Determination of total antibodies to treponema pallidum. When is a false positive test for syphilis possible?

Treponema pallidum, antibodies

This is the detection of total antibodies of class M and G to the causative agent of syphilis, which can be used as an effective ultra-sensitive screening test for the diagnosis of early infection with syphilis.

Russian synonyms

Total antibodies to the causative agent of syphilis (treponema pallidum), antibodies to Treponema pallidum IgG/IgM antigens.

English synonyms

Syphilis IgM, IgG; Treponema pallidum Antibodies, Total; Antibodies to T. pallidum, IgM/IgG, Anti-Treponema pallidum IgG/IgM.

Research method

Immunochemiluminescent analysis.

What biomaterial can be used for research?

venous blood.

How to properly prepare for research?

Do not smoke for 30 minutes before donating blood.

General information about the study

The analysis is carried out in order to detect Treponema pallidum (pallid treponema) - the bacteria that causes syphilis - a chronic venereal disease. infection, which is most often transmitted sexually, for example by direct contact with a syphilitic ulcer (chancre), is also possible intrauterine infection. The source of infection is a sick person. Syphilis is easily curable, but threatens serious health problems if left untreated. An infected mother is able to transmit the disease to her fetus, which can develop serious and irreversible changes.

There are several stages of syphilis. Primary occurs approximately 2-3 weeks after infection. One or sometimes several ulcers, called chancre, usually appear on the part of the body that has come into contact with the chancre of the sick person, such as the penis or vagina. Often chancre painless and may go unnoticed, especially if it is in the rectum or cervix. The ulcer disappears in 4-6 weeks.

Secondary syphilis begins 2-8 weeks after the first appearance of a hard chancre. This stage of the disease is characterized by the appearance of a roseolous-papular rash on the skin, more often on the palms and soles. There are other symptoms such as fever, fatigue, swelling lymph nodes, sore throat and body aches. If syphilis is left untreated, it can develop into latent form, at which infected person does not show any symptoms, but he continues to be a carrier of the infection. This stage sometimes lasts for years.

In 15% of untreated patients, late, or tertiary, syphilis develops, which can last for several years and finally lead to mental illness, blindness, neurological problems (neurosyphilis), heart disease, and even death.

There are several methods that can be used to test for syphilis. One of them allows you to determine antibodies to T. pallidum in the blood. This analysis is the most sensitive and specific for the detection of treponemal antibodies at all stages, including early ones.

When a person comes in contact with T. pallidum, they the immune system reacts by producing antibodies to the bacteria. Two types of antibodies to pale treponema can be detected in the blood: IgM and IgG.

In response to infection with T. pallidum, IgM antibodies to T. pallidum are produced by the body first. They are detected in most patients at the end of the second week of the disease and are present in them in the primary and secondary stages. Immunoglobulins of class G to T. pallidum in detectable amounts appear in the blood 3-4 weeks after infection. Their concentration increases and on the 6th week begins to prevail over the concentration of IgM, reaching a maximum, and then remains at a certain level for a long time.

Starting from the 4th week, the amount of both types of immunoglobulins in the blood increases, which leads to a positive test result for total antibodies to T. Pallidum. This allows you to use this study for early diagnosis T. pallidum infections.

After effective treatment the concentration of immunoglobulins gradually decreases, but this happens slowly, in some cases, antibodies can be detected after a year or more.

Syphilis can be treated with antibiotics, preferably penicillin derivatives. On the early stage the disease is treated more easily and quickly. Longer therapy may be needed for patients infected for more than a year.

What is research used for?

• For the diagnosis of syphilis.
• For examination of all pregnant women with a preventive purpose (preferably at the first appointment with a gynecologist, when registering).

When is the study scheduled?

• For symptoms of syphilis, such as a hard chancre on the genitals or in the throat.
• When the patient is being treated for another STD, such as gonorrhea.
• During pregnancy, because syphilis can be transmitted to the developing fetus and even kill him.
• When it is necessary to determine the exact cause of the disease, if the patient has non-specific symptoms which are similar to syphilis (neurosyphilis).
• If the patient is infected, they should repeat the syphilis test at 3, 6, 12, and 24 months to ensure that the treatment has been successful.

What do the results mean?

Reference values

Result: negative.

S/CO ratio (signall/cutoff): 0 - 0.9.

A positive result means the patient has a recent infection. However, a negative result does not always mean that the patient does not have syphilis.

Positive result

A positive result in a previously seronegative patient, as well as a significant increase in titers in paired sera taken at an interval of 7 days, indicates primary infection. The detection of antibodies to treponema in the blood of a newborn helps confirm the diagnosis of congenital syphilis.

In addition, the reason positive result may be tertiary or latent syphilis.

Negative result

A negative test result may indicate the absence of infection or too early a period when an immune response has not developed. At the same time, the absence of antibodies in an infant born from an infected mother does not exclude congenital disease, because at the time of the study, antibodies may not yet form.

What can influence the result?

False-positive results may occur in diseases such as HIV, Lyme disease, malaria, systemic lupus erythematosus, certain types of pneumonia, as well as drug addiction and pregnancy.

