Using the Captia Select Syph-G enzyme-linked immunosorbent assay (ELISA), we analyzed the sera of 1,771 patients from a high-risk population attending sexually transmitted disease (STD) clinics. We focused on discrepancies between the results of the immunoglobulin G (IgG) ELISA and the Treponema pallidum hemagglutination (TPHA) test. We identified 57 patients (3.22%) with conflicting results in the IgG ELISA and TPHA test. In order to resolve these discrepancies, these patients' health records were reviewed and additional serological tests (rapid plasma reagin, IgM ELISA, fluorescent treponemal antibody absorption, and Western blotting) were performed. We subsequently diagnosed 22 of these 57 (38.6%) patients with late latent syphilis. None of the patients with discordant test results was diagnosed with early syphilis. We followed 35 of these 57 patients, analyzing two consecutive serum samples at 3 weeks and at 3 months. Discordant results persisted in 12 (33.3%) patients. We successfully resolved the test result discrepancies for 28 patients (80%) involved in follow-up. Captia SelectSyph-G ELISA showed a sensitivity of 99.0%, a specificity of 98.0%, and positive and negative predictive values of 99.3% and 97.2%, respectively. Based on the results of this study, we conclude that the Captia SelectSyph-G ELISA is a reliable tool for syphilis testing in a high-risk population and recommend the utilization of the Captia SelectSyph-G ELISA as a confirmatory test in at-risk patients.

Department of Medical Microbiology Faculty of Medicine Masaryk University Pekarska 53 656 91 Brno Czech Republic

Zobrazit více v PubMed

Aktas, G., H. Young, A. Moyes, and S. Badur. 2005. Evaluation of the serodia Treponema pallidum particle agglutination, the Murex Syphilis ICE and the Enzywell TP tests for serodiagnosis of syphilis. Int. J. STD AIDS 16:294-298. PubMed

Halling, V. W., M. F. Jones, J. E. Bestrom, A. D. Wold, J. E. Rosenblatt, T. F. Smith, and F. R. Cockerill III. 1999. Clinical comparison of the Treponema pallidum CAPTIA Syphilis-G enzyme immunoassay with the fluorescent treponemal antibody absorption immunoglobulin G assay for syphilis testing. J. Clin. Microbiol. 37:3233-3234. PubMed PMC

Larsen, S. A., B. M. Steiner, and A. H. Rudolph. 1995. Laboratory diagnosis and interpretation of tests for syphilis. Clin. Microbiol. Rev. 8:1-21. PubMed PMC

Lefevre, J.-C., M.-A. Bertrand, and R. Bauriaud. 1990. Evaluation of the Captia enzyme immunoassays for detection of immunoglobulins G and M to Treponema pallidum in syphilis. J. Clin. Microbiol. 28:1704-1707. PubMed PMC

Marangoni, A., V. Sambri, F. Cavrini, A. Frabetti, E. Storni, S. Accardo, D. Servidio, F. Foschi, L. Montebugnoli, C. Prati, and R. Cevenini. 2005. Treponema denticola infection is not a cause of false positive Treponema pallidum serology. New Microbiol. 28:215-221. PubMed

Nandwani, R., and D. T. Evans. 1995. Are you sure it's syphilis? A review of false positive serology. Int. J. STD AIDS 6:241-248. PubMed

Ooi, C., P. Robertson, and B. Donovan. 2002. Investigation of isolated positive syphilis enzyme immunoassay (ICE Murex) results. Int. J. STD AIDS 13:761-764. PubMed

Pope, V., and M. B. Fears. 1998. Captia Syphilis-G: an enzyme immunoassay for treponemal antibodies, p. 332-345. In S. A. Larsen, V. Pope, R. E. Johnson, and E. J. Kennedy, Jr. (ed.), a manual of tests for syphilis. American Public Health Association, Washington, DC.

Pope, V., M. B. Fears, W. E. Morrill, A. Castro, and S. E. Kikkert. 2000. Comparison of the Serodia Treponema pallidum particle agglutination, Captia Syphilis-G, and SpiroTek Reagin II tests with standard test techniques for diagnosis of syphilis. J. Clin. Microbiol. 38:2543-2545. PubMed PMC

Reisner, B. S., L. M. Mann, C. A. Tholcken, R. T. Waite, and G. L. Woods. 1997. Use of the Treponema pallidum-specific Captia Syphilis IgG assay in conjunction with the rapid plasma reagin to test for syphilis. J. Clin. Microbiol. 35:1141-1143. PubMed PMC

Ross, J., A. Moyes, H. Young, and A. McMillan. 1991. An analysis of false positive reactions occurring with the Captia Syph G EIA. Genitourin. Med. 67:408-410. PubMed PMC

Schmidt, B. L., M. Edjlalipour, and A. Luger. 2000. Comparative evaluation of nine different enzyme-linked immunosorbent assays for determination of antibodies against Treponema pallidum in patients with primary syphilis. J. Clin. Microbiol. 38:1279-1282. PubMed PMC

Silletti, R. P. 1995. Comparison of CAPTIA Syphilis G enzyme immunoassay with rapid plasma reagin test for detection of syphilis. J. Clin. Microbiol. 33:1829-1831. PubMed PMC

Young, F. 2006. Syphilis: still with us, so watch out! J. Fam. Health Care 16:77-81. PubMed

Young, H., A. Moyes, A. McMillan, and J. Patterson. 1992. Enzyme immunoassay for anti-treponemal IgG: screening or confirmatory test? J. Clin. Pathol. 45:37-41. PubMed PMC

Young, H., A. Moyes, L. Seagar, and A. McMillan. 1998. Novel recombinant-antigen enzyme immunoassay for serological diagnosis of syphilis. J. Clin. Microbiol. 36:913-917. PubMed PMC

Zakoucka, H., V. Polanecky, and V. Kastankova. 2004. Syphilis and gonorrhoea in the Czech Republic. Eur. Surveill. 9:18-20. PubMed

Zrein, M., I. Maure, F. Boursier, and L. Soufflet. 1995. Recombinant antigen-based enzyme immunoassay for screening of Treponema pallidum antibodies in blood bank routine. J. Clin. Microbiol. 33:525-527. PubMed PMC