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

G¨¹NTER JÄGER; ALEXANDER HERBIG; LEONOR S¨¢NCHEZ-BUS¨®; NATASHA ARORA; LEYLA RIVERO DAVIS; ALEXANDER PELTZER; PETER KOMERICKI; MAR¨ªA A. PANDO; MICHAL STROUHAL; ANTONIO MARTINEZ; DENISE K¨¹HNERT; STEVEN J. NORRIS; LENKA MIKALOV¨¢; FERNANDO GONZ¨¢LEZ-CANDELAS; PATRICK FRENCH; VERENA J. SCHUENEMANN; HOMAYOUN C. BAGHERI; LUC¨ªA GALLO VAULET; ALEXANDER SEITZ; ARTURO CENTURION LARA; LINDA GRILLOV¨¢; DAVID ŠMAJS; KIRSTEN I. BOS; KAY NIESELT; SYLVIA BRUISTEN; PAUL R. GRANT; MARCELO RODR¨ªGUEZ FERMEPIN; LORENZO GIACANI; PHILIPP P. BOSSHARD; JOHANNES KRAUSE

Nature Microbiology

Springer Nature

Año: 2016 vol. 2 p. 16245 - 16245

The abrupt onslaught of the syphilis pandemic starting in the late fifteenth century established this devastating infectiousdisease as one of the most feared in human history. Surprisingly, despite the availability of effective antibiotic treatment since the mid-twentieth century, this bacterial infection caused by Treponema pallidum subsp. pallidum (TPA), has been re-emerging globally in the last few decades with an estimated 10.6 million cases2 in 2008. Although resistance to penicillin has not yet been identified, an increasing number of strains fail to respond to the second-line antibiotic azithromycin. 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 pathogen4. Here, we used DNA capture and whole genome sequencing to successfully interrogate genome-wide variation from syphilis patient specimens, combining it with laboratory samples of TPA and two other subspecies. Phylogenetic comparisons based on the sequenced genomes indicate that the TPA strains examined share acommon ancestor after the fifteenth century, within the early modern era. Moreover, most contemporary strains are azithromycin-resistant and members of a globally dominant cluster named here as SS14-¦¸. This cluster diversified from a common ancestor in the midtwentieth century subsequent to the discovery of antibiotics. Its recent phylogenetic expansi¨®n and global presence point to the emergence of a pandemic strain cluster.