A total of 54 clinical samples, including genital lesion swabs, whole blood and cerebrospinal fluid from patients diagnosed with syphilis were collected in 2006 and in 2013 in Buenos Aires, Argentina. Treponemal DNA was detected in 43 of the analyzed samples (79.6%) and further analyzed using Sequencing-based molecular typing (SBMT) and Enhanced CDC-typing (ECDCT). By SBMT, 10 different Treponema pallidum subsp. pallidum (TPA) genotypes were found, of which six were related to the TPA SS14 strain, and four to the TPA Nichols strain. The 23S rRNA gene was amplified in samples isolated from 42 patients, and in six of them (14.3%), either the A2058G (four patients, 9.5%) or the A2059G (two patients, 4.8%) mutations were found. In addition to Taiwan, Madagascar and Peru, Argentina is another country where the prevalence of Nichols-like isolates (26.8%) is greater than 10%.

Department of Biology Faculty of Medicine Masaryk University Brno Czech Republic

Instituto de Investigaciones Biomédicas en Retrovirus y SIDA Universidad de Buenos Aires CONICET Buenos Aires Argentina

Universidad de Buenos Aires Facultad de Farmacia y Bioquímica Departamento de Bioquímica Clínica Cátedra de Microbiología Clínica Buenos Aires Argentina

Universidad de Buenos Aires Hospital de Clínicas José de San Martín Programa de Enfermedades de Transmisión Sexual Buenos Aires Argentina

Universidad de Buenos Aires Instituto de Fisiopatología y Bioquímica Clínica Buenos Aires Argentina

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Newman L, Rowley J, Vander Hoor S, Wijesooriya NS, Unemo M, Low N, et al. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting. PLOS ONE. 2015;10 (12): e0143304 10.1371/journal.pone.0143304 PubMed DOI PMC

Pando MA, Bautista CT, Maulen S, Duranti R, Marone R, Rey J, et al. Epidemiology of human immunodeficiency virus, viral hepatitis (B and C), PubMed DOI

Pando MA, Balán IC, Marone R, Dolezal C, Leu CS, Squiquera L, et al. HIV and other sexually transmitted infections among men who have sex with men recruited by RDS in Buenos Aires, Argentina: high HIV and HPV infection. PLOS ONE. 2012; 7: 39834. PubMed PMC

Pando MA, Coloccini RS, Reynaga E, Rodriguez Fermepin M, Gallo Vaulet L, Kochel TJ, et al. Violence as a barrier for HIV prevention among female sex workers in Argentina. PLOS ONE. 2013; 8: 54147. PubMed PMC

Dos Ramos Farías MS, Garcia MN, Reynaga E, Romero M, Vaulet MLG, Fermepín MR, et al. First report on sexually transmitted infections among trans (male to female transvestites, transsexuals, or transgender) and male sex workers in Argentina: high HIV, HPV, HBV, and syphilis prevalence. Int J Infect Dis. 2011; 15: 635–640. PubMed

Schmunis GA, Zicker F, Segura EL, del Pozo AE. Transfusion-transmitted infectious diseases in Argentina, 1995 through 1997. Transfusion. 2000;40: 1048–1053. PubMed

Falistocco C, Vulcano S, Levite V, Ziaurris C, Adaszco A, Galarza P, et al. VIH y Sífilis, seroprevalencia en puérperas de Argentina UNICEF; 2012; Argentina.

Lafond RE, Lukehart SA. Biological basis for syphilis. Clin Microbiol Rev. 2006;19: 29–49. 10.1128/CMR.19.1.29-49.2006 PubMed DOI PMC

Ho EL, Lukehart SA. Syphilis: using modern approaches to understand an old disease. J Clin Invest. 2011; 121: 4584–4592. 10.1172/JCI57173 PubMed DOI PMC

Stamm LV. Global challenge of antibiotic-resistant PubMed DOI PMC

Pillay A, Liu H, Chen CY, Holloway B, Sturm AW, Steiner B, et al. Molecular subtyping of PubMed

Marra CM, Sahi SK, Tantalo LC, Godornes C, Reid T, Behets F, et al. Enhanced molecular typing of PubMed DOI PMC

Flasarová M, Šmajs D, Matějková P, Woznicová V, Heroldová-Dvoráková M, Votava M. Molecular detection and subtyping of PubMed

Flasarová M, Pospíšilová P, Mikalová L, Vališová Z, Dastychová E, Strnadel R, et al. Sequencing-based molecular typing of PubMed DOI

