ArticleSexually transmitted diseases2016
Macrolide Resistance in Treponema pallidum Correlates With 23S rDNA Mutations in Recently Isolated Clinical Strains.
Article in Sexually transmitted diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
21 citing papers in PubMed, 37 citations in OpenAlex.
- Putative mechanisms of ocular inflammation in syphilis.Journal of ophthalmic inflammation and infection · 2026Review
- A New Era in Treponema pallidum Cultivation: Current Advances and Future Directions.Sexually transmitted diseases · 2026Review
- Article
- First Report of Genetic Resistance to Azithromycin inMicroorganisms · 2025Article
- Antimicrobial Resistance in Curable Sexually Transmitted Infections.Current HIV/AIDS reports · 2025Review
- Majority of Treponema pallidum ssp. pallidum MLST allelic profiles in the Czech Republic (2004-2022) belong to two SS14-like clusters.Scientific reports · 2024Article
- Antimicrobial treatment and resistance in sexually transmitted bacterial infections.Nature reviews. Microbiology · 2024Review
- Resurgence of syphilis: focusing on emerging clinical strategies and preclinical models.Journal of translational medicine · 2023Review
- Molecular Characteristics of Macrolide Resistance inInfection and drug resistance · 2023Article
- Optimising treatments for sexually transmitted infections: surveillance, pharmacokinetics and pharmacodynamics, therapeutic strategies, and molecular resistance prediction.The Lancet. Infectious diseases · 2020Review
- Effectiveness and Tolerability of Oral Amoxicillin in Pregnant Women with Active Syphilis, Japan, 2010-2018.Emerging infectious diseases · 2020Article
- Successful isolation of Treponema pallidum strains from patients' cryopreserved ulcer exudate using the rabbit model.PloS one · 2020Article
- Molecular Characterization Based on MLST and ECDC Typing Schemes and Antibiotic Resistance Analyses ofFrontiers in cellular and infection microbiology · 2020Article
- Genomic epidemiology of syphilis reveals independent emergence of macrolide resistance across multiple circulating lineages.Nature communications · 2019Article
- Comparison ofJournal of biosciences · 2019Article
- Article
- Circulation of DistinctJournal of clinical microbiology · 2019Article
- The wide utility of rabbits as models of human diseases.Experimental & molecular medicine · 2018Review
- Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHigh rates of 23S rDNA mutations implicated in macrolide resistance have been identified in Treponema pallidum samples from syphilis patients in many countries. Nonetheless, some clinicians have been reluctant to abandon azithromycin as a treatment for syphilis, citing the lack of a causal association between these mutations and clinical evidence of drug resistance. Although azithromycin resistance has been demonstrated in vivo for the historical Street 14 strain, no recent T. pallidum isolates have been tested. We used the well-established rabbit model of syphilis to determine the in vivo efficacy of azithromycin against 23S rDNA mutant strains collected in 2004 to 2005 from patients with syphilis in Seattle, Wash.
methodsGroups of 9 rabbits were each infected with a strain containing 23S rDNA mutation A2058G (strains UW074B, UW189B, UW391B) or A2059G (strains UW228B, UW254B, and UW330B), or with 1 wild type strain (Chicago, Bal 3, and Mexico A). After documentation of infection, 3 animals per strain were treated with azithromycin, 3 were treated with benzathine penicillin G, and 3 served as untreated control groups. Treatment efficacy was documented by darkfield microscopic evidence of T. pallidum, serological response, and rabbit infectivity test.
resultsAzithromycin uniformly failed to cure rabbits infected with strains harboring either 23S rDNA mutation, although benzathine penicillin G was effective. Infections caused by wild type strains were successfully treated by either azithromycin or benzathine penicillin G.
conclusionsA macrolide resistant phenotype was demonstrated for all strains harboring a 23S rDNA mutation, demonstrating that either A2058G or A2059G mutation confers in vivo drug resistance.
Indexed as
Identifiers
What OpenQuestion holds
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.