Abstract
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.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Adult
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Animals
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Anti-Bacterial Agents* / pharmacology
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Anti-Bacterial Agents* / therapeutic use
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Child
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Child, Preschool
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Czech Republic / epidemiology
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DNA, Bacterial / analysis
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DNA, Bacterial / isolation & purification
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Drug Resistance, Bacterial / genetics*
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Humans
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Infant
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Infant, Newborn
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Macrolides / pharmacology
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Macrolides / therapeutic use
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Male
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Middle Aged
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Mutation*
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Prevalence
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RNA, Ribosomal, 23S / genetics*
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Rabbits
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Sequence Analysis, DNA
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Spiramycin* / pharmacology
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Spiramycin* / therapeutic use
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Syphilis / drug therapy*
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Syphilis / epidemiology
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Syphilis / microbiology
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Treatment Failure
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Treponema pallidum / drug effects*
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Treponema pallidum / genetics
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Young Adult
Substances
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Anti-Bacterial Agents
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DNA, Bacterial
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Macrolides
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RNA, Ribosomal, 23S
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Spiramycin