General (clinical) blood test
21.04.2019

Routes of infection with Treponema pallidum, symptoms of infection, treatment. Treponema pallidum - the causative agent of syphilis

There are many in the world different bacteria and viruses. They can call serious illnesses in the human body and thereby greatly undermine its health.

One of them is pallidum diagnosed treponema. For human body it is the source of a common sexually transmitted disease called syphilis. Unfortunately, it is difficult to treat and is too contagious.

What does this disease mean?

There are spirochete bacteria, and Treponema pallidum is one of them. It is a microbe, it is transparent, thin and corkscrew-like due to its spiral body.

It consists of an average of ten turns.

The internal structure of the bacterium is as follows:

  • Nucleoid with DNA.
  • Cytoplasm with various components, which control metabolic processes and protein synthesis.
  • Cytoplasmic membrane.
  • The outer cell wall that protects the bacterium from the effects of drugs and body antibodies.
  • At the ends there are organs of movement, they help the bacteria move throughout the body. To move, she uses four movements: flexion, rotation, translation, contractile. When moving, the curls can change their number.

Treponema is the classic form of syphilis. But besides it, there are three more subtypes of the disease, but they are not typical for all geographical areas. So this is:

Suitable environment for bacteria

Treponema is a bacterium that can be enriched with energy without the need for oxygen. It requires moisture and warmth to reproduce. In the human body, it develops in the lymphatic system. Due to the fact that it is too mobile, it can easily penetrate into the middle of our body, using a cut in the skin or mucous membrane. It enters the body like a corkscrew and is located in the nearest lymph node. Over time, it begins to multiply and covers everything lymphatic system. In addition, damage occurs blood vessels, which causes blood clots to form.

The spread of bacteria throughout the body occurs through the blood and lymph flow, so it can end up in any organ or system. This stage is called secondary syphilis. This bacterium is very tenacious and resistant to drugs.

In order for a bacterium to “feel” well in the body, it needs a neutral environment. Because of this, it cannot be detected on the walls of the vagina, because the acidic environment does not allow it to move. However, the cervix or external genitalia is suitable for it.

Bacteria reproduce by dividing into separate parts, which contain all the structures of the cell.

How does a bacterium behave in unfavorable conditions?

If there is a threat to the bacterium, it begins to “defend itself.” She can take one of two forms that will help her survive:

  • Cyst. To do this, the bacterium curls into a sphere and begins to secrete mucus to protect itself. We can say that this is a kind of hibernation, because during this period no symptoms of the disease appear. This condition is called latent syphilis. With the slightest change in conditions, the bacterium “comes to life” again.
  • L-shape. This means that the bacterium has lost its protective wall and, due to the fact that it has not completed division, it has grown. Right now she is difficult to treat.

When the bacteria leaves human body, and finds itself in a dry environment, it dies. If it gets into water or wet clothes, its life is extended by several days. If a bacterium is exposed to temperatures greater than sixty degrees Celsius, it dies within fifteen minutes. If the temperature reaches one hundred degrees, it will happen instantly. At zero degrees, the life of a bacterium lasts two days.

If we talk about the environment, then alkaline and acidic have a detrimental effect on it. You can get rid of it by washing with laundry soap or a weak acidic solution; an alkaline solution is also suitable.

You can also use antiseptics to eliminate it; it dies immediately after treatment:

  • Sublimate (0.001%);
  • Chlorhexidine (0.05%);
  • Phenol (1–2%);
  • Alcohol (70%).

If you use vodka, its lifespan increases to twenty minutes.

To cope with bacteria that have already entered the body, it is necessary to use antibiotics:

  • Tetracycline.
  • Penicillin.
  • Cephalosporin.
  • Macrolides.

Penicillin is mainly used for treatment; if it does not help, then other drugs are used as analogues. They will also help if the patient has an individual intolerance to the drug.

Who can become infected

The risk group includes people aged twenty to forty-five years, with the peak of infection occurring in their thirties.

It should be noted that several years ago, this disease mainly affected men who used the services of women of easy virtue.

Today, the situation has completely changed, and the disease is increasingly being diagnosed in women who are in childbearing age. This is how congenital syphilis spreads. Every year the number of newborns diagnosed with congenital syphilis increases.

The connection between treponema and syphilis

Treponema is the name given to the causative agent of the disease syphilis, and this is a venereal disease. It enters the body through damage to the skin or microscopic injuries to the mucous membrane. Can also penetrate through the blood.

The main route of transmission of this bacterium is sexual contact, less often it can penetrate during surgical interventions, in rare cases there are household ways infection (through clothing, dishes, personal belongings).

There are also cases of transmission of bacteria from mother to child during birth canal, or during lactation.

In any case, infection occurs from sick people.

Syphilis always develops slowly, but it does so quite confidently. The incubation period can last up to one and a half months.

The development of the disease can occur in three stages:

  1. Primary. In this case, in the place where the bacteria penetrated, it will be detected chancre. The patient will develop malaise, low body temperature, aches in all bones, and inflammation of the lymph nodes.
  2. Secondary. At this stage, bacteria spread throughout the body, affecting internal organs and various systems. During the development of this disease, the patient experiences hepatitis, nephrosis, pancreatitis, and arthritis. The main difference of this stage is a rash on the skin and mucous membranes, as well as an increase in lymph nodes.
  3. Tertiary. During this stage, diffuse and infiltrative formations are formed. Vivid symptoms begin to appear, but still the hidden development of the disease predominates. This stage begins approximately five years after infection.

However, the most dangerous thing is primary syphilis, because it is during this period that the disease is transmitted most often. After all, at this time ulcers appear on the skin and mucous membranes. With a single sexual contact, infection occurs in thirty percent of cases, but if the intimacy is constant, then the probability of infection reaches one hundred percent.

Immunity to disease

There is no human immunity to syphilis, but some studies have confirmed that individuals they still have it. This manifests itself in the production of antibodies that prevent the infection from multiplying.

