scholarly journals Comparison of Diagnostic Accuracy of PCR Targeting the 47-Kilodalton Protein Membrane Gene of Treponema pallidum and PCR Targeting the DNA Polymerase I Gene: Systematic Review and Meta-analysis

2015 ◽  
Vol 53 (11) ◽  
pp. 3522-3529 ◽  
Author(s):  
Angèle Gayet-Ageron ◽  
Christophe Combescure ◽  
Stephan Lautenschlager ◽  
Béatrice Ninet ◽  
Thomas V. Perneger
Keyword(s):  
Meta Analysis ◽  
Treponema Pallidum ◽  
Quality Criteria ◽  
Secondary Syphilis ◽  
Bibliographic Databases ◽  
Case Definitions ◽  
Content Type ◽  
Early Syphilis ◽  
Similar Accuracy ◽  
Pcr Targeting

Treponema pallidumPCR (Tp-PCR) testing now is recommended as a valid tool for the diagnosis of primary or secondary syphilis. The objectives were to systematically review and determine the optimal specific target gene to be used forTp-PCR. Comparisons of the performance of the two main targets aretpp47andpolAgenes were done using meta-analysis. Three electronic bibliographic databases, representing abstract books from five conferences specialized in infectious diseases from January 1990 to March 2015, were searched. Search keywords included (“syphilis” OR “Treponema pallidum” OR “neurosyphilis”) AND (“PCR” OR “PCR” OR “molecular amplification”). We included diagnostic studies assessing the performance ofTp-PCR targetingtpp47(tpp47-Tp-PCR) or thepolAgene (polA-Tp-PCR) in ulcers from early syphilis. All studies were assessed against quality criteria using the QUADAS-2 tool. Of 37 studies identified, 62.2% were judged at low risk of bias or applicability. Most used the U.S. Centers for Disease Control and Prevention (CDC) case definitions for primary or secondary (early) syphilis (89.2%;n= 33); 15 (40.5%) used darkfield microscopy (DFM). We did not find differences in sensitivity and specificity between the twoTp-PCR methods in the subgroup of studies using adequate reference tests. Among studies using DFM as the reference test, sensitivities were 79.8% (95% confidence intervals [CI], 72.7 to 85.4%) and 71.4% (46.0 to 88.0%) fortpp47-Tp-PCR andpolA-Tp-PCR (P= 0.217), respectively; respective specificities were 95.3% (93.5 to 96.6%) and 93.7% (91.8 to 95.2%) (P= 0.304). Our findings suggest that the twoTp-PCR methods have similar accuracy and could be used interchangeably.

scholarly journals Performance of the 47-Kilodalton Membrane Protein versus DNA Polymerase I Genes for Detection of Treponema pallidum by PCR in Ulcers

2014 ◽  
Vol 53 (3) ◽  
pp. 976-980 ◽  
Author(s):  
Angèle Gayet-Ageron ◽  
Frédéric Laurent ◽  
Jacques Schrenzel ◽  
Béatrice Charton ◽  
Gisela Jimenez-Getaz ◽  
...  
Keyword(s):  
Target Gene ◽  
Treponema Pallidum ◽  
Secondary Syphilis ◽  
Dna Polymerase I ◽  
Perfect Agreement ◽  
Content Type ◽  
Sexually Transmitted ◽  
Polymerase I ◽  
Pcr Targeting ◽  
Protein Versus

Treponema pallidumPCR (Tp-PCR) is a direct diagnostic method for primary and secondary syphilis, but there is no recommendation regarding the best choice of target gene. In this study, we sequentially tested 272 specimens from patients with sexually transmitted ulcers usingTp-PCR targeting thetpp47and thenpolAgenes. The two methods showed similar accuracies and an almost-perfect agreement.

scholarly journals A New Specimen for Syphilis Diagnosis: Evidence by High Loads of Treponema pallidum DNA in Saliva

