To find out if polymerase chain reaction could be used as a diagnostic tool for detecting neurosyphilis, we have applied the PCR for the detection of Treponema pallidum DNA in the cerebrospinal fluid (CSF) of syphilis patients. The results of the PCR of the CSF in 26 patients with at various stages of illness were compared with the results of other conventional tests used in the WHO criteria. T. pallidum was detected in the CSF of patients at all stages of syphilis, which indicates that they invade the central nervous system from the early stages of infection. However, the presence of T. pallidum in the CSF was not correlated with the results of other tests used in the WHO criteria, and its significance in the diagnosis of neurosyphilis should further be evaluated.
Cerebrospinal Fluid/*microbiology ; DNA, Bacterial/analysis ; Human ; Neurosyphilis/cerebrospinal fluid/*microbiology ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Support, Non-U.S. Gov't ; Treponema pallidum/genetics/*isolation & purification

OBJECTIVETo establish a multiplex polymerase chain reaction (M-PCR) assay for simultaneous detection of pathogens causing genital ulcer disease (GUD).

METHODSBased on the gene-specific region of the following pathogens: Chlamydia trachomatis omp1/ompb, herpes simplex virus (HSV) DNA polymerase, Treponema pallidum tpp47, Haemophilus ducreyi 16s rRNA, four sets of primers were designed and an M-PCR assay was developed to detect four pathogens in one test. The assay was evaluated with diagnostic result of golden standard for each pathogen.

RESULTSOf the 51 clinical samples, M-PCR showed slightly higher positive rate (47.1%) of HSV than cell culture (23.6%). Meanwhile, the positive rate of T. pallidum detected by M-PCR and dark-field microscopy was 19.6% (10/51) and 15.7% (8/51), respectively. Only one sample was positive for H. ducreyi and no sample was positive for C. trachomatis detected by both M-PCR assay and culture.

CONCLUSIONThis primary study indicated that M-PCR assay can simultaneously and rapidly detect the four etiologic pathogens causing GUD.

Chlamydia trachomatis ; genetics ; isolation & purification ; DNA Primers ; Haemophilus ducreyi ; genetics ; isolation & purification ; Herpesvirus 1, Human ; genetics ; isolation & purification ; Herpesvirus 2, Human ; genetics ; isolation & purification ; Humans ; Polymerase Chain Reaction ; methods ; Sexually Transmitted Diseases ; complications ; microbiology ; virology ; Treponema pallidum ; genetics ; isolation & purification ; Ulcer ; complications ; microbiology ; virology