography. In addition, the serological diagnosis of neurosyphilis has been worked out by the determination of the TPHA-index and the detection of antitreponemal IgM-antibodies in the cerebrospinal fluid. The relative frequency of latent syphilis infections has increased over the past years and serodiagnosis of syphilis, thus, become more and more important. The availability of five independent test systems has enabled the elaboration of a test profile which keeps the margin of error to below 0.1%. A further method, the ELISA technique is at present under investigation and renders promising results by the use of recently developed reagents.

Cerebrospinal Fluid↗
PubMed1981

[The redox potential of the large intestine in swine in relation to swine dysentery].

The redox potential of (Eh) +111 +/- 25 mV was measured in the large intestine of newly born piglets. In the post-weaning period the Eh values decreased significantly to -173 +/- 27 mV and remained at this level also in the healthy sows (-214 +/- 55 mV). The Eh value recorded in dysenteric pigs was -188 +/- 5 mV, and this was not statistically significant in relation to the healthy weaned piglets. The Eh level measured in the blood agar prepared with cysteine and covered by a thick growth of the strain Treponema hyodysenteriae, which had been incubated in an anaerobic medium for five days, was -218 +/- 18 mV. The Eh of piglets after weaning was not the decisive condition for the development of dysentery. However, it can be assumed that the impossibility of eliciting dysentery in microbe-free and gnotobiotic pigs is associated with a relatively high redox potential of a microbially unpopulated or insufficiently populated intestine.

Animals↗
PubMed2000

[Intravenous drug users serologic control: what may be prevented?].

OBJECTIVE: To report of IDU serologic control done in 1997 in comparison with another of 1990, in a Health-Care Area of Madrid, Spain, focussing to hepatitis B virus prevention. PATIENTS AND METHODS: Cross-sectional study. LOCATION: Fuenlabrada-Leganés, 400,000 inhabitants Health-Care Area in the Southeast of Madrid. PATIENTS: 233 IDU submitted for serological study during 1997 (mean age, 29.5; standard deviation, 6.8; 85.8% males). INTERVENTIONS: HIV, HBV, HCV and Treponema pallidum; serological markers were done at Severo Ochoa Hospital and a search for previous reports since 1991. Study of HBV previous vaccination was done with HBsAb marker in HBV seronegative patients. RESULTS: Prevalence: HBV 39.5% (IC = 33.2-46.1), HCV 49.3% (IC = 42.8-55.9), HIV 11.1% (IC = 7.5-16.1), syphilis 3.4% (IC = 1.5-7). Statistically meaning falls in rates were detected comparing them with results from 1990 (HBV: 67.5%; HCV: 75.1%; HIV: 50.1%; n = 261; p < 0.001). Only 5 (3.55%) out of 141 HBV seronegative patients showed HBsAb titres above 10 mU/I, although 55 (39%) of them had been tested for HBV previously. Nineteen (20.6%) out of 92 patients with HBV markers had previous seronegative reports and 3 of them suffered an acute viral infection. CONCLUSIONS: We have seen a statistically meaning fall in seroprevalence of the studied agents although a low HBV vaccination rate was achieved.

Adult↗
PubMed1983

[Value of the indirect immunofluorescence test in syphilis and toxoplasma diagnosis].

The examination tests annually necessary for a serological examination for syphilis and toxoplasmosis are in the first place as to their quantity in the diagnostics of the infection. For the performance of this large number of tests the use of a method is necessary which corresponds to the necessities of rationalisation of the laboratory work in the same way as to the demands to quality, which is characterized by specificity, sensitivity and reproducibility. For these criteria in the framework of the syphilis serology the TPHA-test is in a higher degree sufficient (with the exception of the early syphilis) than the FTA-ABS-test. The small quantity of the imported test set which is at present at our disposal does not allow a general application of this test, so that the FTA-ABS-test is the most usual method. Moreover, by means of FTA-ABS-IgM and 19 S-IgM-FTA-ABS-test valuable diagnostic additional informations (early diagnosis of the infection, L. connata diagnostics, estimation of the success of therapy) can be got which neither the TPI nor the TPHA-test are able to give. For the diagnosis of toxoplasmosis the IFT shows at present a higher value of precision than ELISA. It is still to be clarified in how far in the higher sensitivity of toxoplasmosis ELISA unspecificities play a role.

Antibody Specificity↗
PubMed1981

Venereal spirochetosis of rabbits: eradication.

