Use of PCR in the diagnosis of XXXX in the United Kingdom.

@entity1 @entity1066 @entity645 @entity1065 @entity14329
OBJECTIVES: To evaluate a @entity14329 polymerase chain reaction (PCR) test in the laboratory diagnosis of @entity1065 in the United Kingdom. SUBJECTS AND SETTING: @entity1 and @entity1 attending genitourinary medicine clinics in England. METHODS: A trial PCR service was offered for the analysis of swabs of ano-genital or oral ulcers suspected to be syphilitic in origin. Clinical details, results of treponemal serology, and other relevant laboratory tests carried out by the sending laboratories were obtained retrospectively by questionnaire. RESULTS: Data from 98 @entity1 , representing 100 episodes of @entity1066 , were analysed. The majority of @entity1 (70) attended clinics in the Greater Manchester area. Eighty six @entity1 were male and 58 were @entity1 who have sex with @entity1 (MSM), of whom 24 were @entity645 positive. PCR results agreed with the clinical diagnosis for 95 @entity1 ; samples from 26 @entity1 were PCR positive and serologically diagnosed as primary (18) or secondary (8) syphilis, whereas 70 @entity1 had PCR negative samples and were not diagnosed as having active syphilis. These data include two @entity645 positive @entity1 who were PCR positive 12 and 21 days before their treponemal seroconversion. One positive PCR result was not supported by positive treponemal serology (this @entity1 coincidentally received a 10 day course of co-amoxiclav 1 week after sampling). Three @entity1 had negative PCR results but positive syphilis serology. The sensitivity, specificity, positive and negative predictive value for primary syphilis were 94.7%, 98.6%, 94.7%, and 98.6%, respectively, and for secondary syphilis these were 80.0%, 98.6%, 88.9%, and 97.2%, respectively. CONCLUSION: PCR is a sensitive and specific test for @entity14329 , and an important adjunct to dark ground microscopy and treponemal serology in diagnosing infectious syphilis in the United Kingdom.
