Bir Üniversite Hastanesinde Beş Yıllık Rapid Plasma Reagin (RPR) ve Treponema Pallidum Hemaglutinasyon Assay (TPHA) Sonuçlarının Değerlendirilmesi

Year 2024, , 198 - 203, 22.05.2024

Demet Gür Vural , Elif Ateş , Yeliz Tanrıverdi Çaycı , Kemal Bilgin , Asuman Bırıncı

https://doi.org/10.33631/sabd.1396198

Abstract

Amaç: Sifilis, Treponema pallidum’ un neden olduğu sıklıkla cinsel yolla bulaşan multisistemik bir hastalıktır. Hastalığın tanısında ve tedavi takibinde sıklıkla serolojik testler kullanılır. Serolojik tanıda geleneksel algoritmada nontreponemal testlerle yapılan taramanın ardından sonucun treponemal testlerle doğrulanması esastır. Bu çalışmada Ondokuz Mayıs Üniversitesi Hastanesi’nde beş yıllık Rapid Plasma Reagin (RPR) ve Treponema Pallidum Hemaglutinasyon Assay (TPHA) test sonuçlarının retrospektif olarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Ocak 2018- Aralık 2022 tarihleri arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Seroloji Laboratuvarı’na sifilis tanı ve takibi amacıyla gönderilen toplam 6516 hastaya ait 10719 test sonucu retrospektif olarak değerlendirilmiştir. Serumlarda RPR (Monlabtest, İngiltere) ve TPHA (Plasmatec, İngiltere) testleri, üretici firmaların önerileri doğrultusunda çalışılmıştır.
Bulgular: Klinik sifilis şüpheli 6516 hastanın 2622 (%40,24)’sinden sadece TPHA, 696 (%10,68)’sından sadece RPR, 3198 (%49,08)’inden ise hem TPHA hem RPR istenmiştir. Sadece TPHA istenen hastalardan dokuzunda (%0,34), sadece RPR istenen hastaların ise altısında (%0,86) pozitiflik saptanmıştır. Hem TPHA hem RPR istenen hastaların sekizinde (%0,25) RPR pozitif-TPHA negatif, 71 (%2,22)’inde RPR pozitif-TPHA pozitif, 3038 (%95)’inde ise RPR negatif-TPHA negatif, 81 (%2,53)’inde RPR negatif-TPHA pozitif bulunmuştur. Yaş gruplarına göre RPR ve TPHA istemi en sık 19-30 yaş grubunda olup 3003 adet test istemi yapılmasına karşın, RPR ve TPHA pozitifliği 31-40 yaş grubunda (%4,32) diğer yaş gruplarına göre daha fazla saptanmıştır. Cinsiyetler arasında, yaş gruplarına göre yapılan istatistiksel analiz sonucu anlamlı fark saptanmıştır (p<0,001).
Sonuç: Yaptığımız çalışma doğrultusunda sifilis enfeksiyonunda özellikle genç-orta yaş grubundaki anlamlı yükseklik, cinsel yolla bulaşan hastalıklar için özellikle gençlere yönelik farkındalığın artırılmasının gerektiğini düşündürmektedir.

Keywords

Serolojik test;, sifilis, Treponema pallidum

Evaluation of Five-Year Rapid Plasma Reagin (RPR) and Treponema Pallidum Hemagglutination Assay (TPHA) Results at a University Hospital

Abstract

Aim: Syphilis is a multisystem disease, often sexually transmitted, caused by Treponema pallidum. Serological tests are often used in the diagnosis of the disease and treatment follow-up. In serological diagnosis, it is essential to confirm the result with treponemal tests after screening with nontreponemal tests in the traditional algorithm. This study aimed to retrospectively evaluate the five-year Rapid Plasma Reagin (RPR) and Treponema Pallidum Hemagglutination Assay (TPHA) test results at xxx University Hospital.
Material and Methods: 10719 test results of a total of 6516 patients sent to xxx Serology Laboratory for syphilis diagnosis and follow-up between January 2018 and December 2022 were evaluated retrospectively. RPR (Monlabtest, England) and TPHA (Plasmatec, England) tests on serums were carried out in accordance with the recommendations of the manufacturers.
Results: Of the 6516 patients with clinical suspicion of syphilis, only TPHA was requested from 2622 (40.24%), only RPR was requested from 696 (10.68%), and both TPHA and RPR were requested from 3198 (49.08%). Positivity was detected in nine (0.34%) of the patients for whom TPHA was requested and in six (0.86%) of the patients for whom only RPR was requested. Of the patients for whom both TPHA and RPR were requested eight (0.25%) were found RPR positive-TPHA negative, 71 (2.22%) were found RPR positive-TPHA positive, and 3038 (95.0%) were found RPR negative- TPHA negative, 81 (2.53%) were found RPR negative- TPHA positive. According to age groups, RPR and TPHA requests were most frequently in the 19-30 age group and although 3003 test requests were made, RPR and TPHA positivity was detected more in the 31-40 age group (4.32%) than other age groups. A significant difference was found between gendersas a result of the statistical analysis made according to age groups (p<0.001).
Conclusion: In line with our study, the significant increase in syphilis infection, especially in the young and middle age group, suggests that awareness of sexually transmitted diseases should be increased, especially among young people.

Keywords

Serological test;, syphilis;, Treponema pallidum

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