Early syphilis in Guangzhou, China: presentation, molecular detection ofTreponema pallidum, and genomic sequences in clinical specimens and isolates obtained by rabbit infectivity testing
Author:
Yang Ligang, Zhang Xiaohui, Chen Wentao, Seña Arlene C.ORCID, Zheng Heping, Jiang Yinbo, Zhao Peizhen, Chen Rongyi, Wang Liuyuan, ke Wujian, Salazar Juan C., Parr Jonathan B., Tucker Joseph D.ORCID, Hawley Kelly L.ORCID, Caimano Melissa J.ORCID, Hennelly Christopher M., Aghakanian Farhang, Zhang Feifei, Chen Jane S., Moody M. Anthony, Radolf Justin D., Yang Bin
Abstract
AbstractBackgroundThe global resurgence of syphilis requires novel prevention strategies. Whole genome sequencing (WGS) ofTreponema pallidum(TPA) using different specimen types is essential for vaccine development.MethodsPatients with primary (PS) and secondary (SS) syphilis were recruited in Guangzhou, China. We collected ulcer exudates and blood from PS participants, and skin biopsies and blood from SS participants forTPA polApolymerase chain reaction (PCR); ulcer exudates and blood were also used to isolateTPAstrains by rabbit infectivity testing (RIT).TPAWGS was performed on 52 ulcer exudates and biopsy specimens and 25 matched rabbit isolates.ResultsWe enrolled 18 PS and 51 SS participants from December 2019 to March 2022. Among PS participants,TPADNA was detected in 16 (89%) ulcer exudates and three (17%) blood specimens. Among SS participants,TPADNA was detected in 50 (98%) skin biopsies and 27 (53%) blood specimens.TPA was isolated from 48 rabbits, with a 71% (12/17) success rate from ulcer exudates and 69% (36/52) from SS bloods. Twenty-three matched SS14 clade genomes were virtually identical, while two Nichols clade pairs had discordanttprKsequences. Forty-two of 52 uniqueTPAgenomes clustered in an SS14 East Asia subgroup, while ten fell into two East Asian Nichols subgroups.ConclusionsOurTPAdetection rate was high from PS ulcer exudates and SS skin biopsies and over 50% from SS whole blood, with RIT isolation in over two-thirds of samples. Our results support the use of WGS from rabbit isolates to inform vaccine development.SummaryWe performedTreponema pallidummolecular detection and genome sequencing from multiple specimens collected from early syphilis patients and isolates obtained by rabbit inoculation. Our results support the use of whole genome sequencing from rabbit isolates to inform syphilis vaccine development.
Publisher
Cold Spring Harbor Laboratory
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