Increased Reporting of Infants Born with Congenital Syphilis to a Local Department of Public Health: A Quality Improvement Project

Introduction Congenital syphilis (CS) remains a significant public health concern. Current reporting guidelines may underreport cases where infants receive penicillin despite non-reactive rapid plasma reagin (RPR-) due to inadequate maternal treatment and delayed infant antibody seroconversion. Methods This quality improvement project analyzed CS cases at a tertiary children's hospital from 2011-2022. A prospective intervention was implemented September 2023 – February 2025 to improve the reporting of cases, including multidisciplinary communication, standardized electronic health record data entry, and regular reminders. Results Prior to the intervention, 154 infants were identified who had a CDC case definition of CS and received penicillin administration therapy, with 107/154 (69.4%) RPR- and not reported to the local Department of Public Health. At the end of the first intervention cycle, a total of 44 infants were reported to the Department of Public Health with 15/44 (34.1%) being RPR- and successfully reported Conclusion This project highlights the limitations of RPR-based reporting for CS surveillance. The implemented intervention improved reporting of cases, including those without maternal RPR positivity, enhancing public health surveillance efforts.