Introduction:

Treponema pallidum is considered as a monomorphic bacterium with very few genomic differences among isolates and subspecies. The genetic diversity of this pathogen has not been explored in depth; however, this kind of studies potentially has a direct impact on the development of new diagnostic methods and vaccines. The objective of this work was to evaluate the genetic diversity of this pathogen in Cuba (2012-2019).

Methods:

Five exploratory studies were carried out based on molecular characterization, detection of one-off mutations and whole genome sequencing of T. pallidum.

Results:

The high level of genetic diversity of T. pallidum in the Cuban context was demonstrated by the detection of 8 subtypes of T. pallidum subsp. pallidum (TPA), 7 genotypes of TPA, the identification of T. pallidum subsp. endemicum in patients diagnosed with venereal syphilis, one-off mutations conferring resistance to macrolides with a high frequency and intra- and inter-strain recombination events in TPA. These findings suggest, as a conclusion, a significant genetic diversity of T. pallidum in the Cuban context with an increased predominance of recombinant genotypes over time, which should be further studied given their potential involvement in the development of this disease.

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