Canadian Public Health Laboratory Network Laboratory Guidelines for Congenital Syphilis and Syphilis Screening in Pregnant Women in CanadaReport as inadecuate




Canadian Public Health Laboratory Network Laboratory Guidelines for Congenital Syphilis and Syphilis Screening in Pregnant Women in Canada - Download this document for free, or read online. Document in PDF available to download.

Canadian Journal of Infectious Diseases and Medical Microbiology - Volume 26 2015, Supplement A, Pages 23A-28A

CPHLN Laboratory Guidelines

Division of Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada

Saskatchewan Disease Control Laboratory, Regina, Saskatchewan, Canada

Alberta Provincial Laboratory for Public Health, Calgary, Alberta, Canada

Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, Canada

Division of Pediatric Infectious Diseases, University of Alberta, Edmonton, Alberta, Canada



Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Despite universal access to screening for syphilis in all pregnant women in Canada, cases of congenital syphilis have been reported in recent years in areas experiencing a resurgence of infectious syphilis in heterosexual partnerships. Antenatal screening in the first trimester continues to be important and should be repeated at 28 to 32 weeks and again at delivery in women at high risk of acquiring syphilis. The diagnosis of congenital syphilis is complex and is based on a combination of maternal history and clinical and laboratory criteria in both mother and infant. Serologic tests for syphilis remain important in the diagnosis of congenital syphilis and are complicated by the passive transfer of maternal antibodies which can affect the interpretation of reactive serologic tests in the infant. All infants born to mothers with reactive syphilis tests should have nontreponemal tests NTT and treponemal tests TT performed in parallel with the mother’s tests. A fourfold or higher titre in the NTT in the infant at delivery is strongly suggestive of congenital infection but the absence of a fourfold or greater NTT titre does not exclude congenital infection. IgM tests for syphilis are not currently available in Canada and are not recommended due to poor performance. Other evaluation in the newborn infant may include long bone radiographs and cerebrospinal fluid tests but all suspect cases should be managed in conjunction with sexually transmitted infection and-or pediatric experts.





Author: Ameeta E Singh, Paul N Levett, Kevin Fonseca, Gayatri C Jayaraman, and Bonita E Lee

Source: https://www.hindawi.com/



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