Important Notes

• Examination for syphilis must necessarily be comprehensive and include taking into account the anamnesis, clinical picture and confirmation of the diagnosis with laboratory data.
• People who are active sex life, you should consult your doctor about any suspicious rash or pain in the genital area.
• If a patient is found to be infected, he or she must notify his or her sexual partner so that he (she) is also examined and, if necessary, treated.
• Syphilis increases the risk of contracting other sexually transmitted diseases, including the risk of contracting HIV, which leads to AIDS.
• Syphilis can also be transmitted through blood transfusion through contaminated medical instruments Therefore, before admission to the hospital, it is very important to conduct an examination.

Who orders the study?

Dermatologist, dermatovenereologist, gynecologist, urologist, infectious disease specialist, therapist, pediatrician.

www.helix.ru

Treponema pallidum: characteristics, blood test, treatment

Treponema is a genus of bacteria that unites numerous species, of which the most common causative agent of syphilis is treponema pallidum (treponema pallidum, pale treponema). This genus also includes yaws and pints. Treponema pallidum is a spiral-shaped bacterium of the family Spirochaetiaceae (spirochetes) that causes infection venereal disease- syphilis. Pathology is characterized by a wave-like course and is manifested by a characteristic clinic. Infection occurs mainly through sexual contact, due to which syphilis is an STI.

Currently, a huge number of venereal diseases are registered in the world, which represent real threat for human life. Treponema pallidum is a dangerous microbe that causes a systemic disease affecting the skin and internal organs. At the site of the introduction of the spirochete, a primary pathological focus is formed - a hard chancre. Then syphilitic rashes appear on the skin, regional lymph nodes increase. With absence adequate therapy internal organs are affected, irreversible changes develop, a fatal outcome is possible.

Treponema pallidum

Morphology

Treponema pallidum is a gram-negative microorganism that has the shape of a thin spiral, twisted into 8-12 small curls. Pale treponema got its name due to the ability to not perceive conventional laboratory dyes.

Spirochete is strict anaerobe, growing well in an oxygen-free environment. But despite this, the viability of bacteria remains on the surrounding household items for 3 or more days. Treponema has flagella and fibrils. Thanks to them and their own cell contractions, the bacterium performs translational, rotational, flexion, wave-like, helical and contractile movements. It quickly penetrates into living cells and rapidly multiplies in them by transverse division.

Pale treponema has a three-layer cell wall, cytoplasm and organelles: ribosomes, mesosomes, vacuoles. Ribosomes synthesize proteins, and mesosomes provide respiration and metabolism. Enzymes and antigens are contained in the cytoplasmic membrane. The body of the bacterium is covered with a mucous structureless capsule that performs protective function.

Physical properties

Microbes are resistant to low temperatures and sensitive to high. When heated, they die within 20 minutes, when dried within 15 minutes, and when boiled - instantly. Antiseptics and disinfectants quickly destroy pale treponema. The destructive effect on the bacterium is exerted by: ultraviolet, light, alcohol, alkalis, vinegar, arsenic, mercury, chlorine-containing disinfectants. Treponema pallidum is resistant to some antibiotics.

Pale treponema manifests its pathogenic properties in a humid and warm environment. In the human body, the favorite place of reproduction are the lymph nodes. At the stage of secondary syphilis, microbes concentrate in the blood and show their pathogenic properties.

cultural properties

Treponema pallidum does not grow on artificial nutrient media, in cell culture and chicken embryos. It is cultivated in rabbit testicles. In these cells, the microbe grows and multiplies well, completely retaining its properties and causing orchitis in the animal. There are enriched culture media designed to isolate a pure culture. Microbes grow on them under a thick layer vaseline oil. In this way, antibodies are obtained that are necessary for setting up specific reactions to syphilis.

Treponemas grow on blood or serum agar in an anoxic environment. At the same time, they lose their pathogenic properties, but retain their antigenic properties. Pathogenic treponemas are able to ferment mannitol, utilize lactate and form specific metabolites.

pathogenicity

Factors and components of pathogenicity and virulence of bacteria include:

1. Adhesin proteins that ensure the fixation of the microbe on the host cell,
2. Myofibrils, which promote deep penetration into the body and migration of bacteria in the host body,
3. Formation of L-forms,
4. Lipopolysaccharides outer membrane,
5. Fragments of a pathogenic cell penetrating deep into tissues,
6. Ability to penetrate into the intercellular junctions of the endothelium,
7. Antigenic variability.

Treponema pallidum has a direct toxic effect on the synthesis of macromolecules - DNA, RNA and proteins. T. pallidum antigens are used in the Wassermann test for the serodiagnosis of syphilis. Under adverse conditions, the spirochete transforms into L-forms, which provide its resistance to antibacterial agents and antibodies.

Epidemiology

Syphilis is a severe anthroponosis. The infection persists only in the human body, which is its natural reservoir in nature. Entrance gates of infection are: damaged squamous or columnar epithelium oral cavity or genitals.

The spread of infectious agents occurs:

• Sexually during intercourse through semen,
• Household way through linen, hygiene products, cosmetic accessories, with a kiss,
• Through the vertical route from an infected mother to her child during childbirth, as well as through milk during breastfeeding,
• through the placenta to later dates pregnancy,
• Hematogenous by direct blood transfusion, during operations, when using a common syringe for drug addicts.