It should also be said that people who have undergone treatment do not have lifelong immunity; they can easily become infected again. But this can happen no less than one year after treatment, if there is direct contact with an infected person.

When this infection is present in the body, it develops non-sterile immunity. It can be found after incubation period and holds on until all the treponemas are eliminated. The main symptoms appear in the second stage, and syphilis becomes latent.

But it should be noted that immunity cannot protect a person from superinfection. This means that a new bacterium has entered the body, even though the treatment of the old one has not yet ended. At the same time they become obvious signs the period of development in which the disease is currently located.

Diagnosis of syphilis

To diagnose a disease, it is necessary to approach the issue comprehensively. The first thing the doctor does is examine the patient, clarify the signs and complaints that have appeared. This determines the formation of chancre, rashes or ulcers on the skin. In this way, the stage of development of the disease can be determined.

However, to confirm a preliminary diagnosis, a series of laboratory research, microbiology will help with this:

  • Bacterioscopic examination. To do this, take material from skin lesions, as well as cracks in the mucosa, and study them under a microscope, trying to examine the treponema.
  • Serological studies. They will help identify antibodies in the body that are produced to protect the body. If antibodies are detected, then the diagnosis is confirmed. However, on their basis it is possible not only to make a diagnosis, but to monitor the therapy performed.

The following serological tests are used for diagnosis:

  1. Wasserman.
  2. Immunofluorescence.
  3. Immobilization of Treponema pallidum.
  4. Passive hemagglutination.

All serological tests detect immune processes, occurring in the body of a syphilitic person. Effective treatment is also being developed based on them.

Treatment of the disease

The first medications for the treatment of syphilis were developed several hundred years ago, and they were based on mercury compounds. These components were then replaced with arsenic, iodine and bismuth. However, they destroyed healthy cells along with diseased cells. Later they were replaced with other components.

Today, therapy is selected depending on the stage of the disease and its development.

Primary syphilis is eliminated in two months if you follow all the doctor’s prescriptions. Antibiotics and tablets are used as therapy, which are taken in a hospital under the supervision of a doctor. In parallel with them, they take drugs that strengthen the immune system.

Secondary and tertiary syphilis is also treated with antibiotics, which are used orally and by injection. All therapy lasts at least three weeks.

Special treatment should be prescribed to the patient if, when diagnosing syphilis, he was diagnosed with another sexually transmitted disease. In this case, treatment will be carried out not only for treponema, but also for the accompanying illness.

If a person has a latent form, late or congenital, then bioquinol is administered intramuscularly. In parallel with treatment, partners are examined.

Therapy for pregnant women is also specific. Its onset should occur in the thirty-second week of pregnancy to reduce the possibility of infection of the fetus. These women are given penicillin injections.

Newborn infected children are treated with intravenous and intramuscular injections, using drugs such as miarsenol, sovarsen and others. Late stages of syphilis are treated with potassium iodide.

Recommendation. Every infected person must understand that there is no vaccine in the world that can get rid of the disease in a very short time. a short time. And today, many clinics offer to eliminate syphilis with two injections.

Don't believe them, it's a scam. If you administer antibiotics in this way, the body will simply get used to them and treatment will be useless.

Possible preventive measures


The first thing a person should stop is promiscuity with strangers. In some cases, even a condom will not protect. But if sexual contact without protection does occur, then it is urgent to treat the genitals with an antiseptic.

After one month, it is better to get tested and be examined by a doctor. You should not take independent treatment measures, because the disease can only hide, which will complicate therapy in the future.

If you live in the same house with an infected person, try to have less contact with him and not share the same things. After effective treatment has taken place, everything that the patient touched must be boiled.

Regular visits to the doctor, at least twice a year, can also be called a preventive measure.

Women during pregnancy should be registered with an obstetrician-gynecologist. If a woman has already had this disease, then she should be on special control at the doctor's.

In addition, proper personal hygiene should be observed. After each sexual intercourse, you should thoroughly wash your genitals with soap. This should be done after the pool and sauna.

After unprotected sexual intercourse, it is better to douche.

The content of the article

Treponema pallidum

Morphology and physiology

T. pallidum has a spiral shape, a protoplastic cylinder, which is twisted into 8-12 whorls. 3 periplasmic flagella extend from the ends of the cell. Treponema pallidum does not accept aniline dyes well, so it is stained with Romanovsky-Giemsa paint. However, the most effective method is to study it in a dark-field or phase-contrast microscope. Microaerophile. On artificial nutrient media not growing. T. pallidum is cultivated in rabbit testicular tissue, where it multiplies well and fully retains its properties, causing orchitis in the animal. Antigens. The antigenic structure of T. pallidum is complex. It is associated with outer membrane proteins, lipoproteins. The latter are cross-reacting antigens common to humans and large cattle. They are used as an antigen in the Wassermann reaction for the serodiagnosis of syphilis.

Pathogenicity and pathogenesis

The virulence factors of Treponema pallidum include outer membrane proteins and LPS, which exhibit their toxic properties after release from the cell. At the same time, apparently, the ability of treponema, when dividing, to form separate fragments that penetrate deep into tissues, can also be attributed to virulence factors. There are three stages in the pathogenesis of syphilis. In primary syphilis, formation is observed primary focus- hard chancre at the site of the entrance gate of infection, with subsequent penetration into regional lymph nodes, where the pathogen multiplies and accumulates. Primary syphilis lasts about 6 weeks. The second stage is characterized by generalization of the infection, accompanied by penetration and circulation of the pathogen in the blood, which is accompanied by skin rashes. The duration of secondary syphilis in untreated patients ranges from 1-2 years. In the third stage, infectious granulomas (gummas prone to decay) are detected, localized in internal organs and tissues. This period in untreated patients it continues for several years and ends with damage to the central nervous system (progressive paralysis) or spinal cord(tabes dorsalis).

