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Kou CX, Wang QQ, Zhang JP, Liu JQ, Zhang HN, Zhang RL. A Novel tp0548 Gene Type of Treponema pallidum Identified in Nanjing, China: Case Report and Review of Literature. Sex Transm Dis 2021; 48:357-361. [PMID: 33093286 DOI: 10.1097/olq.0000000000001320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The tp0548 gene, hypothesized to encode for an outer-membrane protein, was originally used in the enhanced Centers for Disease Control and Prevention typing for molecular typing of Treponema pallidum. It plays an important role in the molecular epidemiology of Treponema because it is not only an important locus of multiple typing approaches but also suitable for strain typing of multiple Treponema subspecies. METHODS A 27-year-old Chinese man attended the Institute of Dermatology, Chinese Academy of Medical Sciences Sexually Transmitted Disease Clinic in Nanjing, China, because of a genital ulcer and inguinal lymphadenopathy for 1 week. Workup consisted of microbiological and hematological investigations, and sequences analysis. The aims of this study were to describe a novel tp0548 sequence type "Qn" of this syphilis strain and to review all previously reported novel tp0548 genotypes. RESULTS We identified a novel tp0548 gene type in a genital ulcer in a patient with primary syphilis in Nanjing, China. Using sequence alignment, we further found that this novel sequence was closely similar to "Q." Following the nomenclature used in the enhanced Centers for Disease Control and Prevention typing methodology, the letters "Qn" was assigned to the new sequence type. CONCLUSION The novel tp0548 sequence type of T. pallidum not only expands the database up to 27 different sequence types but also indicates the substantial genetic diversity of the tp0548 gene sequence.
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Affiliation(s)
- Cai-Xia Kou
- From the Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College
| | - Qian-Qiu Wang
- From the Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College
| | - Jin-Ping Zhang
- From the Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College
| | - Jin-Quan Liu
- From the Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College
| | - Hai-Ni Zhang
- From the Institute of Dermatology, Chinese Academy of Medical Science and Peking Union Medical College
| | - Rui-Li Zhang
- Department of Dermatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Liu D, Tong ML, Liu LL, Lin LR, Zhang HL, Yang TC. Characterisation of the novel clinical isolate X-4 containing a new tp0548 sequence-type. Sex Transm Infect 2020; 97:120-125. [PMID: 33214321 DOI: 10.1136/sextrans-2020-054687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/10/2020] [Accepted: 10/25/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES A novel tp0548 sequence-type was identified in one clinical isolate (X-4) from a patient diagnosed with primary syphilis in Xiamen, China. To precisely define and characterise a new clinical isolate, we performed further genome-scale molecular analysis. METHODS The pooled segment genome sequencing method followed by Illumina sequencing was performed. RESULTS This novel sequence-type contained a unique nucleotide substitution 'T' at position 167 and belonged to the SS14-like clade of TPA strains, as determined by phylogenetic analysis. Multi-locus sequence analysis of nine chromosomal loci demonstrated that the X-4 isolate was clustered within a monophyletic group of TPA strains. Whole-genome phylogenetic analysis subsequently corroborated the TPA strain classification of the X-4 isolate and revealed that the isolate was closely related to the SS14 strain, with 42 single-nucleotide variations and 12 insertions/deletions. In addition, high intrastrain heterogeneity in the length of the poly G/C tracts was found in the TPAChi_0347 locus, which might indicate that this gene of the X-4 isolate is likely involved in phase variation events. The length heterogeneity of the poly A/T tracts was lower than the genetic variability of the poly G/C tracts, and all the observed intrastrain variations fell within coding regions. CONCLUSION The novel tp0548 sequence-type was determined to belong to a new TPA isolate, X-4. The identification of variable length in homopolymetic tracts (G/C and A/T) could provide a snapshot of the genes that potentially involved in genotype-phenotype variations. These findings provide an unequivocal characterisation for better understanding the molecular variation of this emerging isolate.
