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1.
Av. odontoestomatol ; 36(3): 161-173, sept.-dic. 2020. graf
Artículo en Español | IBECS | ID: ibc-197415

RESUMEN

INTRODUCCIÓN: la sífilis es una infección bacteriana, que se puede transmitir por contacto sexual o de forma congénita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. MATERIAL Y MÉTODO: se realizó una búsqueda en la base de datos PubMed, utilizándose como palabras clave: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "oral manifestations", "oral lesions". Como criterios de inclusión se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sífilis y trabajos en inglés y español. No hubo restricción por fecha. RESULTADOS: se seleccionaron un total de 18 artículos, la N total de pacientes fue de 201. El 10,05% padecía sífilis primaria, el 52,76% sífilis secundaria y el 36, 68% sífilis terciaria. Las lesiones orales predominantes de la sífilis primaria fueron úlceras, inflamación, chancro sifilítico; en la sífilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamación, lesiones papulares, lesiones maculares, lesiones erosivas; en la sífilis terciaria aparecen gomas sifilíticos, lesiones leucoplásicas y atrofia lingual. DISCUSIÓN: la sífilis es una infección bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnóstico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomática


INTRODUCTION: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. MATERIAL AND METHOD: a search was made in the PubMed database, using as keywords: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "Oral manifestations", "oral lesions". The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. RESULTS: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. DISCUSSION: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form


Asunto(s)
Humanos , Sífilis/patología , Sífilis/epidemiología , Enfermedades de la Boca/patología , Sífilis/diagnóstico , Boca/lesiones , Diagnóstico Diferencial , Penicilinas/administración & dosificación , Penicilina G Benzatina/administración & dosificación , Doxiciclina/administración & dosificación , Amoxicilina/administración & dosificación , Probenecid/administración & dosificación
2.
PLoS Pathog ; 16(9): e1008871, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32936831

RESUMEN

Deconvolution of syphilis pathogenesis and selection of candidate syphilis vaccinogens requires detailed knowledge of the molecular architecture of the Treponema pallidum outer membrane (OM). The T. pallidum OM contains a low density of integral OM proteins, while the spirochete's many lipoprotein immunogens are periplasmic. TP0751, a lipoprotein with a lipocalin fold, is reportedly a surface-exposed protease/adhesin and protective antigen. The rapid expansion of calycin/lipocalin structures in the RCSB PDB database prompted a comprehensive reassessment of TP0751. Small angle X-ray scattering analysis of full-length protein revealed a bipartite topology consisting of an N-terminal, intrinsically disordered region (IDR) and the previously characterized C-terminal lipocalin domain. A DALI server query using the lipocalin domain yielded 97 hits, 52 belonging to the calycin superfamily, including 15 bacterial lipocalins, but no Gram-negative surface proteins. Surprisingly, Tpp17 (TP0435) was identified as a structural ortholog of TP0751. In silico docking predicted that TP0751 can bind diverse ligands along the rim of its eight-stranded ß-barrel; high affinity binding of one predicted ligand, heme, to the lipocalin domain was demonstrated. qRT-PCR and immunoblotting revealed very low expression of TP0751 compared to other T. pallidum lipoproteins. Immunoblot analysis of immune rabbit serum failed to detect TP0751 antibodies, while only one of five patients with secondary syphilis mounted a discernible TP0751-specific antibody response. In opsonophagocytosis assays, neither TP0751 nor Tpp17 antibodies promoted uptake of T. pallidum by rabbit peritoneal macrophages. Rabbits immunized with intact, full-length TP0751 showed no protection against local or disseminated infection following intradermal challenge with T. pallidum. Our data argue that, like other lipoprotein lipocalins in dual-membrane bacteria, TP0751 is periplasmic and binds small molecules, and we propose that its IDR facilitates ligand binding by and offloading from the lipocalin domain. The inability of TP0751 to elicit opsonic or protective antibodies is consistent with a subsurface location.


