A A Noda1, L Grillová2, R Lienhard3, O Blanco1, I Rodríguez1, D Šmajs4. 1. Department of Mycology-Bacteriology, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba. 2. Department of Biology, Masaryk University, Brno, 625 00, Czech Republic. 3. Department of Medical Microbiology, ADMED Microbiology, La Chaux-de-Fonds, Switzerland. 4. Department of Biology, Masaryk University, Brno, 625 00, Czech Republic. Electronic address: dsmajs@med.muni.cz.
Abstract
OBJECTIVES: Bejel, caused by Treponema pallidum subsp. endemicum (TEN), was until now considered as a non-venereal disease endemic in areas with hot and dry climates. This study has identified TEN in clinical samples from Cuban patients previously diagnosed with syphilis. METHODS: We performed sequencing-based molecular typing on 92 samples from Cuban individuals diagnosed with syphilis. Moreover, to differentiate T. pallidum subspecies, multi-locus sequence analysis (MLSA) was designed and was applied to suspicious samples. RESULTS: Nine samples, from six patients, had a nucleotide sequence similarity (at all typing loci) to the Bosnia A genome, which is the infectious agent of bejel. Additionally, MLSA clearly supported a TEN classification for the treponemal samples. Clinical and epidemiological data from the six patients also suggested sexual transmission of bejel as well as the endemicity of this rare treponematosis in Cuba. CONCLUSIONS: Molecular identification of Treponema pallidum subsp. endemicum, the agent of bejel, in Cuban patients diagnosed with syphilis indicates the clear limitations of a diagnosis based exclusively on serology, geographical occurrence, clinical symptoms and anamnestic data. This finding has important implications for Global Public Health Systems, including paradigm changes regarding the location of endemic outbreaks, clinical aspects and transmission of this neglected disease.
OBJECTIVES: Bejel, caused by Treponema pallidum subsp. endemicum (TEN), was until now considered as a non-venereal disease endemic in areas with hot and dry climates. This study has identified TEN in clinical samples from Cuban patients previously diagnosed with syphilis. METHODS: We performed sequencing-based molecular typing on 92 samples from Cuban individuals diagnosed with syphilis. Moreover, to differentiate T. pallidum subspecies, multi-locus sequence analysis (MLSA) was designed and was applied to suspicious samples. RESULTS: Nine samples, from six patients, had a nucleotide sequence similarity (at all typing loci) to the Bosnia A genome, which is the infectious agent of bejel. Additionally, MLSA clearly supported a TEN classification for the treponemal samples. Clinical and epidemiological data from the six patients also suggested sexual transmission of bejel as well as the endemicity of this rare treponematosis in Cuba. CONCLUSIONS: Molecular identification of Treponema pallidum subsp. endemicum, the agent of bejel, in Cuban patients diagnosed with syphilis indicates the clear limitations of a diagnosis based exclusively on serology, geographical occurrence, clinical symptoms and anamnestic data. This finding has important implications for Global Public Health Systems, including paradigm changes regarding the location of endemic outbreaks, clinical aspects and transmission of this neglected disease.
Authors: Petra Pospíšilová; Philippe Alain Grange; Linda Grillová; Lenka Mikalová; Pervenche Martinet; Michel Janier; Annie Vermersch; Nadjet Benhaddou; Pascal Del Giudice; Isabelle Alcaraz; François Truchetet; Nicolas Dupin; David Šmajs Journal: PLoS One Date: 2018-07-19 Impact factor: 3.240
Authors: Linda Grillová; Tanika Bawa; Lenka Mikalová; Angèle Gayet-Ageron; Kay Nieselt; Michal Strouhal; Patrice Sednaoui; Tristan Ferry; Matthias Cavassini; Stephan Lautenschlager; Fabrizio Dutly; Marta Pla-Díaz; Michael Krützen; Fernando González-Candelas; Homayoun C Bagheri; David Šmajs; Natasha Arora; Philipp P Bosshard Journal: PLoS One Date: 2018-07-30 Impact factor: 3.240