Macrolide treatment failure in a case of secondary syphilis: a novel A2059G mutation in the 23S rRNA gene of Treponema pallidum subsp. pallidum.

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.

• Authors: Petra Matějková, Magdalena Flasarová, Hana Zákoucká, Milan Bořek, Soňa Křemenová, Petr Arenberger, Vladana Woznicová, George M Weinstock, David Šmajs
• Journal: Journal of medical microbiology (J Med Microbiol) Vol. 58 Issue Pt 6 Pg. 832-836 (Jun 2009) ISSN: 0022-2615 [Print] England
• PMID: 19429763 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• DNA, Bacterial
• Macrolides
• RNA, Ribosomal, 23S
• Spiramycin

Topics

• Adolescent
• Adult
• Animals
• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Child
• Child, Preschool
• Czech Republic (epidemiology)
• DNA, Bacterial (analysis, isolation & purification)
• Drug Resistance, Bacterial (genetics)
• Humans
• Infant
• Infant, Newborn
• Macrolides (pharmacology, therapeutic use)
• Male
• Middle Aged
• Mutation
• Prevalence
• RNA, Ribosomal, 23S (genetics)
• Rabbits
• Sequence Analysis, DNA
• Spiramycin (pharmacology, therapeutic use)
• Syphilis (drug therapy, epidemiology, microbiology)
• Treatment Failure
• Treponema pallidum (drug effects, genetics)
• Young Adult