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• W3183049511 abstract "<h3>Background</h3> Treponema pallidum subsp. pallidum infection (TP) may be diagnosed either directly by dark-field microscopy (DFM) or polymerase chain reaction (PCR) assay, or indirectly by serology. TP PCR and serology are currently the mainstay of laboratory-based diagnosis due to technical challenges associated with DFM. We describe the performance of TP PCR and serology in the diagnosis of primary syphilis at Western Sydney Sexual Health Centre (WSSHC). <h3>Methods</h3> This is a retrospective study of primary syphilis cases diagnosed at WSSHC over a five-year period (2015–2019). Medical case records were reviewed to extract laboratory results. Patients without a prior history of syphilis were screened with either an enzyme-linked immunosorbent total antibody assay (EIA, WSSHC-associated laboratory) or a chemiluminescent microparticle immunoassay (CMIA, private laboratories). The non-treponemal Venereal Disease Research Laboratory (VDRL) assay was used to screen patients previously-treated for syphilis. An in-house PCR assay tested ulcer-derived DNA extracts for TP. The study received Ethics Committee approval. <h3>Results</h3> 93 primary syphilis cases (92 with ulceration, 1 with inguinal lymphadenopathy) were diagnosed in the study period. TP PCR was performed in 84/92 (91%) cases and positive in 76/84 (90%) cases. Overall, syphilis serology detected 79/93 (85%) primary syphilis cases. 75/93 (81%) cases had no laboratory evidence of prior syphilis; 18 cases (19%) had previous reactive treponemal serology. Treponemal antibodies were present in 63/75 (84%) first-episode syphilis cases; 12/75 (16%) had non-reactive treponemal serology. Most cases with previously-treated syphilis had reactive VDRL tests (16/18, 89%). There were 64 PCR positive/serology reactive cases, 12 TP PCR positive/serology non-reactive cases, 7 PCR negative/serology reactive cases and one clinically-diagnosed case (negative TP PCR/non-reactive serology). Serology was reactive in all 9 cases where TP PCR was not performed (8 EIA reactive, 1 VDRL reactive). <h3>Conclusion</h3> Primary syphilis is best diagnosed using a combined approach with TP PCR and syphilis serology." @default.
• W3183049511 created "2021-07-19" @default.
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• W3183049511 date "2021-07-01" @default.
• W3183049511 modified "2023-09-27" @default.
• W3183049511 title "P355 The performance of laboratory-based diagnostic assays to diagnose primary syphilis cases at Western Sydney Sexual Health Centre, 2015–2019" @default.
• W3183049511 doi "https://doi.org/10.1136/sextrans-2021-sti.400" @default.
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