Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups

나은희; Seon Cho; 김수영; Han-Ik Cho; Jong-Yil Chai

Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups

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Type: Academic journal

Author: 나은희 Seon Cho 김수영 Han-Ik Cho Jong-Yil Chai

Journal: 대한진단검사의학회 Annals of Laboratory Medicine Annals of Laboratory Medicine 제37권 제6호 KCI Accredited Journals

Published: 2017.1

Pages: 511 - 515 (5page)

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Comparison of Traditional and Reverse Syphilis Screening Algorithms in Medical Health Checkups

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Background: The syphilis diagnostic algorithms applied in different countries vary significantly depending on the local syphilis epidemiology and other considerations, including the expected workload, the need for automation in the laboratory and budget factors. This study was performed to investigate the efficacy of traditional and reverse syphilis diagnostic algorithms during general health checkups. Methods: In total, 1,000 blood specimens were obtained from 908 men and 92 women during their regular health checkups. Traditional screening and reverse screening were applied to the same specimens using automatic rapid plasma regain (RPR) and Treponema pallidum latex agglutination (TPLA) tests, respectively. Specimens that were reverse algorithm (TPLA) reactive, were subjected to a second treponemal test performed by using the chemiluminescent microparticle immunoassay (CMIA). Results: Of the 1,000 specimens tested, 68 (6.8%) were reactive by reverse screening (TPLA) compared with 11 (1.1%) by traditional screening (RPR). The traditional algorithm failed to detect 48 specimens [TPLA(+)/RPR(-)/CMIA(+)]. The median TPLA cutoff index (COI) was higher in CMIA-reactive cases than in CMIA-nonreactive cases (90.5 vs 12.5 U). Conclusions: The reverse screening algorithm could detect the subjects with possible latent syphilis who were not detected by the traditional algorithm. Those individuals could be provided with opportunities for evaluating syphilis during their health checkups. The COI values of the initial TPLA test may be helpful in excluding false-positive TPLA test results in the reverse algorithm

#Syphilis #Treponema pallidum #Rapid plasma regain #RPR) #Treponema pallidum latex agglutination #Chemiluminescent microparticle immunoassay #Algorithm

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Binnicker MJ / 2012 / Direct comparison of the traditional and reverse syphilis screening algorithms in a population with a low prevalence of syphilis / J Clin Microbiol 50 :

Centers for Disease Control and Prevention / 2011 / Discordant results from reverse sequence syphilis screening-five laboratories, United States, 2006-2010 / MMWR Morb Morta

Greenblatt RM / 1998 / Genital ulceration as a risk factor for human immunodeficiency virus infection / AIDS 2 : 47 ~ 50

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