Comparison of a new rapid plasma reagin card test with the standard rapid plasma reagin 18-mm circle card test and the venereal disease research laboratory slide test for serodiagnosis of syphilis.

The rapid plasma reagin (RPR) card test manufactured by Beckman Instruments, Inc., was compared, qualitatively and quantitatively, with the Venereal Disease Research Laboratory (VDRL) slide test and the standard RPR 18-mm circle card tests for the serodiagnosis of syphilis. Sera from 638 individuals were used in this study. Two pilot lots and two production lots of antigen were submitted by Beckman Instruments, Inc., for evaluation. Qualitative agreement among the three RPR card tests was 98.1%; between the Beckman RPR card and the VDRL slide tests, 95.0%; and between the reference RPR card and the VDRL slide tests, 95.5%. The Beckman RPR card test was 95.3% specific, whereas the specificities of the reference RPR card and the VDRL slide tests were 98.8% and 96.1%, respectively. Sensitivities of the three nontreponemal tests were: Beckman RPR card test production lots, 94.7%; reference RPR card test, 96.8%; and VDRL slide test, 90.6%. Quantitative agreement +/- 1 dilution among the three RPR card tests was 93.0%, whereas quantitative agreement was approximately 40% when both RPR card tests were compared with the VDRL slide test. We found the Beckman RPR card test comparable to the standard RPR card tests. Therefore, the decision of which test to use for the serodiagnosis of syphilis is at the discretion of the user.

EDTA-treated plasma in the rapid plasma reagin card test and the toluidine red unheated serum test for serodiagnosis of syphilis.

Both the rapid plasma reagin (RPR) 18-mm circle card test and the toluidine red unheated serum test (TRUST) were designed to be more rapid than the Venereal Disease Research Laboratory slide test for the serodiagnosis of syphilis. The RPR card test, although originally designed as the teardrop card test for use with plasma, has received recognition from the Centers for Disease Control as a standard test for syphilis for use with serum samples only. In this study, 132 EDTA plasma-serum pairs were tested in both the RPR card test and TRUST immediately after the blood was drawn and the serum or plasma was separated from the cellular constituents of the blood. The plasma samples were further tested at 24-h intervals of storage at 25 and 4 degrees C for 72 h. Special attention was paid to any increase in roughness in nonreactive specimens. The greatest increase in roughness (16.7%) was seen with the TRUST after 72 h at 25 degrees C. An additional 174 plasma-serum pairs were tested after 18 h of storage at 25 degrees C. Comparisons of the results of the 306 serum specimens with their corresponding plasma pairs gave 99.0% qualitative agreement for both tests. Quantitative agreement +/- 1 dilution between serum-plasma pairs tested within 18 h was 92.1% (35 of 38) for the RPR card test and 94.1% (32 of 34) for the TRUST. Our results with plasma from blood drawn with EDTA as the anticoagulant were comparable with results with serum specimens for both tests when plasma specimens were tested within 18 to 24 h.

Evaluation of a new rapid plasma reagin card test as a screening test for syphilis.

This study evaluates the American Dade (Biokit Laboratories) rapid plasma reagin (Dade RPR) card test, currently used in Spain for the diagnosis of syphilis, which has been recently released to the U.S. market. Used as a basis for comparison with the Dade card test were the 18-mm standard rapid plasma reagin (standard RPR) card test and the Venereal Disease Research Laboratory (VDRL) slide test, using both fresh sera obtained from 505 individuals and paired serum-plasma specimens from 174 individuals. Results obtained proved the Dade RPR card test with serum to be very similar to the standard RPR card test; sensitivity was 92.3% and specificity was approximately 99% for both RPR card tests. Although the sensitivity of the VDRL slide test was lower at 88.5%, its specificity was also approximately 99%. Quantitatively, the agreement +/- 1 dilution between the two card tests was 93.6%. Agreement +/- 1 dilution between the Dade RPR card test and the VDRL slide test was 46.5% for sera, comparable to the standard RPR-VDRL agreement of 50%. In the limited evaluation of the RPR card tests with plasma, the specificity was 99.4% and the sensitivity was 100% for both tests. Quantitative agreement +/- 1 dilution between plasma and serum pairs was 100% for the Dade RPR card test. Our results showed that the Dade RPR card test is as sensitive and as specific as the standard RPR card test. Therefore, it was concluded that one card test has no particular advantage over the other.