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Affiliation(s)
- Dan Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Man-Li Tong
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China.,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Li-Li Liu
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Li-Rong Lin
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China
| | - Hui-Lin Zhang
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China .,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
| | - Tian-Ci Yang
- Center of Clinical Laboratory, Zhongshan Hospital, School of Medicine, Xiamen University, Xiamen, China .,Institute of Infectious Disease, School of Medicine, Xiamen University, Xiamen, China
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Fernandez MC, Giacani L. Molecular and Immunological Strategies Against Treponema pallidum Infections. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Grillová L, Bawa T, Mikalová L, Gayet-Ageron A, Nieselt K, Strouhal M, Sednaoui P, Ferry T, Cavassini M, Lautenschlager S, Dutly F, Pla-Díaz M, Krützen M, González-Candelas F, Bagheri HC, Šmajs D, Arora N, Bosshard PP. Molecular characterization of Treponema pallidum subsp. pallidum in Switzerland and France with a new multilocus sequence typing scheme. PLoS One 2018; 13:e0200773. [PMID: 30059541 PMCID: PMC6066202 DOI: 10.1371/journal.pone.0200773] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/03/2018] [Indexed: 11/19/2022] Open
Abstract
Syphilis is an important public health problem and an increasing incidence has been noted in recent years. Characterization of strain diversity through molecular data plays a critical role in the epidemiological understanding of this re-emergence. We here propose a new high-resolution multilocus sequence typing (MLST) scheme for Treponema pallidum subsp. pallidum (TPA). We analyzed 30 complete and draft TPA genomes obtained directly from clinical samples or from rabbit propagated strains to identify suitable typing loci and tested the new scheme on 120 clinical samples collected in Switzerland and France. Our analyses yielded three loci with high discriminatory power: TP0136, TP0548, and TP0705. Together with analysis of the 23S rRNA gene mutations for macrolide resistance, we propose these loci as MLST for TPA. Among clinical samples, 23 allelic profiles as well as a high percentage (80% samples) of macrolide resistance were revealed. The new MLST has higher discriminatory power compared to previous typing schemes, enabling distinction of TPA from other treponemal bacteria, distinction between the two main TPA clades (Nichols and SS14), and differentiation of strains within these clades.
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Affiliation(s)
- Linda Grillová
- Department of Biology, Masaryk University, Brno, Czech Republic
| | - Tanika Bawa
- Department of Fundamental Neuroscience, University of Geneva, Geneva, Switzerland
| | - Lenka Mikalová
- Department of Biology, Masaryk University, Brno, Czech Republic
| | - Angèle Gayet-Ageron
- Division of Clinical Epidemiology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Kay Nieselt
- Center for Bioinformatics, University of Tübingen, Tübingen, Germany
| | - Michal Strouhal
- Department of Biology, Masaryk University, Brno, Czech Republic
| | | | | | - Matthias Cavassini
- Department of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | | | - Fabrizio Dutly
- IMD Institut für medizinische & molekulare Diagnostik AG, Zurich, Switzerland
| | - Marta Pla-Díaz
- Unidad Mixta Infección y Salud Pública FISABIO/Universidad de Valencia, CIBER in Epidemiology and Public Health, Valencia, Spain
| | - Michael Krützen
- Department of Anthropology, University of Zurich, Zurich, Switzerland
| | - Fernando González-Candelas
- Unidad Mixta Infección y Salud Pública FISABIO/Universidad de Valencia, CIBER in Epidemiology and Public Health, Valencia, Spain
| | | | - David Šmajs
- Department of Biology, Masaryk University, Brno, Czech Republic
| | - Natasha Arora
- Institute for Evolutionary Biology and Environmental Studies, University of Zurich, Zurich, Switzerland
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Philipp P. Bosshard
