scholarly journals Characterization of Treponema pallidum Particle Agglutination Assay-Negative Sera following Screening by Treponemal Total Antibody Enzyme Immunoassays

2010 ◽  
Vol 17 (11) ◽  
pp. 1718-1722 ◽  
Author(s):  
P. A. C. Maple ◽  
D. Ratcliffe ◽  
E. Smit
Keyword(s):  
Venereal Disease ◽  
Treponema Pallidum ◽  
Hiv Positive ◽  
Immunoblot Assay ◽  
Agglutination Assay ◽  
Disease Research ◽  
Confirmatory Assay ◽  
Particle Agglutination

ABSTRACT Following a laboratory audit, a significant number of Treponema pallidum particle agglutination assay (TPPA)-negative sera were identified when TPPA was used as a confirmatory assay of syphilis enzyme immunoassay (EIA) screening-reactive sera (SSRS). Sera giving such discrepant results were further characterized to assess their significance. A panel of 226 sera was tested by the Abbott Murex ICE Syphilis EIA and then by the Newmarket Syphilis EIA II. TPPA testing was performed on 223 sera. Further testing by the Venereal Disease Research Laboratory (VDRL) test, the Mercia Syphilis IgM EIA, the fluorescent treponemal antibody (FTA-ABS) assay, and INNO-LIA immunoblotting was undertaken in discrepant cases. One hundred eighty-seven of 223 (83.8%) SSRS were TPPA reactive, while 26 (11.6%) sera which were reactive in both the ICE and Newmarket EIAs were nonreactive by TPPA. The majority (68%) of the TPPA-discrepant sera were from HIV-positive patients and did not represent early acute cases, based on previous or follow-up samples, which were available for 22/26 samples. FTA-ABS testing was performed on 24 of these sera; 14 (58.3%) were FTA-ABS positive, and 10 (41.7%) were FTA-ABS negative. Twenty-one of these 26 sera were tested by INNO-LIA, and an additional 4 FTA-ABS-negative samples were positive. In this study, significant numbers (18/26) of SSRS- and TPPA-negative sera were shown by further FTA-ABS and LIA (line immunoblot assay) testing to be positive. The reason why certain sera are negative by TPPA but reactive by treponemal EIA and other syphilis confirmatory assays is not clear, and these initial findings should be further explored.

scholarly journals Detección de Treponema pallidum subespecie pallidum para el diagnóstico de sífilis congénita mediante reacción en cadena de la polimerasa anidada

Biomédica ◽  
2018 ◽  
Vol 38 (1) ◽  
pp. 128 ◽  
Author(s):  
Gladys Pinilla ◽  
Lesly Campos ◽  
Andrea Durán ◽  
Jeannette Navarrete ◽  
Liliana Muñoz
Keyword(s):  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Rapid Plasma Reagin ◽  
Agglutination Assay ◽  
Disease Research ◽  
Particle Agglutination

Introducción. La sífilis es una enfermedad producida por Treponema pallidum subespecie pallidum cuya incidencia mundial es de 12 millones de casos por año, aproximadamente; de estos, más de dos millones se presentan en mujeres gestantes, siendo la sífilis congénita la complicación más grave de esta infección en el embarazo.Objetivo. Detectar la presencia de T. pallidum subespecie pallidum en muestras clínicas para el diagnóstico de sífilis congénita mediante reacción en cadena de la polimerasa (PCR) anidada y determinar su concordancia con las pruebas serológicas.Materiales y métodos. Mediante PCR convencional y anidada, se amplificaron tres genes diana (polA, 16S ADNr y TpN47) y se confirmaron los productos de amplificación de los genes TpN47 y polA por secuenciación. Las pruebas serológicas empleadas fueron la VDRL (Venereal Disease Research Laboratory), la de reagina plasmática rápida (Rapid Plasma Reagin, RPR) y la de aglutinación de partículas para Treponema pallidum (Treponema pallidum Particle Agglutination Assay, TPPA).Resultados. La sensibilidad para la PCR convencional fue de 52 pg y, para la PCR anidada, de 0,52 pg. La especificidad con los iniciadores TpN47 y polA fue de 100 %; los resultados de la secuenciación mostraron una identidad de 97 % con T. pallidum. En 70 % de las muestras, los resultados de las pruebas serológicas y la PCR anidada concordaron.Conclusión. El gen TpN47 resultó ser el mejor blanco molecular para la identificación de T. pallidum. La PCR anidada se presenta como una alternativa de diagnóstico molecular promisoria para el diagnóstico de sífilis congénita.

scholarly journals Characterization of Sera with Discordant Results from Reverse Sequence Screening for Syphilis

