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Cited by 85Syphilis Diagnosis and TreatmentVector-borne infectious diseasesReproductive tract infections research

Macrolide Resistance and Molecular Types of Treponema pallidum Causing Primary Syphilis in Shanghai, China

Martin, Irene E., Gu, Weiming, Yang, Yang, Tsang, Raymond S. W.·2009·Clinical Infectious Diseases
DOI 10.1086/600878
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Abstract

BACKGROUND: The resurgence of syphilis in China requires laboratories to update their methods for molecular epidemiology investigation and surveillance. This study focuses on implementing polymerase chain reaction (PCR) diagnostic tests for syphilis and for detection of molecular subtypes and macrolide resistance among strains causing primary syphilis in the city of Shanghai, China. METHODS: Swabs were obtained from the genital lesions of 39 patients who presented with symptoms compatible with primary syphilis. Eight of the patients also provided whole blood samples. Swabs were also obtained from 10 patients without syphilis who presented with genital ulcers. PCR tests to amplify 3 common but unlinked treponemal genes were performed on DNA samples extracted from these specimens. Molecular subtyping was based on genetic characterization of 2 treponemal repeat genes, arp and tpr. Detection of macrolide resistance was accomplished by identification of the 23S ribosomal RNA gene mutation associated with the resistance pattern. RESULTS: Thirty-eight patients with primary syphilis were found to have Treponema pallidum DNA in their genital lesions by PCR assays using primers that target the bmp, tpp-47, and polA genes. None of the patients without syphilis had positive PCR results. Five molecular subtypes were identified, with 1 type (14f) causing 79% of the cases. All 38 patients were found to be infected with macrolide-resistant strains. CONCLUSIONS: Three common treponemal gene targets (bmp, tpp-47, and polA) were detectable by PCR in patients with primary syphilis. A single clone characterized as 14f and showing macrolide resistance appeared to have caused most of the primary syphilis cases in this study.

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  • Consistent and correct use of latex condoms reduces the risk for HPV infection and HPV-associated diseases, genital herpes, syphilis, and chancroid when the infected area or site of potential exposure is covered.

    “In addition, consistent and correct use of latex condoms reduces the risk for HPV infection and HPV-associated diseases, genital herpes, syphilis, and chancroid when the infected area or site of potential exposure is covered (23–27).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [23]

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Authors
Martin, I. E., Gu, W., Yang, Y., & Tsang, R. S. W.
Affiliations
  • Shanghai Skin Disease Hospital (CN)
  • Public Health Agency of Canada (CA)
Corresponding author
Tsang, Raymond S. W.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2009-08-15
Volume
49
Issue
4
Pages
515-521
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/600878
OpenAlex
W2101338065
Cited by
85
References
25
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 5 · 2016: 4 · 2015: 7 · 2014: 7 · 2013: 11 · 2012: 16
FWCI
6.63
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
Health Canada
Topics
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Keywords
Treponema pallidum, primary syphilis, macrolide resistance, molecular subtyping, 23S rRNA mutations, syphilis resurgence, Shanghai
MeSH terms
Adult, Anti-Bacterial Agents, Bacterial Proteins, China, DNA, Bacterial, DNA, Ribosomal, Female, Genotype, Humans, Male, Middle Aged, RNA, Ribosomal, 23S, Syphilis, Treponema pallidum, Bacterial Typing Techniques, Polymerase Chain Reaction, DNA Fingerprinting, Point Mutation, Molecular Epidemiology, Macrolides, Drug Resistance, Bacterial, Young Adult

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