The risk of infection is increased in medical workers- dentists, cosmetologists. Infection occurs during medical manipulations and procedures that damage the skin. Treponema pallidum is contracted by disorderly persons sexual life having several sexual partners, neglecting barrier methods of contraception. In order for infection to occur, the patient must have a lot of bacteria in the secret, and the partner must have lesions on the mucous membrane.

the first manifestations of the disease

The patient is most contagious during periods of primary and secondary syphilis, when the first signs of the disease appear on the skin and genital mucosa. At this time, many spirochetes are released into the environment.

Currently registered big number patients with extragenital chancres located on the mucous membrane of the mouth, pharynx, anus. They have rashes localized on the face, syphilides - on the palms and soles. Tertiary period of syphilis recent times develops in very rare cases and is almost asymptomatic.

Symptoms

Incubation is characterized by the migration of bacteria through the lymphatic and blood vessels and their active reproduction in the lymph nodes. The duration of the period is from 3 weeks to 3 months.

Congenital syphilis develops as a result of intrauterine infection of the fetus. This severe pathology is manifested by a characteristic triad of symptoms in a child: congenital deafness, keratitis, Hutchinson's teeth.

Diagnostics

Diagnosis of syphilis includes questioning and examining the patient, collecting anamnestic information, and clinical trials who play important role in the detection of pale treponema and diagnosis.

• Microscopic examination of the biomaterial. Bacterioscopy of a smear-imprint of a chancre or biopsy of a lymph node is carried out in the first 4 weeks of the disease. To obtain a high-quality smear, the surface of erosion and ulcers is treated with saline, a scraping is performed, and a preparation for microscopy is prepared from the resulting material. The smear is stained according to Romanovsky-Giemsa. Treponema has a pale pink color. Live microbes in an unstained and unfixed smear are not visible under a light microscope. To detect them, dark-field or phase-contrast microscopy is used. For dark-field microscopy, material is taken from a syphilitic ulcer and examined in a special apparatus. The bacterium has the ability to refract light: in the microscope, it looks like a white spiral strip. Fluorescent microscopy is also used to detect treponema in various clinical materials.

Syphilis is treated by a dermatovenereologist. He selects therapy individually, taking into account the stage, clinic of the disease and the characteristics of the patient. Complex treatment promotes complete recovery, which must be confirmed by laboratory.

Treatment of syphilis is etiotropic, aimed at the destruction of the pathogen - treponema pallidum. Patients are prescribed large doses of antibiotics to which this microbe is sensitive. Usually, penicillins "Benzylpenicillin", tetracyclines "Doxycycline", macrolides "Clarithromycin", "Sumamed", cephalosporins "Cefazolin", fluoroquinolones "Ciprofloxacin" are used. Antibacterial therapy is continued for 2 months. Pregnant women are also treated.

Immunostimulation, vitamin therapy, physiotherapy complement etiotropic treatment and help patients recover from illness. Preventive therapy is carried out to the sexual partner and persons who have been in contact with the patient.

Video: dermatovenereologist on the treatment of syphilis

Prevention

Preventive actions consist in observing personal hygiene, using separate linen and utensils, individual cosmetics. It is recommended immediately after unprotected intercourse to treat the genitals or other parts of the body with which contact has occurred with a solution of chlorhexidine or albucide. These funds must be home first aid kit.

For preventive purposes, examine:

1. Donors
2. pregnant women,
3. Employees of kindergartens, schools, catering and medical institutions,
4. Patients admitted to hospital.

Modern antimicrobial therapy allows you to get rid of the pathology and makes the prognosis of the disease favorable. Only a dermatovenereologist will be able to choose the right and sufficient treatment for the stage of the disease. Self-medication of syphilis is strictly prohibited. An incompletely cured pathology can turn into chronic form. Such a patient is dangerous to those around him.

Syphilis is a social disease, the treatment of which must be approached seriously and responsibly.

Video: syphilis in the Health program

izppp.ru

Treponema pallidum: what is it?

Syphilis is one of the most severe autoimmune diseases affecting entire organ systems - respiratory, cardiovascular, nervous, bone. The causative agent of syphilis is a single-celled microorganism - a pale spirochete, which has the ability to penetrate the body in case of violations of the integrity of the skin and mucous tissue. In our time, it has been proven that infection can be transmitted even in the absence of microtraumas, through biological fluids - sperm, vaginal discharge.

What is treponema

The first mention of a disease that affects people up to a fatal outcome dates back to the thirties of the 16th century. However, the bacterium itself could only be identified at the beginning of the 20th century. The difficulty was associated with the refractive properties of the microorganism, which is why it is extremely difficult to see it even with a microscope. Because of this, he received the name - poor spirochete.

What does pale treponema look like, what kind of microorganism is it, many people ask. Externally, the filamentous bacterium is curved like a screw and has 8 to 14 whorls. different lengths and magnitude. Smooth movement is provided by fibrils - tubes of flagellin proteins. The spongy body at one end of the microcreature, represented by two round protrusions, helps treponema to penetrate into human cells.