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Li Y, Li J, Hu W, Luo H, Zhou J, Li C, Chen C. Gene subtype analysis of Treponema pallidum for drug resistance to azithromycin. Exp Ther Med 2018; 16:1009-1013. [PMID: 30116352 DOI: 10.3892/etm.2018.6241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 01/08/2018] [Indexed: 11/06/2022] Open
Abstract
Azithromycin has been widely used for the treatment of Treponema pallidum. However, the drug resistance of T. pallidum for azithromycin is currently increasing. The aim of the present study was to analyze the association between gene subtypes of T. pallidum and drug resistance for azithromycin. The gene subtypes of T. pallidum were assayed by a polymerase chain reaction technique. Drug resistance of T. pallidum was analyzed using an antimicrobial susceptibility test. The results demonstrated that gene type tpr presented higher drug resistance compared with arp and tp0548 gene types of T. pallidum. Gene type tpr was identified as eight gene subtypes (14a/f, 14e/f, 12e/f, 12d/f, 6d/f, 11d/f, 14j/f and 8d/f) among 324 cases. It was identified that 23S rRNA A2058G mutation was observed in gene subtypes 14a/f, 14e/f and 12e/f. A2059G mutation occurred in the gene subtypes 8d/f, 12d/f, 6d/f, 11d/f and 14j/f. The proportions of azithromycin-resistant genotypes harboring either the A2058G or the A2059G mutation among the T. pallidum strains were 34.2 and 65.8%, respectively. The antimicrobial susceptibility test demonstrated that A2059G mutations exhibited a higher drug resistance for azithromycin compared with A2058G mutations. In conclusion, these results indicate that azithromycin resistance in T. pallidum is associated with gene subtype, which may contribute to the treatment of T. pallidum.
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Affiliation(s)
- Yuecui Li
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Jin Li
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Weiyue Hu
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Hongxia Luo
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Jing Zhou
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Chenghang Li
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
| | - Chunjiao Chen
- Department of Infectious Diseases, The First People's Hospital of Yongkang, Yongkang, Zhejiang 321300, P.R. China
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Šmajs D, Strouhal M, Knauf S. Genetics of human and animal uncultivable treponemal pathogens. INFECTION GENETICS AND EVOLUTION 2018; 61:92-107. [PMID: 29578082 DOI: 10.1016/j.meegid.2018.03.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
Treponema pallidum is an uncultivable bacterium and the causative agent of syphilis (subsp. pallidum [TPA]), human yaws (subsp. pertenue [TPE]), and bejel (subsp. endemicum). Several species of nonhuman primates in Africa are infected by treponemes genetically undistinguishable from known human TPE strains. Besides Treponema pallidum, the equally uncultivable Treponema carateum causes pinta in humans. In lagomorphs, Treponema paraluisleporidarum ecovar Cuniculus and ecovar Lepus are the causative agents of rabbit and hare syphilis, respectively. All uncultivable pathogenic treponemes harbor a relatively small chromosome (1.1334-1.1405 Mbp) and show gene synteny with minimal genetic differences (>98% identity at the DNA level) between subspecies and species. While uncultivable pathogenic treponemes contain a highly conserved core genome, there are a number of highly variable and/or recombinant chromosomal loci. This is also reflected in the occurrence of intrastrain heterogeneity (genetic diversity within an infecting bacterial population). Molecular differences at several different chromosomal loci identified among TPA strains or isolates have been used for molecular typing and the epidemiological characterization of syphilis isolates. This review summarizes genome structure of uncultivable pathogenic treponemes including genetically variable regions.
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Affiliation(s)
- David Šmajs
- Department of Biology, Masaryk University, Kamenice 5, Building A6, 625 00 Brno, Czech Republic.
| | - Michal Strouhal
- Department of Biology, Masaryk University, Kamenice 5, Building A6, 625 00 Brno, Czech Republic.
| | - Sascha Knauf
- Work Group Neglected Tropical Diseases, Pathology Unit, German Primate Center, Leibniz Institute for Primate Research, Kellnerweg 4, 37077 Göttingen, Germany,.
