Evaluation of the microenzyme-linked immunosorbent assay with Treponema pallidum antigen

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Abstract
Whole-cell sonicates of T. pallidum, Nichols strain, were evaluated in an enzyme-linked immunosorbent assay (ELISA) for syphilis; results were read in a Dynatek Microelisa Reader. The antigen was evaluated with sera from patients with syphilis, persons presumed normal and biological false-positives. There were 297 sera tested by the ELISA with T. pallidum antigens, the Venereal Disease Research Laboratory (VDRL) slide test, the fluorescent treponemal antibody absorption (FTA-Abs) test and the microhemagglutination assay for T. pallidum antibodies (MHA-TP). The results of all of the tests were compared. The ELISA, with 89.3% sensitivity, was less sensitive than the VDRL (93.3%) and FTA-Abs (100.0%) tests but more sensitive than the MHA-TP (76.0%). The ELISA was considerably more sensitive in primary syphilis than the MHA-TP. Specificity was as follows: ELISA, 98.5%; FTA-Abs test, 97.8%; MHA-TP, 98.2%; and VDRL test, 92.7%. The ELISA has good potential as a confirmatory test in the serodiagnosis of syphilis.