Immunity

With syphilis, a humoral and cellular immune response occurs. The resulting antibodies do not have protective properties. The cellular immune response is associated with fixation of the pathogen and the formation of granulomas. However, elimination of treponemes from the body does not occur. At the same time, unfavorable environmental conditions induce the formation of cysts by treponema, which are localized in the wall of blood vessels. It is believed that this indicates the transition of the disease into remission. Along with cysts, treponemes form L-forms. With syphilis, HRT is formed, which can be detected by an allergic skin test with a killed suspension of treponemes. It is believed that the manifestation of the tertiary period of syphilis is associated with HRT.

Ecology and epidemiology

Syphilis is a typically anthroponotic infection. Only people who are reservoirs of infection in nature get sick. Transmission of infection occurs through sexual contact and, much less frequently, through underwear and other objects. In external environment(air) treponemes die quickly.

Syphilis and other treponematoses

Syphilis is a chronic infectious venereal disease of humans, has a cyclical progressive course, affects the skin, mucous membranes, internal organs and nervous system. The causative agent of the disease is Treponema pallidum.There are three main periods of development of syphilis, methods laboratory diagnostics which have their own characteristics. In the early period of the disease, the material for laboratory diagnosis is discharge from chancre, punctate from lymph nodes, scrapings from roseola, syphilides, etc. During the secondary and tertiary periods, blood serum and cerebrospinal fluid are examined. Due to the fact that isolating pure cultures of treponemes in conventional bacteriological laboratories is impossible, during the primary period of the disease (rarely later) a bacterioscopic diagnostic method is performed. Starting from the secondary period, they mainly use serological methods.

Bacterioscopic examination

Before taking pathological material, the syphilitic ulcer is first wiped with a cotton swab to remove sebaceous plaque and contaminating microflora. Then the bottom of the chancre is irritated with a scalpel or a metal spatula, or the ulcer is vigorously squeezed from the sides with fingers in a rubber glove to release wound exudate. With a small amount clear liquid it can be added to a drop of 0.85% sodium chloride solution. If it is impossible to take material from the bottom of the chancre (phimosis, scarring of the ulcer, etc.), a puncture of the regional lymph nodes is performed. A drop of liquid from the ulcer or punctate is applied to a thin glass slide (1.1-1.2 mm), covered with a coverslip and examined in dark field of view (more beautiful!), or using a phase-contrast or anoptral microscope. Pale treponema in a dark field of view has the appearance of a slightly shiny thin delicate spiral with steep, uniform, rounded primary curls. The movements are smooth, so it bends at an angle. But especially characteristic of it are pendulum-like oscillations. The causative agent of syphilis must be distinguished from Treponema refringens (which colonizes the external genitalia), which is thicker, rougher, with uneven large curls and has active erratic movements, but does not bend. Treponemas of fusosp-irochetous symbiosis are distinguished by a thin pattern, gentle curls and erratic movement. When diagnosing oral syphilis, pallid treponema should be differentiated from dental treponemes, especially T. dentium, as well as from T. buccalis. The first of them is generally difficult to distinguish from syphilitic. It is, however, shorter, has 4-8 sharp curls, and there is no pendulum-like movement. T. buccalis is thicker, has rough initial curls and erratic movement. If there is any doubt, it should be taken into account that all saprophytic treponemes, unlike the pale one, are well stained with aniline dyes. They do not penetrate the lymph nodes, so the study of punctates has a greater diagnostic value. Identification of typical treponemes in the punctate of lymph nodes unquestionably confirms the diagnosis of syphilis. So, dark-field examination of pressed drops is the best method for identifying the causative agent of syphilis. Its advantages are that the material is examined quickly, and the morphology of treponemes in the living state is most characteristic. Touch-up smears using the Burri method are no longer used. If it is impossible to conduct research in a dark field of view, you can use various methods staining. Treponema pallidum does not accept aniline dyes well. Of the many proposed staining methods, the best results are obtained when using Romanoveki-Giemsa staining. The prepared smears are fixed methyl alcohol or in Nikiforov's mixture. Clarity results are obtained when Romanovsky-Giemsa paint is poured into the preparation. To do this, fragments of matches are placed in a Petri dish, a glass slide is placed on them, smear down, and dye is poured until it wets the smear. The painting time is doubled. Under microscopy, pale treponemas have a soft pink color, while other types of treponemas are painted blue or blue-violet. You can also use the Morozov silvering method. Treponemas completely retain their morphological features and appear brown or almost black under a microscope. But silver-plated preparations are not stored for a long time. IN Lately Treponema staining methods are rarely used. If treatment of syphilis with chemotherapy is started, it is practically impossible to identify the pathogen in pathological materials even with the help of a dark field of view. Upon receipt negative analysis it needs to be repeated.