Asunto(s)
Proteínas Bacterianas/inmunología , Vacunas Bacterianas/inmunología , Inmunización , Lipoproteínas/inmunología , Sífilis/inmunología , Treponema pallidum/inmunología , Animales , Proteínas Bacterianas/genética , Vacunas Bacterianas/genética , Humanos , Lipoproteínas/genética , Dominios Proteicos , Pliegue de Proteína , Conejos , Sífilis/genética , Sífilis/patología , Sífilis/prevención & control , Treponema pallidum/genética , Treponema pallidum/patogenicidad
4.
PLoS One ; 15(1): e0227769, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31929602

RESUMEN

Clinical isolates of Treponema pallidum subspecies pallidum (T. pallidum) would facilitate study of prevalent strains. We describe the first successful rabbit propagation of T. pallidum from cryopreserved ulcer specimens. Fresh ulcer exudates were collected and cryopreserved with consent from syphilis-diagnosed patients (N = 8). Each of eight age-matched adult male rabbits were later inoculated with a thawed specimen, with two rabbits receiving 1.3 ml intratesticularly (IT), and six receiving 0.6 ml intravenously (IV) and IT. Monitoring of serology, blood PCR and orchitis showed that T. pallidum grew in 2/8 rabbits that were inoculated IV and IT with either a penile primary lesion specimen (CDC-SF003) or a perianal secondary lesion specimen (CDC-SF007). Rabbit CDC-SF003 was seroreactive by T. pallidum Particle Agglutination (TP-PA) and Rapid Plasma Reagin (RPR) testing, PCR+, and showed orchitis by week 6. Euthanasia was performed in week 7, with treponemal growth in the testes confirmed and quantified by qPCR and darkfield microscopy (DF). Serial passage of the extract in a second age-matched rabbit also yielded treponemes. Similarly, rabbit CDC-SF007 showed negligible orchitis, but was seroreactive and PCR+ by week 4 and euthanized in week 6 to yield T. pallidum, which was further propagated by second passage. Using the 4-component molecular typing system for syphilis, 3 propagated strains (CDC-SF003, CDC-SF007, CDC-SF008) were typed as 14d9f, 14d9g, and 14d10c, respectively. All 3 isolates including strain CDC-SF011, which was not successfully propagated, had the A2058G mutation associated with azithromycin resistance. Our results show that immediate cryopreservation of syphilitic ulcer exudate can maintain T. pallidum viability for rabbit propagation.


Asunto(s)
Sífilis/microbiología , Sífilis/patología , Treponema pallidum/aislamiento & purificación , Animales , Criopreservación , Modelos Animales de Enfermedad , Humanos , Masculino , Tipificación Molecular , Conejos , Sífilis/diagnóstico , Treponema pallidum/genética , Treponema pallidum/fisiología
5.
Med Hist ; 64(1): 116-141, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31933505

RESUMEN

In early twentieth-century France, syphilis and its controversial status as a hereditary disease reigned as a chief concern for physicians and public health officials. As syphilis primarily presented visually on the surface of the skin, its study fell within the realms of both dermatologists and venereologists, who relied heavily on visual evidence in their detection, diagnosis, and treatment of the disease. Thus, in educational textbooks, atlases, and medical models, accurately reproducing the visible signposts of syphilis - the colour, texture, and patterns of primary chancres or secondary rashes - was of preeminent importance. Photography, with its potential claims to mechanical objectivity, would seem to provide the logical tool for such representations. Yet photography's relationship to syphilographie warrants further unpacking. Despite the rise of a desire for mechanical objectivity charted in the late nineteenth century, artist-produced, three-dimensional, wax-cast moulages coexisted with photographs as significant educational tools for dermatologists; at times, these models were further mediated through photographic reproduction in texts. Additionally, the rise of phototherapy complicated this relationship by fostering the clinical equation of the light-sensitive photographic plate with the patient's skin, which became the photographic record of disease and successful treatment. This paper explores these complexities to delineate a more nuanced understanding of objectivity vis-à-vis photography and syphilis. Rather than a desire to produce an unbiased image, fin-de-siècle dermatologists marshalled the photographic to exploit the verbal and visual rhetoric of objectivity, authority, and persuasion inextricably linked to culturally constructed understandings of the photograph. This rhetoric was often couched in the Peircean concept of indexicality, which physicians formulated through the language of witness, testimony, and direct connection.


