Evaluation of Macrolide Resistance and Enhanced Molecular Typing of Treponema pallidum in Patients with Syphilis in Taiwan: a Prospective Multicenter Study
Hsiu Wu,Sui-Yuan Chang,Nan Yao Lee,Wen-Chi Huang,Bing-Ru Wu,Chia-Jui Yang,Shiou-Haur Liang,Chen-Hsiang Lee,Wen Chien Ko,Hsi-Hsun Lin,Yen-Hsu Chen,Wen-Chun Liu,Yi-Ching Su,Chia-Yin Hsieh,Pei-Ying Wu,Chien-Ching Hung +15 more
TLDR
It is found that type 14 f/f was the most common T. pallidum strain in this multicenter study on syphilis in Taiwan and that none of the isolates exhibited 23S rRNA mutations causing resistance to macrolides.Abstract:
Studies of macrolide resistance mutations and molecular typing using the newly proposed enhanced typing system for Treponema pallidum isolates obtained from HIV-infected patients in the Asia-Pacific region are scarce. Between September 2009 and December 2011, we conducted a survey to detect T. pallidum using a PCR assay using clinical specimens from patients with syphilis at six major designated hospitals for HIV care in Taiwan. The T. pallidum strains were genotyped by following the enhanced molecular typing methodology, which analyzed the number of 60-bp repeats in the acidic repeat protein (arp) gene, T. pallidum repeat (tpr) polymorphism, and the sequence of base pairs 131 to 215 in the tp0548 open reading frame of T. pallidum. Detection of A2058G and A2059G point mutations in the T. pallidum 23S rRNA was performed with the use of restriction fragment length polymorphism (RFLP). During the 2-year study period, 211 clinical specimens were obtained from 136 patients with syphilis. T. pallidum DNA was isolated from 105 (49.8%) of the specimens, with swab specimens obtained from chancres having the highest yield rate (63.2%), followed by plasma (49.4%), serum (35.7%), and cerebrospinal fluid or vitreous fluid (18.2%) specimens. Among the 40 fully typed specimens, 11 subtypes of T. pallidum were identified. Subtype 14f/f (18 isolates) was the most common isolates, followed by 14f/c (3), 14b/c (3), and 14k/f (3). Among the isolates examined for macrolide resistance, none had the A2058G or A2059G mutation. In conclusion, we found that type 14 f/f was the most common T. pallidum strain in this multicenter study on syphilis in Taiwan and that none of the isolates exhibited 23S rRNA mutations causing resistance to macrolides.read more
Citations
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An Update on the Global Epidemiology of Syphilis
Noah Kojima,Jeffrey D. Klausner +1 more
TL;DR: Continued vigilance and investment are needed to address syphilis worldwide as the epidemiology of syphilis differs in high-, and low- and middle-income countries.
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The Endemic Treponematoses
TL;DR: All human treponematoses share remarkable similarities in pathogenesis and clinical manifestations, consistent with the high genetic and antigenic relatedness of their etiological agents.
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Syphilis: Re-emergence of an old foe.
TL;DR: Genomic and proteomic studies have provided some new information concerning how this spirochete may evade host defense mechanisms to persist for long periods in the host.
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Syphilis: antibiotic treatment and resistance.
TL;DR: Information is presented here on the diagnosis and recommended antibiotic treatment of syphilis and the challenge of macrolide-resistant T. pallidum.
Molecular subtyping of Treponema pallidum in an arizona county with increasing syphilis morbidity : Use of specimens from ulcers and blood
Madeline Y. Sutton,Hsi Liu,Bret Steiner,Allan Pillay,Thomas Mickey,Lyn Finelli,Stephen A. Morse,Lauri E. Markowitz,Michael E. St. Louis +8 more
TL;DR: This investigation demonstrates that multiple subtypes of T. pallidum can be found in an area with high syphilis morbidity, although 1 subtype (14f) was predominant, although 2 specimens were from epidemiologically linked patients.
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