title: Comparison of CDC and sequence-based molecular typing of syphilis treponemes: tpr and arp loci are variable in multiple samples from the same patient.
abstract: BACKGROUND
  Molecular typing of syphilis-causing strains provides important epidemiologic data. We tested whether identified molecular subtypes were identical in PCR-positive parallel samples taken from the same patient at a same time. We also tested whether subtype prevalence differs in skin and blood samples.
  
  
  RESULTS
  Eighteen syphilis positive patients (showing both positive serology and PCR), with two PCR-typeable parallel samples taken at the same time, were tested with both CDC (Centers for Disease Control and Prevention) and sequence-based typing. Samples taken from 9 of 18 patients were completely typed for TP0136, TP0548, 23S rDNA, arp, and tpr loci. The CDC typing revealed 11 distinct genotypes while the sequence-based typing identified 6 genotypes. When results from molecular typing of TP0136, TP0548, and 23S rDNA were analyzed in samples taken from the same patient, no discrepancies in the identified genotypes were found; however, there were discrepancies in 11 of 18 patients (61.1%) samples relative to the arp and tpr loci. In addition to the above described typing, 127 PCR-positive swabs and whole blood samples were tested for individual genotype frequencies. The repetition number for the arp gene was lower in whole blood (WB) samples compared to swab samples. Similarly, the most common tpr RFLP type "d" was found to have lower occurrence rates in WB samples while type "e" had an increased occurrence in these samples.
  
  
  CONCLUSIONS
  Differences in the CDC subtypes identified in parallel samples indicated genetic instability of the arp and tpr loci and suggested limited applicability of the CDC typing system in epidemiological studies. Differences in treponemal genotypes detected in whole blood and swab samples suggested important differences between both compartments and/or differences in adherence of treponeme variants to human cells.
authors.affiliation: Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Lenka
authors.initials: L
authors.lastname: Mikalová
authors.forename: Petra
authors.initials: P
authors.lastname: Pospíšilová
authors.forename: Vladana
authors.initials: V
authors.lastname: Woznicová
authors.forename: Ivana
authors.initials: I
authors.lastname: Kuklová
authors.forename: Hana
authors.initials: H
authors.lastname: Zákoucká
authors.forename: David
authors.initials: D
authors.lastname: Smajs
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D001769:Blood / Q000382:microbiology; D014644:Genetic Variation; D006801:Humans; D058889:Molecular Typing / Q000379:methods*; D012150:Polymorphism, Restriction Fragment Length; D012338:RNA, Ribosomal, 23S / Q000235:genetics; D012867:Skin / Q000382:microbiology; D013587:Syphilis / Q000382:microbiology*; D014210:Treponema pallidum / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D001426:Bacterial Proteins; D012338:RNA, Ribosomal, 23S
references.citation: Infect Immun. 2007 Jun;75(6):3021-6
references.pmid: 17403876
references.citation: Br J Ophthalmol. 2006 May;90(5):647-8
references.pmid: 16622098
references.citation: J Clin Microbiol. 2005 Aug;43(8):3743-6
references.pmid: 16081904
references.citation: N Engl J Med. 2004 Jul 8;351(2):154-8
references.pmid: 15247355
references.citation: Epidemiol Mikrobiol Imunol. 2006 Aug;55(3):105-11
references.pmid: 16970074
references.citation: J Clin Microbiol. 2010 Feb;48(2):497-502
references.pmid: 20007388
references.citation: J Clin Microbiol. 1997 Jun;35(6):1348-52
references.pmid: 9163442
references.citation: Mol Microbiol. 2009 Jun;72(5):1087-99
references.pmid: 19432808
references.citation: J Clin Microbiol. 2012 Jun;50(6):1895-9
