Short-term (2 weeks) store at 2-8°C. Long term, aliquot and store at -20°C. Avoid multiple freeze/thaw cycles
Stability
36 months
Introduction
Treponema pallidum is a spirochaete bacterium with various subspecies that cause the diseases syphilis, bejel, and yaws. It is transmitted only amongst humans. It is a helically coiled microorganism usually 6–15 μm long and 0.1–0.2 μm wide.
Keywords
T. pallidum; Treponema pallidum; T. pallidum p15/p17/p47; Syphilis
Citations
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Background
Syphilis is a sexually transmitted disease caused by the Treponema pallidum. Signs and symptoms of syphilis vary according to the stage of the disease: stage I usually presents as a single, hard, painless chancre, between 1 cm and 2 cm in diameter; stage II presents with a diffuse rash, usually involving the palms of the hands and soles of the feet, and there may also be ulcers in the mouth or the vagina; latent syphilis can last for several years asymptomatically; and stage III presents with gummas (soft, non-cancerous growths), neurological problems and heart problems. Syphilis is most often transmitted through sexual activity, and there is also mother-to-child transmission, resulting in babies with congenital syphilis.
Treponema pallidum is spiral-shaped, highly mobile Gram-negative bacteria that cause human diseases including yaws (subspecies pertenue), pinta (subspecies carateum) and bejel (subspecies endemicum), of which subspecies pallidum causes human syphilis. Humans are the only known natural host for subspecies pallidum, and it survives for a short number of days in the absence of a host due to its small genome, which is unable to encode most of the metabolic pathways required for major nutrients.
Figure 1. Morphology and membrane structure of T. pallidum (Source: Radolf JD, et al. 2016)
Early infection with syphilis is difficult to diagnose clinically. Diagnosis of syphilis is usually confirmed by blood tests or direct visual inspection by dark-field microscopy. Blood tests are categorized into nontreponemal and treponemal tests. The nontreponemal test is the initial method used, but there is a possibility of false positives. False positives can be avoided by using specific antibody tests such as Treponema pallidum particle agglutination assay (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs). Treponemal antibody tests can be positive two to five weeks after the initial infection and can last for years.
Figure 2. Progression of syphilis serology throughout the stages of the disease (Source: Satyaputra F, et al. 2021)
Alternative Names
Treponema pallidum p15/p17/p47 Chimeric Antigen T. pallidum p15/p17/p47 Chimeric Antigen
References
1. Satyaputra F, et al. The Laboratory Diagnosis of Syphilis. J Clin Microbiol. 2021 Sep 20;59(10):e0010021
2. Radolf JD, et al. Treponema pallidum, the syphilis spirochete: making a living as a stealth pathogen. Nat Rev Microbiol. 2016 Dec;14(12):744-759.
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References
New trends in congenital syphilis: epidemiology, testing in pregnancy, and management
Purpose of review: In light of alarming increases in the incidence of congenital syphilis in many middle and higher income countries across the globe, this review summarizes recent changes in the epidemiology of syphilis, highlights recommended changes to testing in pregnancy and provides an update for the management of syphilis infection in pregnancy (SIP) and of the infant born to a mother with SIP.
Recent findings: The re-emergence of congenital syphilis is a result of increasing infectious syphilis in women of childbearing age, which is in turn a result of increasing syphilis in the general population particularly in Indigenous and marginalized populations. Potential reasons for the increase include changing sexual practices and increased travel and migration, as well as factors that limit healthcare access, particularly access to antenatal care and limited awareness and education amongst mothers and maternity services. A single antenatal test for syphilis is insufficient; more frequent testing in pregnancy is necessary even for women deemed to be low risk. The management of SIP and of the newborn is complex and guidelines should be readily available with clear recommendations.
Summary: Congenital syphilis is preventable. The current crisis calls for a global and national multipronged, co-ordinated approach involving public health and hospital systems which includes education of individuals and healthcare workers, availability of updated guidelines for prevention and treatment, prioritization of antenatal testing, assurance of accessible and prompt treatment and appropriate assessment and follow-up of infants.
Syphilis Laboratory Guidelines: Performance Characteristics of Nontreponemal Antibody Tests
We reviewed the relevant syphilis diagnostic literature to address the following question: what are the performance characteristics, stratified by the stage of syphilis, for nontreponemal serologic tests? The database search included key terms related to syphilis and nontreponemal tests from 1960-2017, and for data related to the venereal disease research laboratory test from 1940-1960. Based on this review, we report the sensitivity and specificity for each stage of syphilis (primary, secondary, early latent, late latent, or unknown duration; tertiary as well as neurosyphilis, ocular syphilis, and otic syphilis). We also report on reactive nontreponemal tests in conditions other than syphilis, false negatives, and automated nontreponemal tests. Overall, many studies were limited by their sample size, lack of clearly documented clinical staging, and lack of well-defined gold standards. There is a need to better define the performance characteristics of nontreponemal tests, particularly in the late stages of syphilis, with clinically well-characterized samples. Published data are needed on automated nontreponemal tests. Evidence-based guidelines are needed for optimal prozone titrations. Finally, improved criteria and diagnostics for neurosyphilis (as well as ocular and otic syphilis) are needed.
COA
Publication 
Figure 1. Morphology and membrane structure of T. pallidum
Figure 2. Progression of syphilis serology throughout the stages of the disease
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