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A resurgence of syphilis infections has been described in a number of countries including Canada in the last decade.This study identified polymerase chain reaction (PCR) positive syphilis cases based on detection ofPCR identified 740 syphilis cases: 718 were adolescents and adults, while 22 were congenital syphilis cases. For non-congenital syphilis investigation, the clinical specimens with the highest yield of positive PCR results were genital (632), oral (73), and anal (55), while for congenital syphilis, they were nasal or nasopharyngeal secretions (20), followed by blood (5) and umbilical cord (4). Female syphilis cases appeared younger (61.7% between 14 and 29 years), while male syphilis cases appeared older (58.4% between 30 and 65 years). Although, overall more syphilis cases (62.7%) occurred in the urban cities; the proportion of urban cases showed a significant decline from 87.0% in 2017 to 55.6% in 2020, while in rural regions it increased from 13.0% in 2017 to 44.4% in 2020. Most (98.8%) PCR- positive specimens were found to contain all threeThis study identified the clinical specimen types andDepuis dix ans, les infections par la syphilis sont en recrudescence dans plusieurs pays, y compris le Canada.La présente étude relève les cas positifs à l’amplification en chaîne par polymérase (PCR) d’après la détection des gènes duLe test PCR a permis de détecter 740 cas de syphilis, soit 718 chez des adolescents et des adultes et 22 cas de syphilis congénitale. Pour ce qui est des examens de la syphilis non congénitale, les échantillons cliniques donnant le plus fort taux de résultats positifs au test PCR ont été prélevés dans la région génitale (632), orale (73) et anale (55), tandis qu’à l’égard des cas de syphilis congénitale, ils provenaient des sécrétions nasales ou nasopharyngées (20), suivis du sang (5) et du cordon ombilical (4). La syphilis se manifestait chez des femmes plus jeunes (61,7 % entre 14 et 29 ans) et plus tard chez les hommes (58,4 % entre 30 et 65 ans). Même si, dans l’ensemble, plus de cas de syphilis (62,7 %) se déclaraient en région urbaine, cette proportion a connu un recul important, passant de 87,0 % en 2017 à 55,6 % en 2020, tandis que la proportion des cas en région rurale a progressé de 13,0 % en 2017 à 44,4 % en 2020. La plupart des échantillons ayant obtenu un résultat positif au test PCR (98,8 %) contenaient les trois gènes duLa présente étude a relevé les types d’échantillons cliniques et les gènes de

Background: Syphilis is a sexually transmitted disease that can have atypical clinical presentations. Conventional laboratory tests to confirm the diagnosis are not rapid enough to affect clinical decision on treatment and contact tracing. Rapid point-of-care tests (POCT) can be useful for control of infectious diseases; however, no POCT for syphilis detection is currently available in Canada. The aim of this study is to evaluate two POCTs (RevealTM Rapid TP (Treponema pallidum) Antibody test and DPP® Syphilis Screen and Confirm test) for detection of infectious syphilis. Methods: One hundred serum samples with known syphilis serological status, based on treponemal and non-treponemal test results, were analysed in the laboratory with two POCTs by two independent operators in a blind fashion. Results were analysed to evaluate their ability to detect infectious syphilis. Results: The Reveal Rapid TP Antibody POCT showed an overall sensitivity of 95.0% and a specificity of 83.3%, while the DPP Syphilis Screen and Confirm POCT showed a sensitivity of 87.5% and a specificity of 98.3%. Both POCTs gave a sensitivity of 100% on active syphilis samples with Venereal Disease Research Laboratory (VDRL) titres of greater than 1:4, but their sensitivities decreased for samples with low VDRL titres. Both POCTs gave weakly or very weakly reactive results on 11.3%–25.0% of the treponemal antibody positive samples. Conclusion: This laboratory evaluation has shown promising results for both POCTs to detect infectious syphilis. Further evaluations in the field would be required to confirm this preliminary finding.