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A retrospective study on nested PCR detection of syphilis treponemes in clinical samples: PCR detection contributes to the diagnosis of syphilis in patients with seronegative and serodiscrepant results

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VRBOVÁ Eliška MIKALOVÁ Lenka GRILLOVÁ Linda POSPÍŠILOVÁ Petra STRNADEL Radim DASTYCHOVÁ Eliška KOJANOVA Martina KREIDLOVA Miluse VANOUSOVA Daniela ROB Filip PROCHAZKA Premysl KRCHŇÁKOVÁ Alena VAŠKŮ Vladimír WOZNICOVÁ Vladana DVOŘÁKOVÁ HEROLDOVÁ Monika KUKLOVA Ivana ZAKOUCKA Hana ŠMAJS David

Rok publikování 2020
Druh Článek v odborném periodiku
Časopis / Zdroj Plos one
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
www https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0237949&type=printable
Doi http://dx.doi.org/10.1371/journal.pone.0237949
Klíčová slova syphilis treponeme; PCR detection
Popis Syphilis, caused byTreponema pallidumssp.pallidum(TPA), is a persisting global health problem. Although syphilis diagnostics relies mainly on serology, serological tests have some limitations, and it is recommended that the final diagnosis be supported by additional tests. The purpose of this study was to analyze the relationship between serology and PCR in syphilis diagnostics. From the year 2004 to May 2019, a total of 941 samples were taken from 833 patients suspected of having syphilis, in Czech Republic. In all these samples, both nested PCR detection of TPA and serology testing were performed. Of the 941 samples, 126 were seronegative, 651 were seropositive, and 164 were serodiscrepant. Among seronegative samples (n = 126), 11 were PCR-positive (8.7%). Among seropositive samples (n = 651; i.e., samples positive for both non-treponemal and treponemal serology tests), 368 samples were PCR-positive (56.5%). The remaining 164 serodiscrepant samples included RPR negative and treponemal serological test-positive samples (n = 154) and a set of 10 RPR-positive samples negative in treponemal serological tests. While the first group revealed 73 PCR-positive samples (47.4%), the second revealed 5 PCR positive samples (50.0%). PCR detection rates were highest in primary syphilis, with lower rates in the secondary and undetermined syphilis stages. As shown here, the nested PCR can improve diagnostics of syphilis, especially in seronegative patients and in patients with discrepant serology.
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