梅毒螺旋体聚合酶链反应阳性的原发性梅毒感染血清梅毒阴性的比例:一项系统回顾和荟萃分析

IF 3.8 4区 医学 Q2 IMMUNOLOGY
Open Forum Infectious Diseases Pub Date : 2025-08-12 eCollection Date: 2025-09-01 DOI:10.1093/ofid/ofaf471
Yasmin Hughes, Janet M Towns, Jason J Ong, Eric P F Chow, Christopher K Fairley, Deborah A Williamson, Jade Bilardi, Jane S Hocking, Shivani Pasricha, Eloise Williams, Francesca Azzato, Marcus Y Chen
{"title":"梅毒螺旋体聚合酶链反应阳性的原发性梅毒感染血清梅毒阴性的比例:一项系统回顾和荟萃分析","authors":"Yasmin Hughes, Janet M Towns, Jason J Ong, Eric P F Chow, Christopher K Fairley, Deborah A Williamson, Jade Bilardi, Jane S Hocking, Shivani Pasricha, Eloise Williams, Francesca Azzato, Marcus Y Chen","doi":"10.1093/ofid/ofaf471","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Earlier syphilis detection is needed to reduce infectiousness and transmission and to improve control. Polymerase chain reaction (PCR) for <i>Treponema pallidum</i> is highly sensitive for detecting primary syphilis but is not often widely available or used. The aim of this systematic review and meta-analysis was to investigate the proportion of PCR-positive, seronegative primary syphilis infections when serology was performed at clinical presentation.</p><p><strong>Methods: </strong>We undertook a systematic review and meta-analysis to identify studies of patients presenting with primary syphilis where <i>T pallidum</i> PCR was performed on the primary syphilis lesion and serology for syphilis was performed on the same occasion. The review was conducted according to the Cochrane protocol. Medline, Embase, and PubMed were searched from 1 January 2000 to 27 November 2022 (date of search). Only studies published in English were included. A pooled estimate of the proportion of PCR-positive, seronegative primary infections was calculated via a random effects model.</p><p><strong>Results: </strong>Of 2571 studies identified, 8 met inclusion criteria and were included. This contributed to 758 individuals with <i>T pallidum</i> PCR<i>-</i>positive primary lesions who had serology performed at the same initial visit. Among these, a pooled estimate of 10% (95% CI, 6%-13%; 73/758; <i>I</i> <sup>2</sup> = 65%, <i>P</i> < .01) was negative on all serologic markers, ranging between 4% (95% CI, 0%-7%; 4/108) and 20% (95% CI, 10%-29%; 14/71).</p><p><strong>Conclusions: </strong><i>T pallidum</i> was detected by PCR in 10% cases, which would have been missed if serology alone was used. <i>T pallidum</i> PCR is important for optimizing early detection of primary syphilis.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"12 9","pages":"ofaf471"},"PeriodicalIF":3.8000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461845/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Proportion of <i>Treponema pallidum</i> Polymerase Chain Reaction-Positive Primary Syphilis Infections That Are Seronegative for Syphilis: A Systematic Review and Meta-analysis.\",\"authors\":\"Yasmin Hughes, Janet M Towns, Jason J Ong, Eric P F Chow, Christopher K Fairley, Deborah A Williamson, Jade Bilardi, Jane S Hocking, Shivani Pasricha, Eloise Williams, Francesca Azzato, Marcus Y Chen\",\"doi\":\"10.1093/ofid/ofaf471\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Earlier syphilis detection is needed to reduce infectiousness and transmission and to improve control. Polymerase chain reaction (PCR) for <i>Treponema pallidum</i> is highly sensitive for detecting primary syphilis but is not often widely available or used. The aim of this systematic review and meta-analysis was to investigate the proportion of PCR-positive, seronegative primary syphilis infections when serology was performed at clinical presentation.</p><p><strong>Methods: </strong>We undertook a systematic review and meta-analysis to identify studies of patients presenting with primary syphilis where <i>T pallidum</i> PCR was performed on the primary syphilis lesion and serology for syphilis was performed on the same occasion. The review was conducted according to the Cochrane protocol. Medline, Embase, and PubMed were searched from 1 January 2000 to 27 November 2022 (date of search). Only studies published in English were included. A pooled estimate of the proportion of PCR-positive, seronegative primary infections was calculated via a random effects model.</p><p><strong>Results: </strong>Of 2571 studies identified, 8 met inclusion criteria and were included. This contributed to 758 individuals with <i>T pallidum</i> PCR<i>-</i>positive primary lesions who had serology performed at the same initial visit. Among these, a pooled estimate of 10% (95% CI, 6%-13%; 73/758; <i>I</i> <sup>2</sup> = 65%, <i>P</i> < .01) was negative on all serologic markers, ranging between 4% (95% CI, 0%-7%; 4/108) and 20% (95% CI, 10%-29%; 14/71).</p><p><strong>Conclusions: </strong><i>T pallidum</i> was detected by PCR in 10% cases, which would have been missed if serology alone was used. <i>T pallidum</i> PCR is important for optimizing early detection of primary syphilis.</p>\",\"PeriodicalId\":19517,\"journal\":{\"name\":\"Open Forum Infectious Diseases\",\"volume\":\"12 9\",\"pages\":\"ofaf471\"},\"PeriodicalIF\":3.8000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461845/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Forum Infectious Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ofid/ofaf471\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofaf471","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:早期梅毒检测需要减少传染性和传播,并改善控制。梅毒螺旋体的聚合酶链反应(PCR)对检测原发性梅毒非常敏感,但通常不广泛提供或使用。本系统综述和荟萃分析的目的是调查在临床表现时进行血清学检查时pcr阳性和血清阴性的原发性梅毒感染的比例。方法:我们进行了一项系统综述和荟萃分析,以确定在同一情况下对原发性梅毒病变进行梅毒血清学检测并进行梅毒T梅毒PCR检测的原发性梅毒患者的研究。本综述按照Cochrane协议进行。从2000年1月1日至2022年11月27日(检索日期)检索Medline、Embase和PubMed。仅纳入以英文发表的研究。通过随机效应模型计算聚合酶链反应阳性和血清阴性原发感染的合并估计比例。结果:在2571项研究中,有8项符合纳入标准。这促成了758例苍白T细胞pcr阳性原发性病变患者在相同的初次就诊时进行血清学检查。其中,10% (95% CI, 6%-13%; 73/758; I 2 = 65%, P < 0.01)在所有血清学标志物上呈阴性,范围在4% (95% CI, 0%-7%; 4/108)和20% (95% CI, 10%-29%; 14/71)之间。结论:PCR检出苍白T的病例占10%,单纯使用血清学可能漏检。梅毒T PCR对优化早期梅毒检测具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Proportion of Treponema pallidum Polymerase Chain Reaction-Positive Primary Syphilis Infections That Are Seronegative for Syphilis: A Systematic Review and Meta-analysis.