Venereal spirochetosis of rabbits, caused by Treponema cuniculi, have been observed since the 1940's in the rabbit colony maintained at The Jackson Laboratory. Treatment of individual rabbits with obvious clinical lesions using a product containing crystalline penicillin and dihydrostreptomycin caused lesions to heal but venereal spirochetosis persisted in the colony. Clinical and serological responses of rabbits receiving three subcutaneous injections of benzathine penicillin G-procaine penicillin G (either 42,000 or 84,000 IU/kg body weight/week) at 7 day intervals were monitored. Both doses were effective. Lesions healed within 2 weeks of the first treatment. Rapid plasma reagin titers declined markedly or disappeared by the sixth week after the first treatment. Based upon the above findings and results of previous epizootiological studies, a program to eradicate venereal spirochetosis from this enzootically infected colony was successfully undertaken.

Animals↗
PubMed2001

Ocular syphilis.

Although the annual incidence of primary and secondary syphilis has dropped to the lowest rate recorded, syphilis remains an important cause of ocular disease. Uveitis is the most common ocular manifestation of syphilis in both HIV-positive and HIV-negative patients, and the diagnosis should prompt an analysis of the cerebrospinal fluid to exclude associated neurosyphilis. Newer modalities such as enzyme immunoassays and genomic amplification using the polymerase chain reaction may prove to be useful techniques to detect Treponema pallidum in intraocular specimens. The preferred treatment for all stages of syphilis remains parenteral penicillin G, although the preparation, dose, route of administration, and duration of therapy are dictated by the stage of disease and various host factors. All patients diagnosed with ocular syphilis should be tested for HIV, because the presence of a primary genital chancre increases the risk of acquiring or transmitting HIV, and because risk factors for the two diseases are similar.

Eye Infections, Bacterial↗
PubMed2002

A randomized, comparative pilot study of azithromycin versus benzathine penicillin G for treatment of early syphilis.

BACKGROUND: Penicillin is the only medication currently recommended for treatment of early syphilis in non-penicillin-allergic patients. Preliminary data suggest that azithromycin may be effective for syphilis therapy. STUDY DESIGN: This was a randomized, comparative pilot study of intramuscular injections of benzathine penicillin G and two oral azithromycin regimens for treatment of syphilis. METHODS: We randomly assigned patients with early syphilis to treatment with either intramuscular injections of 2.4 million units of benzathine penicillin G or azithromycin administered orally, either as a single 2.0-g dose or as two 2.0-g doses given 1 week apart. Serological response to therapy was evaluated at 3, 6, 9, and 12 months following therapy. Participants whose rapid plasma reagin (RPR) test became nonreactive or whose RPR titer decreased > or =2 dilutions were classified as responding to therapy. When serological tests did not show a response to therapy, the treatment was classified as a failure if RPR titers increased > or =2 dilutions. Nonresponders were those whose serologic titers remained within +/-1 dilution of the initial RPR titer. RESULTS: Cumulative response rates were as follows: benzathine penicillin G, 86% (12 of 14); azithromycin, 2.0-g single dose, 94% (16 of 17); and azithromycin, two 2.0-g doses given 1 week apart, 83% (24 of 29). Therapy failed for one patient treated with benzathine penicillin and one patient treated with the two-dose azithromycin regimen, whereas in six patients the clinical manifestations of infection resolved but there was no serological response. CONCLUSION: Oral therapy with 2.0 g of azithromycin as a single dose or as two doses 1 week apart is a promising alternative to therapy with benzathine penicillin G for syphilis and should be studied further.

Administration, Oral↗
PubMed2004

Maternal syphilis: pathophysiology and treatment.

Despite the long history of medical interest in syphilis and its effects on pregnancy outcome, many fundamental questions about the pathophysiology and treatment of syphilis during pregnancy remain unanswered. However, understanding has been advanced by recent scientific reports such as those which delineate the complete sequence of the genome of the syphilis spirochaete, provide a more precise description of fetal and neonate infection by use of rabbit infectivity tests and describe the gestational age distribution of fetal death secondary to syphilis. It appears that fetal syphilitic involvement progresses in a rather predictable fashion, and although there is disagreement about the optimal prenatal treatment regimen, programmatic efforts to prevent fetal death must provide seropositive pregnant women with a recommended treatment early in pregnancy, and certainly before the third trimester.

Female↗
PubMed2006

[Microbiological study on the prognosis of immediate implant and periodontal disease].

