Ordering Recommendations

This assay should be ordered only in patients with a known history of syphilis. A specific treponemal assay (EIA or TPPA) will remain positive for life and should not be repeated.

Performed

Routine: Monday - Friday
Labor and Delivery / Antepartum: Daily

Methodology

Semi-Quantitative Charcoal Flocculation

Reported

Routine: 1 - 3 days

Synonyms

  • Syphilis Screen in Serum, Quantitative
  • Quantitative Rapid Plasma Reagin Test
  • Non-Treponemal Test
  • T. pallidum
  • Treponema pallidum
  • Syphilis Quantitation
  • RPR Quant
  • SYPHS
  • Rapid Plasma Reagin Titer
  • Quantitative RPR
  • Microbiology Serology

Performing Lab

Microbiology

Add-on Eligibility

Yes

Specimen Type

Blood

Specimen Preparation

Blood specimens collected in Serum Separator Tubes (SSTs) must be centrifuged within 2 hours of the collection time for optimal sample integrity.

NOTE: Specimens collected in SSTs MUST sit for 30 minutes prior to centrifugation to allow for complete clot formation.

Specimen Volume

2.0 mL (Minimum: 1.0 mL)

Collection Container

Serum Separator Tube (SST, Gold Top Vacutainer)

Pediatric Collection

2 Serum Separator Microtainers (SST, Gold Top Microtainer)
      

Unacceptable Conditions

  1. CORD bloods are unacceptable specimens for RPR testing
  2. More than one specimen within 24 hours
  3. Lipemic or grossly hemolyzed specimens
  4. Specimens containing particulate matter or exhibiting obvious microbial contamination
  5. Specimens that have been improperly collected, stored, or transported
  • Specimens received in a collection tube other than a Serum Separator Tube
  • Specimens not received within 5 days of collection
  • Aliquot not made within 5 days of collection
  • Specimens not refrigerated within 24 hours of collection
  • Specimens not frozen 5 days after collection
  1. Specimens containing less than 0.5 mL of serum once separated from cells
  2. Unlabeled or mislabeled specimens

Storage/Transport Temperature

Transport Instructions    
Collection Location Transport Temperature Processing Required Timeframe
ED/Inpatient Room Temperature None Specimen must be received by the lab within 2 hours of collection
Laboratory/
Outpatient/
Off-Site		 Room Temperature Allow blood to clot for 30 minutes in a vertical position. Centrifuge to separate from cells within 2 hours of collection. Specimen must be received by the lab within 24 hours of collection
Refrigerated (Ice Packs) Allow blood to clot for 30 minutes in a vertical position. Centrifuge to separate from cells within 2 hours of collection. Specimen must be received by the lab within 5 days of collection

Storage: Refrigerated

Stability (from collection to initiation)

Stability:
Prior to separation from cells:
  • Room Temperature: 2 hours
After separation from cells:
  • Room Temperature: 24 hours
  • Refrigerated: 5 days
  • Frozen at -20°C: Freeze serum aliquot for storage beyond 5 days

Laboratory Storage: Refrigerated
Laboratory Retention: 7 days

Collection Instructions

Labeling Instructions:
When labeling blood tubes, leave a small window visible for the lab to assess the fill volume and sample integrity. Ensure that the barcode is in the correct orientation.


Collection Instructions:
Follow the correct order of draw when collecting with additional orders and tube types:
     

Processing Instructions:
  1. Invert the collection tube according to the number of inversions in the chart above
  2. Place the tube upright in a rack and allow the tube to sit for 30 minutes to ensure adequate clotting time
  3. Centrifuge within 2 hours of collection

Reference Interval

Non-Reactive

Interpretive Data

Since this test is detecting a non-specific antibody, biologic false positive reactions will occur in many viral diseases, malaria, pneumococcal pneumonia, tuberculosis, leprosy, yaws, as well as some autoimmune diseases. Many false positive results, especially those that result from a febrile disease, will spontaneously disappear within 3-6 months. False negative results may be seen early in syphilis when the reagin concentration is too low to detect, in latent or tertiary syphilis or when alcohol is present in the blood.

Positive test results usually revert to nonreactive following therapy during primary and secondary stages, however reversion rarely occurs in latent or tertiary syphilis. The RPR should become nonreactive after 1 year of successful therapy in primary syphilis and 2 years in secondary syphilis. As a general rule, the longer the disease has been established prior to treatment, the longer some reactivity persists.

When following a positive titer with a quantitative non-treponemal test, a fourfold increase in titer (i.e., 1:16 increasing to 1:64) indicates infection, reinfection or treatment failure. A fourfold decrease in titer generally indicates appropriate response to therapy. The same non-treponemal test used initially should be used for subsequent quantitative testing, since up to a fourfold difference in endpoint titers can occur with certain sera in various non-treponemal tests.

