Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test
Definitive diagnosis of early syphilis currently requires darkfield microscopy and/or a newly reactive sérologie test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microsco...
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Veröffentlicht in: | Sexually transmitted diseases 1987-07, Vol.14 (3), p.156-159 |
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creator | ROMANOWSKI, BARBARA FORSEY, ELAINE PRASAD, ERROL LUKEHART, SHEILA TAM, MILTON HOOK, EDWARD W. |
description | Definitive diagnosis of early syphilis currently requires darkfield microscopy and/or a newly reactive sérologie test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy. |
doi_str_mv | 10.1097/00007435-198707000-00007 |
format | Article |
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The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy.</description><identifier>ISSN: 0148-5717</identifier><identifier>EISSN: 1537-4521</identifier><identifier>DOI: 10.1097/00007435-198707000-00007</identifier><identifier>PMID: 3310278</identifier><identifier>CODEN: STRDDM</identifier><language>eng</language><publisher>Hagerstown, MD: J. B. Lippincott Company</publisher><subject>Adult ; Antibodies, Monoclonal ; Biological and medical sciences ; Female ; Fluorescent Antibody Technique ; General aspects ; Human infectious diseases. 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The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy.</description><subject>Adult</subject><subject>Antibodies, Monoclonal</subject><subject>Biological and medical sciences</subject><subject>Female</subject><subject>Fluorescent Antibody Technique</subject><subject>General aspects</subject><subject>Human infectious diseases. Experimental studies and models</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Original Articles</subject><subject>Syphilis Serodiagnosis - methods</subject><issn>0148-5717</issn><issn>1537-4521</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1987</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFUDtPwzAQthColMJPQPKA2AJ-xvFYFQqViljKHDmOLaVy7GAnQ_89KQ3lltN9j7vTBwDE6AkjKZ7RWIJRnmFZCCTGKfuFLsAccyoyxgm-BHOEWZFxgcU1uElpj44zwjMwoxQjIoo52LyY3ui-CR4GC3fRdMGbVsFOOdfUQwurA1Rw7YYQTdLG9_Aj-KBd8MrBpe-bKtQHuDOpvwVXVrlk7qa-AF_r193qPdt-vm1Wy22mGcZ9RoRQUjBJpDYsz3XNtakxzquCCa6YYoRX0hBrLc0toYigglnBtOHGEstzugCPp71dDN_DeLhsm_Ez55Q3YUhlgRHjCB2FxUmoY0gpGlt2sWlVPJQYlccUy78Uy3OKJ2i03k83hqo19dk4xTbyDxOvklbORuV1k86yglIuqfxfs099iGeaMZkzzBn9Aa4Pgq4</recordid><startdate>19870701</startdate><enddate>19870701</enddate><creator>ROMANOWSKI, BARBARA</creator><creator>FORSEY, ELAINE</creator><creator>PRASAD, ERROL</creator><creator>LUKEHART, SHEILA</creator><creator>TAM, MILTON</creator><creator>HOOK, EDWARD W.</creator><general>J. B. Lippincott Company</general><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19870701</creationdate><title>Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test</title><author>ROMANOWSKI, BARBARA ; FORSEY, ELAINE ; PRASAD, ERROL ; LUKEHART, SHEILA ; TAM, MILTON ; HOOK, EDWARD W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-277a974929ce466cd5ced116b8475a4a425b9e2fff36f2302084f74ce5ef2f563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1987</creationdate><topic>Adult</topic><topic>Antibodies, Monoclonal</topic><topic>Biological and medical sciences</topic><topic>Female</topic><topic>Fluorescent Antibody Technique</topic><topic>General aspects</topic><topic>Human infectious diseases. Experimental studies and models</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Original Articles</topic><topic>Syphilis Serodiagnosis - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ROMANOWSKI, BARBARA</creatorcontrib><creatorcontrib>FORSEY, ELAINE</creatorcontrib><creatorcontrib>PRASAD, ERROL</creatorcontrib><creatorcontrib>LUKEHART, SHEILA</creatorcontrib><creatorcontrib>TAM, MILTON</creatorcontrib><creatorcontrib>HOOK, EDWARD W.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Sexually transmitted diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ROMANOWSKI, BARBARA</au><au>FORSEY, ELAINE</au><au>PRASAD, ERROL</au><au>LUKEHART, SHEILA</au><au>TAM, MILTON</au><au>HOOK, EDWARD W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test</atitle><jtitle>Sexually transmitted diseases</jtitle><addtitle>Sex Transm Dis</addtitle><date>1987-07-01</date><risdate>1987</risdate><volume>14</volume><issue>3</issue><spage>156</spage><epage>159</epage><pages>156-159</pages><issn>0148-5717</issn><eissn>1537-4521</eissn><coden>STRDDM</coden><abstract>Definitive diagnosis of early syphilis currently requires darkfield microscopy and/or a newly reactive sérologie test for syphilis. The efficacy of dark-field microscopy depends on the availability of a microscope, the skill of the clinician in obtaining a specimen, and the expertise of the microscopist. Serologie diagnosis may be affected by the delay between the appearance of the primary chancre and the onset of sérologie reactivity. We used a pathogen-specific fluorescein-conjugated monoclonal antibody to examine lesion exudates from 128 consecutive patients and compared these data with results of dark-field microscopy, the rapid plasma reagin (RPR) test, and the fluorescent treponemal antibody-absorbed (FTA-Abs) test. The monoclonal antibody test demonstrated Treponema pallidum in 48 (73%) of 66 patients with infectious syphilis, while dark-field microscopy was positive for 52 (79%) of 66 patients. None of 62 patients without syphilis was positive by either test. The FTA-Abs test was reactive for 61 patients (92%) of the 66 with infectious syphilis. Thus the fluorescent monoclonal antibody test for detection of T. pallidum in direct smears is as sensitive and specific as dark-field microscopy for the diagnosis of infectious syphilis. It has the potential to provide a convenient, accurate means for definitive diagnosis of genital ulcer disease by health care personnel without ready access to dark-field microscopy.</abstract><cop>Hagerstown, MD</cop><pub>J. B. Lippincott Company</pub><pmid>3310278</pmid><doi>10.1097/00007435-198707000-00007</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Antibodies, Monoclonal Biological and medical sciences Female Fluorescent Antibody Technique General aspects Human infectious diseases. Experimental studies and models Humans Infectious diseases Male Medical sciences Original Articles Syphilis Serodiagnosis - methods |
title | Detection of Treponema pallidum by a Fluorescent Monoclonal Antibody Test |
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