Asunto(s)
Anatomía Artística/historia , Ilustración Médica/historia , Modelos Anatómicos , Fotograbar/historia , Sífilis/historia , Atlas como Asunto/historia , Distinciones y Premios , Dermatología/educación , Dermatología/historia , Francia , Historiografía , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Sífilis/patología , Sífilis Congénita/historia , Venereología/educación , Venereología/historia
6.
J Am Acad Dermatol ; 82(1): 156-160, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31306731

RESUMEN

BACKGROUND: Syphilis is often misdiagnosed clinically, and biopsies might be required. OBJECTIVE: To determine histopathologic features that distinguish secondary syphilis from pityriasis lichenoides (PL), pityriasis rosea (PR), and early mycosis fungoides (MF). METHODS: Histopathologic features of 100 cases of syphilis, 110 cases of PL, 72 cases of PR, and 101 cases of MF were compared. RESULTS: Elongated rete ridges and interstitial inflammation favor syphilis over PL (likelihood ratios 3.44 and 2.72, respectively), but no feature reliably distinguishes between them. Secondary syphilis and PR can be distinguished by neutrophils in the stratum corneum, plasma cells, interface dermatitis with lymphocytes and vacuoles, and lymphocytes with ample cytoplasm. Plasma cells and lymphocytes with ample cytoplasm are rare in early MF and can be used as distinguishing features. CONCLUSIONS: Histopathologic features characteristic of syphilis can be seen in PL, PR, and early MF. Distinguishing syphilis from PL can be difficult histologically, and a high index of suspicion is required. Although elongation of rete and interstitial inflammation favor syphilis, plasma cells (historically considered a significant feature of syphilis) are often encountered in PL. Vacuolar interface dermatitis with a lymphocyte in every vacuole is considered characteristic of PL, but this feature appears to be more common in syphilis.


Asunto(s)
Micosis Fungoide/diagnóstico , Pitiriasis Liquenoide/diagnóstico , Pitiriasis Rosada/diagnóstico , Neoplasias Cutáneas/diagnóstico , Sífilis/diagnóstico , Sífilis/patología , Diagnóstico Diferencial , Humanos , Micosis Fungoide/patología , Pitiriasis Liquenoide/patología , Pitiriasis Rosada/patología , Sensibilidad y Especificidad , Neoplasias Cutáneas/patología
8.
Acta Med Port ; 32(12): 776-781, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31851887

RESUMEN

Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity, as these may be visible and interfere with basic functions such as speech or swallowing. Moreover, the oral cavity may function as a reservoir for future spread of these infections. In order to successfully control this problem, a greater focus on oral sex should be persued, along with promotion of the use of condom and education on safe oral sex practices. Furthermore, examination of the oral cavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oral transmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis and gonorrhea, among others.


Asunto(s)
Enfermedades de la Boca/complicaciones , Sexo Seguro , Conducta Sexual , Enfermedades de Transmisión Sexual/transmisión , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/transmisión , Chlamydia trachomatis , Gonorrea/diagnóstico , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/patología , Infecciones por VIH/transmisión , Herpes Simple/diagnóstico , Herpes Simple/transmisión , Humanos , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/patología , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/patología , Sífilis/diagnóstico , Sífilis/patología , Sífilis/transmisión
10.
Sex Transm Dis ; 46(12): 816-818, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31764769

RESUMEN

Two individuals with human immunodeficiency virus presented in acute renal failure with nephrotic range proteinuria and were diagnosed with secondary syphilis. One of them also had elevated transaminases. Kidney biopsies revealed membranous nephropathy, a rare complication of secondary syphilis, in both cases. Normal hepatic and renal function were restored after treatment with penicillin.


