Origin of modern syphilis and emergence of a pandemic Treponema pallidum cluster

Authors

ARORA Natasha SCHUENEMANN Verena J. JÄGER Günter PELTZER Alexander SEITZ Alexander HERBIG Alexander STROUHAL Michal GRILLOVÁ Linda SÁNCHEZ-BUSÓ Leonor KÜHNERT Denise BOS Kirsten I. DAVIS Leyla Rivero MIKALOVÁ Lenka BRUISTEN Sylvia KOMERICKI Peter FRENCH Patrik GRANT Paul R. PANDO María A. VAULET Lucía Gallo FERMEPIN Marcelo Rodríguez MARTINEZ Antonio LARA Arturo Centurion GIACANI Lorenzo NORRIS Steven J. ŠMAJS David BOSSHARD Philipp GONZÁLEZ-CANDELAS Fernando NIESELT Kay KRAUSE Johannes BAGHERI Homayoun C.

Year of publication 2017
Type Article in Periodical
Magazine / Source Nature Microbiology
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.1038/nmicrobiol.2016.245
Field Microbiology, virology
Keywords syphilis; Treponema pallidum
Description The abrupt onslaught of the syphilis pandemic that started in the late fifteenth century established this devastating infectious disease as one of the most feared in human history 1. Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection, which is caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases in 2008 (ref. 2). Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin 3. Little is known about the genetic patterns in current infections or the evolutionary origins of the disease due to the low quantities of treponemal DNA in clinical samples and difficulties in cultivating the pathogen 4. Here, we used DNA capture and whole-genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combined with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share a common ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and are members of a globally dominant cluster, named here as SS14-omega. The cluster diversified from a common ancestor in the mid-twentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic divergence and global presence point to the emergence of a pandemic strain cluster.

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