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.
This article has been cited by other articles:
Stamm, L. V.
(2010). Global Challenge of Antibiotic-Resistant Treponema pallidum. Antimicrob. Agents Chemother.
54: 583-589
[Abstract][Full Text]
Martin, I. E., Tsang, R. S. W., Sutherland, K., Tilley, P., Read, R., Anderson, B., Roy, C., Singh, A. E.
(2009). Molecular Characterization of Syphilis in Patients in Canada: Azithromycin Resistance and Detection of Treponema pallidum DNA in Whole-Blood Samples versus Ulcerative Swabs. J. Clin. Microbiol.
47: 1668-1673
[Abstract][Full Text]
Matejkova, P., Flasarova, M., Zakoucka, H., Borek, M., Kremenova, S., Arenberger, P., Woznicova, V., Weinstock, G. M., Smajs, D.
(2009). Macrolide treatment failure in a case of secondary syphilis: a novel A2059G mutation in the 23S rRNA gene of Treponema pallidum subsp. pallidum. J Med Microbiol
58: 832-836
[Abstract][Full Text]
French, P, Gomberg, M, Janier, M, Schmidt, B, van Voorst Vader, P, Young, H
(2009). IUSTI: 2008 European Guidelines on the Management of Syphilis. Int J STD AIDS
20: 300-309
[Full Text]
Ballout, A., Yombi, J.-C., Hassoun, Z., Goffin, E., Kanaan, N.
(2008). Secondary syphilis after renal transplantation. NDT Plus
1: 442-444
[Full Text]
Kingston, M, French, P, Goh, B, Goold, P, Higgins, S, Sukthankar, A, Stott, C, Turner, A, Tyler, C, Young, H
(2008). UK National Guidelines on the Management of Syphilis 2008. Int J STD AIDS
19: 729-740
[Full Text]
Bai, Z.-G., Yang, K.-H., Liu, Y.-L., Tian, J.-H., Ma, B., Mi, D.-H., Jiang, L., Tan, J.-Y., Gai, Q.-Y.
(2008). Azithromycin vs. benzathine penicillin G for early syphilis: a meta-analysis of randomized clinical trials. Int J STD AIDS
19: 217-221
[Abstract][Full Text]
Eccleston, K., Collins, L., Higgins, S. P
(2008). Primary syphilis. Int J STD AIDS
19: 145-151
[Abstract][Full Text]
Pandori, M. W., Gordones, C., Castro, L., Engelman, J., Siedner, M., Lukehart, S., Klausner, J.
(2007). Detection of Azithromycin Resistance in Treponema pallidum by Real-Time PCR. Antimicrob. Agents Chemother.
51: 3425-3430
[Abstract][Full Text]
Zetola, N. M., Engelman, J., Jensen, T. P., Klausner, J. D.
(2007). Syphilis in the United States: An Update for Clinicians With an Emphasis on HIV Coinfection. Mayo Clin Proc.
82: 1091-1102
[Abstract][Full Text]
Goh, B. T, Thornton, A. C
(2007). Antenatal screening for syphilis. Sex. Transm. Infect.
83: 345-346
[Full Text]
French, P.
(2007). Syphilis. BMJ
334: 143-147
[Full Text]
MacDonald, N., Wong, T.
(2007). Canadian guidelines on sexually transmitted infections, 2006. CMAJ
176: 175-176
[Full Text]
Lomax, N, Wheeler, H, Anaraki, S, Anderson, H, Goh, B
(2006). Management of a syphilis outbreak in street sex workers in east London. Sex. Transm. Infect.
82: 437-438
[Abstract][Full Text]
Morshed, M. G., Jones, H. D.
(2006). Treponema pallidum macrolide resistance in BC. CMAJ
174: 349-349
[Full Text]
Ballard, R. C., Berman, S. M., Fenton, K. A., Savaris, R. F., Abeche, A. M., Klausner, J. D., Kohn, R. P., Kent, C. K., Riedner, G., Grosskurth, H., Hayes, R., Holmes, K. K.
(2006). Azithromycin versus Penicillin for Early Syphilis. NEJM
354: 203-205
[Full Text]
LaFond, R. E., Lukehart, S. A.
(2006). Biological Basis for Syphilis. Clin. Microbiol. Rev.
19: 29-49
[Abstract][Full Text]
Goh, B T
(2005). Syphilis in adults. Sex. Transm. Infect.
81: 448-452
[Abstract][Full Text]
Riedner, G., Rusizoka, M., Todd, J., Maboko, L., Hoelscher, M., Mmbando, D., Samky, E., Lyamuya, E., Mabey, D., Grosskurth, H., Hayes, R.
(2005). Single-Dose Azithromycin versus Penicillin G Benzathine for the Treatment of Early Syphilis. NEJM
353: 1236-1244
[Abstract][Full Text]
Holmes, K. K.
(2005). Azithromycin versus Penicillin G Benzathine for Early Syphilis. NEJM
353: 1291-1293
[Full Text]
Previous