2020 ◽  
Author(s):  
Cuini Wang ◽  
Zhixiang Hu ◽  
Xin Zheng ◽  
Meiping Ye ◽  
Chunjie Liao ◽  
...  
Keyword(s):  
Treponema Pallidum ◽  
Digital Pcr ◽  
Secondary Syphilis ◽  
Clearance Time ◽  
Chain Reaction ◽  
Nested Polymerase Chain Reaction ◽  
Detection Rates ◽  
Polymerase Chain ◽  
Pcr Targeting ◽  
Latent Syphilis

Abstract Background DNA from many pathogens can be detected in saliva. However, the presence and quantity of Treponema pallidum DNA in patients with syphilis in saliva is unknown. Methods 234 patients with syphilis with different stages and 30 volunteers were enrolled. Paired saliva and plasma samples were collected from all participants. Consecutive saliva samples from 9 patients were collected every 4 hours following treatment. Treponema pallidum DNA in samples was determined by nested polymerase chain reaction (PCR) and droplet digital PCR targeting polA and Tpp47. Results Treponema pallidum DNA detection rates in saliva and plasma were 31.0% (9/29) and 51.7% (15/29) in primary syphilis (P = .11), 87.5% (63/72) and 61.1% (44/72) in secondary syphilis (P < .001), 25.6% (21/82) and 8.5% (7/82) in latent syphilis (P = .004), and 21.6% (11/51) and 5.9% (3/51) in symptomatic neurosyphilis (P = .021), respectively. Median (range) loads of Tpp47 and polA in saliva were 627 (0–101 200) and 726 (0–117 260) copies/mL, respectively, for patients with syphilis. In plasma, however, loads of Tpp47 and polA were low: medians (range) of 0 (0–149.6) and 0 (0–176) copies/mL, respectively. Loads of T. pallidum DNA in saliva during treatment fluctuated downward; the clearance time was positively correlated with the loads of T. pallidum DNA before treatment. Conclusions Collection of saliva is noninvasive and convenient. The high loads of T. pallidum DNA in saliva and reduction after treatment indicated that saliva can be not only a diagnostic fluid for syphilis but also an indicator of therapeutic effectiveness.

scholarly journals In Vitro Susceptibility of Treponema pallidum subsp. pallidum to Doxycycline

2020 ◽  
Vol 64 (10) ◽  
Author(s):  
Diane G. Edmondson ◽  
Gary P. Wormser ◽  
Steven J. Norris
Keyword(s):  
Clinical Efficacy ◽  
Culture System ◽  
Minimum Bactericidal Concentration ◽  
Treponema Pallidum ◽  
Effective Therapy ◽  
In Vitro Susceptibility ◽  
Content Type ◽  
First Report ◽  
Early Syphilis

ABSTRACT Doxycycline is regarded as an effective therapy for early syphilis, and there is increasing interest in using doxycycline for prophylaxis of this infection. However, the MIC of doxycycline for Treponema pallidum subsp. pallidum has not been reported previously. In this study, an in vitro culture system was utilized to determine that the MIC of doxycycline is 0.06 to 0.10 μg/ml for four strains of T. pallidum subsp. pallidum (Nichols, SS14, UW231B, and UW249B). The Nichols strain cultured in vitro with doxycycline was also tested for infectivity in rabbits, and the minimum bactericidal concentration (MBC) was found to be ≤0.1 μg/ml using this method. The low MIC and MBC values are consistent with the previously demonstrated clinical efficacy of doxycycline for the treatment of early syphilis. This study represents the first report of the in vitro susceptibility of T. pallidum to doxycycline, and the resulting information may be useful in the consideration of doxycycline for use in prevention of syphilis.

scholarly journals Treponema pallidumNucleic Acid Amplification Testing To Augment Syphilis Screening among Men Who Have Sex with Men

2019 ◽  
Vol 57 (8) ◽  
Author(s):  
Matthew Golden ◽  
Meghan O’Donnell ◽  
Sheila Lukehart ◽  
Paul Swenson ◽  
Paul Hovey ◽  
...  
Keyword(s):  
Transmitted Disease ◽  
Treponema Pallidum ◽  
Secondary Syphilis ◽  
23S Rrna ◽  
Serological Testing ◽  
Content Type ◽  
Sexually Transmitted ◽  
Syphilis Screening ◽  
Sex With Men ◽  
Latent Syphilis

ABSTRACTSyphilis 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 rRNATreponema pallidumreal-time transcription-mediated amplification (TMA) assay performed on rectal and pharyngeal mucosal swabs.T. pallidumPCR assays for thetpp47gene 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.

