Among the pathogens venereal diseases There are also deadly ones. For example, about Treponema pallidum you need to know that it is very dangerous bacteria. It is very mobile, penetrates the human body quickly, and multiplies at the same speed, affecting internal organs. Medicine has been studying it for a long time. It is known that Treponema pallidum is the causative agent of the disease.

Antibodies to Treponema

Treponemas concentrate on the mucous membranes. They are easily transmitted not only through sexual contact, but also in everyday life, through dishes and towels. What’s even worse is that the body does not develop immunity to these bacteria, and even after complete cure there is a risk of re-infection.

Most people infected with syphilis have antibodies to Treponema pallidum in their blood. In primary and secondary syphilis - in 88% and 76% of cases. In other patients they cannot be detected, or they may be completely absent. For example, antibodies of the IgM class are not present in the body of patients who have been treated in the past. But make no mistake, the absence of antibodies in the blood is not evidence of adequate treatment. Indeed, at the latent stage of syphilis, antibodies to treponema can also be detected only in 20% of cases.

Symptoms of Treponema pallidum infection

The symptoms themselves indicate that Treponema pallidum is present in the body. Depending on the stage of the disease, these are the following signs.

A person has to take a test to determine syphilis almost more often than anyone else: hiring, medical examinations, preventive examinations, pregnancy. Performing these studies is necessary - they allow you to identify the disease in the early stages, when treatment will be most effective.

The positive result obtained often baffles a person, especially in the absence of any reason. Detection of false-positive syphilis is enough common occurrence, and therefore you should not give in to panic ahead of time. According to information from various sources, up to 30% of primary studies may give an incorrect result. There are many reasons for this phenomenon: changes in the state of the body, somatic diseases. To better understand why they appear, it is worth taking a closer look at the research question.

Types of tests for syphilis

Methods clinical trials are rapidly improving every year. With the development of new diagnostic methods, a false positive reaction to syphilis is becoming less common. If necessary, diagnostics may include several different techniques– this allows you to get the most reliable result.

Non-treponemal research methods

These techniques are aimed at identifying proteins that are formed as a result of the activity of the pallidum spirochete. They are aimed at identifying “traces” of the pathogen. Such methods have a relatively high percentage of error (up to 10%). Such techniques are nonspecific, but they allow the degree of infection to be determined by the antibody titer.

Wasserman reaction RW

The most common test performed to identify Treponema pallidum is a serological blood test. The Wasserman reaction allows you to determine the presence of the disease in just a few minutes. Therefore, this technique is most often used in laboratories - it does not require much time and has a relatively low cost.

To perform the analysis it is used cerebrospinal fluid or blood. The test material can be collected from a finger (if there is only one analysis) or from a vein (if several studies are required). The result of the analysis may be not only a false positive, but also a false negative. It is possible under the following circumstances:

• early stage of infection, when the number of treponemes in the body is still low;
• chronic disease in the quiescence stage, when the number of antibodies decreases.

Pay attention! A false negative result occurs extremely rarely, and therefore if there is at least one positive result out of four, it is necessary to undergo additional examination.

Recipitation microreaction (MR)

This research technique is based on the antigen-antibody reaction. She demands no large quantity material to perform. Aimed at identifying antilipid antibodies that are produced during the destruction of treponema cells. Both the patient's blood and cerebrospinal fluid are used for the study.

Because cell destruction can occur in other cases than syphilis, the test is used as a screening test rather than a confirmatory test. There are two analogues of this technique:

• Microscopic test (VDRL). Inactivated blood serum is used to perform the analysis. If a lesion is suspected nervous system syphilis, cerebrospinal fluid is used as the test material.
• Macroscopic test (RPR). It is considered a rapid diagnostic method. Visual counting of plasma reagins is used.

This reaction if not observed required sterility may show a false positive result. The appearance of such an analysis is also possible with nonspecific tissue damage, which entails the destruction of lipids. If there is a positive result, a mandatory treponemal test is recommended for confirmation.

Treponemal research methods

This category of analyzes provides the most accurate data and is rarely false positives. Research is aimed at identifying specific proteins that are released by the body in response to infection. These methods have a higher cost, and therefore are used as confirmatory rather than screening ones.

