早期梅毒误诊原因探讨

目的了解早期梅毒临床表现及误诊原因，探讨组织病理学在梅毒诊断中的意义。方法对823例早期梅毒患者均作梅毒血清学检测，其中28例进行病理学检查。结果Ⅰ期梅毒112例，甲苯胺红不加热血清试验（TRUST）及密螺旋体颗粒凝集试验（TPPA）、梅毒特异性抗体检测（WB）阳性106例；Ⅱ期梅毒711例，TRUST、TPPA及WB均呈阳性。结论梅毒血清学检测对早期梅毒的诊断具有重要意义，病理检查对硬下疳、扁平湿疣、鳞屑性丘疹皮疹诊断有一定意义，而斑疹呈非特异性炎症改变，不具诊断意义。     

TP-TRUST与TP-ELISA法检测梅毒结果回顾分析

梅毒是由梅毒螺旋体感染引起的性传播疾病,也可通过血液及母婴等方式传播,具有高度传染性。梅毒螺旋体可侵犯中枢神经系统,危害心血管系统,损害骨骼系统,晚期可累及全身各个脏器造成多器官病变．直至死亡。近年来梅毒感染人数在全国呈较快的上升趋势．而梅毒患者是唯一传染源,早期梅毒传染性较强．因此加强临床梅毒患者的早期检查诊断对防止梅毒扩散及梅毒患者的早期治疗具有重要意义。目前检测梅毒的方法主要有病原学及血清学检测．目前血清学检测有多种不同的方法。     

3种梅毒血清学试验方法选择的临床分析

目的比较常用的3种梅毒血清学试验方法,选择最合适的梅毒筛查的方法。方法采用目前临床实验室检测梅毒最常用的梅毒血浆快速反应素试验(RPR)、梅毒特异性抗体酶联免疫吸附试验(TP-ELISA)、梅毒螺旋体抗体血球凝集试验(TPPA)3种方法对住院及门诊患者进行梅毒血清学筛查。结果 3种试验方法阳性率中TP-ELISA法与TPPA法检测结果差异无统计学意义,而RPR法检测结果与TP-ELISA法和TPPA法比较差异均有统计学意义(P0.01)。结论实验室应合理选用3种不同方法进行梅毒血清学检测,将减少漏诊和误诊率,为临床对梅毒患者的正确诊断提供参考依据,并且在判定梅毒的临床发展、分期、痊愈及药物疗效方面都具有十分重要的意义。     

梅毒血清学检测方法的选择与产前常规筛查中的应用探讨

梅毒（syphilis）是由苍白螺旋体的苍白亚种即梅毒螺旋体（Tr_eponema Pallidum TP）所引起的是一种古老的性传播疾病,它可以侵犯皮肤、黏膜及其他多种组织器官,病程长、危害大.近年来,梅毒的发病率呈逐年上升趋势,孕期梅毒感染可造成畸胎、早产、先天梅毒、胎儿死亡等严重危害.各大医院相继开展了产前、术前、输血前梅毒血清学常规检测项目,由于用于梅毒血清学检验方法较多,各医院所选择的检测方法也不相同,如果没有形成合理的检测流程,很容易造成漏诊和误诊.采用科学的梅毒血清学筛查诊断流程,不仅能够有效地提高筛查诊断效率,而且对于避免医疗纠纷,减少患者心理压力及家庭矛盾具有重要的意义[1].     

干燥综合征患者TPPA和TRUST检测梅毒抗体假阳性1例

梅毒是由梅毒螺旋体(又称苍白螺旋体)感染引起的一种慢性疾病,可引起多器官感染,严重危害患者的生命健康[1].梅毒的诊断主要根据流行病学史、临床表现和实验室检查.目前血清学检查包括非梅毒螺旋体血清学试验和梅毒螺旋体血清学试验,其中梅毒螺旋体明胶颗粒凝集试验(TPPA)是实验室血清学检测梅毒螺旋体的重要方法,该方法准确度和...     

