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Acta Dermato-venereologica May 2024
Topics: Humans; Male; Syphilis; Treponema pallidum; Anti-Bacterial Agents; Treatment Outcome; Adult; Syphilis, Cutaneous; Syphilis Serodiagnosis; Biopsy; Skin
PubMed: 38813741
DOI: 10.2340/actadv.v104.27983 -
PloS One 2024Rapid syphilis testing plays a crucial role in global health strategies, addressing the urgent need for prompt and accurate diagnostics, especially in settings with...
Rapid syphilis testing plays a crucial role in global health strategies, addressing the urgent need for prompt and accurate diagnostics, especially in settings with limited resources. Despite their practical utility, these tests often lack thorough validation, leading to concerns about their efficacy and reliability. This study aims to evaluate two prototypes of the Onsite Syphilis Ab Combo Rapid Test (Fd and Ff) and compare their performance with the established chemiluminescent microparticle immunoassay (CMIA) method. Employing a reverse algorithm approach, the study analyzed 450 serum samples, including those from syphilis patients, healthy individuals, and cases with potential cross-reactions. Results of the rapid test kit were then correlated with CMIA findings, RPR, and TPPA titers. The results showed that prototype Fd exhibited a sensitivity of 100.0%, specificity of 98.8%, positive predictive value (PPV) of 8.4%, negative predictive value (NPV) of 100.00% and accuracy of 98.8%. Similarly, prototype Ff exhibited sensitivity of 100.0%, but with a slightly higher specificity of 99.6%, PPV of 21.5%, NPV of 100.0% and accuracy of 99.6%. Moreover, both prototypes Fd and Ff of the Onsite Syphilis Ab Combo Rapid Test demonstrated significant efficacy diagnostic tool, offering clear and straightforward interpretation for clinicians in varied CMIA, RPR and TPPA titer scenarios. The Onsite Syphilis Ab Combo Rapid Test prototypes, Fd and Ff, demonstrated high sensitivity and specificity, comparable to CMIA methods. The effectiveness highlights their suitability for syphilis screening, particularly in non-laboratory settings or situations requiring immediate results. The validation of these prototypes supports their integration into current syphilis diagnostic algorithms, potentially contributing to improved public health outcomes.
Topics: Humans; Treponema pallidum; Syphilis; Reagent Kits, Diagnostic; Antibodies, Bacterial; Syphilis Serodiagnosis; Sensitivity and Specificity; Male; Female; Adult; Middle Aged; Immunoassay; Reproducibility of Results; Rapid Diagnostic Tests
PubMed: 38809884
DOI: 10.1371/journal.pone.0303477 -
Scientific Reports May 2024Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of...
Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2-25.5) and Leptospira spp. (1.7%, 95% CI 0.4-4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5-17 years old had 4.02 (95% CI 1.18-13.70, p-value = 0.03) and 2.42 (95% CI 1.09-5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35-80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22-4.68, p-value = 0.01) and 2.24 (1.15-4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations.
Topics: Humans; Kenya; Adolescent; Male; Child; Female; Adult; Child, Preschool; Middle Aged; Leptospirosis; Fever; Animals; Young Adult; Leptospira; Bacterial Zoonoses; Brucellosis; Brucella; Outpatients; Q Fever; Aged; Serologic Tests; Zoonoses
PubMed: 38806576
DOI: 10.1038/s41598-024-62714-8 -
Indian Journal of Ophthalmology Jun 2024Leptospirosis is a waterborne zoonotic disease prevalent in tropical regions, causing significant morbidity and mortality. It can involve any organ in its primary stage,...
PURPOSE
Leptospirosis is a waterborne zoonotic disease prevalent in tropical regions, causing significant morbidity and mortality. It can involve any organ in its primary stage, and uveitis is its late complication. While advanced laboratory diagnosis is available only in tertiary care centers globally, a cost-effective bedside assessment of clinical signs and their scoring could offer a provisional diagnosis.
