{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T20:09:02Z","timestamp":1792613342144,"version":"4.5.0"},"reference-count":36,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2012,8,27]]},"published-print":{"date-parts":[[2013,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review and estimate pooled sensitivity and specificity of the polymerase chain reaction (PCR) technique compared to recommended reference tests in the diagnosis of suspected syphilis at various stages and in various biological materials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>\n                      Search of three electronic bibliographic databases from January 1990 to January 2012 and the abstract books of five congresses specialized in the infectious diseases' field (1999\u20132011). Search key terms included syphilis,\n                      <jats:italic>Treponema pallidum<\/jats:italic>\n                      or neurosyphilis and molecular amplification, polymerase chain reaction or PCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review methods<\/jats:title>\n                    <jats:p>We included studies that used both reference tests to diagnose syphilis plus PCR and we presented pooled estimates of PCR sensitivity, specificity, and positive and negative likelihood ratios (LR) per syphilis stages and biological materials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1160 identified abstracts, 69 were selected and 46 studies used adequate reference tests to diagnose syphilis. Sensitivity was highest in the swabs from primary genital or anal chancres (78.4%; 95% CI: 68.2\u201386.0) and in blood from neonates with congenital syphilis (83.0%; 55.0\u201395.2). Most pooled specificities were \u223c95%, except those in blood. A positive PCR is highly informative with a positive LR around 20 in ulcers or skin lesions. In the blood, the positive LR was &lt;10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The pooled values of LR showed that\n                      <jats:italic>T. pallidum<\/jats:italic>\n                      PCR was more efficient to confirm than to exclude syphilis diagnosis in lesions. PCR is a useful diagnostic tool in ulcers, especially when serology is still negative and in medical settings with a high prevalence of syphilis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2012-050622","type":"journal-article","created":{"date-parts":[[2012,9,30]],"date-time":"2012-09-30T20:42:10Z","timestamp":1349037730000},"page":"251-256","source":"Crossref","is-referenced-by-count":118,"title":["Sensitivity, specificity and likelihood ratios of PCR in the diagnosis of syphilis: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"89","author":[{"given":"Ang\u00e8le","family":"Gayet-Ageron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Lautenschlager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Ninet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas V","family":"Perneger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Combescure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,9,28]]},"reference":[{"key":"2024051409524098000_89.3.251.1","unstructured":"WHO. Global prevalence and incidence of selected curable sexually transmitted infections: overview and estimates. Geneva: World Health Organization, 2001. http:\/\/www.who.int\/hiv\/pub\/sti\/en\/who_hiv_aids_2001.02.pdf ."},{"key":"2024051409524098000_89.3.251.2","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31822e1075"},{"key":"2024051409524098000_89.3.251.3","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318195bd2b"},{"key":"2024051409524098000_89.3.251.4","first-page":"1","article-title":"Case definitions for infectious conditions under public health surveillance. Centers for Disease Control and Prevention","volume":"46","year":"1997","journal-title":"MMWR Recomm Rep"},{"key":"2024051409524098000_89.3.251.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.8.1.1","article-title":"Laboratory diagnosis and interpretation of tests for syphilis","volume":"8","author":"Larsen","year":"1995","journal-title":"Clin Microbiol Rev"},{"key":"2024051409524098000_89.3.251.6","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.5.1941-1946.2001"},{"key":"2024051409524098000_89.3.251.7","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1128\/jcm.29.1.62-69.1991","article-title":"Sensitive detection of Treponema pallidum by using the polymerase chain reaction","volume":"29","author":"Burstain","year":"1991","journal-title":"J Clin Microbiol"},{"key":"2024051409524098000_89.3.251.8","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1128\/jcm.29.8.1711-1718.1991","article-title":"Use of polymerase chain reaction and rabbit infectivity testing to detect Treponema pallidum in amniotic fluid, fetal and neonatal sera, and cerebrospinal