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J Infect Dis. 2018 Oct 16. doi: 10.1093/infdis/jiy604. [Epub ahead of print]

Multilocus sequence typing of Treponema pallidum subsp. pallidum in Cuba from 2012 to 2017.

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Department of Biology, Masaryk University, Brno, Czech Republic.
Department of Mycology-Bacteriology, Institute of Tropical Medicine ¨Pedro Kourí¨, Havana, Cuba.
Department of Bacteriology and Serology, ADMED Microbiology, La Chaux-de-Fonds, Switzerland.



The increased prevalence of syphilis in Cuba prompted us to map the circulating Treponema pallidum subsp. pallidum (TPA) allelic profiles in this geographic region.


Samples were collected from 2012-2017, from 83 male patients with ulcers or skin lesions, and were examined using MLST. Additionally, we analyzed the 23S rDNA and 16S rDNA regions for the presence of possible mutations leading to macrolide and tetracycline resistance.


Among 94% of fully typed strains, we found seven different allelic profiles, from which four had not been previously described. More than 87% of patients were infected with the TPA SS14-like group and only 8.2% with the TPA Nichols-like group. As in other countries, the 1.3.1 allelic profile (i.e., the SS14-like profile) was the most common profile. In addition, one of the newly described allelic profiles represents TPA strains that arose by recombination events between members of different TPA subgroups. More than 90% of the patients were infected with treponemes harboring the A2058G mutation. However, we did not find any potential tetracycline resistant TPA mutations.


Our study invites the Public Health authorities in Cuba to use tetracycline antibiotics for treatment of syphilis, in penicillin allergic patients, instead of macrolides.


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