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Comparisons of fully automated syphilis tests with conventional VDRL and FTA-ABS tests

 Seung Jun Choi  ;  Yongjung Park  ;  Eun Young Lee  ;  Sinyoung Kim  ;  Hyon-Suk Kim 
 CLINICAL BIOCHEMISTRY, Vol.46(9) : 834-837, 2013 
Journal Title
Issue Date
Antibodies, Bacterial/blood ; Automation, Laboratory ; Fluorescent Treponemal Antibody-Absorption Test* ; Humans ; Sensitivity and Specificity ; Syphilis/diagnosis* ; Syphilis/immunology ; Treponema pallidum/immunology
Fluorescent treponemal antibody absorption (FTA-ABS) ; Rapid plasma regain (RPR) ; Syphilis ; Treponema pallidum particle agglutination (TPPA) ; Venereal Disease Research Laboratory (VDRL)
BACKGROUND: Serologic tests are widely used for the diagnosis of syphilis. However, conventional methods require well-trained technicians to produce reliable results. We compared automated nontreponemal and treponemal tests with conventional methods. METHODS: The HiSens Auto Rapid Plasma Reagin (AutoRPR) and Treponema Pallidum particle agglutination (AutoTPPA) tests, which utilize latex turbidimetric immunoassay, were assessed. A total of 504 sera were assayed by AutoRPR, AutoTPPA, conventional VDRL and FTA-ABS. Among them, 250 samples were also tested by conventional TPPA. RESULTS: The concordance rate between the results of VDRL and AutoRPR was 67.5%, and 164 discrepant cases were all VDRL reactive but AutoRPR negative. In the 164 cases, 133 showed FTA-ABS reactivity. Medical records of 106 among the 133 cases were reviewed, and 82 among 106 specimens were found to be collected from patients already treated for syphilis. The concordance rate between the results of AutoTPPA and FTA-ABS was 97.8%. The results of conventional TPPA and AutoTPPA for 250 samples were concordant in 241 cases (96.4%). AutoRPR showed higher specificity than that of VDRL, while VDRL demonstrated higher sensitivity than that of AutoRPR regardless of whether the patients had been already treated for syphilis or not. Both FTA-ABS and AutoTPPA showed high sensitivities and specificities greater than 98.0%. CONCLUSIONS: Automated RPR and TPPA tests could be alternatives to conventional syphilis tests, and AutoRPR would be particularly suitable in treatment monitoring, since results by AutoRPR in cases after treatment became negative more rapidly than by VDRL.
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sin Young(김신영) ORCID logo https://orcid.org/0000-0002-2609-8945
Kim, Hyon Suk(김현숙) ORCID logo https://orcid.org/0000-0001-5662-7740
Park, Yong Jung(박용정)
Lee, Eun Young(이은영)
Choi, Seung Jun(최승준) ORCID logo https://orcid.org/0000-0003-0736-1055
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