Serological diagnosis of syphilis

When conducting serological reactions The following research methods, unified in Ukraine, are now used: complement fixation reaction (CFR), immunofluorescence (RIF), treponemal immobilization (PIT), microprecipitation reaction (MPR) and enzyme-linked immunosorbent assay (ELISA). For many years, the main and most common reaction was considered the reaction complement fixation or Wassermann reaction (RW, RW). To perform it, use the blood serum of a patient with syphilis and cerebrospinal fluid in case of damage to the nervous system. The technique for staging the Wasserman reaction does not differ from the technique for performing RSC. The only difference is that for RO, not only specific treponemal, but nonspecific cardiolipin antigen is used.l Taking 5-10 ml of blood from the ulnar vein is carried out on an empty stomach or no earlier than 6 hours after a meal. You should not take blood from patients with elevated temperature after drinking alcohol and fatty foods, in pregnant women 10 days before childbirth and women in labor. The serum extracted from the blood is heated at a temperature of 56 ° C for 30 minutes to inactivate its own complement. RO must be placed with two antigens: specific and nonspecific. Ultrasound-specific treponemal antigen is prepared from cultures of Treponema pallidum (Reiter strain) grown in test tubes and exposed to ultrasound. It is produced in the form of freeze-dried powder. Nonspecific cardiolipin antigen is prepared by alcoholic extraction of lipids from bovine heart and purification from ballast mixtures, packaged in 2 ml ampoules. To introduce the antigen into the PO, it is titrated according to these instructions. Immediately before staging RV, titration of complement and hemolytic serum is carried out according to the same scheme as in RSC. The Wasserman reaction is performed using both qualitative and quantitative methods. A qualitative reaction is carried out in three test tubes with two antigens according to the usual scheme. The results of the reaction are assessed according to the 4 plus system: positive reaction - when there is a complete or significant delay in hemolysis (4 +, 3 +); weakly positive reaction - partial delay of hemolysis (2 +); questionable reaction - slight delay in hemolysis (1 +). In the event of complete hemolysis, the RO is considered negative. Each serum that gave a positive qualitative reaction must be examined using a quantitative method with its serial dilution from 1:10 to 1:640. The titer of the test serum (reagin titer) is considered to be its maximum dilution, at which causes a complete (4 +) or significant (3 +) delay in hemolysis. The quantitative method for establishing RO has important to evaluate the effectiveness of syphilis treatment. A rapid decrease in reagin titer indicates successful therapy. If the serum titer does not decrease for a long time, this indicates a lack of effectiveness of the drugs used and the need to change treatment tactics. In case of pilosis for seronegative primary syphilis or latent, tertiary or congenital, it is recommended to perform the Wasserman test in the cold according to the same scheme. If neurosyphilis is suspected, RO is performed with cerebrospinal fluid, which is inactivated since it does not contain its own complement. Undiluted liquor is introduced into the reaction in dilutions of 1:2 and 1:5. The Wasserman reaction becomes positive 2-3 weeks after the appearance of chancre. In secondary syphilis, it is positive in 100% of cases, in tertiary syphilis - in 75%. In addition, in the complex of serological reactions (CSR), a microprecipitation reaction with blood plasma or inactivated serum is used as a screening test.

Precipitation microreaction

Precipitation microreaction is performed with cardiolipin antigen. The principle of the reaction is that when an emulsion of cardiolipin antigen is added to the plasma or serum of a patient with syphilis, a precipitate (antigen-antibody complex) is formed, which precipitates in the form of flakes white. The following technique is used: three drops of plasma (or inactivated serum) are pipetted into the well of the plate, then one drop of standard cardiolipin antigen emulsion is added. The reaction components are mixed by shaking the plate for 5 minutes, after which three drops of 0.9% sodium chloride solution are added and left at room temperature for another 5 minutes. Mandatory control with weakly positive blood serum. The results are assessed with the naked eye over an artificial light source. When large flakes appear in the hole, the reaction is considered positive (4 +, 3 +), medium and small flakes are considered weakly positive (2 +, 1 +). At negative result no precipitate is formed. The microreaction of precipitation can also be carried out using a quantitative method to establish the titer of precipitating antibodies and evaluate the effectiveness of treatment on this basis. Higher MRP titers are obtained with plasma than with serum. Abroad, the analogue of MRP with patient serum is VDRL (Veneral disease research laboratoiy), and with plasma - RPR (Rapid plasma reagin).

Immunofluorescence reaction (RIF)

The group of specific reactions that are widely used for the serological diagnosis of syphilis includes indirect reaction immunofluorescence. As an antigen, it uses a suspension of pathogenic pallid Treponema strain Nichols from the parenchyma of rabbit testicles on the 7th day after infection. The reaction is carried out in two modifications: RIF-ABS and RIF-200. In the first option, an antibody sorbent (sonicate) is used - ultrasonic treponemal antigen for CSC. It is produced by the Kaunas enterprise for the production of bacterial preparations (Lithuania). With the RIF-200 option, the patient's serum is diluted 200 times in order to remove the influence of group antitreponemal antibodies. RIF-ABS is performed on thin, well-defatted glass slides. On the back of the glass, a glass cutter marks 10 circles with a diameter of 0.7 cm. Within the circle, an antigen is applied to the glass - a suspension of pale treponema - in such a quantity that there are 50-60 of them in the field of view. The smears are dried in air, fixed over a flame and in acetone for 10 minutes. Add 0.2 ml of sorbent (sonicate) and 0.5 ml of the patient’s blood serum into a separate test tube and mix well. The mixture is applied to the smear (antigen) so as to cover it evenly, and kept for 30 minutes in a humid chamber at 3–7 ° C (phase II reaction). After this, the smear is washed with phosphate buffer, dried and anti-shobulin fluorescent serum is applied to it for 30 minutes, placed in a humid chamber at 37 ° C (phase II). The preparation is washed again with phosphate buffer, dried and examined under a fluorescent microscope. positive reaction Treponema pallidums emit golden-green light; when negative, they do not glow. The technique for setting RIF-200 is the same as RIF-ABS, only the patient’s blood serum is first diluted 200 times with phosphate buffer. When performing an immunofluorescence reaction with the cerebrospinal fluid of a patient with syphilis of the nervous system, RIF-c and RIF-10 are used, i.e. The liquor is introduced into the reaction uninactivated and diluted, or diluted 1:10.

