{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"bioRxiv"}],"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:33:00Z","timestamp":1793406780091,"version":"4.5.0"},"posted":{"date-parts":[[2025,10,15]]},"group-title":"Microbiology","reference-count":25,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.biorxiv.org\/about\/FAQ#license"}],"funder":[{"award":["R56AI175016"],"award-info":[{"award-number":["R56AI175016"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,10,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  We demonstrated no differences in susceptibility to penicillin G and ceftriaxone in three modern\n                  <jats:italic>T. pallidum<\/jats:italic>\n                  isolates (UW244B, UW249B, and UW330B), each carrying a variant of the penicillin-binding protein (PBP) Tp0705. This suggests that these polymorphisms should not be a reason for concern when \u03b2-lactams are prescribed for syphilis treatment.\n                <\/jats:p>\n                <jats:sec>\n                  <jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    We report that three modern\n                    <jats:italic>Treponem<\/jats:italic>\n                    a pallidum isolates carrying amino acid polymorphisms at positions 506, 625, and 708 of the penicillin-binding protein (PBP) Tp0705 are equally susceptible to penicillin G and ceftriaxone.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.10.14.682455","type":"posted-content","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T01:10:34Z","timestamp":1760577034000},"source":"Crossref","is-referenced-by-count":2,"title":["Susceptibility to Penicillin G and Ceftriaxone in Three Clinical\n                  <i>Treponema pallidum<\/i>\n                  Isolates is not Altered by Amino Acid Polymorphisms in the Tp0705 Penicillin Binding Protein"],"prefix":"10.64898","author":[{"given":"Lauren C.","family":"Tantalo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathyani D.","family":"Chamakuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7443-0527","authenticated-orcid":false,"given":"Alexander L.","family":"Greninger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole A.P.","family":"Lieberman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Giacani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2025101803150878000_2025.10.14.682455v1.1","unstructured":"WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 - Accountability for the global health sector strategies 2016\u20132021: actions for impact. https:\/\/wwwwhoint\/publications\/i\/item\/9789240027077. 2021."},{"key":"2025101803150878000_2025.10.14.682455v1.2","unstructured":"WHO. World Health Organization. Syphilis. 2024. https:\/\/wwwwhoint\/news-room\/fact-sheets\/detail\/syphilis. 2024."},{"key":"2025101803150878000_2025.10.14.682455v1.3","unstructured":"CDC. STD Treatment Guidelines - Syphilis. Morbidity and Mortality Weekly Report. 2021."},{"issue":"12","key":"2025101803150878000_2025.10.14.682455v1.4","doi-asserted-by":"crossref","first-page":"e994","DOI":"10.1016\/S2666-5247(23)00219-7","article-title":"Antimicrobial susceptibility of Treponema pallidum subspecies pallidum: an in-vitro study","volume":"4","year":"2023","journal-title":"Lancet Microbe"},{"issue":"6","key":"2025101803150878000_2025.10.14.682455v1.5","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.3201\/eid2606.191300","article-title":"Effectiveness and Tolerability of Oral Amoxicillin in Pregnant Women with Active Syphilis, Japan, 2010-2018","volume":"26","year":"2020","journal-title":"Emerg Infect Dis"},{"key":"2025101803150878000_2025.10.14.682455v1.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ270"},{"key":"2025101803150878000_2025.10.14.682455v1.7","doi-asserted-by":"publisher","DOI":"10.1136\/sti.79.5.415"},{"issue":"10","key":"2025101803150878000_2025.10.14.682455v1.8","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1093\/cid\/cix611","article-title":"A Multicenter Study Evaluating Ceftriaxone and Benzathine Penicillin G as Treatment Agents for Early Syphilis in Jiangsu, China","volume":"65","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2025101803150878000_2025.10.14.682455v1.9","doi-asserted-by":"publisher","DOI":"10.1086\/313725"},{"issue":"5","key":"2025101803150878000_2025.10.14.682455v1.10","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1093\/cid\/ciab187","article-title":"Clinical Efficacy of Cefixime for the Treatment of Early Syphilis","volume":"73","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025101803150878000_2025.10.14.682455v1.11","doi-asserted-by":"crossref","unstructured":"Klementov\u00e1 T , Z\u00e1kouck\u00e1 H , B\u00ed\u017eov\u00e1 B , Unemo M , Rob F. Cefixime versus benzathine penicillin G for the treatment of early syphilis-a randomized, controlled open label trial. J Antimicrob Chemother. 2025.","DOI":"10.1093\/jac\/dkaf268"},{"issue":"1","key":"2025101803150878000_2025.10.14.682455v1.12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/s44259-023-00006-3","article-title":"A large screen identifies beta-lactam antibiotics which can be repurposed to target the syphilis agent","volume":"1","year":"2023","journal-title":"NPJ Antimicrob Resist"},{"issue":"22","key":"2025101803150878000_2025.10.14.682455v1.13","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1056\/NEJMc2314441","article-title":"Near-Universal Resistance to Macrolides of Treponema pallidum in North America","volume":"390","year":"2024","journal-title":"N Engl J Med"},{"key":"2025101803150878000_2025.10.14.682455v1.14","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M400666200"},{"key":"2025101803150878000_2025.10.14.682455v1.15","first-page":"1131921","article-title":"Association between treatment failure in patients with early syphilis and penicillin resistance-related gene mutations of Treponema pallidum: Protocol for a multicentre nested case-control study","volume":"10","year":"2023","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"2025101803150878000_2025.10.14.682455v1.16","first-page":"224","article-title":"Resistance to ceftriaxone and penicillin G among contemporary syphilis strains confirmed by natural in vitro mutagenesis","volume":"5","year":"2025","journal-title":"Commun Med (Lond)"},{"key":"2025101803150878000_2025.10.14.682455v1.17","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-11216-7"},{"key":"2025101803150878000_2025.10.14.682455v1.18","doi-asserted-by":"crossref","unstructured":"Edmondson DG , Hu B , Norris SJ . Long-Term In Vitro Culture of the Syphilis Spirochete Treponema pallidum subsp. pallidum. mBio. 2018;9(3).","DOI":"10.1128\/mBio.01153-18"},{"issue":"1","key":"2025101803150878000_2025.10.14.682455v1.19","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1128\/AAC.32.1.68","article-title":"In vitro culture system to determine MICs and MBCs of antimicrobial agents against Treponema pallidum subsp","volume":"32","year":"1988","journal-title":"pallidum (Nichols strain). 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