Specific antibodies begin to be produced by the body only a few weeks after infection with treponema. They can persist for a long period after the disease is cured. Therefore, specific tests may show positive results for a long time after remission.

Pay attention! For positive RW and negative specific it is used rerun research in a few weeks.

Enzyme immunoassay (ELISA, EIA)

It is based on assessing the level of immunoglobulins of the IgA, IgB and IgM classes. The first two types of proteins are produced in the body already from 2 weeks of infection, and IgM - a month after infection.

The analysis is interpreted based on the ratio of the presence of immunoglobulins:

• only IgA was detected – no more than 14 days have passed since infection;
• IgA and IgB were detected – infection occurred 14 to 28 days ago;
• all three types were detected - syphilis in the body for more than 28 days;
• only IgM detected – late syphilis.

The presence of IgM may be a sign of already cured syphilis - synthesis immunoglobulins IgM may continue for several months after remission.

Immunofluorescence reaction (RIF, FTA)

Used to confirm infection at the earliest stages. For the study, blood is taken from a finger or vein. The result is similar to the RW analysis, where a minus is indicated, or from 1 to 4 pluses. If there is at least one plus, additional research may be prescribed.

False-positive results when performing RIF are extremely rare - they can occur in pregnant women, as well as in patients with connective tissue diseases.

Passive agglutination test (RPHA, TPHA)

The antibody titer allows you to determine the presence of syphilis and its stage. This technique provides reliable data already from 28 days after infection. Blood from a finger or vein is used for assessment. An increase in the number of antibodies means a later stage of the disease.

The most accurate research methods

The analyzes of this group differ high sensitivity, and therefore the error in their results is extremely low. They are distinguished by more high cost, in comparison with other methods, and a more complex execution technique.

Polymerase chain reaction (PCR)

PCR analysis is considered one of the most highly accurate. It is aimed at identifying areas of pathogenic DNA in the human body. The method requires specialized equipment and reagents, and therefore is used in rare cases.

Immunoblotting

Combined research method. Aimed at determining immunoglobulins in the patient’s blood serum. The analysis checks for the presence of a complex of antibodies, which is used to establish the diagnosis. This technique uses electrophoresis, which separates immunodeterminants, and an ELISA reaction, which reveals the separated points.

Treponema pallidum immobilization reaction (TPI)

A highly specific test that determines the response of blood serum to Treponema pallidum. It is widely used all over the world because it has high probability exact result. Special antibodies (immunomobilins) in a patient with syphilis can immobilize treponema. In the blood healthy person there are no such antibodies. It is on the presence/absence of this ability that the research methodology is based.

RIBT is used to identify those types of syphilis in which the Wasserman reaction gives negative results– damage to the nervous system, internal organs, hidden form diseases. A false positive result is extremely rare in the CIS countries. The cause of its appearance may be sarcoidosis, leprosy.

Causes of false positive results

The Wasserman reaction can determine “acute” and “chronic” false-positive results. Its severity depends on the nature of the changes in the person’s condition. RW can indicate the stage of exacerbation in the following cases:

• infectious diseases in the acute stage;
• traumatic injuries;
• myocardial infarction;
• administration of any vaccine several days before the test;
• food poisoning.

These conditions are characterized hard work immune system, which leads to increased production of antibodies. They are mistakenly recognized in the reaction as antibodies to treponema, and therefore a positive result occurs.

In the presence of chronic pathologies, the immune system produces a large number of nonspecific antibodies that can cause a reaction. In RW, such a condition may show a false positive result. Therefore, it is worth warning your doctor about the following diseases:

• chronic pathologies of connective tissues;
• tuberculosis;
• chronic diseases of viral etiology: HIV, hepatitis B, C, D;
• chronic liver diseases;
• autoimmune pathologies.

With age, redox reactions in the patient's body slow down. Aging tissue may also produce a false positive result, and therefore for patients old age More precise research methods are prescribed.

Pay attention! At positive reaction Wasserman, additional research is being conducted to provide a more accurate picture.

