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J Med Microbiol 58 (2009), 832-836; DOI: 10.1099/jmm.0.007542-0
© 2009 Society for General Microbiology
ISSN 0022-2615

Macrolide treatment failure in a case of secondary syphilis: a novel A2059G mutation in the 23S rRNA gene of Treponema pallidum subsp. pallidum

Petra Matejková1, Magdalena Flasarová2, Hana Zákoucká3, Milan Borek3, Sona Kremenová4, Petr Arenberger4, Vladana Woznicová2, George M. Weinstock5 and David Smajs1

1 Department of Biology, Faculty of Medicine, Masaryk University, Building A6, Kamenice 5, 625 00 Brno, Czech Republic

2 Department of Medical Microbiology, Faculty of Medicine, Masaryk University, Pekarská 53, 656 91 Brno, Czech Republic

3 National Reference Laboratory for Diagnostics of Syphilis, National Institute of Public Health, Srobárova 48, 100 42 Prague 10, Czech Republic

4 Department of Dermatovenerology, Faculty Hospital Královské Vinohrady, Srobárova 50, 100 34 Prague 10, Czech Republic

5 Genome Sequencing Center, Washington University School of Medicine, 4444 Forest Park Avenue, St Louis, MO 63108, USA

Correspondence
David Smajs
dsmajs{at}med.muni.cz

Received October 26, 2008
Accepted February 10, 2009

We report an occurrence of treatment failure after oral spiramycin therapy in a man with secondary syphilis and a reported penicillin and tetracycline allergy. Molecular detection revealed treponemal DNA in the blood of the patient and sequencing of the 23S rDNA identified an A to G transition at the gene position corresponding to position 2059 in the Escherichia coli 23S rRNA gene. The occurrence of this novel 23S rDNA mutation was examined among 7 rabbit-propagated syphilitic strains of Treponema pallidum and among 22 syphilis patient isolates from the Czech Republic. The prevalence of A2058G and A2059G mutations among clinical specimens was 18.2 and 18.2 %, respectively.

Abbreviations: CDC, Centers for Disease Control and Prevention; FTA-ABS, fluorescent treponemal antibody absorption; RPR, rapid plasma reagin; SPHA, solid phase haemadsorption; TP-PA, Treponema pallidum particle agglutination.

A table of primer sequences is available as supplementary data with the online version of this paper.






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