Fig 1.
Screening and enrollment flowchart.
Table 1.
Sociodemographic and sexual behavior characteristics among enrolled participants.
Fig 2.
Clinical features of early syphilis in our patient cohort.
(A-C) Chancres. (D and E) Patchy “moth eaten” alopecia of secondary syphilis. (F) Condyloma lata. (G) Mucous patches of secondary syphilis. (H-I) Diffuse maculopapular exanthems of secondary syphilis. (J-K) Classic palmar and plantar rashes of secondary syphilis.
Table 2.
Clinical characteristics among enrolled participants with early syphilis.
Table 3.
Median TPA polA copies and % positive by syphilis stage and sample type.
Table 4.
Correlation between darkfield microscopy (DFM) results and TPA polA PCR % positive in matching genital ulcer swabs.
Table 5.
Rabbit infectivity polA positivity compared to TPA DNA extracted from ES patient’s skin and blood.
Fig 3.
Recombination-masked TPA whole-genome phylogeny derived from 33 unique specimens obtained from 32 individuals enrolled in Cali, 10 recently published genomes from Peru and Argentina, and three reference TPA genomes (MexicoA, SS14, Nichols) and one Treponema pallidum subsp. pertenue reference genome (SamoaD).
The presence of TPA 23S rRNA mutations associated with macrolide resistance (A2058G and A2059G) are shown. TPA population groups previously assigned using Bayesian modeling in a recent analysis by Seña et al. [25] are included to facilitate comparison to global TPA strains.
Fig 4.
(A) Variability in the BamA β-barrel occurs predominantly in extracellular loops (ECL) 3, 5, 7, and 8. (B) Location in the BamA β-barrel of ECL variants shown in Fig 4, panel A. Colors indicate the frequency of each substitution. The blowup shows the two amino acid substitutions [glutamine to arginine (Q605R) and a lysine to glutamic acid (K612E)] in ECL4 of the BamA proteoform in TPA strain infecting early syphilis patient shown in panels C-E. POTRA domain not displayed to improve visual clarity of the BamA β-barrel domain. (C-E) Destructive penile genital ulcer, macular rash on palms and wrists and roseola like exanthem over the torso in the patient with ECL 4 mutations.