AIM
To analyze the diagnostic potential of demographic and clinical signs in a large cohort of serologically confirmed leptospiral uveitis patients.
METHODS
In this retrospective study, demographic and clinical parameters of 876 seropositive leptospiral uveitis patients and 1042 nonleptospiral uveitis controls were studied. Multivariable logistic regression analysis with bootstrap confidence interval (CI) characterized the diagnostic predictors. The performance of the model was evaluated using the area under the receiver operating curve (AUROC).
RESULTS
Presence of nongranulomatous uveitis (odds ratio [OR] = 6.9), hypopyon (OR = 4.6), vitreous infiltration with membranous opacities (OR = 4.3), bilateral involvement (OR = 4), panuveitis (OR = 3.3), vasculitis (OR = 1.9), disc hyperemia (OR = 1.6), absence of retinochoroiditis (OR = 15), and absence of cystoid macular edema (OR = 8.9) emerged as predictive parameters. The AUROC value was 0.86 with 95% CI of 0.846-0.874. At a cut-off score of 40, the sensitivity and specificity were 79.5 and 78.4, respectively.
CONCLUSION
The study demonstrates that ocular signs can serve as diagnostic predictors for leptospiral uveitis, enabling primary care ophthalmologists to make bedside diagnosis. This can be further confirmed by laboratory methods available at tertiary care centers.
Topics: Humans; Retrospective Studies; Leptospirosis; Male; Female; Eye Infections, Bacterial; Uveitis; Adult; Leptospira; Middle Aged; ROC Curve; Young Adult; Adolescent
PubMed: 38804803
DOI: 10.4103/IJO.IJO_1376_23 -
CMAJ : Canadian Medical Association... May 2024
Topics: Humans; Syphilis; Point-of-Care Systems; Syphilis Serodiagnosis; Treponema pallidum; Point-of-Care Testing; Sensitivity and Specificity
PubMed: 38802133
DOI: 10.1503/cmaj.231548 -
The Western Journal of Emergency... May 2024The incidence of sexually transmitted infections (STI) increased in the United States between 2017-2021. There is limited data describing STI co-testing practices and...
INTRODUCTION
The incidence of sexually transmitted infections (STI) increased in the United States between 2017-2021. There is limited data describing STI co-testing practices and the prevalence of STI co-infections in emergency departments (ED). In this study, we aimed to describe the prevalence of co-testing and co-infection of HIV, hepatitis C virus (HCV), syphilis, gonorrhea, and chlamydia, in a large, academic ED.
METHODS
This was a single-center, retrospective cross-sectional study of ED patients tested for HIV, HCV, syphilis, gonorrhea or chlamydia between November 27, 2018-May 26, 2019. In 2018, the study institution implemented an ED-based infectious diseases screening program in which any patient being tested for gonorrhea/chlamydia was eligible for opt-out syphilis screening, and any patient 18-64 years who was having blood drawn for any clinical purpose was eligible for opt-out HIV and HCV screening. We analyzed data from all ED patients ≥13 years who had undergone STI testing. The outcomes of interest included prevalence of STI testing/co-testing and the prevalence of STI infection/co-infection. We describe data with simple descriptive statistics.
RESULTS
During the study period there were 30,767 ED encounters for patients ≥13 years (mean age: 43 ± 14 years, 52% female), and 7,866 (26%) were tested for at least one of HIV, HCV, syphilis, gonorrhea, or chlamydia. We observed the following testing frequencies (and prevalence of infection): HCV, 7,539 (5.0%); HIV, 7,359 (0.9%); gonorrhea, 574 (6.1%); chlamydia, 574 (9.8%); and syphilis, 420 (10.5%). Infectious etiologies with universal testing protocols (HIV and HCV) made up the majority of STI testing. In patients with syphilis, co-infection with chlamydia (21%, 9/44) and HIV (9%, 4/44) was high. In patients with gonorrhea, co-infection with chlamydia (23%, 8/35) and syphilis (9%, 3/35) was high, and in patients with chlamydia, co-infection with syphilis (16%, 9/56) and gonorrhea (14%, 8/56) was high. Patients with HCV had low co-infection proportions (<2%).