Grillová L, Pĕtrošová H, Mikalová L, Strnadel R, Dastychová E, Kuklová I, et al. Molecular typing of PubMed DOI PMC

Tamura K, Stecher G, Peterson D, Filipski A, Kumar S. MEGA6: Molecular Evolutionary Genetics Analysis version 6.0. Mol Biol Evol. 2013; 30: 2725–2729. 10.1093/molbev/mst197 PubMed DOI PMC

Bandelt HJ, Forster P, Röhl A. Median-joining networks for inferring intraspecific phylogenies. Mol Biol Evol. 1999; 16: 37–48. PubMed

World Medical Association. World Medical Association Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subject. JAMA. 2013; 310: 2191–2194. 10.1001/jama.2013.281053 PubMed DOI

Mikalová L, Grillová L, Osbak K, Strouhal M, Kenyon C, Crucitti T, Šmajs D. Molecular typing of syphilis-causing strains among HIV-positive patients in Antwerp, Belgium. Sex Transm Dis. 2017; Forthcoming. PubMed

Cruz AR, Pillay A, Zuluaga AV, Ramirez LG, Duque JE, Aristizabal GE, et al. Secondary syphilis in Cali, Colombia: new concepts in disease pathogenesis. PLoS Negl Trop Dis. 2010; 4: 690. PubMed PMC

Flores JA, Vargas SK, Leon SR, Perez DG, Ramos LB, Chow J, et al. PubMed DOI

Tipple C, McClure MO, Taylor GP. High prevalence of macrolide resistant PubMed DOI

Dai T, Li K, Lu H, Gu X, Wang Q, Zhou P. Molecular typing of PubMed DOI PMC

Grimes M, Sahi SK, Godornes BC, Tantalo LC, Roberts N, Bostick D, et al. Two mutations associated with macrolide resistance in PubMed DOI PMC

Peng RR, Yin YP, Wei WH, Wang HC, Zhu BY, Liu QZ, et al. Molecular typing of PubMed DOI

Grange PA, Allix-Beguec C, Chanal J, Benhaddou N, Gerhardt P, Morini JP, et al. Molecular subtyping of PubMed DOI

Tian H, Li Z, Li Z, Hou J, Zheng R, Li F, et al. Molecular typing of PubMed DOI

Wu BR, Yang CJ, Tsai MS, Lee KY, Lee NY, Huang WC, et al. Multicentre surveillance of prevalence of the 23S rRNA A2058G and A2059G point mutations and molecular subtypes of PubMed DOI

Khairullin R, Vorobyev D, Obukhov A, Kuular UH, Kubanova A, Kubanov A, et al. Syphilis epidemiology in 1994–2013, molecular epidemiological strain typing and determination of macrolide resistance in PubMed DOI

Read P, Tagg KA, Jeoffreys N, Guy RJ, Gilbert GL, Donovan B. PubMed PMC

Salado-Rasmussen K, Cowan S, Gerstoft J, Larsen HK, Hoffmann S, Knudsen TB, et al. Molecular Typing of PubMed DOI

Xiao Y, Liu S, Liu Z, Xie Y, Jiang C, Xu M, et al. Molecular Subtyping and Surveillance of Resistance Genes In PubMed DOI

Florindo C, Reigado V, Gomes JP, Azevedo J, Santo I, Borrego MJ. Molecular typing of PubMed DOI PMC

Pillay A, Liu H, Ebrahim S, Chen CY, Lai W, Fehler G, et al. Molecular typing of PubMed DOI PMC

Liu H, Rodes B, George R, Steiner B. Molecular characterization and analysis of a gene encoding the acidic repeat protein (Arp) of PubMed DOI

Mikalová L, Pospíšilová P, Woznicová V, Kuklová I, Zákoucká H, Šmajs D. Comparison of CDC and sequence-based molecular typing of syphilis treponemes: PubMed DOI PMC

Šmajs D, Norris SJ, Weinstock GM. Genetic diversity in PubMed DOI PMC

Pětrošová H, Pospíšilová P, Strouhal M, Čejková D, Zobaníková M, Mikalová L, et al. Resequencing of PubMed PMC

Nechvátal L, Pětrošová H, Grillová L, Pospíšilová P, Mikalová L, Strnadel R, et al. Syphilis-causing strains belong to separate SS14-like or Nichols-like groups as defined by multilocus analysis of 19 PubMed DOI