Treponema pallidum immobilization reaction (PIT)

The immobilization reaction of pallid treponema (PIT) is based on the phenomenon of loss of their mobility in the presence of immobilizing antitreponemal antibodies from the patient's serum and complement under conditions of anaerobiosis. A suspension of pale treponema from the testicular tissue of a rabbit infected with the Nichols laboratory strain is used as an antigen in the reaction. The suspension is diluted with a sterile 0.85% sodium chloride solution so that there are 10-15 spirochetes in the field of view. To carry out the reaction, 0.05 ml of the patient’s blood serum, 0.35 ml of antigen and 0.15 ml of complement are mixed in a sterile test tube. The experiment is accompanied by serum, antigen and complement controls. The test tubes are placed in an anerostat, anatomical conditions are created and kept in a thermostat for 18-20 hours at a temperature of 35 ° C. Then pressed drops are prepared from each test tube, at least 25 treponemes are counted and how many of them are mobile and how many are noted are noted. The percentage of specific immobilization of pale treponema is calculated using the formula: x = (A-B) / B * 100, where X is the percentage of immobilization, A is the number of mobile treponemes in the control tube, B is the number of mobile treponemes in the test tube. The reaction is considered positive when the percentage of immobilization is 50 or more, weakly positive - from 30 to 50, doubtful - from 20 to 30 and negative - from 0 to 20. In practical laboratories they use the simpler melanger method PIT for M.M. Ovchinnikov. Anaerobic experimental conditions are created by placing the reacting mixture (serum, antigen, complement) in a melangeur, both ends of which are closed with a rubber ring. The melanger technique allows you to do without complex equipment and apparatus for creating anaerobiosis, but gives results that are not obtained by the classical microanaerostat technique. Treponema immobilization reactions and immunofluorescence are considered the most specific in the serological diagnosis of syphilis. And yet, PIT, despite its specificity, is not recommended for use in widespread practice due to the laboriousness of its implementation.

Enzyme-linked immunosorbent assay (ELISA)

Linked immunosorbent assay(ELISA) is carried out with both cadriolipin antigen (nonspecific, selection reaction) and treponemal antigen (specific reaction), which confirms the diagnosis of syphilis. Principle indirect method ELISA consists of introducing the test serum into the antigen adsorbed on the solid phase in the wells of the plate. If it contains antibodies against treponemes, an antigen-antibody complex is formed (phase II). After washing off unbound nonspecific antibodies, antiglobulin serum conjugated with an enzyme (most often horseradish peroxidase) is added to the wells. The conjugate is firmly attached to the antigen-antibody complex (phase II). After washing the unbound conjugate, the OPD staining substrate - orthophenylenediamine (phase III) is added to the wells. The peroxidase reaction is stopped by adding sulfuric acid. For control, the same samples are used with positive and obviously negative sera. The results of the analysis are recorded using a photometer that determines the optical density in a dual-wave mode (492 nm and 620 nm). To perform an enzyme antibody reaction, in addition to a photometer, you need one- and eight-channel automatic pipettes with a polypropylene tip and corresponding sets of diagnostic test systems. The ELISA method finds wide application in the serological diagnosis of syphilis. It is equally effective for detecting the disease in the incubation period (1-2 weeks after infection), with clinical manifestations disease and its hidden forms. Very often, ELISA is used in screening examinations of the population, especially at blood transfusion stations. In laboratory practice, the immune adhesion reaction (IAR) and the indirect hemagglutination reaction (IRHA) are also sometimes used. The first of them is based on the fact that pathogenic testicular treponemes of the Nichols strain, when mixed with the patient’s serum in the presence of complement and human red blood cells, adhere to the surface of red blood cells. RNGA is widely used for diagnosing syphilis due to its methodological simplicity. It becomes positive within three weeks after infection. Positive result reactions remain for years after recovery. An analogue of this reaction abroad is TRHA (Treponema pallidum haemoagglutination).

Treponema pallidum can provoke the development of severe autoimmune diseases, which affect organs and various body systems. She has high degree resistance to adverse conditions and is able to penetrate the body in different ways.

For effective treatment of treponema pallidum, it is necessary to conduct laboratory tests that will help determine the severity and form of the disease. There are several methods for diagnosing and treating spirochetes, depending on the stage of the disease.

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    What is Treponema pallidum?

    Treponema pallidum is a bacterium that causes syphilis. Discovered in 1905 by German microbiologists Eric Hoffmann and Fritz Schaudin. A pathogenic microorganism can enter the body through damaged skin or injured areas of the mucous membrane.

    Treponema became known to microbiology only at the beginning of the 20th century, because it is difficult to see even with a microscope. The microorganism has special properties in the refraction of light. Because of this, it is called the pale spirochete. Outwardly, it resembles a corkscrew because it has a spiral shape and has a transparent structure.

    Morphology provides the following structure of Treponema pallidum:

    • nucleoid with DNA;
    • various components of semi-liquid form that control metabolism and protein synthesis;
    • cytoplasmic membrane;
    • the outer cell wall that protects the bacterium from the effects of antibodies and medicines;
    • organs of movement that help bacteria move throughout the body of an infected person.

    Treponema - classic shape syphilis. However, there are other subspecies of bacteria that are characteristic of certain geographical areas:

    • in Africa and Southeast Asia - yaws;
    • in Latin America - pint;
    • in the Middle East - bejel.

    Treponema pallidum is resistant to many antibiotics, including macrolides.

    Blood test for syphilis - Wasserman reaction

    Spirochete and external environment

    Treponema reproduces in a moist, warm environment at a temperature of 37 degrees by division. These favorable conditions are provided by the human body.

    But when infected with a bacterium the immune system begins to produce antibodies. Faced with the threat of destruction, the spirochete changes its form, in which it is better preserved. It can take one of the following states:

    1. 1. Cyst. To do this, the bacterium curls into a sphere and begins to produce protective mucus. The characteristics of the condition resemble a kind of dream, because during this period the pathogen does not manifest itself in any way. The spirochete enters a latent form. If the effect of antibodies decreases, the bacterium “comes to life” again.
    2. 2. L-shape. The bacterium acquires it when its protective wall becomes weak due to incomplete division, leading to an increase.

    If a pathogenic microorganism finds itself in a dry external environment, it dies. If it gets into water or wet clothes, it can survive for several more days. The lifespan of a bacterium under unfavorable conditions is also determined by temperature:

    • it dies when exposed to heat of more than 60 degrees for 15 minutes;
    • instant destruction of the structure occurs when the temperature reaches 100 degrees;
    • at zero temperature the bacterium can live for 2 days.