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Kyunghoon Lee ◽  
Hyewon Park ◽  
Eun Youn Roh ◽  
Sue Shin ◽  
Kyoung Un Park ◽  
...  
Keyword(s):  
Treponema Pallidum ◽  
Screening Tests ◽  
Rapid Plasma Reagin ◽  
Agglutination Assay ◽  
Reverse Sequence ◽  
National University ◽  
Seoul National University ◽  
Particle Agglutination

Reverse sequence screening for syphilis (RSSS) (screening with treponemal tests, followed by confirmation with nontreponemal tests) has been increasingly adopted. CDC recommends confirmation of discordant results (reactive EIA/CIA and nonreactive nontreponemal test) withTreponema pallidumparticle agglutination assay (TP-PA). We characterized sera with discordant results from RSSS with Architect Syphilis TP CIA. Among 15,713 screening tests using Architect Syphilis TP at Seoul National University Gangnam Center between October 2010 and May 2011, 260 (1.7%) showed reactive results. Rapid plasma reagin (RPR) and TP-PA were performed on 153 available sera among them. On sera with discordant results between Architect Syphilis TP and TP-PA, INNO-LIA Syphilis Score and FTA-ABS were performed. Among 153 sera, RPR was nonreactive in 126 (82.4%). Among them, TP-PA was positive in 103 (81.7%), indeterminate (±) in 7 (5.6%), and negative in 16 (12.7%). Out of 16 CIA(+)/RPR(−)/TP-PA(−) sera, INNO-LIA Syphilis Score and/or FTA-ABS were negative on 14 sera. Out of 7 CIA(+)/RPR(−)/TP-PA(±) sera, INNO-LIA Syphilis Score and FTA-ABS were positive/reactive in 6 sera. RSSS with confirmation by TP-PA on sera with discordant results between Architect Syphilis TP and RPR effectively delineated those discordant results and could be successfully adopted for routine checkup for syphilis.

scholarly journals Cerebrospinal fluid examination may be useful in diagnosing neurosyphilis in asymptomatic HIV+ patients with syphilis

2016 ◽  
Vol 74 (2) ◽  
pp. 128-132 ◽  
Author(s):  
Ronald Salamano ◽  
Raquel Ballesté ◽  
Abayubá Perna ◽  
Natalia Rodriguez ◽  
Diego Lombardo ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Hiv Patients ◽  
Hemagglutination Assay ◽  
Protein Levels ◽  
Disease Research ◽  
Csf Analysis ◽  
High Degree ◽  
Asymptomatic Hiv

ABSTRACT Lumbar puncture in neurologically asymptomatic HIV+ patients is still under debate. There are different criteria for detecting neurosyphilis through cerebrospinal fluid (CSF), especially in cases that are negative through the Venereal Disease Research Laboratory (VDRL), regarding cellularity and protein content. However, a diagnosis of neurosyphilis can still exist despite negative VDRL. Treponema pallidum hemagglutination assay (TPHA) titers and application of the TPHA index in albumin and IgG improve the sensitivity, with a high degree of specificity. Thirty-two patients were selected for this study. VDRL was positive in five of them. The number of diagnoses reached 14 when the other techniques were added. It was not determined whether cellularity and increased protein levels were auxiliary tools in the diagnosis. According to our investigation, CSF analysis using the abovementioned techniques may be useful in diagnosing neurosyphilis in these patients.

Biological false-positive tests comprise a high proportion of Venereal Disease Research Laboratory reactions in an analysis of 300,000 sera

2005 ◽  
Vol 16 (11) ◽  
pp. 722-726 ◽  
Author(s):  
Alexandra Geusau ◽  
Harald Kittler ◽  
Ulrike Hein ◽  
Edda Dangl-Erlach ◽  
Georg Stingl ◽  
...  
Keyword(s):  
Retrospective Study ◽  
False Positive ◽  
Research Laboratory ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Transmitted Infection ◽  
Specific Test ◽  
Disease Research ◽  
Syphilis Screening

