Spirochetemia due to Treponema pallidum using polymerase-chain-reaction assays in patients with early syphilis: prevalence, associated factors and treatment response

Clin Microbiol Infect. 2014 Aug;20(8):O524-7. doi: 10.1111/1469-0691.12504. Epub 2014 Jan 21.

Abstract

Between 2009 and 2013, polymerase-chain-reaction assay was used to detect Treponema pallidum in the blood samples collected from 296 patients with early syphilis (241 being HIV infected) and 102 patients (34.5%) had spirochetemia. The presence of spirochetemia was associated with lower CD4 counts (per 10-cell/mm(3) decrease, adjusted odds ratio (AOR), 1.020; 95% CI, 1.006-1.036) and secondary syphilis (AOR, 4.967; 95% CI, 2.016-12.238). Patients with early latent syphilis were less likely to achieve serological response compared with those with primary or secondary syphilis (AOR, 0.317; 95% CI, 0.142-0.708). However, serological response was not affected by presence of spirochetemia or antibiotic regimens.

Keywords: Azithromycin; molecular diagnosis; penicillin; sexually transmitted infection; spirochete.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy*
  • Bacteremia / epidemiology
  • CD4 Lymphocyte Count
  • DNA, Bacterial / blood*
  • Female
  • Humans
  • Male
  • Polymerase Chain Reaction*
  • Prevalence
  • Syphilis / diagnosis*
  • Syphilis / drug therapy*
  • Syphilis / epidemiology
  • Treponema pallidum / isolation & purification*

Substances

  • Anti-Bacterial Agents
  • DNA, Bacterial