In addition to the fact that the outer fibrils are resistant to many enzymes, its body is, as it were, protected by a mucopolysaccharide shell. This garment provides protection from antibodies and phagocytosis by immune cells.

The causative agent of syphilis is viable in a humid, warm environment, and multiplies at a temperature of 37 degrees by dividing into two or more parts.

When produced antibodies, antibacterial agents or not enough heat does not allow the bacteria to become active, it takes a coccal or cystic form and hides in the tissues, waiting for a favorable moment. If syphilis is caused by one of these transformed organisms, a longer incubation period usually follows, and treponema becomes resistant to certain antibiotics.

Ways of infection

Pale spirochete is distinguished by enviable vitality, due to the elasticity of the body and maximum adaptability to various adverse conditions. She does not need oxygen, loves humidity, and she also needs blood plasma that does not contain fibrinogen.

During penetration, the bacterium is literally screwed into human tissues, like a drill, while rotating around its axis. The danger lies mainly in unprotected sex. But the ways of introducing the infection may be different:

• Through hygiene items, personal items, a damp towel or washcloth;
• Hematogenous way - through the blood;
• Transplacental way - from mother to fetus;
• Through carelessly disinfected instruments during surgery, dental procedure.

It is important to know with regard to such a pathogen as pale treponema that this creature does not die at low temperatures, but changes shape, therefore it can stay on various household objects for a long time, and when conditions change, strike when a person does not expect it at all. That is why it is necessary to keep clean not only your body, but also things.

Treatment is usually long. It can be effective only if the sick person consults a doctor at the first symptoms. In addition, due to the high viability of the microorganism, repeated damage is possible.

Modern methods for detecting the causative agent of syphilis

Pale spirochete can be identified due to the characteristic signs of the disease. They may differ at different stages of progression.

Main symptoms:

• In primary infection, a hard chancre, a pink or red ulcer, is hard and painless. Basically, it appears at the sites of infection - on the genitals, in the mouth, on the lips. On the initial stage there is also an increase in lymph nodes;
• The secondary stage involves rashes all over the body, fever, damage to the mucous membranes, false signs ORZ;
• The tertiary period may come after many years. The infection actively destroys the internal organs, bone skeleton, affects the organs of hearing, vision, brain.

Diagnosis of the disease is carried out in several ways. For this, the following procedures are carried out:

• Dark-field contrast microscopy is performed using a special microscope and a sample serous fluid chancre;
• Laboratory analysis of urine and blood, suggesting staining of the microorganism;
• Polymerase chain reaction(PCR) that recognizes bacterial DNA;
• Wasserman reaction;
• Immunofluorescence (RIF), the method is aimed at finding antibodies to pale treponema during the interaction of a special solution of antibodies and the patient's blood serum;
• Passive hemagglutination based on the immunological bonding of erythrocytes when particles of a pathogenic bacterium are fixed on them - since the blood contains antibodies, the erythrocytes stick together, and after a month the reaction becomes positive, it can remain so after antibiotic therapy;
• ELISA analysis (enzymatic immunoassay) - using this technique, antibodies to treponema pallidum of different types are detected, in addition, ELISA makes it possible to determine their number, which allows us to assume the specifics of the course of the disease, its severity and duration.

The most accurate and informative is considered linked immunosorbent assay, so it should be considered in more detail.

It is a completely normal reaction of the body for the introduction infectious agent is an immune response. Pale spirochete is identified by lymphocytes as a stranger, and active synthesis of immunoglobulins begins. Total antibodies to infection - IgM are formed within a week after infection, IgG - a month later.

It's two different class, which are formed in the early stages of the defeat of syphilis. To successfully fight the disease, treatment should be aimed at lowering the level of IgM and a consistently high concentration of IgG. This ratio shows good performance strong immunity developed to treponema.

In turn, antibodies to treponema pallidum, using receptors, begin to come into close contact with the antigens of the pathogen. Testing using the ELISA method allows you to fix these complexes of hostile cells and make certain predictions.

For example, a baby born to an infected mother should be tested. A test for treponema pallidum antibodies will be positive in a child in the first year of life, since in his body there are IgG antibodies transmitted from the mother. This confirms the fact of transplacental infection.

How the analysis is done

The study is carried out in the laboratory, as special medical equipment is required. To work, a doctor needs a panel with round recesses (about a hundred holes) and prepared antigen concentrates for treponema. They are placed in the holes. The patient comes to the laboratory in the morning and donates blood from a vein on an empty stomach. To determine antibodies, only serum is required, which is separated from the blood. Next, the doctor observes the reaction to various antigens in the recesses.

In addition to introducing enzymes into the wells to read information, dyes are added there, since further decoding will occur using a color table. Thus, the total bodies, their number, etc. are determined. The medical equipment in this process is represented by a spectrophotometer. It is necessary to identify the density of samples, their difference from control tests. As a result, the result is established - the degree of severity of the pathology.

It should be noted that a treponema pallidum antibody positive result can persist in a person for many years, despite successful therapy, sometimes it remains so until the end of life.

