P3-S6.03 Seroreversion of treponemal tests in cases meeting Canadian surveillance criteria for confirmed congenital syphilis
Notice bibliographique
Résumé
Background Serologic tests for syphilis remain the mainstay of diagnosis. However, diagnosis of congenital syphilis is complicated by the passive transfer of maternal antibodies to the infant. Non treponemal test (NTT) titres should decline by age 3 months and should be non reactive by age 6 months if the infant was not infected or was infected but adequately treated. Limited data exist on the serologic outcome of treponemal tests (TT) in cases with clinical or laboratory evidence of congenital syphilis at birth. Methods Cases meeting Canadian surveillance criteria for confirmed early congenital syphilis [within 2 years of birth] ( http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/09vol35/35s2/Syphilis-eng.php ) were reviewed from the Alberta Health Services Edmonton zone from 2005 to 2010. Under Alberta's Public Health Act, maternal stage, treatment information and serologic follow-up and infant clinical, laboratory and treatment information are obtained and stored in a provincial STI database. Results 22 cases met surveillance criteria for confirmed congenital syphilis: six were either stillborn/deceased at birth, three are still under 18 month serologic follow-up, one had persistently reactive TT (21 months) and four had reactive TT at the end of their follow-up period (ages 11, 12, 13 and 15 months). 3/5 cases with persistently reactive TT were treated with 9–10 days of intravenous penicillin within 0–2 days of birth, 1 at 3 months of age and 1 at 8 months of age. In 4/5 of these cases, the RPR had reverted to non reactive at the end of the follow-up period while in the 5th case (treated at 8 months), the RPR declined from a titre of 1:4096 dilutions at birth to 1:64 dilutions at 11 months of age. The remaining eight cases had negative TTs, as summarised in the table. All were treated with 10 days of intravenous penicillin (except case #2 treated with 9 days) see Abstract P3-S6.03 table 1. Abstract P3-S6.03 Table 1 Seroreversion TT Congenital Syphillis Case* Maternal stage/GA at treatment Neonatal/infant diagnostic features Infant age at treatment (GA at birth) Infant age /final serologic results 1 Primary/postpartum Abnormal CSF (4) Birth (34 weeks) 7 months/RPR NR, TPPA NR, FTA-ABS NR 2 Primary/postpartum Abnormal CSF (3) Birth (unknown) 14 months/RPR NR, TPPA NR Abnormal long bone radiographs Intraventricular haemorrhage Fetal hydrops 3 Primary/postpartum Abnormal CSF (3) Birth (38 weeks) 10 months/syphilis EIA negative 4 Early latent/postpartum Abnormal CSF (3) Birth (30 weeks) 5 months/syphilis EIA negative 5 Early latent/34 weeks GA Abnormal CSF (3) Abnormal long bone radiographs Birth (37 weeks) 12 mos/syphilis EIA negative 6 Primary/postpartum Abnormal CSF (3) Birth (38 weeks) 18 months/syphilis EIA negative 7 Early latent/postpartum Abnormal CSF (4) Birth (36 weeks) 19 months/syphilis EIA negative 8 Secondary/28 weeks GA Abnormal CSF (4) Intrauterine anaemia, hydrops, cardiomegaly, ascites. Positive syphilis PCR from intrauterine fetal blood Birth (36 weeks) 13 months/syphilis EIA negative CSF, cerebrospinal fluid; GA, gestational age; NR, non reactive; R, reactive; EIA, enzyme immunoassay; RPR, rapid plasma reagin; TPPA, Treponema pallidum particle agglutination; FTA-ABS, fluorescent treponemal antibody absorbed; PCR, polymerase chain reaction. * Number of CSF abnormalities (elevated WBC, RBC or protein, low glucose, reactive VDRL). Conclusions As with early treatment of primary syphilis cases, seroreversion of TT can occur in cases meeting clinical and laboratory criteria for congenital syphilis. Seroreversion was observed with older TT such as TPPA and FTA-ABS as well as the newer syphilis EIA.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».