In patients without a known history of Syphilis, this test may be included as part of the following algorithm:

Ordering

Ordering Recommendations

This assay should be ordered only in patients with a known history of syphilis. A specific treponemal assay (EIA or TPPA) will remain positive for life and should not be repeated.

Performed

Routine: Monday - Friday
Labor and Delivery / Antepartum: Daily

Methodology

Semi-Quantitative Charcoal Flocculation

Reported

Routine: 1 - 3 days

Synonyms

  • Syphilis Screen in Serum, Quantitative
  • Quantitative Rapid Plasma Reagin Test
  • Non-Treponemal Test
  • T. pallidum
  • Treponema pallidum
  • Syphilis Quantitation
  • RPR Quant
  • SYPHS
  • Rapid Plasma Reagin Titer
  • Quantitative RPR
  • Microbiology Serology

Performing Lab

Microbiology

Add-on Eligibility

Yes
Collection

Specimen Type

Blood

Specimen Preparation

Blood specimens collected in Serum Separator Tubes (SSTs) must be centrifuged within 2 hours of the collection time for optimal sample integrity.

NOTE: Specimens collected in SSTs MUST sit for 30 minutes prior to centrifugation to allow for complete clot formation.

Specimen Volume

2.0 mL (Minimum: 1.0 mL)

Collection Container

Serum Separator Tube (SST, Gold Top Vacutainer)

Pediatric Collection

2 Serum Separator Microtainers (SST, Gold Top Microtainer)
      

Unacceptable Conditions

  1. CORD bloods are unacceptable specimens for RPR testing
  2. More than one specimen within 24 hours
  3. Lipemic or grossly hemolyzed specimens
  4. Specimens containing particulate matter or exhibiting obvious microbial contamination
  5. Specimens that have been improperly collected, stored, or transported
  • Specimens received in a collection tube other than a Serum Separator Tube
  • Specimens not received within 5 days of collection
  • Aliquot not made within 5 days of collection
  • Specimens not refrigerated within 24 hours of collection
  • Specimens not frozen 5 days after collection
  1. Specimens containing less than 0.5 mL of serum once separated from cells
  2. Unlabeled or mislabeled specimens

Storage/Transport Temperature

Transport Instructions    
Collection Location Transport Temperature Processing Required Timeframe
ED/Inpatient Room Temperature None Specimen must be received by the lab within 2 hours of collection
Laboratory/
Outpatient/
Off-Site		 Room Temperature Allow blood to clot for 30 minutes in a vertical position. Centrifuge to separate from cells within 2 hours of collection. Specimen must be received by the lab within 24 hours of collection
Refrigerated (Ice Packs) Allow blood to clot for 30 minutes in a vertical position. Centrifuge to separate from cells within 2 hours of collection. Specimen must be received by the lab within 5 days of collection

Storage: Refrigerated

Stability (from collection to initiation)

Stability:
Prior to separation from cells:
  • Room Temperature: 2 hours
After separation from cells:
  • Room Temperature: 24 hours
  • Refrigerated: 5 days
  • Frozen at -20°C: Freeze serum aliquot for storage beyond 5 days

Laboratory Storage: Refrigerated
Laboratory Retention: 7 days

Collection Instructions

Labeling Instructions:
When labeling blood tubes, leave a small window visible for the lab to assess the fill volume and sample integrity. Ensure that the barcode is in the correct orientation.


Collection Instructions:
Follow the correct order of draw when collecting with additional orders and tube types:
     

Processing Instructions:
  1. Invert the collection tube according to the number of inversions in the chart above
  2. Place the tube upright in a rack and allow the tube to sit for 30 minutes to ensure adequate clotting time
  3. Centrifuge within 2 hours of collection
Result Interpretation

Reference Interval

Non-Reactive

Interpretive Data

Since this test is detecting a non-specific antibody, biologic false positive reactions will occur in many viral diseases, malaria, pneumococcal pneumonia, tuberculosis, leprosy, yaws, as well as some autoimmune diseases. Many false positive results, especially those that result from a febrile disease, will spontaneously disappear within 3-6 months. False negative results may be seen early in syphilis when the reagin concentration is too low to detect, in latent or tertiary syphilis or when alcohol is present in the blood.

Positive test results usually revert to nonreactive following therapy during primary and secondary stages, however reversion rarely occurs in latent or tertiary syphilis. The RPR should become nonreactive after 1 year of successful therapy in primary syphilis and 2 years in secondary syphilis. As a general rule, the longer the disease has been established prior to treatment, the longer some reactivity persists.

When following a positive titer with a quantitative non-treponemal test, a fourfold increase in titer (i.e., 1:16 increasing to 1:64) indicates infection, reinfection or treatment failure. A fourfold decrease in titer generally indicates appropriate response to therapy. The same non-treponemal test used initially should be used for subsequent quantitative testing, since up to a fourfold difference in endpoint titers can occur with certain sera in various non-treponemal tests.

In patients without a known history of Syphilis, this test may be included as part of the following algorithm:

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