This retrospective study on syphilis screening at the sexually transmitted infection (STI) unit of a University Department emphasizes the necessity of a treponemal-specific test as the appropriate screening test. The Venereal Disease Research Laboratory (VDRL) test for syphilis screening may, under certain circumstances, yield positive results in patients not infected with Treponema pallidum, a phenomenon referred to as biological false-positive (BFP) VDRL test. The aim of this study was to determine the frequency of BFP tests in a large sample of sera. In this retrospective study, we analysed the results of parallel VDRL and T. pallidum haemagglutination (TPHA) testing of a total of 514,940 blood samples obtained from patients at the Vienna General Hospital between January 1988 and November 1999. Patients' sera with incomplete data on stage and sex and duplicate sera were excluded, leaving 300,000 sera for analysis. The seroprevalence for syphilis was 1.77% ( n = 5320), as determined by a positive TPHA test. It was significantly higher in male than in female patients (2.03% versus 1.58%, P<0.001). Of the patients reactive in the TPHA test, 3257 (61.2%) were negative in the VDRL. With regard to reactivity in VDRL testing, 2799 patients (0.92%) of the study population were positive, of whom 736 (26%) were biological false positive. BFP reactivity was found in 0.24% of all patients and was significantly higher in women than in men (0.27% versus 0.20%, P<0.001) and in patients over 60 years of age (0.34%) as compared with those under 60 (0.25%, P<0.001). This proportion might be even higher, as reactivity in the VDRL at 1:0 and 1:2 dilutions without a positive treponemal test was not reported. The subgroup of HIV-positive patients ( n = 1415) revealed a 10-fold higher rate of BFP tests (2.1% versus 0.24), an effect being statistically significant. In a low syphilis prevalence population, BFP reactions comprise a high proportion of all VDRL reactors. Therefore, the use of the VDRL as a screening procedure is challenged.

scholarly journals Sexual abuse leading to secondary syphilis in an intellectually disabled person: a case report

2021 ◽  
Vol 7 (6) ◽  
pp. 872
Author(s):  
Rajesh Munusamy ◽  
Nithin Nagaraja
Keyword(s):  
Sexual Abuse ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Secondary Syphilis ◽  
Penicillin G ◽  
Intellectually Disabled ◽  
Transmitted Infection ◽  
Sexual Transmitted Infection ◽  
Benzathine Penicillin G

<p class="abstract">Syphilis is a sexual transmitted infection (STI) caused by a spirochete, <em>Treponema pallidum</em>. Condylomata lata is a characteristic lesion seen in secondary syphilis. Here we reported a case of 24 year old unmarried male with intellectual disability who presented with condyloma lata over the scrotum, prepuce and perianal region and with moth eaten alopecia over scalp since 1 month. Here the patients mother revealed he had promiscuous relationship with multiple friends, which is a sexual abuse since the patient is intellectually disabled. Clinically diagnosed as secondary syphilis. Venereal disease research laboratory (VDRL) test titre was reactive at 1:32 and <em>Treponema pallidum </em>hemagglutination test (TPHA) was positive. Biopsy was also done, which confirmed diagnosis. Single dose of injection benzathine penicillin G, 2.4 million units was administered intramuscularly. Patient did not develop a Jarisch-herxheimer reaction. On follow up his lesions healed and VDRL titres also came down and non-reactive at 3 months. Here in this case sexual abuse lead to secondary syphilis since patient was intellectually disabled so he couldn’t address his complaints clearly. Hence counselling was done to the patient and family members by dermatologist and psychiatrist.</p><p class="abstract"> </p>

scholarly journals Cerebrospinal Fluid Treponema pallidum Particle Agglutination Assay for Neurosyphilis Diagnosis

2017 ◽  
Vol 55 (6) ◽  
pp. 1865-1870 ◽  
Author(s):  
Christina M. Marra ◽  
Clare L. Maxwell ◽  
Shelia B. Dunaway ◽  
Sharon K. Sahi ◽  
Lauren C. Tantalo
Keyword(s):  
Cerebrospinal Fluid ◽  
Vision Loss ◽  
Treponema Pallidum ◽  
Training Data ◽  
Validation Data ◽  
Data Set ◽  
Convenience Sample ◽  
Content Type ◽  
Agglutination Assay ◽  
Particle Agglutination

ABSTRACT Limited data suggest that the cerebrospinal fluid Treponema pallidum particle agglutination assay (CSF-TPPA) is sensitive and a CSF Treponema pallidum hemagglutination assay (CSF-TPHA) titer of ≥1:640 is specific for neurosyphilis diagnosis. CSF-TPPA reactivity and titer were determined for a convenience sample of 191 CSF samples from individuals enrolled in a study of CSF abnormalities in syphilis (training data set). The sensitivity of a reactive test and the specificity for reactivity at serial higher CSF dilutions were determined. Subsequently, CSF-TPPA reactivity at a 1:640 dilution was determined for all available samples from study participants enrolled after the last training sample was collected (validation data set, n = 380). Neurosyphilis was defined as (i) a reactive CSF Venereal Disease Research Laboratory test (CSF-VDRL), (ii) detection of T. pallidum in CSF by reverse transcriptase PCR, or (iii) new vision loss or hearing loss. In the training data set, the diagnostic sensitivities of a reactive CSF fluorescent treponemal antibody absorption test (CSF-FTA-ABS) and a reactive CSF-TPPA did not differ significantly (67 to 98% versus 76 to 95%). The specificity of a CSF-TPPA titer of ≥1:640 was significantly higher than that of lower dilutions and was not significantly different from that of CSF-VDRL. In the validation data set, the diagnostic specificity of a CSF-TPPA titer of ≥1:640 was high and did not differ significantly from that of CSF-VDRL (93 to 94% versus 90 to 91%). Ten CSF samples with a nonreactive CSF-VDRL had a CSF-TPPA titer of ≥1:640. If a CSF-TPPA titer of ≥1:640 was used in addition to a reactive CSF-VDRL, the number of neurosyphilis diagnoses would have increased from 47 to 57 (21.3%). A CSF-TPPA titer cutoff of ≥1:640 may be useful in identifying patients with neurosyphilis when CSF-VDRL is nonreactive.

