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@article{1312005,
author = {Šmajs, David and Paštěková, Lenka and Grillová, Linda},
article_location = {McLean},
article_number = {4},
doi = {http://dx.doi.org/10.4269/ajtmh.15-0316},
keywords = {SINGLE-DOSE AZITHROMYCIN; COMPLETE GENOME SEQUENCE; RIBOSOMAL-RNA GENES; HUMAN-IMMUNODEFICIENCY-VIRUS; PENICILLIN-BINDING PROTEIN; TIME MULTIPLEX PCR; SECONDARY SYPHILIS; TREATMENT FAILURE; POINT MUTATION; ERYTHROMYCIN RESISTANCE},
language = {eng},
issn = {0002-9637},
journal = {American Journal of Tropical Medicine and Hygiene},
title = {Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains?},
volume = {93},
year = {2015}
}
TY - JOUR
ID - 1312005
AU - Šmajs, David - Paštěková, Lenka - Grillová, Linda
PY - 2015
TI - Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains?
JF - American Journal of Tropical Medicine and Hygiene
VL - 93
IS - 4
SP - 678-683
EP - 678-683
PB - American Society of Tropical Medicine and Hygiene
SN - 00029637
KW - SINGLE-DOSE AZITHROMYCIN
KW - COMPLETE GENOME SEQUENCE
KW - RIBOSOMAL-RNA GENES
KW - HUMAN-IMMUNODEFICIENCY-VIRUS
KW - PENICILLIN-BINDING PROTEIN
KW - TIME MULTIPLEX PCR
KW - SECONDARY SYPHILIS
KW - TREATMENT FAILURE
KW - POINT MUTATION
KW - ERYTHROMYCIN RESISTANCE
N2 - Treponema pallidum ssp. pallidum (TPA) causes over 10 million new cases of syphilis worldwide whereas T. pallidum ssp. pertenue (TPE), the causative agent of yaws, affects about 2.5 million people. Although penicillin remains the drug of choice in the treatment of syphilis, in penicillin-allergic patients, macrolides have been used in this indication since the 1950s. Failures of macrolides in syphilis treatment have been well documented in the literature and since 2000, there has been a dramatic increase in a number of clinical samples with macrolide-resistant TPA. Scarce data regarding the genetics of macrolide-resistant mutations in TPA suggest that although macrolideresistance mutations have emerged independently several times, the increase in the proportion of TPA strains resistant to macrolides is mainly due to the spread of resistant strains, especially in developed countries. The emergence of macrolide resistance in TPA appears to require a two-step process including either A2058G or A2059G mutation in one copy of the 23S rRNA gene and a subsequent gene conversion unification of both rRNA genes. Given the enormous genetic similarity that was recently revealed between TPA and TPE strains, there is a low but reasonable risk of emergence and spread of macrolide-resistant yaws strains following azithromycin treatment.
ER -
ŠMAJS, David, Lenka PAŠTĚKOVÁ and Linda GRILLOVÁ. Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains? \textit{American Journal of Tropical Medicine and Hygiene}. McLean: American Society of Tropical Medicine and Hygiene, 2015, vol.~93, No~4, p.~678-683. ISSN~0002-9637. Available from: https://dx.doi.org/10.4269/ajtmh.15-0316.
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