    Alkaline and acidic environments are detrimental to the spirochete. She dies when exposed to it laundry soap or weak solution acids.

    Routes of infection

    Treponema pallidum is distinguished by its vitality due to its elastic structure and ability to adapt to various unfavorable conditions. For its existence, it does not require oxygen, but only a moist, warm environment and blood plasma without fibrinogen.

    The spirochete enters the human body by screwing into the tissue like a drill. The risk of infection is greatest through sexual contact with infected partner.But there are other ways of penetration of a pathogenic microbe:

    • through hygiene products used by several people;
    • through blood;
    • from mother to fetus - transplacental method;
    • in case of violation of the conditions of the operation and dental procedures(careless disinfection of instruments).

    Treponema pallidum with low temperatures change their shape rather than die.

    Symptoms and manifestations of diseases

    Treponema pallidum causes syphilis in the infected person. The disease in the human body can develop and occur in 3 stages. Each stage of the disease has its own signs and symptoms:

    1. 1. Primary. At the site of penetration of the bacterium, a hard chancre is found - a painless, dense formation with a characteristic red tint. The patient experiences malaise, aches in all bones and joints of the body, a slight increase in temperature and inflammation of the lymph nodes.
    2. 2. Secondary. At this stage, treponema affects internal organs and various systems. The patient may develop pancreatitis, arthritis, nephrosis or hepatitis. A characteristic feature of the second stage of syphilis is a rash on the skin and mucous membrane, as well as an increase in the size of the lymph nodes.
    3. 3. Tertiary. Leaking last stage with the formation of accumulations of blood and lymph. Vivid symptoms begin to appear, but the latent course of the disease predominates.

    The most dangerous is primary syphilis, which poses a threat to others. At this stage, the infected person develops ulcerative formations on the skin and mucous membranes. Even a single sexual contact with a patient gives a 30% chance of infection, and if the intimacy is constant (more than 2-3 times), then infection occurs with a 100% chance.

    Methods for detecting the causative agent of syphilis

    Treatment and disposal of treponema pallidum depends on how timely syphilis was diagnosed in the patient. Today there are several effective methods testing:

    1. 1. Microscopic analysis of the blood or urine of an infected person on a dark background. This is one of the most effective ways research on spirochetes, because the bacteria will be in a familiar environment. To detect them and determine the stage of the disease, contrast staining is performed with a special solution. This method can identify other pathogenic microorganisms that differ from Treponema pallidum and do not affect the development of syphilis in the body.
    2. 2. Burri staining of bacteria. To detect a spirochete, the urine or blood of the person being examined is mixed with a special ink and allowed to dry. If gray spirals are observed under a microscope, then syphilis is diagnosed.
    3. 3. A smear from the mucous membrane of the genital organ. This method The study allows you to determine the presence/absence of Treponema pallidum and the treatment strategy. In order to natural microflora did not interfere with the analysis and to increase the accuracy of the result, the place from which the smear is taken is treated with special indifferent substances.
    4. 4. Test for the total amount of antibodies. After infection IgM antibodies are formed after a week, IgG - after a month. Their concentrations are healthy person practically equal to zero. Therefore, if they increase, then the initial form of syphilis is diagnosed. Analysis of the amount of total antibodies allows us to determine the stage of the disease and the tactics of drug therapy. Treatment is aimed at reducing IgM levels and achieving a consistently high IgG concentration. Studies have shown that this ratio allows you to develop strong immunity to treponema.

    Carrying out an antibody test can be complicated if the patient has diseases thyroid gland or oncological processes. The effectiveness of the study is also low in pregnant women.

    Treatment

    To get rid of syphilis, only specialists should prescribe drug therapy, because self-treatment will not destroy bacteria, but will only change their shape.

    If syphilis is detected promptly at the first stage, successful treatment is possible within 2 months. The main therapy is aimed at eliminating treponema antibacterial drugs. They are prescribed and given to the patient under the supervision of doctors in a hospital setting. At the same time, immunomodulatory treatment is carried out.

    For secondary or tertiary syphilis, antibiotics are used, which are prescribed orally or by injection. All treatment lasts at least 3 weeks.

    In some cases, syphilis occurs together with other sexually transmitted diseases. Then treatment of concomitant diseases is carried out. For latent syphilis, the patient is prescribed Bijoquinol intramuscularly. It is recommended to examine the partners of the infected person.

    If treponema pallidum was detected in pregnant women, then therapy begins from the 32nd week of gestation in order to reduce the possibility of infection of the fetus. For this purpose, Penicillin injections are prescribed. If at birth the baby still becomes infected from the mother, then he is given intravenous and intramuscular injections. The drugs Sovarsen and Miarsenol are used.

    It is necessary to try to minimize contact with infected people and not share things with them. Even after effective treatment, it is necessary to disinfect all objects touched by the infected person. It is worth remembering that Treponema pallidum is very tenacious.

Treponema pallidum can provoke the development of severe autoimmune diseases that affect organs and various body systems. It has a high degree of resistance to adverse conditions and is able to penetrate the body in different ways.

For effective treatment of treponema pallidum, it is necessary to conduct laboratory tests that will help determine the severity and form of the disease. There are several methods for diagnosing and treating spirochetes, depending on the stage of the disease.

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    What is Treponema pallidum?

    Treponema pallidum is a bacterium that causes syphilis. Discovered in 1905 by German microbiologists Eric Hoffmann and Fritz Schaudin. A pathogenic microorganism can enter the body through damaged skin or injured areas of the mucous membrane.

    Treponema became known to microbiology only at the beginning of the 20th century, because it is difficult to see even with a microscope. The microorganism has special properties in the refraction of light. Because of this, it is called the pale spirochete. Outwardly, it resembles a corkscrew because it has a spiral shape and has a transparent structure.

