{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:34:13Z","timestamp":1792416853148,"version":"4.4.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T00:00:00Z","timestamp":1643068800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Syphilis diagnosis may be challenging, especially in the asymptomatic and early clinical stages. We evaluated the presence of Treponema pallidum DNA (TP-DNA) in various sample types to elucidate transmissibility during various syphilis stages.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study was conducted at the Amsterdam Centre for Sexual Health. We included adult men who have sex with men (MSM), who were suspected of having syphilis. The 2020 European guidelines definitions were followed for the diagnosis and staging of syphilis. Using a polymerase chain reaction (PCR) targeting the polA gene of Treponema pallidum (TP-PCR), we tested the following study samples on TP-DNA: peripheral blood, oropharyngeal swab, ano-rectal swab, and urine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From November 2018 to December 2019 we included 293 MSM. Seventy clients had primary syphilis, 73 secondary syphilis, 86 early latent syphilis, 14 late latent syphilis, 23 treated syphilis, and 27 had no syphilis. TP-DNA was detected in at least 1 study sample in 35\/70 clients with primary syphilis (2\/70 peripheral blood, 7\/70 oropharynx, 13\/70 ano-rectum, and 24\/70 urine); in 62\/73 clients with secondary syphilis (15\/73 peripheral blood, 47\/73 oropharynx, 37\/73 ano-rectum, and 26\/73 urine); and in 29\/86 clients with early latent syphilis (5\/86 peripheral blood, 21\/86 oropharynx, 11\/86 ano-rectum, and 6\/86 urine). TP-DNA was not detected in clients with late latent syphilis or treated syphilis, nor in clients without syphilis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>TP-DNA was frequently detected in various sample types in the absence of lesions. This is in line with the high transmission rate of syphilis and opens diagnostic opportunities for early presymptomatic syphilis stages.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac056","type":"journal-article","created":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T20:13:02Z","timestamp":1643055182000},"page":"1054-1062","source":"Crossref","is-referenced-by-count":33,"title":["Detection of <i>Treponema pallidum<\/i> DNA During Early Syphilis Stages in Peripheral Blood, Oropharynx, Ano-Rectum and Urine as a Proxy for Transmissibility"],"prefix":"10.1093","volume":"75","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-5292","authenticated-orcid":false,"given":"S A","family":"Nieuwenburg","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H C A","family":"Zondag","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S M","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"},{"name":"Amsterdam institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V W","family":"Jongen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M F","family":"Schim van der Loeff","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"},{"name":"Amsterdam institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"},{"name":"Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A P","family":"van Dam","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"},{"name":"Department of Medical Microbiology, Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H J C","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service Amsterdam , Amsterdam , The Netherlands"},{"name":"Amsterdam institute for Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"},{"name":"Department of Dermatology, Amsterdam UMC, University of Amsterdam , Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,25]]},"reference":[{"key":"2022092921003958000_CIT0001","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1001\/jama.290.11.1510","article-title":"Update on syphilis: resurgence of an old problem.","volume":"290","author":"Golden","year":"2003","journal-title":"JAMA"},{"key":"2022092921003958000_CIT0002","doi-asserted-by":"crossref","first-page":"363","DOI":"10.15698\/mic2016.09.523","article-title":"Syphilis: re-emergence of an old foe.","volume":"3","author":"Stamm","year":"2016","journal-title":"Microb Cell"},{"key":"2022092921003958000_CIT0003","doi-asserted-by":"crossref","first-page":"e235","DOI":"10.1016\/S1473-3099(17)30310-9","article-title":"Sexually transmitted infections: challenges 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