Macrolide Resistance in Treponema pallidum in the United States and Ireland
Sheila A. Lukehart, Ph.D., Charmie Godornes, B.S., Barbara J. Molini, M.S., Patricia Sonnett, B.S., Susan Hopkins, M.D., Fiona Mulcahy, M.D., Joseph Engelman, M.D., Samuel J. Mitchell, M.D., Ph.D., Anne M. Rompalo, M.D., Christina M. Marra, M.D., and Jeffrey D. Klausner, M.D., M.P.H.
Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.
For decades, syphilis infection has been treated with penicillin,and Treponema pallidum has not developed resistance to penicillin.In many countries, the recommended treatment for early syphilisis a single dose of penicillin G benzathine, which maintainsbactericidal levels for weeks, killing the slowly metabolizingtreponemes. Azithromycin, which has a long tissue half-lifeand can be administered orally, was found to be effective inthe treatment of syphilis in a rabbit model1 and in small studiesin humans.2,3,4,5,6 Because of its convenience and efficacy,azithromycin is increasingly being used for the treatment ofsyphilis by clinicians and in disease-control activities . . . [Full Text of this Article]
Methods
Samples
Gene Sequencing and Restriction-Digestion Analysis
In Vivo Resistance Studies
Results
Clinical Failure of Azithromycin Therapy in a Patient in San Francisco
Identification of the Mutation in the 23S rRNA Genes
Screening of Samples from Multiple Geographic Sites
Confirmation of Azithromycin Resistance in Vivo
Discussion
Source Information
From the Departments of Medicine (S.A.L., C.G., B.J.M., P.S., C.M.M.) and Neurology (C.M.M.), University of Washington, Seattle; St. James Hospital, Dublin (S.H., F.M.); the San Francisco Department of Health, San Francisco (J.E., S.J.M., J.D.K.); the Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta (S.J.M.); and the Department of Medicine, Johns Hopkins University, Baltimore (A.M.R.).
Address reprint requests to Dr. Lukehart at the Department of Medicine, Box 359779, Harborview Medical Center, 325 9th Ave., Seattle, WA 98104, or at lukehart@u.washington.edu.
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