Syphillis - serology

Alternative Names/Synonyms	Serologic detection of Treponema pallidum subspecies pallidum (syphilis)
Laboratory	Microbiology
Sub-section	Serology
Specimen Type	○ Serum ○ CSF

Other Information

○ Syphilis serology is indicated for routine diagnosis of suspected infections and treatment monitoring. For initial syphilis testing on newborns, it is recommended that maternal serum also be submitted.
○ Testing for syphilis serology on serum is indicated for diagnosis of suspected syphilis infections, and treatment monitoring of syphilis cases. Screening is recommended for individuals presenting with risk factors, and pregnant people in their first trimester or at the first prenatal visit. Repeat screening in pregnancy should be considered for individuals with ongoing or high risk.
○ Testing for syphilis serology on CSF samples is indicated for diagnosis and monitoring of treatment of neurosyphilis. It is recommended to be performed on all patients with HIV and syphilis and on infants with suspected congenital syphilis.

Specimen Requirements (Volume (mL))

Serum: 1.5 mL
CSF: 1.0 mL

Specimen Requirements (Tube Type)

Serum: Serum Separator Tube (clotted blood)
OR
CSF: Sterile container (MUST ALSO submit a blood sample along with the CSF for Clinical Syphilis Serology)

Collection Requirements

Serum:
○ Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood
CSF:
○ Decontaminate skin, perform lumbar puncture to collect at least 1 mL of CSF in sterile container

Sample Stability

Refer to section Sample Processing / Delivery

Referral Laboratory

In-house PHL Confirmation (non-Donor)

Routine Turnaround Time

○ Up to 3 days for non reactive specimens; up to 6 days for reactive specimens
○ CSF: up to 5 days

Laboratory Contact Information

416-586-4800 extension 4432

Approval Required

Sample Processing / Delivery

○ Label specimen container. Place specimens in biohazard bag and seal.

○ Specimens should be transported to the UHN/SH Microbiology Laboratory at room temperature (20-25˚C) ASAP after collection. If a delay of more than 24h is expected, store specimen at refrigeration temperature (2-8˚C).

○ UHN/SH Microbiology Laboratory will perform the first treponemal test in house and will refer specimen to the Public Health Ontario Laboratory for testing if positive.