Syphilis Serologic Confirmation (Sendout)

Ordering Note: For use by UW-MT Immunology Laboratory only. Reflex supplementary testing for borderline/reactive Serologic Syphilis Screen [SYPHSC] results.

Testing Algorithm: CMIA (detection of IgG and IgM antibodies by Abbott chemiluminescent Immunoassay) and RPR (Rapid Plasma Reagin, qualitative and quantitative) are performed on each specimen. If the results are inconclusive or discrepant between the two tests, a confirmatory TP-PA (Treponema pallidum Particle Agglutination) is performed.

Treponemal Specific Assays:

• CMIA (chemiluminescent Immunoassay): Detection of IgG and IgM antibodies by Abbott.
• TP-PA: (Treponema pallidum Particle Agglutination) Confirmation of IgG and IgM antibodies by Fujirebio.

Non-Treponemal Specific Assay:

• RPR: (Rapid Plasma Reagin) Qualitative and quantitative detection of non-specific antibodies by BD.

Immunology: If RSYPHC reflexes from SYPHSC, aliquot extra serum into a separate vial (labeled with RSYPHC Sunquest CID). Freeze serum at -20°C.

Sendouts:

• Immunology will deliver serum aliquot with a completed WA PHL STI Requisition for sendout to the state lab.
• Package each patient's sample in an individual biohazard bag with a copy of the associated requisition (one patient per bag).
  • Orders received with multiple patient samples/requisitions in the same biohazard bag may be rejected by WA PHL.
• Send samples on dry ice with the DLMP courier.

WAPHL Specimen Collection and Submission Instructions: Syphilis, Reference

Stability: Frozen: Indefinitely; Refrigerated: 5 days; Ambient: Unacceptable.

Rejection Criteria: Unacceptable specimen type, not refrigerated or frozen, insufficient specimen volume, leaky specimen.