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Cited by 57Syphilis Diagnosis and TreatmentReproductive tract infections researchVector-borne infectious diseases

Prevalence of the 23S rRNA A2058G point mutation and molecular subtypes in Treponema pallidum in the United States, 2007 to 2009.

The A2058G Prevalence Workgroup·2012·Sexually Transmitted Diseases
DOI 10.1097/olq.0b013e31826f36de
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Abstract

BACKGROUND: The 23S rRNA A2058G point mutation in Treponema pallidum is associated with macrolide antibiotic treatment failure. Its prevalence and potential association with a molecular subtype within the United States are unknown. METHODS: During 2007 to 2009, 11 clinics across the United States sent samples from genital ulcers to the Centers for Disease Control and Prevention. Molecular techniques were used to identify T. pallidum DNA sequences, the A2058G mutation, and subtype of T. pallidum. Accompanying epidemiologic information was abstracted from medical records. RESULTS: A total of 141 samples with T. pallidum were collected from individuals whose median age was 33 years (range, 13-68 years): 118 were male (69% reported as men having sex with men [MSM]). The A2058G mutation was carried in 75 samples (53%) with T. pallidum, with samples from MSM (versus women and other men) more likely carrying the A2058G mutation (65/82 samples versus 8/57 samples; prevalence ratio, 5.7; 95% confidence interval, 2.9-10.8). Of 98 strain-typed samples, 61 (62%) were the 14d9 subtype of T. pallidum, which was also associated with samples with T. pallidum from MSM (prevalence ratio, 3.5; 95% confidence interval, 1.9-6.5). However, among T. pallidum from MSM, the A2058G mutation was not associated with the 14d9 subtype. CONCLUSIONS: The A2058G mutation and 14d9 subtype of T. pallidum were present throughout the United States. Both were more commonly found in T. pallidum from MSM compared with women or other men but were not associated with each other. Treating syphilis with azithromycin should be done cautiously and only when treatment with penicillin or doxycycline is not feasible.

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  • T. pallidum chromosomal mutations are associated with azithromycin and other macrolide resistance.

    “because of T. pallidum chromosomal mutations associated with azithromycin and other macrolide resistance”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [608]

  • Documented treatment failures with azithromycin for syphilis have occurred in multiple U.S. geographic areas.

    “documented treatment failures in multiple U.S. geographic areas”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [608]

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Authors
Workgroup, T. A. P.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
The A2058G Prevalence Workgroup
Venue
Sexually Transmitted Diseases
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-10
Volume
39
Issue
10
Pages
794-798
ISSN
0148-5717 (ISSN-L)
DOI
10.1097/olq.0b013e31826f36de
OpenAlex
W2409326670
Cited by
57
References
30
Citations by year
2025: 1 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 9 · 2017: 1 · 2016: 4 · 2015: 8 · 2014: 11 · 2013: 3 · 2012: 1
FWCI
4.91
Type
journal article
Language
en
Open access
closed
Locations
  • Sexually Transmitted Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
Keywords
Treponema pallidum, syphilis, macrolide resistance, molecular subtypes, men who have sex with men, genital ulcers, azithromycin treatment, syphilis epidemiology, United States
MeSH terms
Adolescent, Adult, Aged, Anti-Bacterial Agents, DNA, Bacterial, Female, Humans, Male, Middle Aged, Penicillin G Benzathine, RNA, Ribosomal, 23S, Syphilis, Treponema pallidum, United States, Prevalence, Point Mutation, Azithromycin, Drug Resistance, Bacterial, Young Adult, Molecular Typing

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