ArticleNature microbiology2021
Global phylogeny of Treponema pallidum lineages reveals recent expansion and spread of contemporary syphilis.
Article in Nature microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers.
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71 citing papers in PubMed, 131 citations in OpenAlex.
- Looking Down the Road: Development of a Future Syphilis Vaccine.Sexually transmitted diseases · 2026Article
- Putative mechanisms of ocular inflammation in syphilis.Journal of ophthalmic inflammation and infection · 2026Review
- The Global Syphilis Epidemic: Turning the Tide.Sexually transmitted diseases · 2026Article
- Doxycycline Resistance and 16S rRNA Mutations in Treponema pallidum (Response).Emerging infectious diseases · 2026Article
- Vaginal microbiomes and their pertinent social context: a microbial ecological review proffering AMR-STI acquisition and emergence.Biology of sex differences · 2026Review
- Phylo-Plex: a phylogenetically informed, low-cost amplicon sequencing platform for deployable high-resolution genomic epidemiology.Nature communications · 2026Article
- Formal description ofInternational journal of systematic and evolutionary microbiology · 2026Article
- Article
- Lineage-specificbioRxiv : the preprint server for biology · 2026Article
- TheJornal brasileiro de doencas sexualmente transmissiveis : DST · 2026Article
- Genome-sequencing of ocular fluid in a patient with syphilitic uveitis: Strain identification and antimicrobial resistance detection.American journal of ophthalmology case reports · 2026Article
- Review
- AI-powered classification and network analysis for knowledge mapping in medicine: a century of neurosyphilis research.BMC medical research methodology · 2025Article
- Syphilis complicated with pericardial effusion: a case report.BMC infectious diseases · 2025Article
- Study on the final diagnosis of nervous system diseases with psychiatric symptoms as manifestation onset.BMC psychiatry · 2025Article
- Complete genome sequences of twoMicrobiology resource announcements · 2025Article
- Analysis ofmSphere · 2025Article
- In vitro analysis of seven syphilis-causing Treponema pallidum strains revealed inherent growth rate differences.Scientific reports · 2025Article
- Dynamics and Persistence of a Generalized Multi-strain SIS Model.Bulletin of mathematical biology · 2025Article
- A novel colorimetric immunosensor based on silk cocoon membrane-integrated ELISA for treponemal antibody detection.Microbiology spectrum · 2025Article
11 more citing papers are in PubMed but not listed here.
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Authors and funding
38 authors at 20 institutions in 11 countries.
Funding
Abstract
Syphilis, which is caused by the sexually transmitted bacterium Treponema pallidum subsp. pallidum, has an estimated 6.3 million cases worldwide per annum. In the past ten years, the incidence of syphilis has increased by more than 150% in some high-income countries, but the evolution and epidemiology of the epidemic are poorly understood. To characterize the global population structure of T. pallidum, we assembled a geographically and temporally diverse collection of 726 genomes from 626 clinical and 100 laboratory samples collected in 23 countries. We applied phylogenetic analyses and clustering, and found that the global syphilis population comprises just two deeply branching lineages, Nichols and SS14. Both lineages are currently circulating in 12 of the 23 countries sampled. We subdivided T. p. pallidum into 17 distinct sublineages to provide further phylodynamic resolution. Importantly, two Nichols sublineages have expanded clonally across 9 countries contemporaneously with SS14. Moreover, pairwise genome analyses revealed examples of isolates collected within the last 20 years from 14 different countries that had genetically identical core genomes, which might indicate frequent exchange through international transmission. It is striking that most samples collected before 1983 are phylogenetically distinct from more recently isolated sublineages. Using Bayesian temporal analysis, we detected a population bottleneck occurring during the late 1990s, followed by rapid population expansion in the 2000s that was driven by the dominant T. pallidum sublineages circulating today. This expansion may be linked to changing epidemiology, immune evasion or fitness under antimicrobial selection pressure, since many of the contemporary syphilis lineages we have characterized are resistant to macrolides.
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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.