新生儿先天梅毒血清学检测探讨

随着近几年梅毒的传播,梅毒发病率不断增加,新生儿先天梅毒的发病率也随之增加。新生儿先天梅毒又被称之为胎传梅毒,是梅毒螺旋体通过母体胎盘进入胎儿血循环中导致的梅毒感染,发病可见于儿童各期,孕妇垂直传播率为70％-100％,对新生儿以及胎儿的健康造成严重危害。先天梅毒患儿在出生时有些并不具有病发症状,因此必须采用血清学检测的方法才能够予以确诊,梅毒螺旋体颗粒凝集实验、甲苯胺红不加热血清实验、抗体捕捉酶免疫测定技术是梅毒血清检测方法中的三种常规方法,其对先天梅毒新生儿的确诊率及治疗后转阴具有重要意义,本文采用血清学检测方法对其进行诊断,并将诊断结果报道如下。     

5种血清学方法检测梅毒螺旋体对比分析

梅毒血清学检验是目前国内外诊断梅毒的主要实验室检查方法。实践中使用的方法较多,探讨各种试验方法在梅毒的诊断、治疗等方面的应用价值,确定适合临床的最佳方法很有必要。本研究运用ELISA、胶体金快速检测试验（ACONSYP）、梅毒螺旋体血疑试验（TPHA）、梅毒螺旋体明胶颗粒凝集试验（11PA）、甲苯胺红不加热血清试验（TRUST）5种血清学检测方法,对各期梅毒患者的标本进行检测,并对检测结果及各种方法的优缺点进行比较分析,为临床梅毒检测方法的选择提供参考。     

梅毒螺旋体血清学检测方法比较

梅毒血清学试验是目前国内外诊断梅毒的主要实验室检查方法，目前使用的方法较多，探讨各种试验方法在梅毒的诊断、治疗等方面的应用价值，确定适合临床的最佳方法很有必要。本研究运用ELISA、胶体金快速检测试验（ACONSYP）、梅毒螺旋体血凝试验（TPHA）、梅毒螺旋体明胶颗粒凝集试验（TPPA）、甲苯胺红不加热血清试验（TRUST）5种血清学检测方法，对各期梅毒患者的标本进行检测，并对检测结果及各种方法的优缺点进行比较分析，为临床梅毒检测方法的选择提供参考。     

疑似先天梅毒患儿的梅毒血清学预后及影响因素分析

目的：评估疑似先天梅毒患儿的预后及其影响因素，以及预防性治疗的干预效果。方法归纳分析十年来我区476例疑似先天梅毒患儿的治疗及梅毒血清学结果随访，对结果进行统计学分析。结果19S-IgM 的检测对于确诊先天梅毒有较高的敏感性（94．4％）及特异性（100％）。19S-IgM阴性的疑似先天梅毒患儿，血清学滴度低于母亲血清学滴度4倍者预后良好，可不用预防性治疗。结论19S-IgM在早期先天梅毒的诊断中具有重要意义，疑似先天梅毒患儿需要加强随访和复查，仅有相应异常的患儿中可应用预防性治疗。     

四种常用梅毒检测试验在基层医院的合理应用

目的探讨四种常用的梅毒血清学试验在基层医院梅毒诊断中的合理应用。方法将110份梅毒螺旋体明胶颗粒凝集试验(TPPA)阳性标本和200份阴性标本均进行梅毒螺旋体酶联免疫吸附试验(TP-ELISA)、快速血浆反应素试验(RPR)、梅毒螺旋体快速诊断试验(TP-RT)检测。将TP-ELISA、RPR、TP-RT与TPPA结果进行比较,采用SPSS19.0进行数据统计。结果 TP-ELISA、TP-RT与TPPA方法一致性检验的KAPPA值分别为0.94,0.95。RPR的检出率为61.82%。结论正确认识梅毒的血清学试验方法的特点并合理应用非常重要,对于基层医院适合先用TPPA进行筛选,阳性的再进行非梅毒螺旋体的抗原血清学试验。大批量查体标本可选用TP-ELISA筛查,阳性的再进行非梅毒螺旋体的抗原血清学试验和TPPA。     

