Fang Juliet, Partridge Elizabeth, Bautista Geoanna M, Sankaran Deepika
Center for Health and Environment, University of California Davis, Davis, USA.
Department of Pediatrics, University of California Davis, Davis, USA.
Cureus. 2022 Dec 27;14(12):e33009. doi: 10.7759/cureus.33009. eCollection 2022 Dec.
Congenital syphilis (CS) has dramatically increased in the United States (US) in the past decade despite the widespread availability of penicillin. Once considered an infection on the verge of elimination, CS has re-emerged as a familiar neonatal pathogen in US hospitals. This rise in cases has prompted the evaluation of potential causes and updates in prevention and management guidelines. Following a structured narrative approach, we reviewed CS data reports, peer-reviewed research articles, and updated management guidelines from state health departments over the past two decades. Our main search criteria centered on the treatment and prevention of CS, with a focus on prenatal health disparities. We identified geographical regions reporting disproportionate rates of CS, examined state laws regarding maternal syphilis testing, and evaluated potential reasons for the recent rise in cases. This article examines the current epidemiology, screening, and management recommendations for perinatal and CS in the US. It also reviews pathogenesis and clinical features in perinatal and pediatric populations. Finally, it highlights the likely contributing factors to increased CS rates and identifies areas for future research. Dramatically rising CS cases in certain regions and racial groups reflect gaps in the prevention, timely diagnosis, treatment, and management of perinatal syphilis and CS. Healthcare providers attending to mothers and children should recognize the re-emergence of this pathogen and be familiar with new screening and management guidelines. Increased federal funding for targeted interventions and research that address vulnerable populations is critical to curbing the re-emergence of this infection.
尽管青霉素已广泛可得，但在过去十年中，美国的先天性梅毒（CS）病例仍急剧增加。CS曾被认为是一种几近消除的感染，如今却再度成为美国医院中常见的新生儿病原体。病例的增加促使人们对潜在病因进行评估，并更新预防和管理指南。我们采用结构化叙述方法，回顾了过去二十年中CS数据报告、同行评议的研究文章以及各州卫生部门更新的管理指南。我们的主要搜索标准集中在CS的治疗和预防上，重点关注产前健康差异。我们确定了报告CS发病率不成比例的地理区域，研究了各州关于孕产妇梅毒检测的法律，并评估了近期病例增加的潜在原因。本文探讨了美国围产期和先天性梅毒的当前流行病学、筛查及管理建议。还回顾了围产期和儿科人群的发病机制及临床特征。最后，强调了导致先天性梅毒发病率上升的可能因素，并确定了未来研究的领域。某些地区和种族群体中先天性梅毒病例的急剧增加反映了围产期梅毒和先天性梅毒在预防、及时诊断、治疗及管理方面存在的差距。照料母婴的医疗服务提供者应认识到这种病原体的再度出现，并熟悉新的筛查和管理指南。增加联邦资金用于针对弱势群体的干预措施和研究，对于遏制这种感染的再度出现至关重要。
