Bejel in Cuba: molecular identification of Treponema pallidum subsp. endemicum in patients diagnosed with venereal syphilis
Language English Country England, Great Britain Media print-electronic
Document type Journal Article
PubMed
29454847
DOI
10.1016/j.cmi.2018.02.006
PII: S1198-743X(18)30154-X
Knihovny.cz E-resources
- Keywords
- Bejel, Cuba, Diagnosis, Molecular typing, Treponema pallidum subsp. endemicum,
- MeSH
- Adult MeSH
- Phylogeny MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Molecular Typing MeSH
- Syphilis epidemiology microbiology MeSH
- Treponema pallidum classification genetics MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Cuba epidemiology MeSH
OBJECTIVES: Bejel, caused by Treponema pallidum subsp. endemicum (TEN), was until now considered as a non-venereal disease endemic in areas with hot and dry climates. This study has identified TEN in clinical samples from Cuban patients previously diagnosed with syphilis. METHODS: We performed sequencing-based molecular typing on 92 samples from Cuban individuals diagnosed with syphilis. Moreover, to differentiate T. pallidum subspecies, multi-locus sequence analysis (MLSA) was designed and was applied to suspicious samples. RESULTS: Nine samples, from six patients, had a nucleotide sequence similarity (at all typing loci) to the Bosnia A genome, which is the infectious agent of bejel. Additionally, MLSA clearly supported a TEN classification for the treponemal samples. Clinical and epidemiological data from the six patients also suggested sexual transmission of bejel as well as the endemicity of this rare treponematosis in Cuba. CONCLUSIONS: Molecular identification of Treponema pallidum subsp. endemicum, the agent of bejel, in Cuban patients diagnosed with syphilis indicates the clear limitations of a diagnosis based exclusively on serology, geographical occurrence, clinical symptoms and anamnestic data. This finding has important implications for Global Public Health Systems, including paradigm changes regarding the location of endemic outbreaks, clinical aspects and transmission of this neglected disease.
Department of Biology Masaryk University Brno 625 00 Czech Republic
Department of Medical Microbiology ADMED Microbiology La Chaux de Fonds Switzerland
Department of Mycology Bacteriology Institute of Tropical Medicine 'Pedro Kourí' Havana Cuba
References provided by Crossref.org
The hare syphilis agent is related to, but distinct from, the treponeme causing rabbit syphilis