Recheck

Repeated is carried out at questionable results screening study. It is prescribed if there are one or two crosses - such an analysis requires additional verification. The test can give false positive results in several cases:

• Early stage of the disease. Before the appearance of chancroid, the amount of immunoglobulins in the body is quite low.
• Late stage of the disease. More than 2 years have passed since the infection, and the antibody titer gradually began to decline.

A repeat analysis, which is carried out after 2-3 weeks, shows exactly whether the disease exists. If there is a positive result a second time, additional clarifying techniques are used.

Tests during pregnancy

One of the most unexpected results may be a positive test result for syphilis in pregnant women, especially if the woman has not changed partners. This situation often terrifies expectant mothers, since treponema can negatively affect the baby’s intrauterine development.

A screening test during pregnancy is carried out several times:

• upon registration, at 12 weeks;
• beginning of the 3rd trimester, at 30 weeks;
• before childbirth.

This is the amount of research that is considered minimal. A false positive may occur due to changes in the body that occur during pregnancy. When a woman is pregnant, her immune system produces a large number of antibodies - this is an evolutionary adaptation to protect the baby in the first year of life.

During pregnancy, an additional clarifying analysis is prescribed, which is characterized by greater accuracy. If a control study shows the presence of a pathogen in the body, treatment is required. The effect of therapy on a growing organism is significantly less possible harm from treponema.

How to prepare for tests?

One way to prevent an incorrect result is to prepare for testing. Due to improper preparation, reactions may occur that are accompanied by the production of nonspecific antibodies, which leads to an incorrect result.

• The test must be taken on an empty stomach. You can only drink clean water.
• A day before blood sampling, you should completely eliminate alcohol - it creates additional stress on the liver, which can lead to a positive result.
• It is recommended to avoid eating fatty and fried foods, spicy foods and large amounts of spices the day before.
• It is recommended to refrain from smoking at least 60 minutes before the test.
• Before drawing blood from a vein, you need to rest for 10-15 minutes in the emergency room.
• Women are not recommended to donate blood during menstruation.
• Analysis cannot be carried out after x-ray examination, physiotherapeutic procedures.
• It is prohibited to donate blood for syphilis during periods of exacerbation of infectious diseases.

Pay attention! If the patient is taking any medications, he should consult a doctor before the test; a break of several days may be required between taking the drugs and the test.

What to do if syphilis is confirmed?

There is no need to worry if you receive an initial screening with positive results. False syphilis is easily determined by repeated testing. If the diagnosis has been confirmed, you need to take measures:

• examination of the sexual partner by a dermatovenerologist;
• examination of close relatives;
• performing preventive treatment to prevent infection in loved ones;
• registration of sick leave for the period of treatment – sick leave does not contain information about the diagnosis, guaranteeing confidentiality;
• At the end of the course of treatment, a special certificate is issued - you need to have it with you in order to avoid questions about false positive results in the next few months.

Positive result for syphilis is not always reliable. Therefore, there is no need to worry and it is recommended to wait for additional research. Correct treatment which was started on time guarantees quick recovery with a minimum of residual effects.

There are so many different microorganisms that for centuries scientists have not been able to fully study them. For example, there is no consensus among researchers regarding the occurrence or origin of syphilis. It is believed that this is one of the most ancient diseases that appeared with the emergence of man.

However, the causative agent of syphilis was officially discovered in 1905 by German microbiologists E. Hoffmann and F. Schaudin. It was they who first discovered a number of biochemical, morphological and cultural properties of Treponema pallidum and its features.

In this article we will try to understand in detail what it is - treponema pallidum. What is its structure, structure, physiological properties, as well as the infectious agent that causes syphilis.

But first, let's define what it means - treponema pallidum. This is the causative agent of syphilis - Treponema pallidum, and it belongs to the order Spirochaetales.

Simple description

Syphilis is a venereal chronic disease that is sexually transmitted. The body's incubation period is about three weeks. After this, in the place where the pathogen was introduced, a primary affect appears in the form of chancre or painless ulcer. If the infection is left untreated, secondary and tertiary syphilis develops.

