Evaluating congenital syphilis in a reverse sequence testing environment

May W. Chen; Ibukunoluwa C. Akinboyo; Paul K. Sue; Pamela K. Donohue; Khalil G. Ghanem; Barbara Detrick; Frank R. Witter; Kathleen R. Page; Ravit Arav-Boger; W. Christopher Golden

doi:10.1038/s41372-019-0387-9

Evaluating congenital syphilis in a reverse sequence testing environment

May W. Chen, Ibukunoluwa C. Akinboyo, Paul K. Sue, Pamela K. Donohue, Khalil G. Ghanem, Barbara Detrick, Frank R. Witter, Kathleen R. Page, Ravit Arav-Boger, W. Christopher Golden

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Objectives: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach. Study design: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR−/FTA+) serology were compared with national or internal guidelines. Results: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR−/FTA−; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS. Conclusions: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.

Original language	English (US)
Pages (from-to)	956-963
Number of pages	8
Journal	Journal of Perinatology
Volume	39
Issue number	7
DOIs	https://doi.org/10.1038/s41372-019-0387-9
State	Published - Jul 1 2019

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Obstetrics and Gynecology

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title = "Evaluating congenital syphilis in a reverse sequence testing environment",

abstract = "Objectives: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach. Study design: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR−/FTA+) serology were compared with national or internal guidelines. Results: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR−/FTA−; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS. Conclusions: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.",

author = "Chen, {May W.} and Akinboyo, {Ibukunoluwa C.} and Sue, {Paul K.} and Donohue, {Pamela K.} and Ghanem, {Khalil G.} and Barbara Detrick and Witter, {Frank R.} and Page, {Kathleen R.} and Ravit Arav-Boger and Golden, {W. Christopher}",

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AU - Akinboyo, Ibukunoluwa C.

AU - Sue, Paul K.

AU - Donohue, Pamela K.

AU - Ghanem, Khalil G.

AU - Detrick, Barbara

AU - Witter, Frank R.

AU - Page, Kathleen R.

AU - Arav-Boger, Ravit

AU - Golden, W. Christopher

PY - 2019/7/1

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N2 - Objectives: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach. Study design: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR−/FTA+) serology were compared with national or internal guidelines. Results: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR−/FTA−; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS. Conclusions: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.

AB - Objectives: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach. Study design: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR−/FTA+) serology were compared with national or internal guidelines. Results: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR−/FTA−; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS. Conclusions: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.

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Evaluating congenital syphilis in a reverse sequence testing environment

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