Secondary syphilis presenting as erythema multiforme in a HIV-positive homosexual man: a case report and literature review

2018 ◽  
Vol 30 (3) ◽  
pp. 304-309
Author(s):  
Hongfang Liu ◽  
Beng-Tin Goh ◽  
Taoyuan Huang ◽  
Yinghui Liu ◽  
Ruzeng Xue ◽  
...  
Keyword(s):  
Plasma Cell ◽  
Erythema Multiforme ◽  
Treponema Pallidum ◽  
Inflammatory Cells ◽  
Secondary Syphilis ◽  
Penicillin G ◽  
Cell Infiltrate ◽  
Early Syphilis ◽  
Skin Histology ◽  
Anal Warts

Early syphilis can rarely cause erythema multiforme-type eruptions as well as triggering erythema multiforme (EM). EM-like lesions in secondary syphilis are characterized by clinical features of EM and laboratory tests consistent with secondary syphilis and the skin histology shows predominantly a plasma cell infiltrate with the presence of treponemes. When EM is triggered by early syphilis, the skin histology shows mixed inflammatory cells usually in the absence of treponemes in the skin lesion. There may also be mixed histology with the presence of treponemes in the absence of a plasma cell infiltrate and vice versa. We describe a case of secondary syphilis presenting as EM with bullae and histology showing EM features without a plasma cell infiltrate but positive for Treponema pallidum by immunohistochemical staining. The patient was also coinfected with cytomegalovirus, human immunodeficiency virus, and anal warts. The EM eruptions resolved with treatment for secondary syphilis with benzathine penicillin G.

Promises kept? A meta-analysis of gang membership prevention programs

2016 ◽  
Vol 2 (2) ◽  
pp. 134-147 ◽  
Author(s):  
Jennifer S. Wong ◽  
Jason Gravel ◽  
Martin Bouchard ◽  
Karine Descormiers ◽  
Carlo Morselli
Keyword(s):  
Small Sample Size ◽  
Meta Analysis ◽  
Prevention Programs ◽  
Small Sample ◽  
Gang Membership ◽  
Bibliographic Databases ◽  
Content Type ◽  
Gang Prevention ◽  
Log Odds ◽  
Positive Effect

Purpose – The purpose of this paper is to synthesize the effects of gang prevention programs on gang membership. Design/methodology/approach – The authors conducted a systematic literature review across 19 bibliographic databases and a meta-analysis of the effectiveness of these strategies. Findings – The database search resulted in 3,850 hits. Of the 162 studies that were screened in full, six involved a prevention program with outcomes commensurate for meta-analysis. Pooled log odds ratios indicate a significant, positive effect of gang prevention programs at reducing gang membership; however, sensitivity analysis demonstrates that the results are driven by the effects of a single study. Originality/value – Despite the small sample size, the current study presents the best available evidence regarding the effectiveness of gang membership prevention programs. There is a critical need in the field of gang control for rigorous evaluation of prevention strategies.

The Effect of Treatment on the Treponema Pallidum Haemagglutination Test in Early Syphilis

1979 ◽  
Vol 24 (4) ◽  
pp. 307-312 ◽  
Author(s):  
Jennifer M. Hunter
Keyword(s):  
Treponema Pallidum ◽  
Secondary Syphilis ◽  
Post Treatment ◽  
Haemagglutination Test ◽  
Early Syphilis ◽  
Haemagglutination Assay ◽  
Effect Of Treatment ◽  
Pre Treatment ◽  
Latent Syphilis

The response of the Treponema Pallidum Haemagglutination Assay (TPHA) to treatment was studied in 61 cases of early infectious syphilis. In none of the 55 cases of early syphilis in which the pre-treatment TPHA was positive did the TPHA test become consistently negative after treatment. In primary and early latent syphilis it was not possible to demonstrate any significant changes, but in some cases of secondary syphilis a significant and rapidfall in TPHA titre occurred with treatment. It is suggested that the post-treatment TPHA titre need not necessarily reflect the stage at which the disease was arrested.