AIM: The aim of the present study was to investigate the prevalence of periodontal marker organisms and specific interleukin-1 (IL-1) gene polymorphisms (which show a close association with periodontitis) and their effect on the success of immediate implant placement postextraction in the patient with periodontal disease. PATIENTS AND METHODS: A group of 59 patients (22 men and 37 women aged 20-81 years, median age 55 years, 18 smokers) with chronic adult periodontitis participated in the study which included a 1-year observation period postoperatively. Prior to tooth extraction two DNA samples were obtained for the microbiological diagnosis of five anaerobic gram-negative pathogens (Haemophilus actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythensis, Prevotella intermedia sensu stricto, Treponema denticola) and to identify the IL-1 gene polymorphisms. Patients were treated with a total of 95 immediate dental implants (26 Ankylos/Friadent and 69 Camlog Root-Line/Camlog Biotechnologies) placed into extraction sites, 78 of which were loaded immediately. After 1 year four failures were observed; all of these patients were smokers. RESULTS: None of these patients showed a positive IL-1 genotype; periodontal marker organisms were only found in one patient. No significant difference was seen in the microbiological pathogens between smokers and nonsmokers. Of 59 patients, 23 (39%) tested positive for IL-1 genotype polymorphism. Smoking was shown to increase the risk of implant failure. No association was observed between failures and the IL-1 gene polymorphisms or pathogens. CONCLUSION: In conclusion, our study shows that periodontally infected sites do not seem to be a contraindication for immediate implantation.

Adult↗
PubMed2005

Periodontal disease and coronary heart disease: a reappraisal of the exposure.

BACKGROUND: Results from studies relating periodontal disease to cardiovascular disease have been mixed. Residual confounding by smoking and use of clinical measures of periodontal disease rather than measures of infection have been 2 major criticisms. The aims of this study were to investigate relationships between prevalent coronary heart disease (CHD) and 2 exposures, (1) clinical periodontal disease and (2) IgG antibodies to 17 oral organisms, and to evaluate the role of smoking in these relationships. METHODS AND RESULTS: Our study is based on a subset of participants in the Atherosclerosis Risk in Communities (ARIC) Study, who received a complete periodontal examination during visit 4 (1996-1998). The exposures were periodontal status and serum IgG antibody levels against 17 periodontal organisms, and the outcome was prevalent CHD at visit 4. Multivariable analyses indicate that periodontal status is not significantly associated with CHD in either ever smokers or never smokers. Similar analyses evaluating antibodies indicate that high antibodies (above the median) to Treponema denticola (odds ratio [OR]=1.7; 95% CI, 1.2 to 2.3), Prevotella intermedia (OR=1.5; 95% CI, 1.1 to 2.0), Capnocytophaga ochracea (OR=1.5; 95% CI, 1.1 to 2.1), and Veillonella parvula (OR=1.7; 95% CI, 1.2 to 2.3) are significantly associated with CHD among ever smokers, whereas Prevotella nigrescens (OR=1.7; 95% CI, 1.1 to 2.6), Actinobacillus actinomycetemcomitans (OR=1.7; 95% CI, 1.2 to 2.7), and Capnocytophaga ochracea (OR=2.0; 95% CI, 1.3 to 3.0) were associated with CHD among never smokers. CONCLUSIONS: Clinical signs of periodontal disease were not associated with CHD, whereas systemic antibody response was associated with CHD in ever smokers and never smokers. These findings indicate that the quality and quantity of the host response to oral bacteria may be an exposure more relevant to systemic atherothrombotic coronary events than clinical measures.

Antibodies, Bacterial↗
PubMed2002

Vaccine candidates in STD.

Sexually transmitted diseases (STDs) are caused by organisms that infect the mucosal surfaces of the genitourinary tract. In spite of its public health importance, current STD vaccine research lags behind work against pathogens that target another mucosal region, the respiratory tract. In the latter case, live-attenuated viral vaccines, killed whole-cell bacterial vaccines, subunit/protein bacterial vaccines, and bacterial polysaccharide vaccines have been enormously successful. To move STD vaccine research forward, complex issues must be resolved. Those include selection of an appropriate antigen (e.g. scientific feasibility and intellectual property rights), the manufacture of the vaccine (e.g. delivery systems, formulation processes, and production steps), and the appropriate public health approach (e.g. medical indications and marketing aspects). Particular scientific problems have delayed STD vaccine development, like incomplete attenuation (human herpes simplex virus type 2), accentuated immunopathology (Chlamydia trachomatis), poor immunogenicity (Treponema pallidum), and broad antigenic heterogeneity (Neisseria gonorrhoeae). Nevertheless, efforts continue with the use of protein antigens: for example, the haemolysin toxoid of Haemophilus ducreyi; the major outer membrane protein(s) of N. gonorrhoeae and C. trachomatis; the glycoprotein D of human herpes simplex virus type 2; and the proteins E6 and E7 of human papilloma virus. It may be predicted that eventual STD vaccines (administered either for prophylaxis or for therapy) will use approaches that include (1) live-attenuated viruses, (2) subunit proteins or inactivated whole organisms given with mucosal adjuvants or with cellular immune response adjuvants, and (3) DNA plasmids expressing the vaccine antigen.

