UT Southwestern researchers discover better tests to detect congenital syphilis in newborns

DALLAS June 6, 2002 A UT Southwestern Medical Center at Dallas research team has developed two blood tests that quickly and reliably diagnose congenital syphilis in newborns.

"This is the first study to document the presence of the syphilis spirochete (bacteria) in the cerebrospinal fluid of infected infants. Thus we are the first to accurately assess diagnostic evaluations of infants for the possibility of central nervous system invasion," said Dr. Pablo Sanchez, professor of pediatrics and senior author of the study appearing in todays issue of The New England Journal of Medicine.

Sanchez said the two blood tests detect either neonatal antibodies to the syphilis bacterium or the DNA of the syphilis organism itself as predictors of central-nervous-system (CNS) infection. Results from the two tests correlated with the detection of the organism in the infants cerebrospinal fluid, and, therefore, the tests could serve as predictors of CNS infection.

This work produced the first valid data to select an effective, cost-efficient neonatal treatment regimen for congenital syphilis.

A pregnant woman with syphilis has about a 60 percent to 80 percent chance of infecting her fetus. Infants born to mothers with syphilis are traditionally hospitalized for multiple daily injections of penicillin over a 10-day period because physical exams and conventional laboratory tests are unable to detect all cases. The most accurate lab test until now required a three-month incubation period.

The UT Southwestern study showed that two tests - immunoglobin M (IgM) immunoblotting and polymerase chain reaction (PCR) detected all cases of central-nervous- system infection in the group of 148 infants studied. The babies were born to syphilis-infected mothers during the 1989-1999 study period.

Earlier research at UT Southwestern had suggested that congenital syphilis might stimulate a detectable reaction by the newborns immune system, despite it

Contact: Barbara Bedrick
UT Southwestern Medical Center

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