Does Syphilis need to be Examined in Cases of Blood and Body Fluid Exposure in Hospitals?

BACKGROUND

Syphilis, caused by Treponema pallidum, represents a significant sexually transmitted infection capable of systemic manifestation. Current guidelines do not recommend syphilis serological screening following blood and body fluid exposure (BBFE) in healthcare settings. This cross-sectional study examined current practices of rapid plasma reagin (RPR) and T. pallidum hemagglutination (TPHA) testing in Japanese hospitals.

METHODS

A web-based questionnaire distributed in November 2023 assessed institutional testing policies and post-exposure protocols.

RESULTS

Among 23 responding institutions, preoperative screening included both RPR and TPHA in nine hospitals (39%) and TPHA alone in seven (31%). For non-preoperative screening, five hospitals (22%) conducted both tests, while six (26%) performed TPHA only. No consensus existed regarding test validity duration, and only one hospital maintained post-exposure prophylaxis protocols.

CONCLUSIONS

Although approximately 75% of institutions conduct routine preoperative syphilis screening, the lack of evidence supporting BBFE transmission and prophylaxis necessitates practice reconsideration.