CONCLUSION
Prevalence of STI co-testing was low among patients with clinical suspicion for STIs; however, co-infection prevalence was high in several co-infection pairings. Future efforts are needed to improve STI co-testing rates among high-risk individuals.
Topics: Humans; Cross-Sectional Studies; Female; Retrospective Studies; Adult; Male; Emergency Service, Hospital; Sexually Transmitted Diseases; Coinfection; Gonorrhea; Syphilis; Prevalence; Middle Aged; Hepatitis C; Mass Screening; HIV Infections; Chlamydia Infections; Adolescent; Young Adult
PubMed: 38801045
DOI: 10.5811/westjem.18404 -
Narra J Apr 2024Leptospirosis is an uncommon infectious illness - a spirochetal zoonosis - caused by species and the primary cause of human leptospirosis is exposure to the urine of...
Leptospirosis is an uncommon infectious illness - a spirochetal zoonosis - caused by species and the primary cause of human leptospirosis is exposure to the urine of infected rodents. Clinical manifestations of human leptospirosis are diverse, ranging from asymptomatic infection to severe life-threatening with multiorgan dysfunction. The severe condition is known as Weil's disease, which is characterized by feverish illness with jaundice, acute kidney damage, and bleeding. The aim of this case report was to present a Weil's disease which occurred simultaneously with a community-acquired pneumonia (CAP) resulting in serious complications. A 41-year-old man with Weil's disease, as well as CAP caused by , and septic shock was presented. The patient was treated accordingly after establishing the diagnosis through history taking, physical examination, and laboratory tests. In this instance, the score for diagnosing leptospirosis based on Modified Faine's Criteria was calculated resulting possible diagnoses; and therefore, therapeutic management was initiated. Despite presenting with severe symptoms, the patient recovered completely after receiving antibiotics and supportive care. This study highlights that when a patient has Weil's disease and a CAP infection, which could cause unfavorable consequence, a prompt diagnosis and proper treatment could result satisfied patient recovery.
Topics: Humans; Adult; Male; Shock, Septic; Community-Acquired Infections; Multiple Organ Failure; Weil Disease; Anti-Bacterial Agents; Pneumonia
PubMed: 38798843
DOI: 10.52225/narra.v4i1.587 -
PloS One 2024In this work, we determined that Treponema pallidum subsp. pallidum (TPA) DAL-1 (belonging to Nichols-like group of TPA strains) grew 1.53 (± 0.08) times faster...
In this work, we determined that Treponema pallidum subsp. pallidum (TPA) DAL-1 (belonging to Nichols-like group of TPA strains) grew 1.53 (± 0.08) times faster compared to TPA Philadelphia 1 (SS14-like group) during in vitro cultivations. In longitudinal individual propagation in rabbit testes (n = 12, each TPA strain), infection with DAL-1 manifested clinical symptoms (induration, swelling, and erythema of testes) sooner than Philadelphia 1 infection, which resulted in a significantly shorter period of the experimental passages for DAL-1 (median = 15.0 and 23.5 days, respectively; p < 0.01). To minimize the confounding conditions during rabbit experiments, the growth characteristics of DAL-1 and Philadelphia 1 strains were determined during TPA co-infection of rabbit testes (n = 20, including controls). During two weeks of intratesticular co-infection, DAL-1 overgrew Philadelphia 1 in all twelve testes, regardless of inoculation ratio and dose (median of relative excess DAL-1 multiplication = 84.85×). Moreover, higher DAL-1 to Philadelphia 1 inoculum ratios appeared to increase differences in growth rates, suggesting direct competition between strains for available nutrients during co-infection. These experiments indicate important physiological differences between the two TPA strains and suggest growth differences between Nichols-like and SS14-like strains that are potentially linked to their virulence and pathogenicity.