Antibodies to treponema pallidum - what are they?

In response to the development of infection, the human immune system produces anti-syphilitic antibodies, therefore serological methods are most often used to diagnose the disease. First, the immune system produces antibodies of the IgM class, then, as the disease develops, synthesis predominates IgG antibodies. Treponema Pallidum at the stage of appearance of these antibodies is characterized acute form. They can remain with the patient for life. It turns out that antibodies to treponema pallidum are also diagnostic tools.

Morphological properties

Treponema consists of cells 6-15 µm long and 0.1-02 µm wide. It consists of cytoplasm surrounded by a cytoplasmic membrane. By appearance The cell of this organism resembles a thin curled thread.

Usually the number of curls varies from 8 to 14. Moreover, these curls are preserved even when moving between other cells.

The photo below shows what type of microorganism this is.

Between the cytoplasm and the membrane there are fibrils. One part of the fibril always remains free, although the other is motionless and fixed. It is the fibrils that represent locomotor system treponema, which allows it to move in a liquid environment. Thanks to this, the microorganism can move, bend and rotate around its axis.

Treponema pallidum is a Gram-negative microorganism, but it does not stain due to the presence of a hydrophobic particle that is impervious to aniline dyes.

According to Romanovsky-Giemsa, treponema acquires weakly pink, and this feature to some extent played a role in the name of the pathogen. The microorganism itself is quite demanding environment. Its comfortable habitat is 30-37 degrees, and it is quickly inactivated by mild cold, heat, and disinfectants.

Biochemical properties

Treponema reproduces by transverse binary fission; the comfortable temperature for this is 37 degrees. Note that in external environment The body's resistance is very weak:

1. Treponema lives outside the human body for a couple of minutes, after which it dries completely. At a temperature of about 40 degrees, it dies within two hours, and at a temperature of 50 degrees, treponema survives for only 15 minutes.
2. Under unfavorable conditions for the body, cysts and L-forms are formed, which can subsequently also acquire a spiral shape.

Note that treponema is a chemoorganoheterotroph by type of metabolism. This means that she needs to live organic matter, which serve as sources of energy. It is precisely because of the inability to exist outside the human environment that its biochemical properties have been studied very poorly.

Antigenic structure

Antigenic structure of a given organism poorly studied. It is represented by a thermolabile protein antigen, as well as a polysaccharide antigen. Speaking in simple words, treponema pallidum antigens are common proteins and polysaccharides of the outer membrane of the cell.

The toxic and antigenic function is performed by lopopolysaccharide cell wall. For Treponema pallidum it is an endotoxin.

Pathogenicity factors

Pathogenicity factors are also poorly studied. After treponema pallidum enters the macroorganism, it releases lipoproteins and specific proteins - lipopolysaccharides. They exhibit toxic properties after the death of the organism. Lipoproteins take part in the activation of the immune system, and the proteins are quite similar in some properties to bacterial hemolysins.

The ability of this microorganism to release lipid antigens and endotoxins is considered a pathogenicity factor. These elements have the properties of autoantigens.

Laboratory diagnostics

Now we more or less understand what it is - Treponema Pallidum. Syphilis can be diagnosed in the laboratory using two methods:

1. Detection of the causative agent of the disease using biological preparations.
2. Serological reactions.

The latter diagnostic method can be used to make a diagnosis and to evaluate the effectiveness of treatment. The peculiarity of serology is that positive results in the early stages of the disease may be completely absent, although the patient will have symptoms. This is easy to explain: incubation period syphilis is 3-5 weeks. However, for people who abuse alcohol, have tuberculosis or HIV infection, the incubation period can last about two weeks.

Upon admission antibacterial drugs the incubation period can increase to 6 months. During this entire time, the concentration of antibodies is quite low and does not reach the diagnostic titer. But a person can still experience clinical symptoms of syphilis. This disease is called seronegative syphilis.

Seropositive syphilis differs clearly severe symptoms and clinical picture. Treponema pallidum antibodies are immediately detected in the blood. A positive result implies immediate treatment of the disease. Otherwise, seropositive syphilis develops into secondary syphilis, and it can last for years.