Background: Earlier syphilis detection is needed to reduce infectiousness and transmission and to improve control. Polymerase chain reaction (PCR) for Treponema pallidum is highly sensitive for detecting primary syphilis but is not often widely available or used. The aim of this systematic review and meta-analysis was to investigate the proportion of PCR-positive, seronegative primary syphilis infections when serology was performed at clinical presentation.

Methods: We undertook a systematic review and meta-analysis to identify studies of patients presenting with primary syphilis where T pallidum PCR was performed on the primary syphilis lesion and serology for syphilis was performed on the same occasion. The review was conducted according to the Cochrane protocol. Medline, Embase, and PubMed were searched from 1 January 2000 to 27 November 2022 (date of search). Only studies published in English were included. A pooled estimate of the proportion of PCR-positive, seronegative primary infections was calculated via a random effects model.

Results: Of 2571 studies identified, 8 met inclusion criteria and were included. This contributed to 758 individuals with T pallidum PCR-positive primary lesions who had serology performed at the same initial visit. Among these, a pooled estimate of 10% (95% CI, 6%-13%; 73/758; I 2 = 65%, P < .01) was negative on all serologic markers, ranging between 4% (95% CI, 0%-7%; 4/108) and 20% (95% CI, 10%-29%; 14/71).

Conclusions: T pallidum was detected by PCR in 10% cases, which would have been missed if serology alone was used. T pallidum PCR is important for optimizing early detection of primary syphilis.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Open Forum Infectious Diseases
Open Forum Infectious Diseases Medicine-Neurology (clinical)
CiteScore
6.70
自引率
4.80%
发文量
630
审稿时长
9 weeks
期刊介绍: Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信