Topics: Animals; Rabbits; Male; Treponema pallidum; Testis; Syphilis
PubMed: 38787868
DOI: 10.1371/journal.pone.0304033 -
Microbial Genomics May 2024Lyme disease (LD), caused by spirochete bacteria of the genus , remains the most common vector-borne disease in the northern hemisphere. outer surface protein A (OspA)...
Lyme disease (LD), caused by spirochete bacteria of the genus , remains the most common vector-borne disease in the northern hemisphere. outer surface protein A (OspA) is an integral surface protein expressed during the tick cycle, and a validated vaccine target. There are at least 20 recognized genospecies, that vary in OspA serotype. This study presents a new sequence-based method for OspA typing using next-generation sequence data. Using a compiled database of over 400 genomes encompassing the 4 most common disease-causing genospecies, we characterized OspA diversity in a manner that can accommodate existing and new OspA types and then defined boundaries for classification and assignment of OspA types based on the sequence similarity. To accommodate potential novel OspA types, we have developed a new nomenclature: OspA type (IST). Beyond the ISTs that corresponded to existing OspA serotypes 1-8, we identified nine additional ISTs that cover new OspA variants in (IST9-10), (IST11-12), and other genospecies (IST13-17). The IST typing scheme and associated OspA variants are available as part of the PubMLST spp. database. Compared to traditional OspA serotyping methods, this new computational pipeline provides a more comprehensive and broadly applicable approach for characterization of OspA type and genospecies to support vaccine development.
Topics: Bacterial Outer Membrane Proteins; Lyme Disease; Lipoproteins; Antigens, Surface; Borrelia burgdorferi; Computer Simulation; Humans; Genome, Bacterial; Borrelia burgdorferi Group; High-Throughput Nucleotide Sequencing; Serogroup; Phylogeny; Bacterial Vaccines
PubMed: 38787376
DOI: 10.1099/mgen.0.001252 -
Scientific Reports May 2024Indigenous communities in Brazil have a complex epidemiological profile, which increases their chances of contracting sexually transmitted diseases. However, limited...
Indigenous communities in Brazil have a complex epidemiological profile, which increases their chances of contracting sexually transmitted diseases. However, limited data is available on Treponema pallidum infections in this population. We investigated the seroprevalence and risk factors associated with T. pallidum infection in an indigenous population of Dourados, Mato Grosso do Sul. Blood samples were collected from September 2017 to March 2020, and the participants were interviewed to obtain comprehensive data on demography and sexual behavior. Serological tests were performed to detect T. pallidum infection. Besides conducting descriptive analysis, we performed Chi-squared tests and determined the bivariate odds ratio. The data were also analyzed using logistic regression. Among the 2190 invited individuals, 1927 (88%) were included in this study. The seroprevalence of T. pallidum infection was 2.91%. The results of a multivariate analysis showed that individuals who were 30-39 years old, with up to 4 years of school education, living in households without piped water, with a history of genital lesions, multiple sexual partners, and having a history of STIs had the highest seroprevalence of T. pallidum. This study showed that behavioral, social, and economic factors play an important role in the transmission of T. pallidum within the indigenous population. Thus, targeted intervention, including imparting education in the native language, mass testing initiatives, and implementing public policies to improve socioeconomic indicators, is needed to reduce the cases of syphilis in this community.
Topics: Humans; Brazil; Male; Adult; Female; Syphilis; Seroepidemiologic Studies; Cross-Sectional Studies; Treponema pallidum; Young Adult; Middle Aged; Adolescent; Risk Factors; Indigenous Peoples; Sexual Behavior
PubMed: 38782949
DOI: 10.1038/s41598-024-59369-w