Sarah A. Rawstron

Evaluation of a Treponema pallidum-specific IgM enzyme immunoassay and Treponema pallidum Western blot antibody detection in the diagnosis of maternal and Congenital syphilis

Background Congenital syphilis (CS) is a result of untreated or inadequately treated maternal syphilis. CS is more likely with early stages of maternal syphilis, but most mothers lack signs or symptoms and the risk of CS is unclear. Goal The goal of this study was to evaluate Treponema pallidum IgM Western blot (TP IgM WB) and a T. pallidum IgM enzyme immunoassay (TP IgM ELISA) in mothers with syphilis to determine if positive tests better indicate a risk of CS than a rapid plasma reagin titer ≥1:16. Study Design Ninety-seven mother–baby pairs with reactive syphilis serology were evaluated. Results TP IgM WB tests were positive in 18 pregnancies (7 of 18 babies had CS) and negative in 79 pregnancies (7 of 82 babies had CS). Thirty-two mothers had titers ≥1:16 (6 babies with CS) and 65 mothers had titers ≤1:8 (8 babies with CS). Conclusion TP IgM tests better identify mothers at risk of delivering babies with CS than maternal titer ≥1:16.

Congenital syphilis and fluorescent treponemal antibody test reactivity after the age of 1 year.

Background Manybelieve that a persistently reactive fluorescent treponemal antibodyabsorption (FTA-ABS) is manifested with congenital syphilis after the age of 1year, that it is useful in the retrospective diagnosis of children withcongenital syphilis, and that it can be used to confirm other treponemaltests. Goal Todetermine whether a reactive FTA-ABS after the age of 12 months is indicativeof congenitalsyphilis. StudyDesign Prospective outpatient follow-up evaluation until atleast the age of 12 months was conducted for 194 babies born to mothers withreactive syphilis serology at delivery, and for two additional children withcongenital syphilis diagnosed when they were younger than 1 year (total, 196children). Results Inthe study group, 54 children had reactive FTA-ABS (reactors) until the age ofat least 12 months or more, and 142 children had nonreactive FTA-ABS(nonreactors) at the age of 12 months or more. Of the 54 reactors, 17 (31%)had evidence of congenital syphilis at birth, whereas evidence of congenitalsyphilis was seen in 14 of the 142 (10%) nonreactors(P = 0.0002). At 15 months,nonreactive FTA-ABS developed in six reactors, and eventually in 15 of 44reactors (34%)tested. Conclusions Areactive FTA-ABS may be seen at 12 months in children with and withoutevidence of congenital syphilis at birth. Not all children with congenitalsyphilis will manifest reactive FTA-ABS at 12 months, and FTA-ABS reactivitywanes withtime.

STD in children: syphilis and gonorrhoea.

Sexually transmitted diseases, besides having an immediate impact on the infected individual, affects all sexual partners, and even the next generation. Infection in young children raises the possibility of sexual abuse, thus having legal as well as medical implications. Syphilis and gonorrhoea are in many ways the archetypal examples of sexually transmitted diseases. They were also thought to be under control, but AIDS and the spread of microbial resistance has reinforced their impact on the public health, and especially the health of children.

Perirectal Screening for Carbapenem-Resistant Enterobacteriaceae Obtained From 100 Consecutive Healthy Pregnant Women in Labor at a Brooklyn Hospital: Results and Risk Factors

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