淮北地区性传播疾病感染情况调查分析

目的探讨安徽淮北地区的性传播疾病（STD）感染特征。方法对558例患者的淋病奈瑟菌（NG）、沙眼衣原体（CT）、解脲支原体（Uu）、快速血浆反应素环状卡片试验（RPR）、梅毒螺旋体抗体检测法（TPPA）检测结果进行分析。结果阳性检出率为：梅毒10.4%（58/558＞NG6.8%（38/558）＞CT5.4%（30/558）＞Uu3.4%（19/558）,梅毒感染占首位,Uu检出率偏低。结论淮北地区的STD感染情况符合我国沿海城市的特征,梅毒感染显著升高应引起重视。Uu检出率偏低,可能与试剂质量有关,应加强试剂的质量监控。     

Performance evaluation of antibody-based point-of-care devices intended for the identification of immune responses to SARS-CoV-2

The novel coronavirus outbreak caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) was first identified in December of 2019 in Wuhan, China. The local outbreak quickly rose to pandemic level that has spread to more than 188 countries with more than 19 million cases and 732,467 deaths worldwide. The current recommendation for testing is RT-PCR based tests of nasopharyngeal or alternatively nasal- and/or oropharyngeal swabs that detects infection with SARS-CoV-2 to diagnose acute infection. However, there is an urgent need for a quick and accurate antibody-based point-of-care test method to quickly identify evidence of SARS-CoV-2 infection among people who might be missed through active case finding and surveillance efforts. Serology tests measure the presence of antibodies in serum after infection. Here we compared the performance characteristics of 6 commercially available antibody-based point-of-care devices and their potential for identification of individuals infected at some time by SARS-CoV-2.     

Results of study of the diagnostic efficiency of the new linear enzyme immunoassay test system "INNO-Lia Syphilis Score"

A comparative study of 224 serum samples certified in different serological tests for syphilis has established the high diagnostic effectiveness of the new linear enzyme immunoassay test system (immune blotting assay "Improved INNO-Lia Syphilis ("IMMO-Lia Syphilis Score")) (Immunogenetics, Gent, Belgium). The assay showed a 100% sensitivity and 98% specificity; the reproducibility of positive and negative results was 100%. It is proposed to use the test system in the laboratories engaged in the expert diagnosis of syphilis as an additional or alternative Treponema pallidum immobilization test and immunofluorescence test supporting the assay of serum or plasma samples for this infection, which has yielded positive results on screening.     

A nonspecific ulcer on upper lip presented as the first and sole sign of syphilis

Syphilis, a sexually transmitted disease, can be categorized as acquired syphilis and congenital syphilis, manifesting diverse lesions involving multiple sites. Oral manifestations at the primary stage of acquired syphilis are usually characterized by its short period and non-specific varied presentations. And oral ulcers as initial and the only presentation of syphilis oral lesions are infrequent and occur in less than 2% of patients. Because of its transient nature and variable manifestations which could mimic other oral ulcerative lesions, oral syphilis presenting as sole ulceration at early stage can be easily neglected and rather difficult to diagnose. Herein, we report a 35-year-old female patient manifested a sole atypical ulceration on her upper lip for approximately 1 month. We highlighted the importance of early and accurate diagnosis, focused on the characteristics of oral chancre, and gave an insight to the differential diagnoses, which would be enlightening and useful in clinical practice.     

Current approaches to laboratory diagnosis of syphilis

The efficiency of chemiluminescence immunoassay (CIA) used as a treponemal test in the serological diagnosis of syphilis was evaluated, by applying the serum samples of 219 patients screened for syphilitic infection. The efficiency of CIA was evaluated in two steps: (1) comparison of the results of tests using the IMMULITE 2000 Syphilis Screen and LIAISON Syphilis screen reagent kits; (2) that of the results of tests applying the IMMULITE 2000 Syphilis Screen and Recombi Best antipallidum-summary antibodies kits. A 100% correlation was found when comparing the results of tests employing the IMMULITE 2000 Syphilis Screen and DiaSorin LIAISON Syphilis Screen kits (n=66). Comparison of CIA using the IMMULITE 2000 Syphilis Screen kits versus that applying the Recombi Best antipallidum-summary antibodies kits (n=153) revealed 3 discordant samples, which amounted to 1.96% of the number of results. Evaluation of the impact of related microorganisms on the detection of T. pallidum antibodies (n= 140) with the IMMULITE 2000 Syphilis Screen kit indicated no interference or cross-reactivity.     

