Accuracy of PCR and serological testing for the diagnosis of primary syphilis: Both tests are necessary

NODA, Angel A., Islay RODRIGUEZ, Linda GRILLOVÁ, Philipp P. BOSSHARD and Reto LIENHARD. Accuracy of PCR and serological testing for the diagnosis of primary syphilis: Both tests are necessary. INTERNATIONAL JOURNAL OF STD & AIDS. LONDON: SAGE PUBLICATIONS LTD, 2019, vol. 30, No 11, p. 1087-1094. ISSN 0956-4624. Available from: https://dx.doi.org/10.1177/0956462419859764.

Basic information

• Original name: Accuracy of PCR and serological testing for the diagnosis of primary syphilis: Both tests are necessary
• Authors: NODA, Angel A. (192 Cuba, guarantor), Islay RODRIGUEZ (192 Cuba), Linda GRILLOVÁ (203 Czech Republic, belonging to the institution), Philipp P. BOSSHARD (756 Switzerland) and Reto LIENHARD (756 Switzerland).
• Edition: INTERNATIONAL JOURNAL OF STD & AIDS, LONDON, SAGE PUBLICATIONS LTD, 2019, 0956-4624.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30303 Infectious Diseases
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 1.406
• RIV identification code: RIV/00216224:14110/19:00112504
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1177/0956462419859764
• UT WoS: 000490799700001
• Keywords in English: Syphilis diagnosis; PCR; serology
• Tags: 14110513, rivok
• Tags: International impact, Reviewed

Abstract

Syphilis, caused by the spirochete Treponema pallidum subspecies pallidum, is a rising global public health concern and laboratory diagnostics remain challenging. Especially during early disease, rapid and accurate diagnosis is crucial to ensure patients and their contacts receive timely treatment to eradicate infection and prevent further transmission. In this prospective observational study, we evaluated the performance of polymerase chain reaction (PCR) and serological testing for the diagnosis of primary syphilis by evaluating anogenital swabs and sera from 178 Cuban patients presenting with ulcers. Three different PCR assays were evaluated targeting polA, tpp47 and 16S rDNA loci. Sera were evaluated with venereal disease research laboratory (VDRL) and T. pallidum hemagglutination (TPHA) assays. Assuming both methods were confirmatory, our data showed that PCR and serology did not correlate well (agreement = 52.3%, kappa 0.0512, 95% CI -0.0928-0.1951, p = 0.496). The sensitivities, specificities, positive and negative predictive values of the PCR assays were 76.1%, 100%, 100% and 57.9%, respectively, while the values for serology were 62.5%, 100%, 100% and 45.2%, respectively. The combination of PCR and serology can offer valuable information for the diagnosis of syphilis in patients presenting with anogenital ulceration avoiding further clinical complications and disease transmission.