fluid","volume":"29","author":"Grimprel","year":"1991","journal-title":"J Clin Microbiol"},{"key":"2024051409524098000_89.3.251.9","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1128\/jcm.29.9.1976-1984.1991","article-title":"Detection by polymerase chain reaction of Treponema pallidum DNA in cerebrospinal fluid from neurosyphilis patients before and after antibiotic treatment","volume":"29","author":"Noordhoek","year":"1991","journal-title":"J Clin Microbiol"},{"key":"2024051409524098000_89.3.251.10","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/167.1.148"},{"key":"2024051409524098000_89.3.251.11","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1128\/jcm.30.2.497-500.1992","article-title":"Detection of Treponema pallidum in early syphilis by DNA amplification","volume":"30","author":"Wicher","year":"1992","journal-title":"J Clin Microbiol"},{"key":"2024051409524098000_89.3.251.12","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-25"},{"key":"2024051409524098000_89.3.251.13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-19"},{"key":"2024051409524098000_89.3.251.14","first-page":"105","article-title":"Molecular detection and subtyping of Treponema pallidum subsp. pallidum in clinical specimens","volume":"55","author":"Flasarova","year":"2006","journal-title":"Epidemiologie, Mikrobiologie, Imunologie"},{"key":"2024051409524098000_89.3.251.15","first-page":"43","article-title":"Detection of Treponema pallidum DNA and RNA in clinical material from patients with syphilis at different stages","volume":"3","author":"Rodionova","year":"2003","journal-title":"Zh Mikrobiol Epidemiol Immunobiol"},{"key":"2024051409524098000_89.3.251.16","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"2024051409524098000_89.3.251.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"2024051409524098000_89.3.251.18","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"2024051409524098000_89.3.251.19","doi-asserted-by":"publisher","DOI":"10.1086\/381227"},{"key":"2024051409524098000_89.3.251.20","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00287-08"},{"key":"2024051409524098000_89.3.251.21","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2008.034314"},{"key":"2024051409524098000_89.3.251.22","first-page":"643","article-title":"PolA PCR in syphilis diagnostic","volume":"10","author":"Heroldova","year":"2004","journal-title":"Clin Microbiol Infect"},{"key":"2024051409524098000_89.3.251.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.10.003"},{"key":"2024051409524098000_89.3.251.24","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02392-08"},{"key":"2024051409524098000_89.3.251.25","doi-asserted-by":"publisher","DOI":"10.1086\/320698"},{"key":"2024051409524098000_89.3.251.26","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2011.049494"},{"key":"2024051409524098000_89.3.251.27","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001273"},{"key":"2024051409524098000_89.3.251.28","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00090-07"},{"key":"2024051409524098000_89.3.251.29","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.2.485-493.2001"},{"key":"2024051409524098000_89.3.251.30","doi-asserted-by":"publisher","DOI":"10.1258\/095646207782716901"},{"key":"2024051409524098000_89.3.251.31","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/175.3.583"},{"key":"2024051409524098000_89.3.251.32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510330081039"},{"key":"2024051409524098000_89.3.251.33","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/19.6.1040"},{"key":"2024051409524098000_89.3.251.34","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1128\/jcm.34.1.49-54.1996","article-title":"Simultaneous PCR detection of Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus types 1 and 2 from genital ulcers","volume":"34","author":"Orle","year":"1996","journal-title":"J Clin Microbiol"},{"key":"2024051409524098000_89.3.251.35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0007093"},{"key":"2024051409524098000_89.3.251.36","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/ajcp\/93.2.252","article-title":"Evaluating diagnostic tests with imperfect standards","volume":"93","author":"Valenstein","year":"1990","journal-title":"Am J Clin Pathol"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2012-050622","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T12:52:57Z","timestamp":1715691177000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2012-050622"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9,28]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2013,4,12]]},"published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.1136\/sextrans-2012-050622"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2012-050622","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,28]]}}}