Observational studyJournal of clinical microbiology2014
Azithromycin-resistant syphilis-causing strains in Sydney, Australia: prevalence and risk factors.
Observational study in Journal of clinical microbiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Article
- Resurgence of syphilis: focusing on emerging clinical strategies and preclinical models.Journal of translational medicine · 2023Review
- Syphilis as Re-Emerging Disease, Antibiotic Resistance, and Vulnerable Population: Global Systematic Review and Meta-Analysis.Pathogens (Basel, Switzerland) · 2022Review
- Resurgence of syphilis, the great imitator.Medical journal, Armed Forces India · 2022Review
- Circulation of DistinctJournal of clinical microbiology · 2019Article
- Gene subtype analysis ofExperimental and therapeutic medicine · 2018Article
- Effects of Sexual Network Connectivity and Antimicrobial Drug Use on Antimicrobial Resistance in Neisseria gonorrhoeae.Emerging infectious diseases · 2018Review
- An Update on the Global Epidemiology of Syphilis.Current epidemiology reports · 2018Article
- Syphilis.Nature reviews. Disease primers · 2017Review
- Article
- Macrolide Resistance in Treponema pallidum Correlates With 23S rDNA Mutations in Recently Isolated Clinical Strains.Sexually transmitted diseases · 2016Article
- Treponema pallidum Strain Types and Association with Macrolide Resistance in Sydney, Australia: New TP0548 Gene Types Identified.Journal of clinical microbiology · 2016Article
- Syphilis: Re-emergence of an old foe.Microbial cell (Graz, Austria) · 2016Review
- Macrolide Resistance in the Syphilis Spirochete, Treponema pallidum ssp. pallidum: Can We Also Expect Macrolide-Resistant Yaws Strains?The American journal of tropical medicine and hygiene · 2015Article
- Syphilis: antibiotic treatment and resistance.Epidemiology and infection · 2015Review
- The molecular epidemiology of Treponema pallidum subspecies pallidum.Sexual health · 2015Article
- Failure of PCR to Detect Treponema pallidum ssp. pertenue DNA in Blood in Latent Yaws.PLoS neglected tropical diseases · 2015Article
- A cross-sectional study of 'yaws' in districts of Ghana which have previously undertaken azithromycin mass drug administration for trachoma control.PLoS neglected tropical diseases · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Azithromycin has shown high efficacy in randomized trials when used for treating infectious syphilis in Africa. However, its use in clinical practice has been limited by the development of antimicrobial drug resistance. Resistance has not previously been reported from Australasia. The aim of this study was to determine the prevalence of and risk factors for azithromycin-resistant syphilis-causing strains in Sydney, Australia. We evaluated 409 samples that were PCR positive for Treponema pallidum DNA collected between 2004 and 2011 for the presence of the A2058G mutation, which confers resistance to macrolide antibiotics such as azithromycin. Overall, 84% of samples harbored the mutation. The prevalence of the mutation increased during the study period (P trend, 0.003). We also collected clinical and demographic data on 220 patients from whom these samples had been collected to determine factors associated with the A2058G mutation; 97% were from men who have sex with men. Reporting sex in countries other than Australia was associated with less macrolide resistance (adjusted odds ratio, 0.25; 95% confidence interval, 0.09 to 0.66; P = 0.005), with other study factors showing no association (age, HIV status, recent macrolide use, stage of syphilis, or history of prior syphilis). Azithromycin cannot be recommended as an alternative treatment for syphilis in Sydney.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.