Syphilis: an old enemy still lurks

PURPOSE: To review the problem of increasing cases of syphilis as a communicable disease and to review different presentations of syphilis and to discuss treatment guidelines. DATA SOURCES: Extensive review of worldwide scientific literature on the epidemiology, diagnosis, and treatment of syphilis. CONCLUSIONS: Syphilis is an infectious sexually transmitted disease, which may have devastating consequences. Previously declining rates have led to complacency in prevention and diagnosis. Primary prevention includes education regarding safer sexual practices. Secondary prevention includes early identification via screening and treatment. IMPLICATIONS FOR PRACTICE: Syphilis is a contagious disease that has devastating consequences if not diagnosed and treated. Providers should keep ever vigilant in its identification. Specifically, it should be considered when evaluating all symptom-less dermatological lesions.     

Comparative study of immunochromatographic sets for rapid diagnosis of syphilis

The paper presents the results of the comparative study of 9 commercial kits made in foreign countries for the rapid diagnosis of syphilis, performed at the Central Research Institute of Dermatovenereological Infections, Russian Agency for Health Care, within the framework of the International Sexual Transmitted Diseases Diagnostic Initiative Program under the aegis of the World Health Organization during 2002-2005. The above diagnostic kits were assessed in the context of the availability of and statement simplicity in the instruction for use; the technological complexity in performing a study procedure and the simplicity in interpreting the findings; the necessity of employing additional laboratory equipment. The parameters of the clinical efficiency (sensitivity and specificity) were studied; a passive sensitized red blood cell agglutination test was used as a reference method. The comprehensive study showed that the "Determine Syphilis TP test system ("Abbot Lab", USA) yielded the best results with a total of 10 scores at 100% sensitivity and 100% sensitivity) while the "Bioline Syphilis anti-TP Test Card" ("Pacific Biotech Co.", Thailand) provided a total of 9 scores at 96% sensitivity and 98% specificity.     

TPPA在梅毒临床血清学诊断和室间质评中的应用

目的评价TRUST和TPPA在梅毒血清学诊断和室间质评中的价值。方法采用TRUST和TPPA检测80例梅毒患者和67例非梅毒患者血清;1998～1999年采用TRUST检测室间质评样本,从2000年开始采用TPPA检测室间质评样本。结果梅毒患者TRUST和TPPA阳性率分别为86.3%(69/80)与100%;TRUST在室间质评样本中的敏感性44.44%,特异性90.00%,符合率68.75%,而TPPA的敏感性、特异性、符合率达到100%。两者的敏感性存在明显差别(χ2＝9.35,P＜0.01)。结论TPPA具有很高的敏感性、特异性,可作为临床诊断梅毒的首选方法。     

韶关市2002年特定人群HIV和梅毒感染情况调查分析

目的　通过调查掌握目前艾滋病和梅毒的发病趋势和流行特点 ,为政府部门制定防治政策提供科学依据。方法HIV用ELISA初筛 ,阳性送广东省疾控中心用蛋白印迹法 (WB)确认 ,梅毒用ELISA初筛 ,阳性送省疾控中心确认。结果356名受检人群中 ,共查出HIV感染者 1 6名 ,阳性率为 4.5% ,梅毒感染者 4 4名 ,阳性率 12.4 %。结论　我市吸毒人群HIV及梅毒感染率较广东省内及某些其他省市的报道高。     

The Disposition of STS* Reactive Blood in a Transfusion Service

Ninety-eight units of Serological Test (or Syphilis (STS) reactive blood were quarantined for one week and transfused into 90 patients. Recipients transfused with donor blood having reagin titers less than eight dils by the Venereal Disease Research Laboratory (VDRL) quantitative tube test failed to have detectable reagin in their sera following transfusion. Four to ten days was the longest period observed for the disappearance of passively trans erred reagin in a patient who was transfused with donor blood having a titer of 64 dils. Fluorescent Treponemal Antibody (FTA) tests were performed on two patients 2 to 3 months after tranfusion and were negative. The fallibility of the conventional STS testing on donor blood is discussed and its failure to demonstrate infectivity is emphasized. Attention is called to the potential danger of fresh blood, especially platelet preparations.