Increased Reporting of Infants Born With Congenital Syphilis to a Local Department of Public Health: A Quality Improvement Project.

Background: Congenital syphilis (CS) remains a significant public health concern. Current reporting guidelines may underreport cases where infants receive penicillin despite nonreactive rapid plasma reagin (RPR-) due to inadequate maternal treatment and delayed infant antibody seroconversion. Methods: This quality improvement project analyzed CS cases at a tertiary children's hospital from 2011 to 2022. A prospective intervention was implemented from September 2023 to February 2025 to improve the reporting of cases, including multidisciplinary communication, standardized electronic medical record data entry, and regular reminders. Results: Prior to the intervention, 154 infants were identified who had a case definition of CS per the Centers for Disease Control and Prevention and received penicillin administration therapy, with 107 of 154 (69.4%) RPR- and not reported to the local department of public health. At the end of the first intervention cycle, 44 infants were reported to the department of public health, with 15 cases (34.1%) being RPR- and successfully reported. Conclusions: This project highlights the limitations of RPR-based reporting for CS surveillance. The implemented intervention improved the reporting of cases, including those without maternal RPR positivity, thereby enhancing public health surveillance efforts.