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.

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.