PDF(Pubmed)
Abstract：
Syphilis, caused by Treponema pallidum, is resurging globally. Molecular typing allows for the investigation of its epidemiology. In Pakistan and other nations, T. pallidum subsp. pallidum has developed widespread macrolide resistance in the past decade. A study at the Peshawar Regional Blood Centre from June 2020-June 2021 analyzed serum samples from 32,812 blood donors in Khyber Pakhtunkhwa, Pakistan, to assess circulating T. pallidum strains and antibiotic resistance. Blood samples were initially screened for T. pallidum antibodies using a chemiluminescent microparticle immunoassay (CMIA). CMIA-reactive samples underwent polymerase chain reaction (PCR) targeted the polA, tpp47, bmp, and tp0319 genes. PCR-positive samples were further analyzed for molecular subtyping using a CDC-developed procedure and tp0548 gene examination. All PCR-positive samples were analyzed for the presence of point mutations A2058G and A2059G in 23S rRNA, as well as the G1058C mutation in 16S rRNA. These mutations are known to impart antimicrobial resistance to macrolides and doxycycline, respectively. Out of 32,812 serum samples, 272 (0.83%) were CMIA-reactive, with 46 being PCR-positive. Nine T. pallidum subtypes were identified, predominantly 14d/f. The A2058G mutation in 23S rRNA was found in 78% of cases, while G1058C in 16S rRNA and A2059G in 23S rRNA were absent. The research found donor blood useful for assessing T. pallidum molecular subtypes and antibiotic resistance, especially when chancres are not present. The prevalent subtype was 14d/f (51.85%), and the high macrolide resistance of 36 (78%) indicates caution in using macrolides for syphilis treatment in Khyber Pakhtunkhwa, Pakistan.
摘要：
梅毒,由梅毒螺旋体引起，正在全球范围内复苏。分子分型可以对其流行病学进行调查。在巴基斯坦和其他国家，T.苍白亚种。在过去的十年中，苍白球已经发展出广泛的大环内酯耐药性。白沙瓦地区血液中心于2020年6月至2021年6月进行的一项研究分析了开伯尔-普赫图赫瓦省32,812名献血者的血清样本。巴基斯坦,评估循环梅毒螺旋体菌株和抗生素耐药性。最初使用化学发光微粒免疫测定(CMIA)筛选血液样品的梅毒螺旋体抗体。CMIA反应样品进行了靶向polA的聚合酶链反应（PCR），tpp47,bmp,和tp0319基因。使用CDC开发的程序和tp0548基因检查进一步分析PCR阳性样品的分子亚型。分析所有PCR阳性样品中23SrRNA中A2058G和A2059G的点突变，以及16SrRNA中的G1058C突变。已知这些突变赋予对大环内酯类和多西环素的抗微生物抗性,分别。32,812份血清样本中,272（0.83%）为CMIA反应型，46为PCR阳性。确定了9种梅毒螺旋体亚型，主要是14d/f。在78%的病例中发现23SrRNA中的A2058G突变,而16SrRNA中的G1058C和23SrRNA中的A2059G缺失。研究发现，献血者血液可用于评估梅毒螺旋体分子亚型和抗生素耐药性，尤其是当Chancres不在的时候.流行亚型为14d/f(51.85%)，36（78％）的高大环内酯耐药性表明在开伯尔-普赫图赫瓦省使用大环内酯治疗梅毒时谨慎，巴基斯坦。