First clinical signs diseases (except for the appearance of chancre) are total treponema pallidum antibodies, that is, IgM and IgG. In addition, an anticardiolipin test (RPR) is performed. These tests are complementary and joint use will help accurately diagnose or exclude syphilis disease.

Treatment of the disease

As already mentioned, if the antibody test is positive, then they resort to treatment for the disease. It should be aimed at destroying the pathogen. Moreover, it is even shown preventive treatment people who have clinical picture absent, but who had sexual contact with a person suffering from an early form of syphilis.

Pregnant women with positive and serological tests also receive preventive treatment. In the Russian Federation there are treatment regimens for this disease, which are systematically updated. They were last revised in 1999.

Primary syphilis is treated by prescribing Benzathine benzylpenicillin, 2.4 million units intramuscularly (2 injections once a week). It is also possible to prescribe bicillin-5 1.5 million units intramuscularly (2 times a week, 5 injections).

As alternative treatment Ampicillin, Ceftriaxone, Doxycycline and other drugs are prescribed. In any case, the doctor prescribes treatment based on the test results.

After the full cycle of treatment, patients should also undergo serological studies over the next two years. If AT titers (non-treponemal tests) are reduced by 4 times within a year after treatment, then this is considered good result, allowing us to conclude that the treatment was effective.

Also, all sexual partners of the patient should be treated, regardless of the results of the serological test. As described above, a serological test may be negative during the incubation period, even despite the presence of treponema pallidum in the human body. You already know what it is.

Prevention and prognosis

The best prevention of the disease is to avoid casual sex and use protective equipment(condoms or chemicals) during sexual intercourse. It is also appropriate to contact 24-hour STI prevention centers.

If syphilis is detected at the primary or secondary stage, the prognosis is favorable. However, later stages of the disease will lead to serious consequences: diseases cardiovascular system, blindness, mental disorder and diseases of the nervous system. Deaths were also recorded.

Now you know what it is - treponema pallidum, and how dangerous syphilis is.

Conclusion

Despite the possible sad consequences, it is almost impossible not to notice the appearance of a pathogen in the body. Any sane person would see a doctor as early as early stage development of the disease, so do not worry about severe consequences. They can only arise on late stage, if a person does not pay attention to the development of the disease at all.

Treponema pallidum is a very dangerous bacterium, the causative agent of syphilis. It quickly penetrates the human body and multiplies at the same speed, severely affecting internal organs.

Description of the bacterium

Treponema pallidum is a bacterium that has a cell wall. Able to live for some time in the environment. This bacterium belongs to the spirochetes. It looks like a spiral with small curls, of which there can be from eight to twelve pieces. It is by their number and shape that this bacterium is determined when a smear microscopy is done.

This microorganism is almost not stained with dyes used in microbiology. Contrast microscopy is used to see the bacteria. This is due to the fact that the shell of the microorganism is very thin and is quickly damaged under the influence of alcohol (and this is precisely what is used to fix the color). When a bacterium becomes silvered, it acquires a reddish-black color.

How long does a bacterium live?

Treponema pallidum, when it gets on objects (mainly bed linen and towels), persists until the substrate in which it was located dries. Most often this is saliva, fluid secreted from ulcers and erosions, sperm, etc. At a temperature of fifty-five degrees, the bacterium can live for approximately fifteen minutes. At a higher level, it dies much faster. During boiling, the bacterium dies in a matter of seconds, that is, almost instantly.

What is harmful to bacteria?

Some media and substances are detrimental to Treponema pallidum:

• bismuth and arsenic;
• mercury;
• penicillin;
• alkalis and acids;
• antiseptics and disinfectant solutions;
• vinegar and alcohol;
• UV and light.

According to research and experiments conducted by scientists, it turned out that this bacterium can sometimes survive for some time and in unfavorable conditions for it. For example, in a poor environment, under light, in a dry state or in the presence of oxygen. If such a microorganism is found, it can live in an unfavorable environment for up to three years.

