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 journalArticle

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 languageEnglish (US)
JournalJournal of Perinatology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Congenital Syphilis
Reagins
Immunoassay
Serology
Mothers
Syphilis
Retrospective Studies
Guidelines
Antibodies
Population

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Chen, M. W., Akinboyo, I. C., Sue, P. K., Donohue, P. K., Ghanem, K. G., Detrick, B., ... Golden, W. C. (2019). Evaluating congenital syphilis in a reverse sequence testing environment. Journal of Perinatology. https://doi.org/10.1038/s41372-019-0387-9

Evaluating congenital syphilis in a reverse sequence testing environment. / Chen, May W.; Akinboyo, Ibukunoluwa C.; Sue, Paul K; Donohue, Pamela K.; Ghanem, Khalil G.; Detrick, Barbara; Witter, Frank R.; Page, Kathleen R.; Arav-Boger, Ravit; Golden, W. Christopher.

In: Journal of Perinatology, 01.01.2019.

Research output: Contribution to journalArticle

Chen, MW, Akinboyo, IC, Sue, PK, Donohue, PK, Ghanem, KG, Detrick, B, Witter, FR, Page, KR, Arav-Boger, R & Golden, WC 2019, 'Evaluating congenital syphilis in a reverse sequence testing environment', Journal of Perinatology. https://doi.org/10.1038/s41372-019-0387-9
Chen, May W. ; Akinboyo, Ibukunoluwa C. ; Sue, Paul K ; Donohue, Pamela K. ; Ghanem, Khalil G. ; Detrick, Barbara ; Witter, Frank R. ; Page, Kathleen R. ; Arav-Boger, Ravit ; Golden, W. Christopher. / Evaluating congenital syphilis in a reverse sequence testing environment. In: Journal of Perinatology. 2019.
@article{085b435c90f04c48b31013ce9b304ae5,
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}",
year = "2019",
month = "1",
day = "1",
doi = "10.1038/s41372-019-0387-9",
language = "English (US)",
journal = "Journal of Perinatology",
issn = "0743-8346",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Evaluating congenital syphilis in a reverse sequence testing environment

AU - Chen, May W.

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 - 2019/1/1

Y1 - 2019/1/1

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.

UR - http://www.scopus.com/inward/record.url?scp=85065649696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065649696&partnerID=8YFLogxK

U2 - 10.1038/s41372-019-0387-9

DO - 10.1038/s41372-019-0387-9

M3 - Article

C2 - 31076626

AN - SCOPUS:85065649696

JO - Journal of Perinatology

JF - Journal of Perinatology

SN - 0743-8346

ER -