Syphilis is a multistage sexually transmitted disease caused by Treponema pallidum ssp. pallidum. In the Czech Republic, there are around 700-800 new syphilis cases annually, continuously increasing since 2012. This study analyzed a total of 1228 samples from 2004 to 2022. Of the PCR-positive typeable samples (n = 415), 68.7% were fully-typed (FT), and 31.3% were partially-typed. Most of the identified isolates belonged to the SS14-clade and only 6.3% were the Nichols-like cluster. While in the beginning of sample collection isolates have been macrolide-susceptible, recent isolates are completely resistant to macrolides. Among the FT samples, 34 different allelic profiles (APs) were found. Most of the profiles (n = 27) appeared just once in the Czech population, while seven profiles were detected more than twice. The most frequent APs belonged to two separate groups of SS14-like isolates, including group of 1.3.1 (ST 1) and 1.26.1 (ST 25) profiles, and the second group containing 1.1.8 (ST 3), 1.1.1 (ST 2), and 1.1.3 (ST 11) (representing 57.5%, and 25.3% of all detected APs, respectively). Both groups consistently differed in 6 nucleotide positions in five genes (TP0150, TP0324, TP0515, TP0548, and TP0691) coding amino-acid replacements suggesting that one or more of these differences could be involved in the higher success of the first group.

1st Department of Dermatovenereology St Annes Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

Department of Biology Faculty of Medicine Masaryk University Brno Czech Republic

Department of Dermatovenereology 1st Faculty of Medicine and General University Hospital Charles University Prague Czech Republic

Department of Dermatovenerology 2nd Faculty of Medicine Charles University Prague Prague Czech Republic

Department of Dermatovenerology University Hospital Brno Czech Republic

Department of Medical Microbiology Faculty of Medicine St Anne's Hospital and Masaryk University Brno Czech Republic

Institute of Medical Biochemistry and Laboratory Diagnostics of the General University Hospital and of the 1st Faculty of Medicine of Charles University Prague Czech Republic

National Reference Laboratory for Diagnostics of Syphilis National Institute for Public Health Prague Czech Republic

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Data provided by Dr. Hana Zákoucká, National Health Institute.

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A new typing scheme demonstrates high discriminatory power for Treponema pallidum subspecies

In vitro isolation of contemporary Treponema pallidum strains directly from clinical samples of syphilis patients