Syphilis Screening in Pre-procedural Patients at a Tertiary Cardiac Care Centre in India

Abstract

Introduction: Routine pre-procedural screening for bloodborne infections is a common practice despite lack of standard guidelines. The incidence of syphilis has shown an upward trend in recent years. Aim: To determine the prevalence and clinical significance of routine screening for syphilis in pre-procedural patients in tertiary care cardiac centre. Materials and Methods: This prospective study included consecutive patients undergoing surgical and percutaneous invasive procedures at a tertiary cardiac care centre from March 2017 to August 2017. All patients were screened for syphilis using ELISA for detection of Treponema pallidum IgG antibodies. All patients who were positive for ELISA were confirmed with Treponema pallidum Haemagglutination Assay (TPHA). Results: A total of 13,865 patients were screened and the seropositive rate was 0.45%. Most patients were in the age group of 51-70 years (71.4%) and were male (76.2%). Three patients had manifestation of cardiovascular syphilis and two patients were positive for HIV also. There was no reported incidence of needlestick injury or mucus membrane exposure to blood products during the procedures. Conclusion: Routine pre-procedural screening for syphilis is not beneficial due to low seroprevalence. Screening must be limited to at risk individuals.

Keywords

• enzyme linked immunosorbent assay
• treponema pallidum hemagglutination assay
• venereal disease research laboratory