Morshed MG, Jones HD. PubMed PMC

Martin IE, Tsang RSW, Sutherland K, Anderson B, Read R, Roy C, et al. Molecular typing of PubMed DOI

Müller EE, Paz-Bailey G, Lewis DA. Macrolide resistance testing and molecular subtyping of PubMed DOI

Van Damme K, Behets F, Ravelomanana N, Godornes C, Khan M, Randrianasolo B, et al. Evaluation of azithromycin resistance in PubMed DOI PMC

Read P, Jeoffreys N, Tagg K, Guy RJ, Gilbert GL, Donovan B. Azithromycin-resistant syphilis-causing strains in Sydney, Australia: prevalence and risk factors. J Clin Microbiol. 2014; 52: 2776–2781. 10.1128/JCM.00301-14 PubMed DOI PMC

Noda AA, Matos N, Blanco O, Rodríguez I, Stamm LV. First Report of the 23S rRNA Gene A2058G Point Mutation Associated with Macrolide Resistance in PubMed DOI

Martin IE, Gu W, Yang Y, Tsang RS. Macrolide resistance and molecular types of PubMed DOI

Li Z, Hou J, Zheng R, Li Z, Wen J, Liu D, et al. Two mutations associated with macrolide resistance in PubMed DOI PMC

Lukehart SA, Godornes C, Molini BJ, Sonnett P, Hopkins S, Mulcahy F, et al. Macrolide resistance in PubMed DOI

Muldoon EG, Walsh A, Crowley B, Mulcahy F. PubMed DOI

Mitchell SJ, Engelman J, Kent CK, Lukehart SA, Godornes C, Klausner JD. Azithromycin-resistant syphilis infection: San Francisco, California, 2000–2004. Clin Infect Dis. 2006; 42: 337–345. 10.1086/498899 PubMed DOI

Katz KA, Pillay A, Ahrens K, Kohn RP, Hermanstyne K, Bernstein KT, et al. Molecular epidemiology of syphilis—San Francisco, 2004–2007. Sex Transm Dis. 2010; 37:660–663. 10.1097/OLQ.0b013e3181e1a77a PubMed DOI

Marra CM, Colina AP, Godornes C, Tantalo LC, Puray M, Centurion-Lara A, et al. Antibiotic selection may contribute to increases in macrolide-resistant PubMed DOI

Su JR, Pillay A, Hook EW, Ghanem KG, Wong W, Jackson D, et al. Prevalence of the 23S rRNA A2058G point mutation and molecular subtypes in PubMed DOI

Chen XS, Yin YP, Wei WH, Wang HC, Peng RR, Zheng HP, et al. High prevalence of azithromycin resistance to PubMed DOI

Šmajs D, Paštěková L, Grillová L. Macrolide Resistance in the Syphilis Spirochete, PubMed DOI PMC

High frequency of Nichols-like strains and increased levels of macrolide resistance in Treponema pallidum in clinical samples from Buenos Aires, Argentina

No bejel among Surinamese, Antillean and Dutch syphilis diagnosed patients in Amsterdam between 2006-2018 evidenced by multi-locus sequence typing of Treponema pallidum isolates

Directly Sequenced Genomes of Contemporary Strains of Syphilis Reveal Recombination-Driven Diversity in Genes Encoding Predicted Surface-Exposed Antigens

MLST typing of Treponema pallidum subsp. pallidum in the Czech Republic during 2004-2017: Clinical isolates belonged to 25 allelic profiles and harbored 8 novel allelic variants

A public database for the new MLST scheme for Treponema pallidum subsp. pallidum: surveillance and epidemiology of the causative agent of syphilis

Complete genome sequences of two strains of Treponema pallidum subsp. pertenue from Indonesia: Modular structure of several treponemal genes

Molecular characterization of Treponema pallidum subsp. pallidum in Switzerland and France with a new multilocus sequence typing scheme

Multi-locus sequence typing of Treponema pallidum subsp. pallidum present in clinical samples from France: Infecting treponemes are genetically diverse and belong to 18 allelic profiles

Sequence Variation of Rare Outer Membrane Protein β-Barrel Domains in Clinical Strains Provides Insights into the Evolution of Treponema pallidum subsp. pallidum, the Syphilis Spirochete

Reanalysis of Chinese Treponema pallidum samples: all Chinese samples cluster with SS14-like group of syphilis-causing treponemes