Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum

Pablo J. Sánchez, George D. Wendel, Emmanuel Grimprel, Martin Goldberg, Mary Hall, Orlando Arencibia-Mireles, Justin D. Radolf, Michael V. Norgard

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

IgM immunoblotting and polymerase chain reaction (PCR) were evaluated for use in diagnosing congenital syphilis, and the prevalence of central nervous system (CNS) invasion by Treponema pallidum during congenital infection was examined. The results of rabbit infectivity testing (RIT) on serum and cerebrospinal fluid (CSF) of 19 infants born to mothers with untreated early syphilis were compared with results of PCR and IgM immunoblotting. Seven infants had clinical evidence of congenital syphilis supported by positive serum IgM immunoblot (7/7), PCR (6/7), and RIT (3/3). Six symptomatic infants (86%) had T. pallidum isolated from CSF by RIT; 5 of 6 RIT-positive CSF samples were positive by PCR, and 2 also were reactive by IgM immunoblot. In 12 asymptomatic infants, 5 (42%) had a reactive serum IgM immunoblot and in 4 of these IgM reactivity was the only evidence of congenital infection. CNS invasion by T. pallidum was uncommon among asymptomatic infants; only 1 (8%) was positive by CSF RIT. The excellent agreement between RIT and PCR further substantiates the use of PCR as a surrogate for RIT. Our data indicate that the diagnosis of asymptomatically infected neonates will require a comprehensive approach using assays for both specific neonatal IgM and T. pallidum DNA in serum and CSF.

Original languageEnglish (US)
Pages (from-to)148-157
Number of pages10
JournalJournal of Infectious Diseases
Volume167
Issue number1
StatePublished - Jan 1993

Fingerprint

Congenital Syphilis
Treponema pallidum
Immunoglobulin M
Central Nervous System
Rabbits
Cerebrospinal Fluid
Polymerase Chain Reaction
Serum
Immunoblotting
Syphilis
Infection
Mothers
Newborn Infant

ASJC Scopus subject areas

  • Immunology
  • Public Health, Environmental and Occupational Health

Cite this

Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum. / Sánchez, Pablo J.; Wendel, George D.; Grimprel, Emmanuel; Goldberg, Martin; Hall, Mary; Arencibia-Mireles, Orlando; Radolf, Justin D.; Norgard, Michael V.

In: Journal of Infectious Diseases, Vol. 167, No. 1, 01.1993, p. 148-157.

Research output: Contribution to journalArticle

Sánchez, Pablo J. ; Wendel, George D. ; Grimprel, Emmanuel ; Goldberg, Martin ; Hall, Mary ; Arencibia-Mireles, Orlando ; Radolf, Justin D. ; Norgard, Michael V. / Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum. In: Journal of Infectious Diseases. 1993 ; Vol. 167, No. 1. pp. 148-157.
@article{ab8cfcc56ed3473b9f9156eaa7b987cb,
title = "Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum",
abstract = "IgM immunoblotting and polymerase chain reaction (PCR) were evaluated for use in diagnosing congenital syphilis, and the prevalence of central nervous system (CNS) invasion by Treponema pallidum during congenital infection was examined. The results of rabbit infectivity testing (RIT) on serum and cerebrospinal fluid (CSF) of 19 infants born to mothers with untreated early syphilis were compared with results of PCR and IgM immunoblotting. Seven infants had clinical evidence of congenital syphilis supported by positive serum IgM immunoblot (7/7), PCR (6/7), and RIT (3/3). Six symptomatic infants (86{\%}) had T. pallidum isolated from CSF by RIT; 5 of 6 RIT-positive CSF samples were positive by PCR, and 2 also were reactive by IgM immunoblot. In 12 asymptomatic infants, 5 (42{\%}) had a reactive serum IgM immunoblot and in 4 of these IgM reactivity was the only evidence of congenital infection. CNS invasion by T. pallidum was uncommon among asymptomatic infants; only 1 (8{\%}) was positive by CSF RIT. The excellent agreement between RIT and PCR further substantiates the use of PCR as a surrogate for RIT. Our data indicate that the diagnosis of asymptomatically infected neonates will require a comprehensive approach using assays for both specific neonatal IgM and T. pallidum DNA in serum and CSF.",
author = "S{\'a}nchez, {Pablo J.} and Wendel, {George D.} and Emmanuel Grimprel and Martin Goldberg and Mary Hall and Orlando Arencibia-Mireles and Radolf, {Justin D.} and Norgard, {Michael V.}",
year = "1993",
month = "1",
language = "English (US)",
volume = "167",
pages = "148--157",
journal = "The Journal of infectious diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Evaluation of molecular methodologies and rabbit infectivity testing for the diagnosis of congenital syphilis and neonatal central nervous system invasion by Treponema pallidum

