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Abstract：
Between 2010 and 2014, we obtained swab specimens to detect Treponema pallidum, with PCR assays, from the oral cavities of 240 patients with 267 episodes of syphilis who reported engaging in unprotected sex practices. The detected treponemal DNA was subjected to genotyping. All of the syphilis cases occurred in men who have sex with men (MSM), and 242 (90.6%) occurred in human immunodeficiency virus-infected patients. The stages of syphilis included 38 cases (14.2%) of primary syphilis of the genital region, 76 (28.5%) of secondary syphilis, 21 (7.9%) of primary and secondary syphilis, 125 (46.8%) of early latent syphilis, and seven (2.6%) others. Concurrent oral ulcers were identified in 22 cases (8.2%). Treponemal DNA was identified from the swabs of 113 patients (42.2%), including 15 (68.2%) with oral ulcers. The most common genotype of T. pallidum was 14f/f. The presence of oral ulcers was associated with identification of T. pallidum in the swab specimens (15/22 (68.2%) vs. 98/245 (40.0%)) (p = 0.01). In multivariate analysis, secondary syphilis (adjusted OR 6.79; 95% CI 1.97-23.28) and rapid plasma reagin (RPR) titres of ≥1: 32 (adjusted OR 2.23; 95% CI 1.02-4.89) were independently associated with the presence of treponemal DNA in patients without oral ulcers. We conclude that detection of treponemal DNA in the oral cavity with PCR assays is not uncommon in MSM, most of whom reported having unprotected oral sex. Although the presence of oral ulcers is significantly associated with detection of treponemal DNA, treponemal DNA is more likely to be identified in patients without oral ulcers who present with secondary syphilis and RPR titres of ≥1: 32.
摘要：
在2010年至2014年之间，我们获得了拭子标本来检测梅毒螺旋体，用PCR检测，来自240例梅毒患者的口腔，其中267例，他们报告从事无保护的性行为。对检测到的螺旋体DNA进行基因分型。所有梅毒病例都发生在男男性行为者（MSM）中，242例(90.6%)发生在人类免疫缺陷病毒感染患者中。梅毒分期包括38例（14.2%）生殖器地区的原发性梅毒，76例（28.5%）二期梅毒，21例（7.9％）原发性和继发性梅毒，125（46.8％）早期潜伏梅毒，和其他七个(2.6%)。22例（8.2％）并发口腔溃疡。从113例患者（42.2%）的拭子中鉴定出螺旋体DNA，其中口腔溃疡15例(68.2%)。梅毒螺旋体最常见的基因型为14f/f。口腔溃疡的存在与拭子标本中梅毒螺旋体的鉴定有关（15/22（68.2％）与98/245（40.0%））（p=0.01）。在多变量分析中，在无口腔溃疡的患者中,二期梅毒(校正OR6.79;95%CI1.97~23.28)和快速血浆反应素(RPR)滴度≥1:32(校正OR2.23;95%CI1.02~4.89)与螺旋体DNA的存在独立相关.我们得出的结论是，用PCR测定法检测口腔中的螺旋体DNA在MSM中并不少见，其中大多数人报告说没有保护口交。虽然口腔溃疡的存在与螺旋体DNA的检测显著相关，在无口腔溃疡且存在二期梅毒且RPR滴度≥1:32的患者中更有可能鉴定出密螺旋体DNA。