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Godornes C, Giacani L, Barry AE, Mitja O, Lukehart SA. Development of a Multilocus Sequence Typing (MLST) scheme for Treponema pallidum subsp. pertenue: Application to yaws in Lihir Island, Papua New Guinea. PLoS Negl Trop Dis 2017; 11:e0006113. [PMID: 29281641 PMCID: PMC5760108 DOI: 10.1371/journal.pntd.0006113] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/09/2018] [Accepted: 11/14/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Yaws is a neglected tropical disease, caused by Treponema pallidum subsp. pertenue. The disease causes chronic lesions, primarily in young children living in remote villages in tropical climates. As part of a global yaws eradication campaign initiated by the World Health Organization, we sought to develop and evaluate a molecular typing method to distinguish different strains of T. pallidum subsp. pertenue for disease control and epidemiological purposes. METHODS AND PRINCIPAL FINDINGS Published genome sequences of strains of T. pallidum subsp. pertenue and pallidum were compared to identify polymorphic genetic loci among the strains. DNA from a number of existing historical Treponema isolates, as well as a subset of samples from yaws patients collected in Lihir Island, Papua New Guinea, were analyzed using these targets. From these data, three genes (tp0548, tp0136 and tp0326) were ultimately selected to give a high discriminating capability among the T. pallidum subsp. pertenue samples tested. Intragenic regions of these three target genes were then selected to enhance the discriminating capability of the typing scheme using short readily amplifiable loci. This 3-gene multilocus sequence typing (MLST) method was applied to existing historical human yaws strains, the Fribourg-Blanc simian isolate, and DNA from 194 lesion swabs from yaws patients on Lihir Island, Papua New Guinea. Among all samples tested, fourteen molecular types were identified, seven of which were found in patient samples and seven among historical isolates or DNA. Three types (JG8, TD6, and SE7) were predominant on Lihir Island. CONCLUSIONS This MLST approach allows molecular typing and differentiation of yaws strains. This method could be a useful tool to complement epidemiological studies in regions where T. pallidum subsp. pertenue is prevalent with the overall goals of improving our understanding of yaws transmission dynamics and helping the yaws eradication campaign to succeed.
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Affiliation(s)
- Charmie Godornes
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Lorenzo Giacani
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Alyssa E. Barry
- Division of Population Health and Immunity, Walter and Eliza Hall Institute, Parkville, Australia
- Department of Medical Biology, University of Melbourne, Parkville, Australia
| | - Oriol Mitja
- Barcelona Institute for Global Health, Hospital Clinic-Universitat de Barcelona, Barcelona, Spain
- Division of Public Health, School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea
- Lihir Medical Center, International SOS-Newcrest Mining, Lihir Island, Papua New Guinea
| | - Sheila A. Lukehart
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
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Li Z, Wang C, Xiao H, Zhao W, Li Z, Zheng R, Hou J, Huang N, Tian H. Enhanced molecular typing of Treponema pallidum
identified a new tp0548 Gene type in Shandong, China. APMIS 2017; 125:937-939. [PMID: 28766763 DOI: 10.1111/apm.12724] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Zhen Li
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Sciences; Jinan Shandong China
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
| | - Chuan Wang
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Sciences; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
- Shandong Provincial Key Lab for Dermatovenereology; Jinan Shandong China
| | - Hailu Xiao
- Affiliated Hospital of Jining Medical University; Jining Shandong China
| | - Wei Zhao
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Sciences; Jinan Shandong China
- Shandong Provincial Key Lab for Dermatovenereology; Jinan Shandong China
| | - Zhongwei Li
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
| | - Rongtao Zheng
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
| | - Jianling Hou
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
| | - Na Huang
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
| | - Hongqing Tian
- Shandong Provincial Institute of Dermatology and Venereology; Provincial Academy of Medical Sciences; Jinan Shandong China
- Shandong Provincial Hospital for Skin Diseases; Jinan Shandong China
