Incidental Syphilis Diagnosed by Real-Time PCR Screening of Urine Samples

Dubourg, Grégory; Edouard, Sophie; Prudent, Elsa; Fournier, Pierre‐Edouard; Raoult, Didier

doi:10.1128/jcm.01026-15

Cited by 21 publications

(25 citation statements)

References 15 publications

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“…Technology research and development of PCR emerges in endlessly, which aims at promoting efficiency by labeling different targets or simplifying operation by using novel probes . Moreover, a specimen urine has been considered as useless, but now has been demonstrated to contain an uncovered candidate biomarkers of T. pallidum, as stated, “garbage is the wealth of been misplaced.” What’s more, PCR has been verified it is helpful in the early phase by many researchers above‐mentioned and the LAMP has also demonstrated capability in detecting T. pallidum in peripheral blood. Therefore, we prefer to think that PCR detection is a very potential test for syphilis diagnosis still needs improvement.…”

Section: Discussion and Prospectsmentioning

confidence: 99%

“…But real‐time PCR is still studied widely because it is a fast and easy format to perform in the laboratory. In this review, five studies about real‐time PCR for syphilis diagnosis are mentioned, in which two of the studies have small sample sizes and use non‐invasive specimens, such as the aqueous humor or urine The sensitivity of these non‐invasive specimens is lower than that of ulcer secretions or skin, which means that they are not appropriate for screening.…”

Section: Introductionmentioning

confidence: 99%

“…But real-time PCR is still studied widely because it is a fast and easy format to perform in the laboratory. In this review, five studies about real-time PCR for syphilis diagnosis are mentioned, in which two of the studies have small sample sizes and use non-invasive specimens, such as the aqueous humor 23 or urine24…”

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confidence: 99%

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PCR detection for syphilis diagnosis: Status and prospects

Zhou

Zhang

et al. 2019

Clinical Laboratory Analysis

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Syphilis, a re‐emerging public health problem worldwide caused by Treponema pallidum subsp pallidum (T. pallidum), usually induces systemic and chronic inflammation in hosts who do not receive timely therapy after exposing to high‐risk factors such as leprous sexual contact. Before the treatment, rapid and accurate detection of syphilis is essential. However, the existing detection methods, which focus on the treponemal or non‐treponemal antibody test, both have inherent limitations. For instance, both of them cannot distinguish the stage and severity of syphilis. Non‐treponemal test such as RPR, which is generally deemed to be used for assessing treatment response, is influenced by biological false positives. Therefore, it is imperative to seek out a new and effective diagnostic test. With recent advancements in molecular biology and whole‐genome sequencing, the molecular diagnosis has increased in popularity, especially the use of polymerase chain reaction (PCR). Here, we firstly present a mini‐review on the research of PCR detection methods used for syphilis diagnosis over the past decade, and we then compare these methodologies to assess their potential and the challenges faced. This information can provide a fresh perspective to help researchers address the current challenges.

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Section: Discussion and Prospectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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PCR detection for syphilis diagnosis: Status and prospects

Zhou

Zhang

et al. 2019

Clinical Laboratory Analysis

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“…In some areas, clinicians and health departments have used HIV NAATs (which have a shorter window period than HIV enzyme immunoassays [EIAs], particularly third-generation EIAs) to screen patients for HIV infection, increasing the identification of persons with acute and early infections (15,16). Although no NAAT for T. pallidum has been approved for use by the U.S. Food and Drug Administration, experimental NAATs performed on genital ulcer, blood, urine, or mucosal swab specimens are sometimes positive in infected persons with negative syphilis serological results (17)(18)(19)(20)(21)(22)(23). We used an experimental transcription-mediated amplification (TMA) assay targeting the 23S rRNA of T. pallidum to test rectal and pharyngeal mucosal swab specimens taken from MSM who were sexually transmitted disease (STD) clinic patients.…”

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confidence: 99%

Treponema pallidum Nucleic Acid Amplification Testing To Augment Syphilis Screening among Men Who Have Sex with Men

et al. 2019

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Syphilis rates in much of the world are now at their highest levels in almost three decades, and new approaches to controlling syphilis, including diagnostic tests with shorter window periods, are urgently needed. We compared the sensitivity of syphilis serological testing using the rapid plasma reagin (RPR) test with that of the combination of serological testing and an experimental 23S rRNA Treponema pallidum real-time transcription-mediated amplification (TMA) assay performed on rectal and pharyngeal mucosal swabs. T. pallidum PCR assays for the tpp47 gene were performed on all TMA-positive specimens, as well as specimens from 20 randomly selected TMA-negative men. A total of 545 men who have sex with men (MSM) who were seen in a sexually transmitted disease clinic provided 506 pharyngeal specimens and 410 rectal specimens with valid TMA results. Twenty-two men (4%) were diagnosed with syphilis on the basis of positive RPR test results and clinical diagnoses, including 3 men with primary infections, 8 with secondary syphilis, 9 with early latent syphilis, 1 with late latent syphilis, and 1 with an unstaged infection. Two additional men were diagnosed based on positive rectal mucosal TMA assay results alone, and both also tested positive by PCR assay. At least 1 specimen was TMA positive for 12 of 24 men with syphilis (sensitivity, 50% [95% confidence interval [CI], 29 to 71%]). RPR testing and clinical diagnosis were 92% sensitive (95% CI, 73 to 99%) in identifying infected men. Combining mucosal TMA testing and serological testing may increase the sensitivity of syphilis screening in high-risk populations.

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“…Seven syphilis positive individuals reported dental problems such as dental caries or gingivitis at the time of study inclusion. The median age of the participants was 42.5 years (interquartile range [IQR]: [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. Almost all (56/60; 93%) were HIV-positive, of which 52/56 (93%) were taking antiretroviral therapy at the time of syphilis diagnosis.…”

Section: Study Participantsmentioning

confidence: 99%

Candidate Treponema Pallidum Biomarkers Uncovered in Urine from Individuals with Syphilis Using Mass Spectrometry

et al. 2018

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A diagnostic test that could detect Treponema pallidum antigens in urine would facilitate the prompt diagnosis of syphilis. Materials & methods: Urine from 54 individuals with various clinical stages of syphilis and 6 controls were pooled according to disease stage and interrogated with complementary mass spectrometry techniques to uncover potential syphilis biomarkers. Results & conclusion: In total, 26 unique peptides were uncovered corresponding to four unique T. pallidum proteins that have low genetic sequence similarity to other prokaryotes and human proteins. This is the first account of direct T. pallidum protein detection in human clinical samples using mass spectrometry. The implications of these findings for future diagnostic test development is discussed. Data are available via ProteomeXchange with identifier PXD009707.

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Incidental Syphilis Diagnosed by Real-Time PCR Screening of Urine Samples

Cited by 21 publications

References 15 publications

PCR detection for syphilis diagnosis: Status and prospects

PCR detection for syphilis diagnosis: Status and prospects

Treponema pallidum Nucleic Acid Amplification Testing To Augment Syphilis Screening among Men Who Have Sex with Men

Candidate Treponema Pallidum Biomarkers Uncovered in Urine from Individuals with Syphilis Using Mass Spectrometry

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