Post-treatment serological changes in some patients with early syphilis exhibit a parabolic trend

2019 ◽  
Vol 30 (14) ◽  
pp. 1389-1396
Author(s):  
Yong Liu ◽  
Que-Qiao Bian ◽  
Shu-Huan Zhang ◽  
Jun Wang ◽  
Zhen-Ming Wang ◽  
...  
Keyword(s):  
Treatment Effectiveness ◽  
Treponema Pallidum ◽  
Secondary Syphilis ◽  
Post Treatment ◽  
Treatment Level ◽  
Early Syphilis ◽  
Primary Syphilis ◽  
Serum Titer ◽  
Pre Treatment ◽  
Latent Syphilis

Early syphilis accounts for a large proportion of patients with syphilis. Non- Treponema pallidum tests are commonly used to assess treatment effectiveness by analyzing the serological titer before treatment and six months after treatment. However, serological changes during the first three months after completion of treatment have not been completely understood. This prompted us to investigate whether serum titers of patients exhibit a continuous decrease post-treatment and to assess the trend of change in serological titer during this period. One hundred and seventy-three eligible patients with early syphilis were included in the analysis. Pre-treatment serological titers and those at three and six months post-treatment were compared and analyzed. Serological recovery was defined as a 4-fold or greater decrease in titer from pre-treatment level. Forty patients (23.1%) were found to have an increased serum titer at three months after treatment. Among the 40 patients, 13 patients had primary syphilis, 5 patients had secondary syphilis, and 22 patients had early latent syphilis. The proportion of patients with primary syphilis was higher, and their initial titers were significantly lower. No significant differences were observed with respect to age, gender, or initial treatment. The assessment results of 17 patients (9.8% of the total patients) change. Serological changes in some patients exhibit a parabolic pattern that may affect the clinician’s assessment of patient recovery. Therefore, more frequent assessment of serological titer might be required within the first six months post-treatment.

Correlation of paretic knee extension strength with gait speed after stroke: A meta-analysis

2021 ◽  
pp. 1-5
Author(s):  
Richard W. Bohannon
Keyword(s):  
Gait Speed ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Knee Extension ◽  
Bibliographic Databases ◽  
Knee Extension Strength ◽  
Extension Force ◽  
Correlational Data ◽  
Using Data ◽  
The Relationship

BACKGROUND AND OBJECTIVE: Numerous studies have addressed the relationship between paretic knee extension strength and comfortable walking speed after stroke. However, the correlations reported are highly variable. This review sought to summarize the correlational data using meta-analysis. METHODS: Relevant literature was identified via a search of 3 bibliographic databases. Articles were screened and perused for inclusion. Included articles were examined for information on the sample studied, procedures for measuring strength and gait speed, and correlations reported between the 2 variables. Meta-analysis was used to calculate a summary correlation. RESULTS: Of 299 unique articles, 18 met inclusion criteria. Articles were diverse in regard to samples studied, procedures described, and correlations reported. Meta-analysis using data from all included studies revealed a summary correlation of 0.51. For studies using hand-held or isokinetic dynamometry, the summary correlation was 0.46 and 0.59 respectively. CONCLUSIONS: This study provides a better indication of the correlation between paretic knee extension strength and comfortable gait speed than individual studies. The correlation is high enough to provide support for the routine measurement of paretic knee extension force for individuals who have experienced a stroke.

scholarly journals Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth A. McGuier ◽  
David J. Kolko ◽  
Mary Lou Klem ◽  
Jamie Feldman ◽  
Grace Kinkler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Human Service ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Implementation Outcomes ◽  
Services Implementation ◽  
Team Functioning

Abstract Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

Sign in / Sign up

Export Citation Format

Share Document