- Shandong Provincial Medical Center for Dermatovenereology; Jinan Shandong China
- Shandong Provincial Key Lab for Dermatovenereology; Jinan Shandong China
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Molecular typing of Treponema pallidum isolates from Buenos Aires, Argentina: Frequent Nichols-like isolates and low levels of macrolide resistance. PLoS One 2017; 12:e0172905. [PMID: 28235102 PMCID: PMC5325558 DOI: 10.1371/journal.pone.0172905] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/10/2017] [Indexed: 11/29/2022] Open
Abstract
A total of 54 clinical samples, including genital lesion swabs, whole blood and cerebrospinal fluid from patients diagnosed with syphilis were collected in 2006 and in 2013 in Buenos Aires, Argentina. Treponemal DNA was detected in 43 of the analyzed samples (79.6%) and further analyzed using Sequencing-based molecular typing (SBMT) and Enhanced CDC-typing (ECDCT). By SBMT, 10 different Treponema pallidum subsp. pallidum (TPA) genotypes were found, of which six were related to the TPA SS14 strain, and four to the TPA Nichols strain. The 23S rRNA gene was amplified in samples isolated from 42 patients, and in six of them (14.3%), either the A2058G (four patients, 9.5%) or the A2059G (two patients, 4.8%) mutations were found. In addition to Taiwan, Madagascar and Peru, Argentina is another country where the prevalence of Nichols-like isolates (26.8%) is greater than 10%.
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Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster. Nat Microbiol 2016; 2:16245. [PMID: 27918528 DOI: 10.1038/nmicrobiol.2016.245] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/03/2016] [Indexed: 11/08/2022]
Abstract
The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history1. Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin3. Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the low quantities of treponemal DNA in clinical samples and difficulties in cultivating the pathogen4. Here, we used DNA capture and whole-genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combined with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share a common ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and are members of a globally dominant cluster, named here as SS14-Ω. The cluster diversified from a common ancestor in the mid-twentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic divergence and global presence point to the emergence of a pandemic strain cluster.
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Previously Identified “k” Sequence Variants of the tp0548 Gene Will Be Renamed as Type “l”. Sex Transm Dis 2015; 42:585. [DOI: 10.1097/olq.0000000000000348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
PURPOSE OF REVIEW The past 15 years have seen a dramatic increase in syphilis diagnoses in several regions including China, North America, Western Europe and Australia. Worldwide, the disease remains prevalent, contributing to substantial adult morbidity and neonatal mortality. Testing and treatment strategies are largely informed by data from the early antibiotic era, but increasing use of molecular diagnostics and new screening strategies could improve the management of syphilis substantially. RECENT FINDINGS The review explores new testing strategies for syphilis, including the importance of screening test selection and advances in point-of-care diagnostics. It then examines molecular studies of Treponema pallidum, covering typing; macrolide resistance; association between genotype and phenotype and the use of PCR in testing and monitoring strategies. SUMMARY Clinicians should be aware of testing strategies employed by their laboratories to ensure optimal sensitivity and specificity. Locally available T. pallidum PCR assays may improve the diagnosis of early disease and inform antibiotic choice. Robust serologic follow-up is still required, but predictors of potential treatment failure, including PCR-measured bacterial load, have been identified. Re-treatment should be considered for patients in the serofast state. The publication of T. pallidum genomes would allow further and more detailed study of strains and disease pathogenesis.
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Molecular Typing of Treponema pallidum. Sex Transm Dis 2015. [DOI: 10.1097/olq.0000000000000239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The 2 Simultaneously Published “k” Sequence Variants of tp0548 Locus of Treponema pallidum ssp. pallidum Isolates Differ. Sex Transm Dis 2015; 42:53. [DOI: 10.1097/olq.0000000000000220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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