Diagnostics and prevention

Modern pharmacology and medicine has a wide range of opportunities to identify such dangerous bacteria like a pale spirochete. Still, it is advisable to contact a qualified and experienced specialist in this field. Today, diagnostic methods are very effective, but the doctor must have indisputable knowledge and skills. In this case, you must strictly follow the recommendations of the doctor, fulfilling all the conditions for the successful completion of the tests.

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Period of execution

The analysis will be ready within 1 day, excluding Sunday (except for the day of taking the biomaterial). You will receive results by email. email as soon as it's ready.

Preparation for analysis

24 hours limit fatty and fried foods, exclude alcohol and heavy physical exercise, as well as radiography, fluorography, ultrasound and physiotherapy.

From 8 to 14 hours before donating blood, do not eat, drink only clean water.

Discuss with your doctor the medications you are taking and the need to stop them.

Analysis Information

Syphilis is a chronic systemic sexually transmitted disease caused by Treponema pallidum. Of all the serological methods for diagnosing syphilis, preference is given to the ELISA method, since it is the most sensitive (over 95%) and specific (100%). This assay can be used as a highly effective screening test and as a diagnostic confirmatory test for syphilis.

Research method - Immunochemiluminescent analysis (ICLA).
Material for research — Blood serum.

Total antibodies to the causative agent of syphilis (total antibodies to Treponema pallidum, to pale treponema, antibodies to Treponema pallidum IgG / IgM antigens, Syphilis IgM IgG, Treponema pallidum Antibodies Total)

Class G immunoglobulins are usually synthesized on the 4th week after infection in higher titers than IgM. They are characterized by prolonged circulation in the body, they are found even after clinical recovery. Syphilitic antibodies can be non-specific (reagins) and specific (anti-treponemal). Reagins are directed both against the lipid antigens of the treponema itself and against autoantigens, which are formed as a result of the destruction of the body's own cells. Under various pathological and physiological conditions, the level of reagins can increase, so they can often be the cause of false positive results during serological tests for syphilis. Accordingly, specific anti-treponemal antibodies are directed only against Treponema pallidum.

Laboratory diagnostics syphilis is regulated by the order of the Ministry of Health of the Russian Federation No. 87 dated March 26, 2001 "On improving the serological diagnosis of syphilis", which approved guidelines on setting up qualifying and diagnostic tests for syphilis. In the serological diagnosis of syphilis, due to the peculiarities of the immune response to this infection, a combination of non-specific (non-treponemal) and specific antigens of the causative agent of syphilis Treponema pallidum (treponemal) tests are used.

Thus, the sequence of examination of patients for syphilis is as follows:
- At primary examination a selection (screening) test is performed, in particular RPR (non-specific antiphospholipid test), modern analogue Wassermann reaction and, in case of a positive result, any specific confirmatory treponemal test (analysis for syphilis RPHA or ELISA).
- The next RPR is set after the end of therapy and the effectiveness of therapy and dynamics are judged by lowering the titer infectious process. Therapy is considered effective when the titer decreases by 4 or more times within 1 year.
- At the end of this period, a specific confirmatory treponemal test (TPHA, ELISA) is performed. It is necessary to take into account the fact that antitreponemal antibodies, and therefore a positive result, remain in the patient for a number of years, or even for life.

Of all the serological methods for diagnosing syphilis, preference is given to the ELISA method, since it is the most sensitive (over 95%) and specific (100%). During this method, specific (treponemal) antibodies of the IgM and IgG (general) classes are determined in the blood. Antibodies of the IgG class appear in the acute period of the disease and can persist in cured patients for life. The complex of serological reactions to syphilis, in accordance with the order of the Ministry of Health of the Russian Federation, must necessarily include the setting of a specific treponemal test (as an ELISA test). This assay can be used as a highly effective screening test and as a diagnostic confirmatory test for syphilis. At the end of 3-4 weeks of the disease, after the appearance of primary syphiloma, a specific treponemal test becomes positive - this corresponds to the primary seropositive period of syphilis. When the first clinical signs diseases, including hard chancre, detection of total antibodies (IgM and IgG) to Tgeropa pallidum antigens can confirm the diagnosis of syphilis. Additional research is to conduct a non-treponemal anticardiolipin test - RPR. These two studies are complementary. When used together with RPR and a test for the determination of total antibodies to Treponema pallidum antigens by ELISA, it is the most effective serological test option to confirm the presence or exclusion of syphilis.

Very often the questions are asked: Are they tested for syphilis during pregnancy? Where to get tested for syphilis? Is it possible to make a rapid analysis for syphilis? How much does a syphilis test cost? We answer: an analysis for syphilis during pregnancy is taken as prescribed by a doctor. You can donate at any partner medical center which you select on our website. You can quickly, within a day, get reliable result in case of a negative test result, if you pass a syphilis test in the treatment room of the BION laboratory. You can also donate blood for syphilis anonymously (in this case, a blood test for syphilis, namely the result of the study, is issued with a full name as "ANONYMOUS"). The price of a blood test for syphilis at LAB4U is on average two times cheaper than in your region.

