Toluidine red unheated serum test (TRUST) of CSF, a nontreponemal test for neurosyphilis

• 作 者: Weiming Gu Yang Yang Lei Wu Zhizhi Zhang Shen Yang Weizhong Hu Lai-King Ng
• 机 构: Shanghai Skin Disease Hospital,Shanghai,China Nat
• 出 处: 第三届中国临床微生物学大会暨微生物学与免疫学论坛
• 发表日期: 2012年8期

　　Background.In the past decade, China has observed an annual increasing rate of syphilis of 14% and cases of neurosyphilis increased accordingly.The reagent of the Venereal Disease Research Laboratory (VDRL)is not approved by the Chinese State Food and Drug Administration (SFDA).The lack of a standardized screening test method is a major handicap for neurosyphilis management.We propose a simple commercially available TRUST reagent as a screening test for neurosyphilis in China.Methods: 824 patients with suspected neurosyphilis were collected for this study.The cerebrospinal fluid (CSF)samples were analyzed by the proposed TRUST test method, the reference VDRL test method.To define the test sensitivity, sequentially diluted WHO Syphilis control serum was analyzed.The samples with discordant results between TRUST and VDRL methods were examined and discussed based on clinical diagnosis.Results: There were 182 positive and 642 negative results obtained using the TRUST test.All TRUST positive cases were positive in the VDRL test; 22 samples of TRUST negative cases tested positive by the VDRL method.The test results indicated the TRUST test method is about one titer less sensitive than the VDRL test method.Conclusions: Our study indicated that the TRUST method has very good test specificity, matching that of the WHO mandatory VDRL method in screening of neurosyphilis.The TRUST method is about 10.8% less sensitive than the VDRL method.The difference in test sensitivity was proved by one titer difference in both quantitative WHO syphilis antibody control and positive clinical sample studies.