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TPA DNA was detected in 50 of 51 SS skin biopsies and 27 of 51 blood specimens. TPA was isolated from 47 rabbits with success rates of 71% (12\/17) and 69% (35\/51), respectively, from ulcer exudates and SS bloods. We obtained paired genomic sequences from 24 clinical samples and corresponding rabbit isolates. Six SS14- and 2 Nichols-clade genome pairs contained rare discordances. Forty-one of the 51 unique TPA genomes clustered within SS14 subgroups largely from East Asia, while 10 fell into Nichols C and E subgroups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our TPA detection rate was high from PS ulcer exudates and SS skin biopsies and over 50% from SS blood, with TPA isolation in more than two-thirds of samples. Our results support the use of WGS from rabbit isolates to inform vaccine development.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiae322","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T19:13:32Z","timestamp":1718651612000},"page":"e1322-e1333","source":"Crossref","is-referenced-by-count":9,"title":["Clinical Presentation of Early Syphilis and Genomic Sequences of <i>Treponema pallidum<\/i> Strains in Patient Specimens and Isolates Obtained by Rabbit Inoculation"],"prefix":"10.1093","volume":"230","author":[{"given":"Ligang","family":"Yang","sequence":"first","affiliation":[{"name":"Dermatology Hospital, Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0275-2543","authenticated-orcid":false,"given":"Xiaohui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Dermatology Hospital, Southern Medical 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