Interpretation of the results of the study "Total antibodies to the causative agent of syphilis (total antibodies to Treponema pallidum, to pale treponema, antibodies to Treponema pallidum IgG / IgM antigens, Syphilis IgM IgG, Treponema pallidum Antibodies Total)"

Attention! The interpretation of test results is for informational purposes, is not a diagnosis and does not replace the advice of a doctor. Reference values ​​may differ from those indicated depending on the equipment used, actual values ​​will be indicated on the results sheet.

A positive test result indicates syphilis in different clinical stages however, in patients who have undergone treatment, a positive result may persist for a long time.

A negative test result may be in the absence of infection or early primary syphilis.

Unit of measurement: Unit

Reference values:

• < 1,0 - отрицательный
• ≥ 1.0 - positive

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Syphilis- This is an infectious disease that is most often transmitted sexually, that is, by direct contact with a syphilitic ulcer (hard chancre). It is easily curable, but if the patient is inactive, it threatens with serious health problems. An infected mother can transmit the disease to her fetus, which subsequently develops dangerous changes.

There are several stages of syphilis. Primary occurs approximately 2-3 weeks after infection. One or sometimes several ulcers, called chancre, usually appear on the part of the body that has come into contact with the chancre of the sick person, such as the penis or vagina. Often, a chancre is painless and goes unnoticed, especially if it is in the rectum or on the cervix. The chancre disappears in 4-6 weeks.
Secondary syphilis begins 2-8 weeks after the onset of a hard chancre. This stage of the disease is characterized by the appearance of a rash, often on the palms and soles. Sometimes there are other symptoms, such as fever, fatigue, swollen lymph nodes, sore throat, and body aches.
Syphilis is able to proceed in a latent form, during which the infected person does not show any symptoms, but at the same time he continues to be a carrier of the infection. This may take years.
Without treatment, about 15% of patients develop symptoms of late, or tertiary, syphilis. This stage sometimes lasts several years and leads to mental illness, blindness, neurological problems, heart disease, and even death.
Syphilis can be treated with antibiotics (penicillin derivatives are preferred). Moreover, at an early stage, the disease is treated easier and faster.
There are several methods that can be used to test for syphilis. One of them allows to detect antibodies to t. pallidum in the blood. This assay is the most sensitive and specific for the detection of treponemal antibodies at all stages.
When there is human contact with t. pallidum, its immune system reacts by producing antibodies to the bacteria. Two types of such antibodies can be detected in the blood: IgM and IgG.
First of all, IgM antibodies are produced. They are detected in most people by the end of the second week of illness and are present in most patients with primary and secondary syphilis, so an IgM test can be used to distinguish between freshly acquired and long-standing infections.
Specific treponemal IgM antibodies are not present in patients treated in the past, but their absence does not in itself indicate the effectiveness of the therapy, since most of those who were not treated, in latent stage syphilis IgM antibodies are also absent.

What is analysis used for?

• In order to detect the bacterium that causes the development of syphilis, treponema pallidum (pallid treponema).
• As a preventive measure for all pregnant women, preferably at the first gynecological appointment, when registering.
• To confirm the diagnosis of "congenital syphilis" in a newborn.
• To distinguish between freshly acquired and long-standing infections.

When is an analysis scheduled?

• For symptoms of syphilis, such as a hard chancre on the genitals or in the throat.
• When a patient is being treated for another sexually transmitted disease, such as gonorrhea.
• During pregnancy, because syphilis can be transmitted to the developing fetus and even kill it.
• When determining the exact cause of the disease, when a person complains of non-specific symptoms similar to those of syphilis.
• If the patient has been infected, they should repeat syphilis tests at 3, 6, 12, and 24 months to ensure that treatment has been successful.

What do the results mean?

Positive result

The presence of IgM class antibodies means that the patient has a freshly acquired infection.
A positive result in a previously antibody-free patient, as well as a significant increase in titers in paired sera taken 7 days apart, confirms primary infection.
The detection of IgM in the blood of a newborn confirms the diagnosis of congenital syphilis, since maternal IgM antibodies, unlike IgG antibodies, do not pass from mother to child through the placenta.

Negative result

A negative result may indicate the absence of the disease or it is too early term when there is no immune response. In addition, this is an indicator of a long-standing infection that occurred more than a month ago.
The absence of IgM antibodies in an infant born to an infected mother does not exclude the presence of a congenital disease, since antibodies may not yet have formed at the time of the study.

What can influence the result?

A false positive result is possible when:

• lyme disease,
• malaria
• systemic lupus erythematosus,
• some types of pneumonia
• addiction,
• pregnancy.

Treponema pallidum, antibodies

This is the detection of total antibodies of class M and G to the causative agent of syphilis, which can be used as an effective ultra-sensitive screening test for the diagnosis of early infection with syphilis.

Russian synonyms

Total antibodies to the causative agent of syphilis (treponema pallidum), antibodies to Treponema pallidum IgG/IgM antigens.

SynonymsEnglish

Syphilis IgM, IgG; Treponema pallidum Antibodies, Total; Antibodies to T. pallidum, IgM/IgG, Anti-Treponema pallidum IgG/IgM.

Research method

Immunochemiluminescent analysis.

