TY - JOUR
T1 - Evaluating congenital syphilis in a reverse sequence testing environment
AU - Chen, May W.
AU - Akinboyo, Ibukunoluwa C.
AU - Sue, Paul K.
AU - Donohue, Pamela K.
AU - Ghanem, Khalil G.
AU - Detrick, Barbara
AU - Witter, Frank R.
AU - Page, Kathleen R.
AU - Arav-Boger, Ravit
AU - Golden, W. Christopher
PY - 2019/7/1
Y1 - 2019/7/1
N2 - 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.
AB - 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.
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U2 - 10.1038/s41372-019-0387-9
DO - 10.1038/s41372-019-0387-9
M3 - Article
C2 - 31076626
AN - SCOPUS:85065649696
SN - 0743-8346
VL - 39
SP - 956
EP - 963
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 7
ER -