The continuing threat of syphilis in pregnancy

Heather R. Moline, James Smith, Jr.

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Purpose of review: Syphilis in pregnancy continues to be a worldwide threat to mothers and their fetuses, and in recent years has been increasing in prevalence. The purpose of this short review is to address current issues in the diagnosis and management of syphilis complicating pregnancies. Recent findings: Maternal syphilis infections and congenital syphilis appear to be increasing in both high and low resource settings. Treponema pallidum ssp. pallidum, the causative spirochete of syphilis, remains one of the few human infectious pathogens that has not been successfully cultured, making identification difficult and research in targeted antimicrobial therapies challenging. Fortunately, syphilis remains sensitive to penicillin, which remains the foundational therapy for this infection. Patients with syphilis and significant penicillin allergies remain a specific challenge in treatment. Of concern is the emergence of T. pallidum resistant to macrolides such as azithromycin. This will limit options in patients with penicillin allergies, and potentially contribute to suboptimal treatment. During pregnancy, penicillin is the only known effective treatment for congenital syphilis, and pregnant patients with penicillin allergy should be desensitized and treated with penicillin. Research focusing on protein expression of the genome of T. pallidum may lead to more accurate screening and diagnosis and development of novel antibiotic therapies. Summary: Obstetric and pediatric providers, public health organizations, and governments should recognize the re-emergence of syphilis globally and in their local healthcare environments. Screening of all pregnant patients with robust treatment and follow-up represents the most effective method to reduce congenital syphilis currently available.

Original languageEnglish
Pages (from-to)101-104
Number of pages4
JournalCurrent Opinion in Obstetrics and Gynecology
Volume28
Issue number2
DOIs
StatePublished - Apr 1 2016

Fingerprint

Syphilis
Penicillins
Pregnancy
Congenital Syphilis
Treponema pallidum
Hypersensitivity
Therapeutics
Mothers
Spirochaetales
Azithromycin
Globus Pallidus
Macrolides
Infection
Research
Obstetrics
Fetus
Public Health
Organizations
Genome
Pediatrics

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

The continuing threat of syphilis in pregnancy. / Moline, Heather R.; Smith, Jr., James.

In: Current Opinion in Obstetrics and Gynecology, Vol. 28, No. 2, 01.04.2016, p. 101-104.

Research output: Contribution to journalReview article

@article{4975e9afecbc4688ab3cdac3c5d86db9,
title = "The continuing threat of syphilis in pregnancy",
abstract = "Purpose of review: Syphilis in pregnancy continues to be a worldwide threat to mothers and their fetuses, and in recent years has been increasing in prevalence. The purpose of this short review is to address current issues in the diagnosis and management of syphilis complicating pregnancies. Recent findings: Maternal syphilis infections and congenital syphilis appear to be increasing in both high and low resource settings. Treponema pallidum ssp. pallidum, the causative spirochete of syphilis, remains one of the few human infectious pathogens that has not been successfully cultured, making identification difficult and research in targeted antimicrobial therapies challenging. Fortunately, syphilis remains sensitive to penicillin, which remains the foundational therapy for this infection. Patients with syphilis and significant penicillin allergies remain a specific challenge in treatment. Of concern is the emergence of T. pallidum resistant to macrolides such as azithromycin. This will limit options in patients with penicillin allergies, and potentially contribute to suboptimal treatment. During pregnancy, penicillin is the only known effective treatment for congenital syphilis, and pregnant patients with penicillin allergy should be desensitized and treated with penicillin. Research focusing on protein expression of the genome of T. pallidum may lead to more accurate screening and diagnosis and development of novel antibiotic therapies. Summary: Obstetric and pediatric providers, public health organizations, and governments should recognize the re-emergence of syphilis globally and in their local healthcare environments. Screening of all pregnant patients with robust treatment and follow-up represents the most effective method to reduce congenital syphilis currently available.",
author = "Moline, {Heather R.} and {Smith, Jr.}, James",
year = "2016",
month = "4",
day = "1",
doi = "10.1097/GCO.0000000000000258",
language = "English",
volume = "28",
pages = "101--104",
journal = "Current Opinion in Obstetrics and Gynecology",
issn = "1040-872X",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - The continuing threat of syphilis in pregnancy

AU - Moline, Heather R.

AU - Smith, Jr., James

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Purpose of review: Syphilis in pregnancy continues to be a worldwide threat to mothers and their fetuses, and in recent years has been increasing in prevalence. The purpose of this short review is to address current issues in the diagnosis and management of syphilis complicating pregnancies. Recent findings: Maternal syphilis infections and congenital syphilis appear to be increasing in both high and low resource settings. Treponema pallidum ssp. pallidum, the causative spirochete of syphilis, remains one of the few human infectious pathogens that has not been successfully cultured, making identification difficult and research in targeted antimicrobial therapies challenging. Fortunately, syphilis remains sensitive to penicillin, which remains the foundational therapy for this infection. Patients with syphilis and significant penicillin allergies remain a specific challenge in treatment. Of concern is the emergence of T. pallidum resistant to macrolides such as azithromycin. This will limit options in patients with penicillin allergies, and potentially contribute to suboptimal treatment. During pregnancy, penicillin is the only known effective treatment for congenital syphilis, and pregnant patients with penicillin allergy should be desensitized and treated with penicillin. Research focusing on protein expression of the genome of T. pallidum may lead to more accurate screening and diagnosis and development of novel antibiotic therapies. Summary: Obstetric and pediatric providers, public health organizations, and governments should recognize the re-emergence of syphilis globally and in their local healthcare environments. Screening of all pregnant patients with robust treatment and follow-up represents the most effective method to reduce congenital syphilis currently available.

AB - Purpose of review: Syphilis in pregnancy continues to be a worldwide threat to mothers and their fetuses, and in recent years has been increasing in prevalence. The purpose of this short review is to address current issues in the diagnosis and management of syphilis complicating pregnancies. Recent findings: Maternal syphilis infections and congenital syphilis appear to be increasing in both high and low resource settings. Treponema pallidum ssp. pallidum, the causative spirochete of syphilis, remains one of the few human infectious pathogens that has not been successfully cultured, making identification difficult and research in targeted antimicrobial therapies challenging. Fortunately, syphilis remains sensitive to penicillin, which remains the foundational therapy for this infection. Patients with syphilis and significant penicillin allergies remain a specific challenge in treatment. Of concern is the emergence of T. pallidum resistant to macrolides such as azithromycin. This will limit options in patients with penicillin allergies, and potentially contribute to suboptimal treatment. During pregnancy, penicillin is the only known effective treatment for congenital syphilis, and pregnant patients with penicillin allergy should be desensitized and treated with penicillin. Research focusing on protein expression of the genome of T. pallidum may lead to more accurate screening and diagnosis and development of novel antibiotic therapies. Summary: Obstetric and pediatric providers, public health organizations, and governments should recognize the re-emergence of syphilis globally and in their local healthcare environments. Screening of all pregnant patients with robust treatment and follow-up represents the most effective method to reduce congenital syphilis currently available.

UR - http://www.scopus.com/inward/record.url?scp=84960346046&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84960346046&partnerID=8YFLogxK

U2 - 10.1097/GCO.0000000000000258

DO - 10.1097/GCO.0000000000000258

M3 - Review article

C2 - 26871538

AN - SCOPUS:84960346046

VL - 28

SP - 101

EP - 104

JO - Current Opinion in Obstetrics and Gynecology

JF - Current Opinion in Obstetrics and Gynecology

SN - 1040-872X

IS - 2

ER -