references.pmid: 22422857
references.citation: J Clin Microbiol. 2008 Nov;46(11):3802-3
references.pmid: 18753355
references.citation: J Clin Microbiol. 2001 May;39(5):1941-6
references.pmid: 11326018
references.citation: FEMS Immunol Med Microbiol. 2007 Nov;51(2):289-301
references.pmid: 17683506
references.citation: Antimicrob Agents Chemother. 2000 Mar;44(3):806-7
references.pmid: 10755994
references.citation: J Clin Microbiol. 2009 Jun;47(6):1668-73
references.pmid: 19339468
references.citation: Sex Transm Dis. 2012 Jan;39(1):42-5
references.pmid: 22183845
references.citation: Acta Derm Venereol. 2012 Nov;92(6):669-74
references.pmid: 22434073
references.citation: J Clin Microbiol. 1991 Sep;29(9):1976-84
references.pmid: 1774324
references.citation: J Clin Microbiol. 2009 Aug;47(8):2510-2
references.pmid: 19494073
references.citation: J Clin Microbiol. 2012 Jul;50(7):2299-304
references.pmid: 22518868
references.citation: PLoS Negl Trop Dis. 2012;6(7):e1717
references.pmid: 22816000
references.citation: Sex Transm Infect. 2009 Aug;85(4):264-9
references.pmid: 19155240
references.citation: Sex Transm Infect. 2011 Oct;87(6):486-8
references.pmid: 21917695
references.citation: Sex Transm Infect. 2009 Oct;85(6):447-51
references.pmid: 19497918
references.citation: Sex Transm Dis. 1998 Sep;25(8):408-14
references.pmid: 9773432
references.citation: J Infect Dis. 1996 Feb;173(2):491-5
references.pmid: 8568320
references.citation: FEMS Immunol Med Microbiol. 2008 Aug;53(3):322-32
references.pmid: 18554302
references.citation: Sex Transm Infect. 2007 Jun;83(3):189-92
references.pmid: 17244664
references.citation: J Clin Microbiol. 1991 Jan;29(1):62-9
references.pmid: 1993770
references.citation: Eur J Clin Microbiol Infect Dis. 2009 Jul;28(7):875-8
references.pmid: 19229562
references.citation: Infect Immun. 1982 Jul;37(1):64-9
references.pmid: 7049954
references.citation: J Clin Microbiol. 2012 Mar;50(3):546-52
references.pmid: 22219306
references.citation: Clin Microbiol Infect. 2006 Dec;12(12):1233-6
references.pmid: 17121633
references.citation: Infect Immun. 2010 Dec;78(12):5178-94
references.pmid: 20876295
references.citation: J Exp Med. 1999 Feb 15;189(4):647-56
references.pmid: 9989979
references.citation: Sex Transm Dis. 2010 Oct;37(10):660-3
references.pmid: 20601928
references.citation: PLoS Negl Trop Dis. 2011 Nov;5(11):e1273
references.pmid: 22087340
references.citation: J Clin Microbiol. 2012 Nov;50(11):3674-7
references.pmid: 22972832
references.citation: Sex Transm Infect. 2012 Oct;88(6):470-4
references.pmid: 22611234
references.citation: Clin Infect Dis. 2009 Aug 15;49(4):515-21
references.pmid: 19583516
references.citation: FEMS Microbiol Lett. 1998 Dec 1;169(1):155-63
references.pmid: 9851047
references.citation: PLoS Negl Trop Dis. 2010 May 18;4(5):e690
references.pmid: 20502522
references.citation: Sex Transm Infect. 2010 Dec;86(7):537-9
references.pmid: 20643660
references.citation: J Clin Microbiol. 2002 Jan;40(1):256-8
references.pmid: 11773125
references.citation: J Infect Dis. 2010 Nov 1;202(9):1380-8
references.pmid: 20868271
references.citation: J Clin Microbiol. 2007 Feb;45(2):659-61
references.pmid: 17151205
references.citation: FEMS Microbiol Lett. 1990 Mar 15;56(3):233-8
references.pmid: 2187739
references.citation: J Clin Microbiol. 1996 Jan;34(1):49-54
references.pmid: 8748271
references.citation: Infect Immun. 2007 Jan;75(1):104-12
references.pmid: 17030565
references.citation: J Infect Dis. 2001 Jun 1;183(11):1601-6
references.pmid: 11343208
references.citation: Sex Transm Dis. 2010 Sep;37(9):544-8
references.pmid: 20539263
references.citation: J Med Microbiol. 2009 Jun;58(Pt 6):832-836
references.pmid: 19429763
references.citation: J Med Microbiol. 2007 Jun;56(Pt 6):715-721
references.pmid: 17510254