Syphillis, a sexually transmitted infection, affects more than
10 million cases annually. It has plagued humankind for over 500 years.
After the first
reported outbreaks struck Europe in 1495, the disease spread rapidly to
other continents and swelled to a global pandemic. When treatment with
the antibiotic penicillin became available in the mid-twentieth century,
infection rates started to decrease dramatically.
Syphilis
Syphilis is a sexually transmitted disease caused by the spirochete bacterium. Syphilis can be passed from mother to her baby during pregnancy.
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‘The current syphilis infections are predominantly due to antibiotic-resistant strains from a pandemic cluster.’
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Strikingly, however, infection with the bacteria Treponema pallidum subsp. pallidum (TPA) has been re-emerging globally in the last few decades. Yet the reason for the resurgence of this sexually transmitted infection remains poorly understood.
New techniques to analyze an old disease
According to the authors of the paper, little is known about the patterns of genetic diversity in current infections or the evolutionary origins of the disease. Because clinical samples from syphilis patients only contain low quantities of treponemal DNA and the pathogen is difficult to culture in the laboratory, researchers from the University of Zurich decided in 2013 to apply DNA capture and whole-genome sequencing techniques, as used by colleagues at the University of Tübingen, to ancient DNA samples.
![Syphilis - Tests and Diagnosis]( "Syphilis - Tests and Diagnosis")
Syphilis is a sexually transmitted disease caused by Treponema pallidum. It causes infection most often in people with high risk sexual activities. It is also called "the great pretender".
The team collected 70 clinical and laboratory samples of syphilis, yaws, and bejel infections from 13 countries spread across the globe. Like syphilis bacteria, the closely related subspecies Treponema pallidum subsp. pertenue (TPE) and Treponema pallidum subsp. endemicum (TEN), which cause yaws and bejel, are transmitted through skin contact and show similar clinical manifestations.
By using genome-wide data, the researchers were able to reconstruct a phylogenetic tree showing a clear separation between the TPA lineage and the TPE/TEN lineage.
"There have been many questions regarding the origin of syphilis since its appearance on the world stage 500 years ago. By combining an evolutionary and an epidemiological approach, we were able to decipher the genetic relation between strains infecting individuals today, and also trace the emergence of a pandemic cluster with high frequency of antibiotic resistance", says Homayoun C. Bagheri, former professor at the UZH Institute for Evolutionary Biology and Environmental Studies.
Current syphilis infections predominantly due to resistant strains from a pandemic cluster
The genomic analyses show the emergence of a pandemic cluster named SS14-Ω, which is present in contemporary infections around the globe and distinct from the cluster comprising the well-studied Nichols reference strain. "Our findings highlight the need to study more extensively the predominant strain type in the contemporary epidemic", states Natasha Arora, researcher at the Zurich Institute of Forensic Medicine and first author of the study published in Nature Microbiology.
An evolutionary finding of epidemiological relevance is that the SS14-Ω cluster originated from a strain ancestor in the mid-20th century - after the discovery of antibiotics. The worrying aspect of this pandemic cluster is its high resistance to azithromycin, a second-line drug that is widely used to treat sexually transmitted infections. Natasha Arora adds: "The good news is that, so far, no Treponema strains have been detected that are resistant to penicillin, the first-line antibiotic for syphilis treatment."
Co-author Philipp Bosshard from the University Hospital Zurich is continuing to collect Swiss patient samples in order to further study the clinical aspects of the work. The researchers are convinced that this type of analysis will open new opportunities to develop a comprehensive understanding of the epidemiology of syphilis - a devastating disease that persists to this day, despite the availability of treatment.
Source: Eurekalert
According to the authors of the paper, little is known about the patterns of genetic diversity in current infections or the evolutionary origins of the disease. Because clinical samples from syphilis patients only contain low quantities of treponemal DNA and the pathogen is difficult to culture in the laboratory, researchers from the University of Zurich decided in 2013 to apply DNA capture and whole-genome sequencing techniques, as used by colleagues at the University of Tübingen, to ancient DNA samples.
Syphilis - Tests and Diagnosis
Syphilis is a sexually transmitted disease caused by Treponema pallidum. It causes infection most often in people with high risk sexual activities. It is also called "the great pretender".
Advertisement
The team collected 70 clinical and laboratory samples of syphilis, yaws, and bejel infections from 13 countries spread across the globe. Like syphilis bacteria, the closely related subspecies Treponema pallidum subsp. pertenue (TPE) and Treponema pallidum subsp. endemicum (TEN), which cause yaws and bejel, are transmitted through skin contact and show similar clinical manifestations.
By using genome-wide data, the researchers were able to reconstruct a phylogenetic tree showing a clear separation between the TPA lineage and the TPE/TEN lineage.
"There have been many questions regarding the origin of syphilis since its appearance on the world stage 500 years ago. By combining an evolutionary and an epidemiological approach, we were able to decipher the genetic relation between strains infecting individuals today, and also trace the emergence of a pandemic cluster with high frequency of antibiotic resistance", says Homayoun C. Bagheri, former professor at the UZH Institute for Evolutionary Biology and Environmental Studies.
Current syphilis infections predominantly due to resistant strains from a pandemic cluster
The genomic analyses show the emergence of a pandemic cluster named SS14-Ω, which is present in contemporary infections around the globe and distinct from the cluster comprising the well-studied Nichols reference strain. "Our findings highlight the need to study more extensively the predominant strain type in the contemporary epidemic", states Natasha Arora, researcher at the Zurich Institute of Forensic Medicine and first author of the study published in Nature Microbiology.
An evolutionary finding of epidemiological relevance is that the SS14-Ω cluster originated from a strain ancestor in the mid-20th century - after the discovery of antibiotics. The worrying aspect of this pandemic cluster is its high resistance to azithromycin, a second-line drug that is widely used to treat sexually transmitted infections. Natasha Arora adds: "The good news is that, so far, no Treponema strains have been detected that are resistant to penicillin, the first-line antibiotic for syphilis treatment."
Co-author Philipp Bosshard from the University Hospital Zurich is continuing to collect Swiss patient samples in order to further study the clinical aspects of the work. The researchers are convinced that this type of analysis will open new opportunities to develop a comprehensive understanding of the epidemiology of syphilis - a devastating disease that persists to this day, despite the availability of treatment.
Source: Eurekalert
Cuba First Country to Eliminate Mother-To-Child HIV, Syphilis Transmission: WHO
Nearly 1 million pregnant women worldwide are infected with syphilis annually, which can result in early fetal loss and stillbirth, neonatal death and infections.
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 Simple, but Rapid Diagnostic Test Helps in Routine Syphilis Screening in Pregnant WomenScientists have revealed that a simple and rapid test done near the patient that can effectively diagnose syphilis in pregnant women. | Advertisement
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