Treponema growth and main antigens

Treponema pallidum is difficult to grow due to its capriciousness. Cells of chicken embryos and humans are not suitable for growing this microorganism. There are two ways in which culture can be distinguished. The first is to infect laboratory rabbits with the bacterium and wait until these animals develop specific orchitis. Second, treponema can be grown on special media under Vaseline oil. The presence of these microorganisms is necessary to obtain the antigens by which syphilis is detected.

Pathogenicity of Treponema pallidum

The pathogenicity of the bacterium Treponema pallidum has its own characteristics:

• due to the presence of the adhesin protein, which interacts with fibronectin of the mucous membranes, “adhesion” to the host cells is ensured;
• the presence of myofibrils and the spiral shape of Treponema pallidum promote deep penetration and cause migration throughout the body;
• antiphagocytic activity occurs due to the ability of this bacterium to bind fibronectin;
• inflammation begins due to the presence of lipoprotein membranes;
• Treponema pallidum is resistant to antibacterial drugs due to the variability of antigenic properties and the ability to form L-forms, which makes it impossible to create a vaccine;
• these bacteria are able not only to live in the interstitium, but also to multiply there.

Antibodies to Treponema pallidum

Treponema pallidums mainly collect on mucous membranes. Therefore, they are easily transmitted not only during sexual intercourse, but also in everyday life. Most often through towels, dishes or kisses. Unfortunately, the human body cannot develop immunity to these bacteria. Therefore, even after complete recovery, it can return again.

To determine the disease, blood is taken for syphilis. Most infected people have antibodies to Treponema pallidum. During primary and recurrent illness- in 88 and 78% of patients, respectively. In the rest they are either not detected or absent altogether. But the absence of antibodies does not mean that the treatment was successful. Antibodies for the disease are generally found in only 20 percent of patients.

After 1-2 weeks from the onset of the disease, a serum analysis is performed. IgM and IgA antibodies to Treponema pallidum appear in the serum during this period. Over a period of six months to nine months, immunoglobulin titers increase, then their number begins to decrease. Over time, the level of antibodies also drops below detectable values. Some cannot be passed from mother to child.

IgG antibodies appear 3-4 weeks after infection with syphilis. And by 6-9 weeks they reach their peak. A high concentration of antibodies persists for a long time and decreases extremely slowly and only after therapy. And the residual titer can remain in the body for life.

Treponema antibodies can only be produced against Treponema pallidum. Therefore, if they are found, we can say for sure that syphilis is present on at the moment or was previously transferred.

Symptoms of Treponema pallidum infection

There are a number of symptoms that indicate the presence of human body Treponema pallidum. When they appear, it is necessary to donate blood; they may vary depending on the stage of the disease.

On the first:

• painful ulcers appear located on the mucous membrane of the mouth, rectum or genital organs;
• The ulcers heal on their own after at least three weeks; the process can last up to six months.

On the second:

• a syphilitic symmetrical pale rash appears on the body;
• headaches, general malaise, fever;
• lymph nodes enlarge;
• Sometimes hair may fall out, and broad condylomas may appear on the genitals.

On the third, defeat occurs:

• nervous system;
• brain and spinal cord;
• internal organs;
• bones.

Effective in the first and second stages complex treatment, including antibiotics, physiotherapy, immunostimulants and restorative drugs. But if you don’t see a doctor in time, then after a few years the third stage of the disease begins, which can be almost impossible to cure.

How is it detected?

To determine whether there are bacteria in the body that cause syphilis, an appropriate test is done. Treponema pallidum by efforts modern medicine can be detected in several ways:

• At the first stage of syphilis, the patient is very contagious and secretes the world around us many bacteria. In this case, smear microscopy is used. To obtain accurate results, the ulcers are treated with saline solution to wash away interfering microflora. Then scraping is done and a smear is made.
• Non-treponemal tests. Screening methods are used here. They are good for initial diagnosis and subsequent monitoring during treatment and medical examination. But these tests often give false result positive. Treponema pallidum may not be present in the body. This happens because the antigens (antibodies) are not taken from the causative agent of the disease.
• Treponema tests are used specifically to identify Treponema pallidum. These methods are used to confirm the diagnosis and rule out syphilis in a false screening test.