{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:20:15Z","timestamp":1740136815566,"version":"3.37.3"},"reference-count":20,"publisher":"Microbiology Society","issue":"4","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002141","name":"public health england","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002141","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,27]]},"abstract":"<jats:p>\n                  <jats:bold>Introduction.<\/jats:bold> Due to the complex nature of treponemal serology interpretation, testing algorithms vary across the UK.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Gap statement.<\/jats:bold> There is currently no gold standard method for interpretation of discordant serology results.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Aim.<\/jats:bold> To analyse serological response in early infection and to determine the best approach for discordant total antibody EIA and TPPA samples.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methodology.<\/jats:bold> National reference laboratory serology and PCR (genital ulcer swabs) results from 2010 to 2017 were extracted from an electronic laboratory database.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results.<\/jats:bold> A total of 24149 sera underwent analysis. Of syphilis PCR positive cases with contemporaneous sera, 33% (17\/52) were IgM positive\/equivocal, whilst all were EIA and TPPA positive. No sera with isolated IgM positivity (0\/90) demonstrated seroconversion consistent with early treponemal infection, in contrast to 17% (2\/12) of sera with isolated TPPA positivity. Isolated EIA positivity was observed in 6.2% (1499\/24149) samples with the same result on repeat testing in 73% (154\/211). In 100 samples with discordant EIA\/TPPA results, IgG Immunoblot was more commonly positive (12\/41, 29%) or equivocal (24\/41, 59%), in those with a higher EIA antibody index, compared to those with a low antibody index, of which none tested positive and 2\/3 (67 %) were equivocal.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion.<\/jats:bold> Isolated IgM positivity was not helpful in identifying early infection; isolated total antibody EIA positivity is unlikely to be a significant finding. IgG immunoblot testing was unable to determine clear treponemal antibody status in nearly half of all EIA\/TPPA discordant samples.<\/jats:p>","DOI":"10.1099\/jmm.0.001479","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T16:16:17Z","timestamp":1650644177000},"source":"Crossref","is-referenced-by-count":1,"title":["The dark art of syphilis serology - an analysis of testing algorithms at a UK reference laboratory"],"prefix":"10.1099","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0941-9866","authenticated-orcid":false,"given":"Antonia","family":"Scobie","sequence":"first","affiliation":[{"name":"Reference Microbiology, UK Health Security Agency, 61, Colindale Avenue, NW9 5EQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin S.","family":"Brown","sequence":"additional","affiliation":[{"name":"Reference Microbiology, UK Health Security Agency, 61, Colindale Avenue, NW9 5EQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3320-3715","authenticated-orcid":false,"given":"Patrick","family":"French","sequence":"additional","affiliation":[{"name":"The Mortimer Market Centre, Central and North West London NHS Trust, London WC1 6JB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7793-7622","authenticated-orcid":false,"given":"Matthew","family":"Donati","sequence":"additional","affiliation":[{"name":"Bristol Public Health Laboratory, UK Health Security Agency, Bristol BS10 5NB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2697-0892","authenticated-orcid":false,"given":"Peter","family":"Muir","sequence":"additional","affiliation":[{"name":"Bristol Public Health Laboratory, UK Health Security Agency, Bristol BS10 5NB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Templeton","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, EH16 4TJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Department of Sexual Health and HIV, North Manchester General Hospital, Manchester, M5 8RB, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemanti","family":"Patel","sequence":"additional","affiliation":[{"name":"Reference Microbiology, UK Health Security Agency, 61, Colindale Avenue, NW9 5EQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9086-9222","authenticated-orcid":false,"given":"Sarah","family":"Alexander","sequence":"additional","affiliation":[{"name":"Reference Microbiology, UK Health Security Agency, 61, Colindale Avenue, NW9 5EQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Fifer","sequence":"additional","affiliation":[{"name":"Reference Microbiology, UK Health Security Agency, 61, Colindale Avenue, NW9 5EQ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.73"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1901593"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1071\/SH14174"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)32411-4"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.2340\/00015555343368"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz943"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.12.107623"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0004711"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD012071.pub2"},{"year":"2016","key":"R10","article-title":"Syphilis serology. UK Standards for Microbiology Investigations. V 44 Issue no: 2.1"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy558"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1258\/ijsa.2008.008103"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.1086\/655832"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis757"},{"year":"2020","key":"R15","article-title":"False positive treponemal (syphilis) IgM enzyme immunoassay results: Adverse incident report"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01782-17"},{"key":"R17","first-page":"133","article-title":"Discordant results from reverse sequence syphilis screening\u2014five laboratories, united states, 2006\u20132010","volume":"60","year":"2011","journal-title":"MMWR Morb Mortal Wkly"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000446"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1159\/000018149"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00102-10"}],"container-title":["Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.001479?crawler=true&mimetype=application\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T20:27:25Z","timestamp":1702585645000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.001479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,27]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4,27]]}},"URL":"https:\/\/doi.org\/10.1099\/jmm.0.001479","relation":{},"ISSN":["0022-2615","1473-5644"],"issn-type":[{"type":"print","value":"0022-2615"},{"type":"electronic","value":"1473-5644"}],"subject":[],"published":{"date-parts":[[2022,4,27]]}}}