Asunto(s)
Lesión Renal Aguda/etiología , Infecciones por VIH/complicaciones , Hepatitis/etiología , Sífilis/complicaciones , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/patología , Lesión Renal Aguda/fisiopatología , Adulto , Coinfección , Diagnóstico Diferencial , Infecciones por VIH/diagnóstico , Infecciones por VIH/patología , Infecciones por VIH/fisiopatología , Hepatitis/diagnóstico , Hepatitis/parasitología , Hepatitis/fisiopatología , Humanos , Masculino , Sífilis/diagnóstico , Sífilis/patología , Sífilis/fisiopatología
11.
BMC Gastroenterol ; 19(1): 191, 2019 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-31744461

RESUMEN

BACKGROUND: Syphilis is a common disease that has been researched and focused on for many years, however, syphilitic hepatitis has not been well-recognized. We report this case of syphilitic hepatitis with intrahepatic cholestasis and liver granulomas to make a deeper impression. CASE PRESENTATION: A 47-year-old male was admitted with jaundice and rashes. The laboratory examination showed abnormal liver enzymes with significant increases in ALP and GGT but mild increases in ALT and AST. His HBV surface antigen was weakly positive, with negative HIV antibody, HCV antibody, and undetectable HBV DNA. The rapid plasma reagin test and the Treponema pallidum particle assay tests for Syphilis were both positive. Abdominal ultrasonography and magnetic resonance cholangiopancreatography revealed the normal biliary tract, liver, and spleen. The liver pathological examination showed cholangiocyte inflammation and micro-granulomas with coagulation necrosis. After 2 months of benzathine penicillin treatment, his liver enzyme decreased rapidly and remained normal after 1-year of follow-up. CONCLUSIONS: Increased liver enzymes, intrahepatic cholestasis and liver granulomas with well-response to antibiotics may provide clues for the diagnosis of syphilitic hepatitis.


Asunto(s)
Hepatitis/microbiología , Sífilis/diagnóstico , Antibacterianos/uso terapéutico , Colestasis Intrahepática/patología , Granuloma/patología , Hepatitis/diagnóstico , Hepatitis/tratamiento farmacológico , Hepatitis/patología , Humanos , Hígado/enzimología , Hígado/patología , Masculino , Persona de Mediana Edad , Penicilina G Benzatina/uso terapéutico , Sífilis/tratamiento farmacológico , Sífilis/patología , Treponema pallidum/aislamiento & purificación
15.
Biosci Rep ; 39(8)2019 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-31358689

RESUMEN

Syphilis caused by Treponema pallidum (T. pallidum) infection is accompanied by inflammatory injury of tissue, and has a worldwide distribution and increasing incidence over the past decade. Tp17 has been reported to be a strong membrane immunogen, and was initially observed to play a role in inflammation during syphilis, reacting intensely with human syphilitic sera. We therefore used recombinant Tp17 (rTp17) as a stimulator in our study. Increasing evidence has demonstrated that microRNA (miRNA)-containing exosomes have emerged as a potential effective therapeutic target for many diseases. However, the biological functions and molecular mechanisms of miR-216a-5p in syphilis pathogenesis remain unknown. Our study first identified dramatically decreased miR-216a-5p in plasma of syphilis patients compared with the healthy control, which was negatively correlated with the expression of inflammatory cytokines, including IL-1ß, IL-6, and TNF-α. Moreover, endothelial cells treated with miR-216a-5p-containing exosomes significantly attenuated the rTp17-induced inflammatory response. More importantly, we identified that miR-216a-5p could bind to the 3'-untranslated region (UTR) of Toll-like receptor (TLR) 4 (TLR4), and overexpression of TLR4 largely rescued the miR-216a-5p-mediated suppression of rTp17-induced inflammatory cytokine production and the TLR4-MYD88 signaling pathway. Thus, our results reveal a novel role of miR-216a-5p-containing exosomes in endothelial cells, implying a potential therapeutic target for inflammation in syphilis patients.


