BACKGROUND: Although azithromycin promised to be a safe and effective single-dose oral treatment of early syphilis, azithromycin treatment failure has been documented and is associated with mutations in the 23S rDNA of corresponding Treponema pallidum strains. The prevalence of strains harboring these mutations varies throughout the United States and the world. We examined T. pallidum strains circulating in Seattle, Washington, from 2001 to 2010 to determine the prevalence of 2 mutations associated with macrolide resistance and to determine whether these mutations were associated with certain T. pallidum strain types. METHODS: Subjects were enrolled in a separate ongoing study of cerebrospinal fluid abnormalities in patients with syphilis. T. pallidum DNA purified from blood and T. pallidum strains isolated from blood or cerebrospinal fluid were analyzed for two 23S rDNA mutations and for the molecular targets used in an enhanced molecular stain typing system. RESULTS: Nine molecular strain types of T. pallidum were identified in Seattle from 2001 to 2010. Both macrolide resistance mutations were identified in Seattle strains, and the prevalence of resistant T. pallidum exceeded 80% in 2005 and increased through 2010. Resistance mutations were associated with discrete molecular strain types of T. pallidum. CONCLUSIONS: Macrolide-resistant T. pallidum strains are highly prevalent in Seattle, and each mutation is associated with discrete strain types. Macrolides should not be considered for treatment of syphilis in regions where prevalence of the mutations is high. Combining the resistance mutations with molecular strain typing permits a finer analysis of the epidemiology of syphilis in a community.
BACKGROUND: Although azithromycin promised to be a safe and effective single-dose oral treatment of early syphilis, azithromycin treatment failure has been documented and is associated with mutations in the 23S rDNA of corresponding Treponema pallidum strains. The prevalence of strains harboring these mutations varies throughout the United States and the world. We examined T. pallidum strains circulating in Seattle, Washington, from 2001 to 2010 to determine the prevalence of 2 mutations associated with macrolide resistance and to determine whether these mutations were associated with certain T. pallidum strain types. METHODS: Subjects were enrolled in a separate ongoing study of cerebrospinal fluid abnormalities in patients with syphilis. T. pallidum DNA purified from blood and T. pallidum strains isolated from blood or cerebrospinal fluid were analyzed for two 23S rDNA mutations and for the molecular targets used in an enhanced molecular stain typing system. RESULTS: Nine molecular strain types of T. pallidum were identified in Seattle from 2001 to 2010. Both macrolide resistance mutations were identified in Seattle strains, and the prevalence of resistant T. pallidum exceeded 80% in 2005 and increased through 2010. Resistance mutations were associated with discrete molecular strain types of T. pallidum. CONCLUSIONS:Macrolide-resistant T. pallidum strains are highly prevalent in Seattle, and each mutation is associated with discrete strain types. Macrolides should not be considered for treatment of syphilis in regions where prevalence of the mutations is high. Combining the resistance mutations with molecular strain typing permits a finer analysis of the epidemiology of syphilis in a community.
Authors: Sheila A Lukehart; Charmie Godornes; Barbara J Molini; Patricia Sonnett; Susan Hopkins; Fiona Mulcahy; Joseph Engelman; Samuel J Mitchell; Anne M Rompalo; Christina M Marra; Jeffrey D Klausner Journal: N Engl J Med Date: 2004-07-08 Impact factor: 91.245
Authors: Samuel J Mitchell; Joseph Engelman; Charlotte K Kent; Sheila A Lukehart; Charmie Godornes; Jeffrey D Klausner Journal: Clin Infect Dis Date: 2005-12-28 Impact factor: 9.079
Authors: Gabriele Riedner; Mary Rusizoka; Jim Todd; Leonard Maboko; Michael Hoelscher; Donan Mmbando; Eleuter Samky; Eligius Lyamuya; David Mabey; Heiner Grosskurth; Richard Hayes Journal: N Engl J Med Date: 2005-09-22 Impact factor: 91.245
Authors: Mohammed G Kiddugavu; Noah Kiwanuka; Maria J Wawer; David Serwadda; Nelson K Sewankambo; Fred Wabwire-Mangen; Fredrick Makumbi; Xianbin Li; Steven J Reynolds; Thomas C Quinn; Ronald H Gray Journal: Sex Transm Dis Date: 2005-01 Impact factor: 2.830
Authors: Christina M Marra; April P Colina; Charmie Godornes; Lauren C Tantalo; Maritza Puray; Arturo Centurion-Lara; Sheila A Lukehart Journal: J Infect Dis Date: 2006-11-03 Impact factor: 5.226
Authors: Christina M Marra; Clare L Maxwell; Stacy L Smith; Sheila A Lukehart; Anne M Rompalo; Molly Eaton; Bradley P Stoner; Michael Augenbraun; David E Barker; James J Corbett; Mark Zajackowski; Charles Raines; Judith Nerad; Romina Kee; Scott H Barnett Journal: J Infect Dis Date: 2004-01-27 Impact factor: 5.226
Authors: Christina M Marra; Clare L Maxwell; Lauren C Tantalo; Sharon K Sahi; Sheila A Lukehart Journal: Clin Infect Dis Date: 2008-10-01 Impact factor: 9.079
Authors: Christina M Marra; Clare L Maxwell; Lauren Tantalo; Molly Eaton; Anne M Rompalo; Charles Raines; Bradley P Stoner; James J Corbett; Michael Augenbraun; Mark Zajackowski; Romina Kee; Sheila A Lukehart Journal: Clin Infect Dis Date: 2004-03-16 Impact factor: 9.079
Authors: Linda Grillová; Helena Pĕtrošová; Lenka Mikalová; Radim Strnadel; Eliška Dastychová; Ivana Kuklová; Martina Kojanová; Miluše Kreidlová; Daniela Vaňousová; Jana Hercogová; Přemysl Procházka; Hana Zákoucká; Alena Krchňáková; Vladimír Vašků; David Šmajs Journal: J Clin Microbiol Date: 2014-08-06 Impact factor: 5.948
Authors: Lorenzo Giacani; Giulia Ciccarese; Christian Puga-Salazar; Ivano Dal Conte; Laura Colli; Marco Cusini; Stefano Ramoni; Sergio Delmonte; Antonietta DʼAntuono; Valeria Gaspari; Francesco Drago Journal: Sex Transm Dis Date: 2018-04 Impact factor: 2.830
Authors: Cheng-Yen Chen; Kai-Hua Chi; Allan Pillay; Eli Nachamkin; John R Su; Ronald C Ballard Journal: J Clin Microbiol Date: 2013-01-02 Impact factor: 5.948