scholarly journals Evaluation of Two Immunoblot Assays and a Western Blot Assay for the Detection of Antisyphilis Immunoglobulin G Antibodies

2009 ◽  
Vol 17 (1) ◽  
pp. 183-184 ◽  
Author(s):  
Ryan J. Welch ◽  
Christine M. Litwin
Keyword(s):  
Western Blot ◽  
Immunoglobulin G ◽  
Treponema Pallidum ◽  
Absorption Test ◽  
Rapid Plasma Reagin ◽  
Western Blot Assay ◽  
Agglutination Assay ◽  
Antibody Absorption ◽  
Particle Agglutination

ABSTRACT In the present study, two immunoglobulin G (IgG) immunoblot assays and one IgG Western blot assay were compared to the rapid plasma reagin test (RPR), the fluorescent treponemal antibody absorption test (FTA-ABS), and the Treponema pallidum particle agglutination assay (TP-PA). The agreement levels of the Viramed, Virotech, and MarDx assays were 97.0%, 96.4%, and 99.4%, and the agreements of samples inconclusive by FTA-ABS and resolved by TP-PA were 91.7%, 83.3%, and 69.4%, respectively.

Syphilitic chorioretinitis presenting as a choroidal granuloma

2020 ◽  
Vol 13 (4) ◽  
pp. e234022
Author(s):  
Avantika Dogra ◽  
Mudit Tyagi ◽  
Hrishikesh Kaza ◽  
Avinash Pathengay
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Research Laboratory ◽  
Rare Case ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Hemagglutination Assay ◽  
Disease Research ◽  
Choroidal Granuloma

A rare case of syphilitic uveitis presenting as a choroidal granuloma is described in this case report. The clinical picture resembled that of a tubercular choroidal granuloma. However, the patient was positive for treponemal (treponema pallidum hemagglutination assay) as well as non-treponemal tests (venereal disease research laboratory test) for syphilis. Therefore, the patient was treated for ocular syphilis and responded to antisyphilitic therapy. There was a complete resolution of the lesion at the end of 14 days of treatment.

Further support from an Irish psychiatric hospital for lack of value of routine serological tests for syphilis

1989 ◽  
Vol 6 (2) ◽  
pp. 142-143 ◽  
Author(s):  
Therese O'Neill ◽  
Brian McCaffrey
Keyword(s):  
Research Laboratory ◽  
Psychiatric Illness ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Venereal Disease Research Laboratory ◽  
Serological Tests ◽  
Infected Blood ◽  
Disease Research ◽  
Previous Infection ◽  
Antibody Tests

AbstractSince the establishment of St. Brendan's Hospital in 1815 many changes have been seen in the pattern of psychiatric illness but none as dramatic as that of neurosyphilis. When Professor John Dunne first worked there in 1922, 20% of the patients suffered from general paralysis of the insane (G.P.I.) for which there was no cure. Around this time Wagner Von Jauregg – a Viennese physician, observed that patients who had suffered malaria during war did not suffer from G.P.I. He introduced malarial therapy successfully for which he received the Nobel Prize in 1927. Professor Dunne introduced this therapy into St. Brendan's after visiting Wagner Von Jauregg in Vienna. Unfortunately the mosquitos used would not bite! He resorted to injecting malarial infected blood. Only benign tertian malaria was effective and it is believed that the high temperatures induced – 40-41°C killed the spirochaete. This was followed by quinine treatment for malaria. The treatment was very successful but superceded in latter years by penicillin. The incidence of syphilis fell dramatically from 1942-1977, although recently it has been reported that it is rising in females and heterosexual males.One hundred consecutive samples routinely tested for syphilis (using the Venereal Disease Research Laboratory (VDRL) and Treponema Pallidum Haemagglutination (TPHA) test), between January and April 1988 were examined. Ninety-eight were negative for VDRL and TPHA. Two patients, both male, revealed evidence of previous infection i.e. VDRL neg, TPHA positive with Fluorescent Treponema Antibody tests (FTABS) reactive and FTA IGM negative in both cases. Neither of the two patients had any signs or symptoms suggestive of neurosyphilis.

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