Asunto(s)
Proteínas Bacterianas/inmunología , Exosomas/inmunología , MicroARNs/inmunología , Transducción de Señal/inmunología , Sífilis/inmunología , Receptor Toll-Like 4/inmunología , Treponema pallidum/inmunología , Proteínas Bacterianas/genética , Citocinas/inmunología , Exosomas/patología , Femenino , Células Endoteliales de la Vena Umbilical Humana/inmunología , Células Endoteliales de la Vena Umbilical Humana/patología , Humanos , Inflamación/inmunología , Inflamación/patología , Masculino , Factor 88 de Diferenciación Mieloide/inmunología , Proteínas Recombinantes/genética , Proteínas Recombinantes/inmunología , Sífilis/patología , Treponema pallidum/genética
16.
Diagn Microbiol Infect Dis ; 95(1): 89-92, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31279583

RESUMEN

Malignant syphilis (also known lues maligna) is a rare and severe variant of secondary syphilis. It is most commonly seen in patients who are infected with human immunodeficiency virus (HIV), and rarely, it can occur in immunocompetent individuals. The exact mechanism of the development of malignant syphilis is not clear. It could probably be associated with immunosuppression, inappropriate immune response of the host, or virulent strain of Treponema pallidum. Coexistence of immunosuppression and inappropriate immune response may predispose to develop malignant syphilis in HIV-infected patients with immune reconstitution inflammatory syndrome. Herein, we report the first case of malignant syphilis after adalimumab therapy for Crohn's disease due to bariatric surgery and discuss the underlying possible pathogenic mechanisms.


Asunto(s)
Adalimumab/efectos adversos , Antiinflamatorios/efectos adversos , Cirugía Bariátrica/efectos adversos , Enfermedad de Crohn/etiología , Sífilis/diagnóstico , Treponema pallidum/aislamiento & purificación , Adalimumab/uso terapéutico , Adulto , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Enfermedad de Crohn/tratamiento farmacológico , Femenino , Humanos , Penicilina G Benzatina/uso terapéutico , Sífilis/tratamiento farmacológico , Sífilis/etiología , Sífilis/patología , Resultado del Tratamiento , Treponema pallidum/efectos de los fármacos
17.
Clin Dermatol ; 37(3): 182-191, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31178101

RESUMEN

Despite advances in the control, diagnosis, and treatment of syphilis, its recognition is ill- understood or often not considered by dermatologists and other physicians who either have little specialized training in the minutiae of sexually transmitted infections (STIs) or whose dermatologic practice is only occasionally consulted by individuals from communities where STIs are prevalent. Our aim is to highlight contemporary ideas and findings on syphilis so that not only is an accurate diagnosis of syphilis made and recognized treatment given, but also necessary measures, such as counseling to exclude other STIs and to prevent reinfection, partner notification, and public health epidemiology as for any other infectious disease, are not forgotten. For syphilis, like human immunodeficiency virus (HIV) infection, not only is the biomedical aspect important, but also are the social and psychologic components.


Asunto(s)
Sífilis , Alopecia/etiología , Diagnóstico Diferencial , Doxiciclina/administración & dosificación , Femenino , Infecciones por VIH , Humanos , Infusiones Intravenosas , Inyecciones Intramusculares , Masculino , Membrana Mucosa/patología , Neurosífilis , Penicilina G Benzatina/administración & dosificación , Embarazo , Prevención Secundaria , Piel/patología , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/patología , Sífilis/transmisión , Serodiagnóstico de la Sífilis/métodos , Tetraciclina/administración & dosificación
18.
PLoS Negl Trop Dis ; 13(6): e0007463, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31216284