AU - Sánchez, Pablo J.

AU - Wendel, George D.

AU - Grimprel, Emmanuel

AU - Goldberg, Martin

AU - Hall, Mary

AU - Arencibia-Mireles, Orlando

AU - Radolf, Justin D.

AU - Norgard, Michael V.

PY - 1993/1

Y1 - 1993/1

N2 - IgM immunoblotting and polymerase chain reaction (PCR) were evaluated for use in diagnosing congenital syphilis, and the prevalence of central nervous system (CNS) invasion by Treponema pallidum during congenital infection was examined. The results of rabbit infectivity testing (RIT) on serum and cerebrospinal fluid (CSF) of 19 infants born to mothers with untreated early syphilis were compared with results of PCR and IgM immunoblotting. Seven infants had clinical evidence of congenital syphilis supported by positive serum IgM immunoblot (7/7), PCR (6/7), and RIT (3/3). Six symptomatic infants (86%) had T. pallidum isolated from CSF by RIT; 5 of 6 RIT-positive CSF samples were positive by PCR, and 2 also were reactive by IgM immunoblot. In 12 asymptomatic infants, 5 (42%) had a reactive serum IgM immunoblot and in 4 of these IgM reactivity was the only evidence of congenital infection. CNS invasion by T. pallidum was uncommon among asymptomatic infants; only 1 (8%) was positive by CSF RIT. The excellent agreement between RIT and PCR further substantiates the use of PCR as a surrogate for RIT. Our data indicate that the diagnosis of asymptomatically infected neonates will require a comprehensive approach using assays for both specific neonatal IgM and T. pallidum DNA in serum and CSF.

AB - IgM immunoblotting and polymerase chain reaction (PCR) were evaluated for use in diagnosing congenital syphilis, and the prevalence of central nervous system (CNS) invasion by Treponema pallidum during congenital infection was examined. The results of rabbit infectivity testing (RIT) on serum and cerebrospinal fluid (CSF) of 19 infants born to mothers with untreated early syphilis were compared with results of PCR and IgM immunoblotting. Seven infants had clinical evidence of congenital syphilis supported by positive serum IgM immunoblot (7/7), PCR (6/7), and RIT (3/3). Six symptomatic infants (86%) had T. pallidum isolated from CSF by RIT; 5 of 6 RIT-positive CSF samples were positive by PCR, and 2 also were reactive by IgM immunoblot. In 12 asymptomatic infants, 5 (42%) had a reactive serum IgM immunoblot and in 4 of these IgM reactivity was the only evidence of congenital infection. CNS invasion by T. pallidum was uncommon among asymptomatic infants; only 1 (8%) was positive by CSF RIT. The excellent agreement between RIT and PCR further substantiates the use of PCR as a surrogate for RIT. Our data indicate that the diagnosis of asymptomatically infected neonates will require a comprehensive approach using assays for both specific neonatal IgM and T. pallidum DNA in serum and CSF.

UR - http://www.scopus.com/inward/record.url?scp=0027533109&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027533109&partnerID=8YFLogxK

M3 - Article

C2 - 8418161

AN - SCOPUS:0027533109

VL - 167

SP - 148

EP - 157

JO - The Journal of infectious diseases

JF - The Journal of infectious diseases

SN - 0022-1899

IS - 1

ER -