    Morphology provides the following structure of Treponema pallidum:

    • nucleoid with DNA;
    • various components of semi-liquid form that control metabolism and protein synthesis;
    • cytoplasmic membrane;
    • the outer cell wall that protects the bacterium from the effects of antibodies and drugs;
    • organs of movement that help bacteria move throughout the body of an infected person.

    Treponema is the classic form of syphilis. However, there are other subspecies of bacteria that are characteristic of certain geographical areas:

    • in Africa and Southeast Asia - yaws;
    • in Latin America - pint;
    • in the Middle East - bejel.

    Treponema pallidum is resistant to many antibiotics, including macrolides.

    Blood test for syphilis - Wasserman reaction

    Spirochete and external environment

    Treponema reproduces in a moist, warm environment at a temperature of 37 degrees by division. These favorable conditions are provided by the human body.

    But when infected with a bacterium, the immune system begins to produce antibodies. Faced with the threat of destruction, the spirochete changes its form, in which it is better preserved. It can take one of the following states:

    1. 1. Cyst. To do this, the bacterium curls into a sphere and begins to produce protective mucus. The characteristics of the condition resemble a kind of dream, because during this period the pathogen does not manifest itself in any way. The spirochete enters a latent form. If the effect of antibodies decreases, the bacterium “comes to life” again.
    2. 2. L-shape. The bacterium acquires it when its protective wall becomes weak due to incomplete division, leading to an increase.

    If a pathogenic microorganism finds itself in a dry external environment, it dies. If it gets into water or wet clothes, it can survive for several more days. The lifespan of a bacterium under unfavorable conditions is also determined by temperature:

    • it dies when exposed to heat of more than 60 degrees for 15 minutes;
    • instant destruction of the structure occurs when the temperature reaches 100 degrees;
    • at zero temperature the bacterium can live for 2 days.

    Alkaline and acidic environments are detrimental to the spirochete. It dies when exposed to laundry soap or a weak acid solution.

    Routes of infection

    Treponema pallidum is distinguished by its vitality due to its elastic structure and ability to adapt to various unfavorable conditions. For its existence, it does not require oxygen, but only a moist, warm environment and blood plasma without fibrinogen.

    The spirochete enters the human body by screwing into the tissue like a drill. The risk of infection is greatest through sexual contact with an infected partner. But there are other ways of penetration of a pathogenic microbe:

    • through hygiene products used by several people;
    • through blood;
    • from mother to fetus - transplacental method;
    • in case of violation of the conditions of the operation and dental procedures (careless disinfection of instruments).

    Treponema pallidum changes its shape at low temperatures rather than dying.

    Symptoms and manifestations of diseases

    Treponema pallidum causes syphilis in the infected person. The disease in the human body can develop and occur in 3 stages. Each stage of the disease has its own signs and symptoms:

    1. 1. Primary. At the site of penetration of the bacterium, a hard chancre is found - a painless, dense formation with a characteristic red tint. The patient experiences malaise, aches in all bones and joints of the body, a slight increase in temperature and inflammation of the lymph nodes.
    2. 2. Secondary. At this stage, treponema affects internal organs and various systems. The patient may develop pancreatitis, arthritis, nephrosis or hepatitis. A characteristic feature of the second stage of syphilis is a rash on the skin and mucous membrane, as well as an increase in the size of the lymph nodes.
    3. 3. Tertiary. The last stage occurs with the formation of accumulations of blood and lymph. Vivid symptoms begin to appear, but the latent course of the disease predominates.

    The most dangerous is primary syphilis, which poses a threat to others. At this stage, the infected person develops ulcerative formations on the skin and mucous membranes. Even a single sexual contact with a patient gives a 30% chance of infection, and if the intimacy is constant (more than 2-3 times), then infection occurs with a 100% chance.

    Methods for detecting the causative agent of syphilis

    Treatment and disposal of treponema pallidum depends on how timely syphilis was diagnosed in the patient. Today there are several effective testing methods:

    1. 1. Microscopic analysis of the blood or urine of an infected person on a dark background. This is one of the most effective ways to study spirochetes, because the bacteria will be in a familiar environment. To detect them and determine the stage of the disease, contrast staining is performed with a special solution. This method can identify other pathogenic microorganisms that differ from Treponema pallidum and do not affect the development of syphilis in the body.
    2. 2. Burri staining of bacteria. To detect a spirochete, the urine or blood of the person being examined is mixed with a special ink and allowed to dry. If gray spirals are observed under a microscope, then syphilis is diagnosed.
    3. 3. A smear from the mucous membrane of the genital organ. This research method allows you to determine the presence/absence of Treponema pallidum and the treatment strategy. To ensure that the natural microflora does not interfere with the analysis and to increase the accuracy of the result, the place from which the smear is taken is treated with special indifferent substances.
    4. 4. Test for the total amount of antibodies. After infection, IgM antibodies are formed within a week, IgG antibodies after a month. Their concentrations in a healthy person are practically zero. Therefore, if they increase, then the initial form of syphilis is diagnosed. Analysis of the amount of total antibodies allows us to determine the stage of the disease and the tactics of drug therapy. Treatment is aimed at reducing IgM levels and achieving a consistently high IgG concentration. Studies have shown that this ratio allows you to develop strong immunity to treponema.

    Carrying out an antibody test can be complicated if the patient has thyroid disease or cancer. The effectiveness of the study is also low in pregnant women.

    Treatment

    To get rid of syphilis, only specialists should prescribe drug therapy, since self-treatment will not destroy the bacteria, but will only change their shape.

    If syphilis is detected promptly at the first stage, successful treatment is possible within 2 months. The main therapy is aimed at eliminating treponema with antibacterial drugs. They are prescribed and given to the patient under the supervision of doctors in a hospital setting. At the same time, immunomodulatory treatment is carried out.