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

Do not smoke for 30 minutes prior to the study.

General information about the study

The analysis is carried out in order to detect Treponema pallidum (pallid treponema) - the bacteria that causes syphilis - a chronic sexually transmitted infection that is most often transmitted sexually, for example, through direct contact with a syphilitic ulcer (hard chancre), intrauterine infection is also possible. The source of infection is a sick person. Syphilis is easily curable, but threatens serious health problems if left untreated. An infected mother is able to transmit the disease to her fetus, which can develop serious and irreversible changes.

There are several stages of syphilis. Primary occurs approximately 2-3 weeks after infection. One or sometimes several ulcers, called chancre, usually appear on the part of the body that has come into contact with the chancre of the sick person, such as the penis or vagina. Often, a chancre is painless and may go unnoticed, especially if it is in the rectum or on the cervix. The ulcer disappears in 4-6 weeks.

Secondary syphilis begins 2-8 weeks after the first appearance of a hard chancre. This stage of the disease is characterized by the appearance of a roseolous-papular rash on the skin, more often on the palms and soles. There are other symptoms such as fever, fatigue, swollen lymph nodes, sore throat and body aches. If syphilis is not treated, it can develop in a latent form, in which the infected person does not show any symptoms, but continues to be a carrier of the infection. This stage sometimes lasts for years.

15% of untreated patients develop late or tertiary syphilis, which can last for several years and eventually lead to mental illness, blindness, neurological problems (neurosyphilis), heart disease, and even death.

There are several methods that can be used to test for syphilis. One of them allows you to determine antibodies to T. pallidum in the blood. This analysis is the most sensitive and specific for the detection of treponemal antibodies at all stages, including early ones.

When a person comes into contact with T. pallidum, their immune system reacts by producing antibodies to the bacteria. Two types of antibodies to pale treponema can be detected in the blood: IgM and IgG.

In response to infection with T. pallidum, IgM antibodies to T. pallidum are produced by the body first. They are detected in most patients at the end of the second week of the disease and are present in them in the primary and secondary stages. Immunoglobulins of class G to T. pallidum in detectable amounts appear in the blood 3-4 weeks after infection. Their concentration increases and on the 6th week begins to prevail over the concentration of IgM, reaching a maximum, and then remains at a certain level for a long time.

Starting from the 4th week, the amount of both types of immunoglobulins in the blood increases, which leads to a positive test result for total antibodies to T. Pallidum. This allows the study to be used for early diagnosis of T. pallidum infection.

After effective treatment, the concentration of immunoglobulins gradually decreases, but this happens slowly, in some cases, antibodies can be detected after a year or more.

Syphilis can be treated with antibiotics, preferably penicillin derivatives. At an early stage, the disease is treated easier and faster. Longer therapy may be needed for patients infected for more than a year.

What is research used for?

• For the diagnosis of syphilis.
• For examination of all pregnant women with a preventive purpose (preferably at the first appointment with a gynecologist, when registering).

When is the study scheduled?

• For symptoms of syphilis, such as a hard chancre on the genitals or in the throat.
• When the patient is being treated for another STD, such as gonorrhea.
• During pregnancy, because syphilis can be transmitted to the developing fetus and even kill him.
• When it is necessary to determine the exact cause of the disease, if the patient has non-specific symptoms that are similar to syphilis (neurosyphilis).
• If the patient is infected, they should repeat the syphilis test at 3, 6, 12, and 24 months to ensure that the treatment has been successful.

What do the results mean?

Reference values

Result: negative.

S/CO ratio (signall/cutoff): 0 - 0.9.

A positive result means the patient has a recent infection. However, a negative result does not always mean that the patient does not have syphilis.

Positive result

A positive result in a previously seronegative patient, as well as a significant increase in titers in paired sera taken at an interval of 7 days, indicates a primary infection. The detection of antibodies to treponema in the blood of a newborn helps to confirm the diagnosis of congenital syphilis.

In addition, tertiary or latent syphilis may be the cause of a positive result.

Negative result

A negative test result may indicate the absence of infection or too early a period when an immune response has not developed. At the same time, the absence of antibodies in an infant born from an infected mother does not exclude a congenital disease, since antibodies may not yet form at the time of the study.

What can influence the result?

False-positive results may occur in diseases such as HIV, Lyme disease, malaria, systemic lupus erythematosus, certain types of pneumonia, as well as drug addiction and pregnancy.

Important Notes

• Examination for syphilis must necessarily be comprehensive and include taking into account the anamnesis, clinical picture and confirmation of the diagnosis with laboratory data.
• Sexually active people should consult a doctor about any suspicious rash or pain in the genital area.
• If a patient is found to be infected, he or she must notify his or her sexual partner so that he (she) is also examined and, if necessary, treated.
• Syphilis increases the risk of contracting other sexually transmitted diseases, including the risk of contracting HIV, which leads to AIDS.
• Syphilis can also be transmitted through blood transfusion through contaminated medical instruments, so it is very important to conduct an examination before admission to a hospital.

• Syphilis RPR (anticardiolipin test / precipitation microreaction), titer
• Treponema pallidum DNA [PCR]
• Syphilis RPHA (passive hemagglutination reaction), titer

Who orders the study?

