Određivanje prisutnosti bakterije Treponema pallidum u bolesnika s primarnim stadijem ranog sifilisa i u kasnom latentnom sifilisu [ Determining the presence of T. pallidum in patients with primary-stage of early syphilis and late latent syphilis. ]

Marinović, Branka (2003) Određivanje prisutnosti bakterije Treponema pallidum u bolesnika s primarnim stadijem ranog sifilisa i u kasnom latentnom sifilisu [ Determining the presence of T. pallidum in patients with primary-stage of early syphilis and late latent syphilis. ]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

A total of 90 subjects, 60 patients with syphilis and 30 healthy controls (volunteer blood donors), were analyzed by using indirect and direct diagnostic laboratory methods for diagnosis of syphilis. The two groups of subjects were comparable for sex distribution and of expected age for the analyzed stages of the disease. The patients with primary stage of early syphilis were of younger age, whereas patients with late latent syphilis were older. Serologic findings mostly corresponded to the stage of the disease, although polymerase chain reaction (PCR), as a direct method for T. pallidum detection, proved useful in patients with negative serologic results. Positive PCR result in patients with primary stage of syphilis and negative results of Venereal Disease Research Laboratory (VDRL) test and Treponema Pallidum Hemagglutination Assay (TPHA) was significant, allowing timely treatment. Positive PCR result obtained in a healthy subject was especially significant and alarming, as volunteer blood donors are serologically tested on a regular basis. DNA was successfully extracted from the blood and tissues of infected rabbits. Amplification of gene DNA polymerase I T. pallidum PCR proved to be more succesful than amplification of gene for 47-kDa antigen of T. pallidum. PCR did not prove to be a sufficiently specific method to establish the diagnosis of syphilis, except in some cases of primary stage early syphilis, and as a complement control in a group of volunteer blood donors.

Abstract in Croatian

U ovom radu laboratorijskim indirektnim i direktnim metodama za dokazivanje sifilisa analizirano je 90 ispitanika od kojih 60 oboljelih od sifilisa te 30 zdravih ispitanika iz kontrolne skupine dobrovoljnih davatelja krvi. Ispitanici su gotovo ravnomjerno bili zastupljeni prema spolu, a i dob im je bila očekivana za stadije bolesti koje smo analizirali. U skupini s primarnim stadijem ranog sifilisa češće su bili mlađi bolesnici, dok su u skupini s kasnim latentnim sifilisom u većem broju bili stariji bolesnici. Serološke pretrage većinom su odgovarale stadiju bolesti, a lančana reakcija polimerazom kao direktna metoda dokazivanja T. pallidum pokazala se korisnom u bolesnika s negativnim nalazima VDRL i TPHA testa. Osobito važan i upozoravajući nalaz pozitivnog PCR testa nađen je u zdravog ispitanika među redovito serološki testiranim dragovoljnim davateljima krvi. DNA je uspješno izolirana iz krvi bolesnika i tkiva zaraženih kunića. Umnažanje gena DNA polimeraze I T. pallidum pokazalo se pogodnije od umnažanja gena za 47-kDa antigen T. pallidum. PCR se nije pokazao metodom izbora za dijagnostiku sifilisa s izuzetkom u nekim slučajevima primarnog stadija sifilisa kao i u svrhu dodatne provjere dobrovoljnih davatelja krvi.

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