Faculty Collaboration Database

Evaluating congenital syphilis in a reverse sequence testing environment. J Perinatol 2019 Jul;39(7):956-963

Date

05/12/2019

Pubmed ID

31076626

DOI

10.1038/s41372-019-0387-9

Scopus ID

2-s2.0-85065649696 (requires institutional sign-in at Scopus site)   3 Citations

Abstract

OBJECTIVES: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach.

STUDY DESIGN: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma  reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR-/FTA+) serology were compared with national or internal guidelines.

RESULTS: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR-/FTA-; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS.

CONCLUSIONS: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.

Author List

Chen MW, Akinboyo IC, Sue PK, Donohue PK, Ghanem KG, Detrick B, Witter FR, Page KR, Arav-Boger R, Golden WC

Author

Ravit Boger MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Female
Fluorescent Treponemal Antibody-Absorption Test
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical
Luminescent Measurements
Male
Retrospective Studies
Syphilis
Syphilis Serodiagnosis
Syphilis, Congenital
Treponema pallidum