We report the circulating genotypes and the frequency of macrolide-resistance patterns among Treponema pallidum pallidum DNA isolated from syphilitic lesions from patients who attended 2 sexual health clinics in Lima, Peru. We implemented and used a molecular typing scheme to describe local T. pallidum pallidum strains. Among 14 specimens, subtype 14d/f was the most prevalent strain in 7 fully typed T. pallidum DNA specimens obtained from men who have sex with men and transgender women presenting with chancre-like lesions. No macrolide-resistance mutations were found in T. pallidum DNA from 10 lesions.

eWe assessed the laboratory performance of the Chembio dual-path platform HIV-syphilis rapid immunodiagnostic test and electronic reader for detection of HIV and Treponema pallidum antibodies in 450 previously characterized serum specimens. For visual or electronic reader HIV antibody detection, the sensitivity was 100% and the specificity was 98.7%. For visual T. pallidum antibody detection, the test sensitivity was 94.7% and the specificity was 100.0%; with the electronic reader, the sensitivity was 94.7% and the specificity was 99.7%. Rapid multiplex point-of-care tests are increasingly available means to screen for syphilis and HIV infections (1-4). Dual screening tests for antibodies to HIV and Treponema pallidum have been evaluated in serum and venipuncture whole-blood samples, showing excellent sensitivity and specificity (5-7). We assessed the laboratory performance of the Chembio dual-path platform (DPP) HIV-syphilis rapid test and the Chembio digital electronic reader with stored serum samples collected from a cohort of men who have sex with men (MSM) and transwomen at high risk for HIV and syphilis infections.Serum specimens were collected between 2013 and 2014 from MSM and transwomen who had been recruited into an ongoing cohort study in Lima, Peru, and the specimens were stored at Ϫ20°C (8). HIV positivity was determined with the Genscreen Ultra HIV Ag-Ab test (Bio-Rad, Hercules, CA), a novel enzyme immunoassay (EIA) which detects HIV p24 antigen (Ag) and HIV antibodies in the same test (9). Positive EIA results were confirmed by Western blotting (New Lav Blot I; Bio-Rad). Specimens also underwent rapid plasma reagin (RPR) testing, using the BD Macro-Vue RPR card test kit (BD, Franklin Lakes, NJ), and Treponema pallidum particle agglutination (TPPA) testing (Serodia; Fujirebio Diagnostics Inc., Tokyo, Japan). All tests were used according to the manufacturers' instructions.The Chembio DPP HIV-syphilis test is a single-use, visual and qualitative immunochromatographic, dual rapid test for the detection of antibodies to HIV types 1 and 2 and Treponema pallidum in human serum, plasma, or venous or fingerprick wholeblood samples (10). A red control line confirms test validity. Visual observation of a red line in the HIV and/or syphilis detection zone is interpreted as a reactive result (10).Immediately after visual interpretation, tests were analyzed using the small, battery-powered, Chembio electronic reader, which was designed specifically to complement the Chembio DPP technology. The electronic reader scans the DPP test cartridge and displays a numerical value based on the test line intensity. If the electronic reader value is higher than the set cutoff value, then the result for the sample is reported as positive; the test result is reported as negative if the measured value is lower than the cutoff value.We estimated the sensitivity, specificity, and 95% confidence intervals (CIs) using the exact binomial method, and we calculated the concordance between the visual results of the Chembio DPP HIV-sy...

dCombining the detection of syphilis and HIV antibodies into one point-of-care test integrates syphilis screening into already existing HIV screening programs, which may be particularly beneficial in settings such as antenatal care. Using the INSTI Multiplex downward-flow immunoassay, we tested 200 stored serum samples from high-risk patients enrolled in a longitudinal study on HIV infection and syphilis in Peruvian men who have sex with men and transgender women. This rapid assay detected HIV and Treponema pallidum serum antibodies with sensitivities of 100% (95% confidence interval [CI], 95.9% to 100%) and 87.4% (95% CI, 81.4% to 92.0%), respectively, and specificities of 95.5% (95% CI, 89.9% to 98.5%) and 97.0% (95% CI, 84.2% to 99.9%), respectively (n ‫؍‬ 200). The sensitivity for syphilis antibody detection was higher in patients with a rapid plasma reagin titer of >1:8 (97.3%) than in those with a titer of <1:4 (90%) or a nonreactive titer (66.7%). While syphilis, an infection caused by the spirochete Treponema pallidum, is a curable disease, it is estimated that there are 5.6 million new syphilis infections in adults annually (1) compared to approximately 2 million new HIV infections (2). Although new syphilis infections are more common, HIV screening has become a priority in low-and middle-income countries. Syphilis frequently presents atypically, which can make it difficult to clinically differentiate from other sexually transmitted infections; thus, effective diagnostic tests are crucial for correctly identifying and managing syphilis infections (3). Highly accurate diagnostic tests for HIV infection and syphilis exist, but they are often inaccessible to people living in areas with the highest burden of disease. Point-of-care tests provide an opportunity to reach those populations through tests that are inexpensive, easy to perform, and rapid, which enables same-day testing and treatment. Combining the detection of syphilis and HIV antibodies into one point-of-care test integrates syphilis screening into already existing HIV screening programs, which might be particularly beneficial in settings such as antenatal care (4).The INSTI Multiplex downward-flow immunoassay (bioLytical Laboratories, Inc., Canada) is for the simultaneous detection of HIV and T. pallidum antibodies. Results can be read in less than 1 min. Previous studies of the INSTI HIV-1/HIV-2 antibody test found it to be highly sensitive, specific, and easy to use (5-11). The INSTI Multiplex assay was developed recently, and no published data on its accuracy, feasibility, or acceptability exist yet.Using the INSTI Multiplex, we tested 200 stored (Ϫ80°C) serum samples from high-risk patients enrolled in a longitudinal study on HIV infection and syphilis in Peruvian men who have sex with men and transgender women (12). Genital lesions are a sign of primary syphilis, and 14 of the 200 serum samples were from patients who had primary syphilis, confirmed by T. pallidum DNA detection using PCR (12). The sera were tested for HIV and T. pallidum ant...

Con el objetivo de evaluar la concordancia entre la autotoma de muestras vaginales y la toma estándar de muestras endocervicales para la identificación de Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis y Candida spp. realizadas por el personal de salud en mujeres de un área urbano-rural del Perú, se realizó un estudio prospectivo y transversal en 206 mujeres en edad fértil, identificamos algunas infecciones de transmisión sexual como Chlamydia trachomatis o Trichomonas vaginalis en 9 mujeres (4,4%). Obtuvimos una concordancia casi perfecta en la identificación de Candida spp. (k=0,97), Chlamydia trachomatis (k=0,92) y Trichomonas vaginalis por microscopía (k=1,00), y considerable para la identificación de Trichomonas vaginalis por cultivo (k=0,66). La técnica de la autotoma de muestras vaginales podría ser usada para la identificación de algunas infecciones de transmisión sexual en población urbano-rural.