    For secondary or tertiary syphilis, antibiotics are used, which are prescribed orally or by injection. All treatment lasts at least 3 weeks.

    In some cases, syphilis occurs together with other sexually transmitted diseases. Then treatment of concomitant diseases is carried out. For latent syphilis, the patient is prescribed Bijoquinol intramuscularly. It is recommended to examine the partners of the infected person.

    If treponema pallidum was detected in pregnant women, then therapy begins from the 32nd week of gestation in order to reduce the possibility of infection of the fetus. For this purpose, Penicillin injections are prescribed. If at birth the baby still becomes infected from the mother, then he is given intravenous and intramuscular injections. The drugs Sovarsen and Miarsenol are used.

    It is necessary to try to minimize contact with infected people and not share things with them. Even after effective treatment, it is necessary to disinfect all objects touched by the infected person. It is worth remembering that Treponema pallidum is very tenacious.

A spirochete (not everyone knows what it is) is a bacterium, a single-celled organism that is pathogenic for humans, that is, capable of causing infectious diseases. The most dangerous type of microbe is Treponema pallidum, which is the causative agent venereal disease- syphilis.

Pallidium) was discovered in 1905 by German scientists and microbiologists E. Hoffmann and F. Schaudin.

Features of the spirochete

That is, it is not stained according to Gram with aniline dyes (methyl violet), but only discolored. This is due to the fact that the composition of the bacterial cell wall (envelope) is stronger than that of gram-positive organisms. This makes the cell resistant to the action of antibacterial substances, be it medications or lysozyme contained in saliva and nasal secretions, an enzyme that can destroy viruses and bacteria.

Spirochete pallidum differs from other bacteria in its length and unusual structure. These cells are twisted in a spiral. The length of the spirochete varies from 8 to 20 microns, which makes it unlike other bacteria. It is quite mobile, contracting, it moves in a helical manner, bending like a snake. On average, a spirochete has about 10 whorls, appearance similar to a corkscrew for uncorking wine.

The cell has fibrils (flagella-like elements) that allow it to move well without touching slippery surfaces and to swim. The fibrils rotate, contract, and provide movement.

The spirochete cell is covered outer membrane, under which there is a cytoplasmic membrane surrounding the protoplasmic cylinder and cytoplasm. The cylinder is covered with flagella, which, being inside the cell, provide its ability to bend and wriggle.

Spirochete pallidum is an anaerobe. That is, it absolutely does not need oxygen to live, which makes it a habitat, for example, the human body. Its sources of energy for life are carbohydrates and amino acids.

But she has some peculiarity. The fact is that the spirochete can reproduce only at a temperature of 37°C by dividing once every 30 hours.

The disease is transmitted mainly through sexual contact, but you can also get sick through close household contact (towels, bath accessories, razors, toothbrushes), or through a blood transfusion from a person infected with syphilis. Also, the fetus becomes infected from a sick mother.

The possibility of transmission of the pathogen through urine and saliva has not been proven, although if there are ulcers in the mouth, spirochetes could theoretically live there. But bacteria live well in the maternal breast milk, sperm.

Development of the disease and its periods

Within 3 weeks after the pale spirochete, the causative agent of syphilis, enters the body, the incubation period lasts, which is asymptomatic. This is followed by the primary period, then the secondary and tertiary.

The bacterium is capable of releasing endotoxin, poisoning the blood and internal organs of the patient.

After the incubation period, a painless ulcer forms at the site of entry of the pathogen, after which the primary period begins, which lasts about 5-6 weeks. Lymph nodes become inflamed.

In the secondary period, symptoms include numerous rashes of various forms on the palms and soles, affecting nervous system patient, internal organs (kidneys, liver, heart).

The immune system tries to restrain the proliferation of the spirochete by providing a protective reaction in the form of antibody production, as a result of which the bacterium slows down its reproduction. The disease subsides for a short time. But the body is not able to overcome all foci of inflammation on its own, so after some time the disease begins to progress again. This can continue for years, which indicates chronic course diseases.

The tertiary stage is characterized by the destruction of tissues and organs, the formation of syphilitic scars, the destruction of cartilaginous and bone tissue. If the patient does not receive treatment, the infection leads to the destruction of body systems (damage to blood vessels, heart muscle, valves).

A woman who is not prescribed treatment before 16 weeks of pregnancy risks losing the fetus, losing the child during childbirth, or becoming the mother of a sick baby congenital syphilis. If children survive after birth, then in the first weeks of their life symptoms of primary and secondary syphilis appear: rash, deformation of the nasal bones, deafness, and protruding forehead.

Adequate treatment

Spirochete pallidum gradually acquired resistance to many types of antibiotics. Ordinary penicillins and macrolides do not affect it. The bacterium can invade the cells lining the inner lining of blood vessels, making it inaccessible to drugs.

Benzathine benzylpenicillin is used for treatment, which can be replaced with erythromycin or tetracycline.

Spirochete pallidum is initially diagnosed or successfully eliminated with adequate treatment. The disease is considered cured in case of seronegation and absence of symptoms for a year.

Nowadays it is rare and develops in the absence of treatment. It is difficult to treat, the resulting disorders are irreversible, leading to disability, even death.

Prevention of infection

Now that the spirochete has become clear - what it is, what danger it poses, it is worth thinking about measures to prevent infection.

First of all, you should lead a discriminating sex life, using protective methods of contraception - condoms.

The use of shared syringes and containers for drug preparation by injection drug addicts - global problem which needs to be addressed at the state level. This can lead not only to the spread of syphilis, but also other the most dangerous diseases(HIV, hepatitis C).

Pregnant women must undergo testing when registering to rule out a disease that is dangerous to the fetus.

Compliance with moral principles and basic rules of hygiene are the main actions that prevent pathogens of sexually transmitted diseases from entering the body. A culture of correct and adequate behavior must be developed from childhood and be an integral part of life in society.
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