Dermatologist, dermatovenereologist, gynecologist, urologist, infectious disease specialist, therapist, pediatrician.

Treponema pallidum is a bacterium of the genus Treponema that causes the infectious disease syphilis. Its length is from 8 to 20 microns, width - from 0.25 to 0.35 microns. It has the shape of a spiral and resembles a corkscrew with 8-12 curls. This type of structure is called spirochete, so this bacterium is also known as pale spirochete.

Long subtle body allows the microbe to easily enter the human body through the mucous membranes. Basically, infection occurs through the genitals.

What is treponema

Pale treponema was discovered in 1905 by German scientists Hoffmann and Shaudin. In the study of Treponema pallidum (Latin name, the spelling T. pallidum is also used) is not detected by Gram staining, therefore the definition of “pale” (Latin pallidum) was assigned to the bacterium. It has 4 subspecies, each of which poses a threat to human health:

Treponema pallidum has a body covered with a mucous structureless capsule, a three-layer cell wall, organelles (vacuoles, ribosomes, mesosomes), cytoplasm. Its ends are usually pointed, they have blepharoplast outgrowths, on which there are about 10 fibrils (filamentous structures) in the form of bundles. Due to cell contractions and existing fibrils, the pale spirochete moves quickly. On the way to its goal, it performs various movements: flexion, translational, rotational, helical, etc.

Under adverse conditions, the forms of pale treponema change, it takes the form of cysts and the L-form:

1. In the L-form, treponemas become spherical, their reproduction stops and the cell wall becomes thinner, but growth and DNA synthesis continues.
2. Cysts are covered with a protective membrane and can be in a latent state in the human body for a long time. When conditions change to favorable, cysts become grains, and then take on their usual shape.

Treponema pallidum is sensitive to ultraviolet light, afraid of alkali, vinegar, alcohol. It shows resistance to low temperatures (withstands freezing up to 1 year), but when heated above 50 ° C, it dies within 15–20 minutes. Outside the human body can live no more than 3 days. It is a strict anaerobe, that is, it does not require free oxygen for energy metabolism. The resistance of cysts and L-form is several times stronger.

Signs of syphilis

Once in the human body through the mucous membrane, the bacterium continues to move through the lymphatic and blood vessels, then settles in the tissues. The first signs of infection usually appear 20–30 days after the microbe enters the body, but sometimes this does not occur until 3–4 months later. There are several stages of the disease: primary syphilis, secondary, etc. Each of them has characteristic symptoms.

Primary syphilis - the stage that occurs immediately after infection, symptoms become noticeable after 10-90 days. The patient may experience weakness, headache, pain in the bones and muscles, fever. Sometimes there is no deterioration in well-being. Lymph nodes are often enlarged. At the site of penetration of the white spirochete, a syphiloma is formed or a small dense knot up to 1 cm in diameter, gradually transforming into an ulcer.

Chancre is single or in the amount of several pieces and occurs not only on the mucous membranes, but also on skin arms, thighs, abdomen, etc. Chancres have varieties called anomalous, their presence is often confusing when making a diagnosis:

The secondary stage begins 3 months after the causative agent of syphilis has entered the body. Its duration can reach 5 years. Periodically there are rashes on the skin (skin syphilides), which disappear on their own after a few weeks. They may have different kind: white spots on the neck (""), abscesses, pale pink spots on the sides, etc. Itching and temperature are absent. Sometimes there is a localized baldness. Syphilides can affect the mucous membrane of the throat in the form of tonsillitis and pharyngitis.

Tertiary syphilis occurs several years after infection. Internal organs are destroyed, characteristic syphilides appear on the skin and mucous membranes. The mucosa and internal organs are affected by gummas - tumors that lead to irreversible tissue breakdown. Tuberculous and gummous syphilides appear on the skin (see photo).

Identification and treatment of the disease

To diagnose syphilis, comprehensive examination. First, the patient is examined by a dermatovenerologist for the presence of rashes on the skin and mucous membranes. Then, laboratory studies of the material taken from ulcers and formations in the patient are carried out. Such studies may be carried out;

1. Treponemal serological tests: RITB, RIF, TPHA, ELISA, immunoblotting. They allow to detect antibodies to treponoma pallidum.
2. Non-treponemal serological tests: Wassermann test, quantitative test
   VDRL, rapid plasma reagin test. The presence of antibodies to tissue phospholipids is determined.
3. Detection of treponema in lesions: PCR, RIF-Tr, dark-field microscopy.

It is important to carefully study all the signs in order to understand what it is, because the symptoms of syphilis coincide with the symptoms of many other diseases. If the diagnosis is confirmed, treatment is prescribed, the type of which depends on the stage of the disease.

Therapy is based on antibiotics. The basis of drugs are usually penicillin, tetracycline or erythromycin. If the patient has a tertiary stage, then bismuth agents are used, which are highly toxic. Can also be practiced intramuscular injection antibacterial drugs, pyrotherapy.

Disinfection of household items is mandatory and helps to kill the pathogen outside the body of the infected. In addition, it is necessary to diagnose and treat the sexual partner.