Bacterial Vaccines↗
PubMed1970

The biological false positive reaction to serological tests for syphilis.

Acute and chronic biological false positive reactions to serological tests for syphilis are discussed. Three cases are presented, one showing an acute and one a chronic reaction, and one in which it was not possible to determine if the reaction was acute or chronic. Once a biological false positive reaction is found, serum from the patient should be tested at intervals for at least six months to determine if the reaction is acute or chronic. If a chronic reaction is found the patient should then be investigated to find the underlying cause. Problem sera from 753 patients are reviewed. Biological false positive reactions were shown by 47 sera and 257 sera gave results indicating they came from patients infected with syphilis. The reactive sera were divided into four groups: sera from blood donors, antenatal patients, cases of recent vaccination, and a miscellaneous group. It was found that in the first three groups the number of sera from patients showing biological false positive reactions was equalled or exceeded by the number showing syphilitic reactions. Biological false positive reactions in sera from cases of lepromatous leprosy and in sera from the inhabitants of the Okapa region of New Guinea are also discussed. It is concluded that sera which give reactive results to reagin detection tests for syphilis and come from patients known to have conditions which cause acute or chronic biological false positive reactions should never be dismissed as such. Experience has shown that a number of these sera will give reactive Treponema pallidum immobilization test results, that is, they come from patients who have or have had syphilis.

Adult↗
PubMed1992

[Uterine cervical carcinoma and human papillomaviruses].

For many years it has been thought that a significant proportion of cervical cancer could be attributed to sexually transmitted agents, such as sperm, smegma, Treponema pallidum, Gonococcus and herpes simplexvirus type 2. Recent advances of molecular biology, however, have revealed that human papillomavirus (HPV) might be the most causative virus of the disease. Since HPV type 16 DNA was found in a patient with cervical cancer in 1983, many HPV types have been cloned from cervical cancers, also from premalignant lesions (intraepithelial neoplasias). In Japan, we have found 6 new types of HPV (HPV 58, 59, 61, 62, 64, 67) in the female genital tract so far. Especially, HPV 58, which was cloned from a patient with cervical squamous cell carcinoma and was already fully sequenced, is thought to be an important agent for the development of cervical cancer as well as HPV 16. Now we are investigating extensively to clarify the real relationship between genital HPV infection and cervical cancer.

Animals↗
PubMed2006

Bacterial profile and burden of periodontal infection in subjects with a diagnosis of acute coronary syndrome.

BACKGROUND: Periodontitis has been identified as a potential risk factor in cardiovascular diseases. It is possible that the stimulation of host responses to oral infections may result in vascular damage and the inducement of blood clotting. The aim of this study was to assess the role of periodontal infection and bacterial burden as an explanatory variable to the activation of the inflammatory process leading to acute coronary syndrome (ACS). METHODS: A total of 161 consecutive surviving cases admitted with a diagnosis of ACS and 161 control subjects, matched with cases according to their gender, socioeconomic level, and smoking status, were studied. Serum white blood cell (WBC) counts, high- and low-density lipoprotein (HDL/LDL) levels, high-sensitivity C-reactive protein (hsC-rp) levels, and clinical periodontal routine parameters were studied. The subgingival pathogens were assayed by the checkerboard DNA-DNA hybridization method. RESULTS: Total oral bacterial load was higher in the subjects with ACS (mean difference: 17.4x10(5); SD: 10.8; 95% confidence interval [CI]: 4.2 to 17.4; P<0.001), and significant for 26 of 40 species including Porphyromonas gingivalis, Tannerella forsythensis, and Treponema denticola. Serum WBC counts, hsC-rp levels, Streptococcus intermedius, and Streptococcus sanguis, were explanatory factors to acute coronary syndrome status (Nagelkerke r2=0.49). CONCLUSION: The oral bacterial load of S. intermedius, S. sanguis, Streptococcus anginosus, T. forsythensis, T. denticola, and P. gingivalis may be concomitant risk factors in the development of ACS.

Bacteroides↗
PubMed1985

Passive protection of segmented swine colonic loops against swine dysentery.

Swine-ligated loops were used to demonstrate passive protection against swine dysentery. Loops inoculated with immune sera containing complement and with homologous Treponema hyodysenteriae were normal at necropsy. Loops inoculated with heat-inactivated immune sera and heterologous T hyodysenteriae were not protected. Loops inoculated with heat-inactivated immune sera and homologous T hyodysenteriae were partially protected. Positive control loops inoculated with isolate B204 (88%) or B234 (44%) T hyodysenteriae and normal sera developed lesions typical of swine dysentery, whereas negative control loops inoculated with nonexposed sera only were normal.

Animals↗