Prepared by:

Tobias, Zelland O.

BS. MedTech

Treponema pallidum –Spp. that responsible for

syphilis.

From family of Spirochete

Pathogenic treponemes:

-T. pallidum

-T. carateum

-T. pertenue

-T. cuniculi

-T. endemicum

Antibodies

May be directed against T. pallidum or

protein antigen group common to

pathogenic treponemes

•IgM in early or untreated latent syphilis

•Rapidly followed by IgG w/c becomes

predominant during secondary stage

Non Treponemal VS.

Treponemal Non – treponemal indirect

method of blood test for

diagnosis.

Tests detect biomarkers that are

released during cellular damage.

Nonspecific antibodies that react

to cardiolipin.

Measure immunoglobulin.

Ideally used for qualitative

syphilis screening.

CDC approved test include

VDRL, RPR.

React in Treponema pallidumstrains.

Detect antibodies specific to T. pallidum.

Although these tests are typically more specific than nontreponemal assays, they will remain positive.

.

Non-Treponemal test Treponemal test

Flocculation Tests

Rapid Plasma Reagin

(RPR)

Venereal Disease

Research

Laboratory(VDRL)

Treponema

Hemaglutination

Absorption(TPHA)

Fluorescent treponemal

antibody absorption (FTA-

ABS)

Cardiolipin Treponemal

Serological Test for SYPHILIS

VDRL (Venereal Disease Research

Laboratory)

ELISA (Enzyme-Linked Immunosorbent

Assay)

RPR (Rapid Plasma Reagin)

FTA-ABS (Fluorescent Treponemal

Antibody Absorption Test)

TPI (Teponema pallidum Immobilization

Test)

TPPA (Treponema pallidum Particle

Agglutination Assay)

MHA-TP (Microhemagglutination Assay)

DARK FIELD MICROSCOPE

VDRL Screening test for syphilis, routine part of prenatal

care during pregnancy .

Several states also require screening for syphilis

prior to obtaining a marriage license.

Measures Antibodies.

Specimen for the test is SERUM

Screening test is most likely to be positive in the

secondary and latent stages of syphilis

Test is not accurate in Early and Tertiary stage.

Positive (Reactive)

Negative result it means (Non-Reactive)

Confirm the results with an FTA-ABS test,

which is a more specific syphilis test.

Body does not always produce antibodies.

ELISA Reaction is performed on polystyrene, the reaction

is between the Antigen and Antibody

Polystyrene carriers which have absorbed an

ultrasonicated preparation of T. Pallidum.

Positive result the carriers (Red-brown-violet)

Negative (White) does not change

Check antibodies for syphilis

RPR RPR test allows to confirm diagnosis and begin

treatment spread of the disease by an infected but

unaware person.

Similar test to the VDRL.

Detection present of non-specific antibody.

Second stage or middle stage is one of the most

accurate stage to perform RPR

FTA-ABS is confirmatory test.

Large clamp (Positive)

NO clumps (Negative)

FTA-ABS Using antibodies specific T.palllidum

Such tests are more specific than non-treponemal

testing

Positive earlier and remains positive longer than

VDRL

Should always be followed to confirm a

positive RPR and/or VDRL test for syphilis

Highly sensitive but time consuming

w/fluorescence: REACTIVE; w/o fluorescence:

NONREACTIVE

TPI

Mixing of live Reiter treponemes from a

testicular chancre of rabbit and patient sera

Immobilization of treponemes = REACTIVE

Treponemes remain motile = NONREACTIVE

Observed under dark-field microscope

Standard test detecting NEUROSYPHILIS.

TPPA Indirect agglutination assay used for detection and

titration of antibodies.

Gelatin particles are sensitized with T.

pallidum antigen.

A negative test shows no clumping of gelatin particles.

A positive test no clumping of gelatin.

TPPA has a sensitivity of 85% to 100%, and

a specificity of 98% to 100%. For 1st stage of syphilis.

Confirmatory test

Treponema pallidum

Particle Agglutination

TPHA & MHA-TP

Uses tanned sheep RBCs coated with

antigens from Nichols strain of TP

Dark Field Microscope Direct detection of the organism and indirect

evidence of infection.

Molecular assays to detect T pallidum DNA, and

histopathologic examination of biopsies of skin or

mucous membranes.

Allows visualization of live treponemes.

Detection on infection before the serological test.

corkscrew appearance (+)

+ result may indicate type of any stage Syphilis

References: cdc.gov/std/syphilis/manual.1998/CHAPT5.pdf

cdc.gov/std/syphilis/stdfact-syphilis.htm

labtestsonline.org/understanding/analytes/syphilis/t

ab/test/

nlm.nih.gov/medlineplus/ency/article/003515.htm

nlm.nih.gov/medlineplus/ency/article/003533.htm

aphl.org/aphlprograms/infectious/std/Documents/I

D_2009Jan_Laboratory-Guidelines-Treponema-

pallidum-Meeting-Report.pdf