title: Molecular differentiation of Treponema pallidum subspecies in skin ulceration clinically suspected as yaws in Vanuatu using real-time multiplex PCR and serological methods.
abstract: We developed a TaqMan-based real-time quadriplex polymerase chain reaction (PCR) to simultaneously detect Treponema pallidum subspecies pallidum, T. pallidum subsp. pertenue, and T. pallidum subsp. endemicum, the causative agents of venereal syphilis, yaws, and bejel, respectively. The PCR assay was applied to samples from skin ulcerations of clinically presumptive yaws cases among children on Tanna Island, Vanuatu. Another real-time triplex PCR was used to screen for the point mutations in the 23S rRNA genes that have previously been associated with azithromycin resistance in T. pallidum subsp. pallidum strains. Seropositivity by the classical syphilis serological tests was 35.5% among children with skin ulcerations clinically suspected with yaws, whereas the presence of T. pallidum subsp. pertenue DNA was only found in lesions from 15.5% of children. No evidence of T. pallidum subsp. pertenue infection, by either PCR or serology was found in ∼59% of cases indicating alternative causes of yaws-like lesions in this endemic area.
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Kai-Hua
authors.initials: KH
authors.lastname: Chi
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Damien
authors.initials: D
authors.lastname: Danavall
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Fasihah
authors.initials: F
authors.lastname: Taleo
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Allan
authors.initials: A
authors.lastname: Pillay
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Tun
authors.initials: T
authors.lastname: Ye
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Eli
authors.initials: E
authors.lastname: Nachamkin
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Jacob L
authors.initials: JL
authors.lastname: Kool
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: David
authors.initials: D
authors.lastname: Fegan
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Asiedu
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Lasse S
authors.initials: LS
authors.lastname: Vestergaard
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines.
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Ballard
authors.affiliation: Laboratory Reference and Research Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, Atlanta, Georgia; Centers for Disease Control and Prevention, Atlanta, Georgia; Ministry of Health, Port Vila, Vanuatu; Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; World Health Organization, Port Vila, Vanuatu; World Health Organization Consultant, Springhill, Brisbane, Australia; Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland; World Health Organization, Western Pacific Regional Office, Manila, Philippines cychen@cdc.gov.
authors.forename: Cheng-Yen
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017963:Azithromycin / Q000494:pharmacology; D001483:Base Sequence; D002648:Child; D017931:DNA Primers; D006801:Humans; D060885:Multiplex Polymerase Chain Reaction / Q000379:methods*; D010679:Philippines / Q000453:epidemiology; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012883:Skin Ulcer / Q000453:epidemiology / Q000382:microbiology*; D014210:Treponema pallidum / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D015001:Yaws / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D017931:DNA Primers; D017963:Azithromycin