Evaluating congenital syphilis in a reverse sequence testing environment.

Journal Article (Journal Article)

OBJECTIVES: To examine the effect of maternal reverse-sequence (RS) syphilis screening on management of infants at risk for congenital syphilis (CS) using a standardized approach. STUDY DESIGN: A retrospective study from 2011 to 2014 at an academic medical center using RS testing, involving chemiluminescent immunoassay (CIA), rapid plasma  reagin (RPR), and fluorescent treponemal antibody-absorption (FTA-ABS) assays for syphilis. Clinical management and outcomes of infants born to mothers with discordant (CIA+/RPR-/FTA+) serology were compared with national or internal guidelines. RESULTS: Sixty-three infants were classified as discordant (n = 21), presumed false positive (CIA+/RPR-/FTA-; n = 16), or true positive (CIA+/RPR+; n = 26) based on maternal serology. Only 24% of cases in the discordant group underwent recommended full evaluation. None of the evaluated infants in the discordant group (n = 8) were diagnosed with CS. CONCLUSIONS: Management of infants with discordant maternal RS serology remained reliant on clinical judgment. In our high-risk population, RS testing did not identify additional cases of CS.

Full Text

Duke Authors

Cited Authors

  • Chen, MW; Akinboyo, IC; Sue, PK; Donohue, PK; Ghanem, KG; Detrick, B; Witter, FR; Page, KR; Arav-Boger, R; Golden, WC

Published Date

  • July 2019

Published In

Volume / Issue

  • 39 / 7

Start / End Page

  • 956 - 963

PubMed ID

  • 31076626

Electronic International Standard Serial Number (EISSN)

  • 1476-5543

Digital Object Identifier (DOI)

  • 10.1038/s41372-019-0387-9


  • eng

Conference Location

  • United States