RESUMEN

BACKGROUND: Pathogenic treponemes related to Treponema pallidum are both human (causing syphilis, yaws, bejel) and animal pathogens (infections of primates, venereal spirochetosis in rabbits). A set of 11 treponemal genome sequences including those of five Treponema pallidum ssp. pallidum (TPA) strains (Nichols, DAL-1, Mexico A, SS14, Chicago), four T. p. ssp. pertenue (TPE) strains (CDC-2, Gauthier, Samoa D, Fribourg-Blanc), one T. p. ssp. endemicum (TEN) strain (Bosnia A) and one strain (Cuniculi A) of Treponema paraluisleporidarum ecovar Cuniculus (TPeC) were tested for the presence of positively selected genes. METHODOLOGY/PRINCIPAL FINDINGS: A total of 1068 orthologous genes annotated in all 11 genomes were tested for the presence of positively selected genes using both site and branch-site models with CODEML (PAML package). Subsequent analyses with sequences obtained from 62 treponemal draft genomes were used for the identification of positively selected amino acid positions. Synthetic biotinylated peptides were designed to cover positively selected protein regions and these peptides were tested for reactivity with the patient's syphilis sera. Altogether, 22 positively selected genes were identified in the TP genomes and TPA sets of positively selected genes differed from TPE genes. While genetic variability among TPA strains was predominantly present in a number of genetic loci, genetic variability within TPE and TEN strains was distributed more equally along the chromosome. Several syphilitic sera were shown to react with some peptides derived from the protein sequences evolving under positive selection. CONCLUSIONS/SIGNIFICANCE: The syphilis-, yaws-, and bejel-causing strains differed relative to sets of positively selected genes. Most of the positively selected chromosomal loci were identified among the TPA treponemes. The local accumulation of genetic variability suggests that the diversification of TPA strains took place predominantly in a limited number of genomic regions compared to the more dispersed genetic diversity differentiating TPE and TEN strains. The identification of positively selected sites in tpr genes and genes encoding outer membrane proteins suggests their role during infection of human and animal hosts. The driving force for adaptive evolution at these loci thus appears to be the host immune response as supported by observed reactivity of syphilitic sera with some peptides derived from protein sequences showing adaptive evolution.


Asunto(s)
Adaptación Biológica , Genes Bacterianos , Genotipo , Sífilis/microbiología , Sífilis/patología , Treponema pallidum/clasificación , Treponema pallidum/genética , Adulto , Genómica , Humanos , Selección Genética , Treponema pallidum/aislamiento & purificación , Adulto Joven
19.
PLoS One ; 14(5): e0217611, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31150464

RESUMEN

A recently introduced Multilocus Sequence Typing scheme for Treponema pallidum subsp. pallidum was applied to clinical samples collected from 2004 to 2017 from the two largest cities (Prague and Brno) in the Czech Republic. Altogether, a total of 675 samples were tested in this study and 281 of them were found PCR-positive for treponemal DNA and typeable. Most of the typed samples (n = 281) were swabs from primary or secondary syphilis lesions (n = 231), and only a minority were whole blood or tissue samples (n = 50). Swab samples from patients with rapid plasma regain (RPR) values of 1-1024 were more frequently PCR-positive (84.6%) compared to samples from patients with non-reactive RPR test (46.5%; p-value = 0.0001). Out of 281 typeable samples, 136 were fully-typed at all TP0136, TP0548, and TP0705 loci. Among the fully and partially typed samples, 25 different allelic profiles were identified. Altogether, eight novel allelic variants were found among fully (n = 5) and partially (n = 3) typed samples. The distribution of TPA allelic profiles identified in the Czech Republic from 2004 to 2017 revealed a dynamic character with allelic profiles disappearing and emerging over time. While the number of samples with the A2058G mutation was seen to increase (86.7% in 2016/2017), the number of samples harboring the A2059G mutation was found to have decreased over time (3.3% in 2016/2017). In addition, we found several allelic profile associations with macrolide resistance or susceptibility, the gender of patients, as well as patient residence.


Asunto(s)
Tipificación de Secuencias Multilocus , Sífilis/microbiología , Treponema pallidum/genética , Adulto , Alelos , Antibacterianos/farmacología , República Checa/epidemiología , ADN Bacteriano/genética , Farmacorresistencia Bacteriana/genética , Femenino , Genotipo , Humanos , Masculino , ARN Ribosómico 23S/genética , Sífilis/genética , Sífilis/patología , Treponema pallidum/patogenicidad , Adulto Joven
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