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Emergence of Novel Chlamydia trachomatis Sequence Types among Chlamydia Patients in the Republic of Belarus. Microorganisms 2022; 10:microorganisms10020478. [PMID: 35208932 PMCID: PMC8876968 DOI: 10.3390/microorganisms10020478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022] Open
Abstract
Chlamydia trachomatis (CT) is a major cause of sexually transmitted diseases worldwide. The multilocus sequence typing (MLST) of clinical samples from random heterosexual chlamydia patients who were either asymptomatic or reported clinical manifestations of genital chlamydiosis (n = 63) in each of the seven major regions of the Republic of Belarus in 2017–2018 revealed 12 different CT sequence types (STs). We found seven known STs, ST4, ST6, ST9, ST13, ST38, ST95 and ST110, and five novel variants, namely ST271–ST275, which have not been detected elsewhere thus far. The ST4 variant was predominant (27/63, 42.9%) and detected in six out of seven regions. The two most common STs, ST9 and ST13, were regularly seen in four out of seven regions. In contrast, the remaining STs, ST6, ST38, ST95, ST110, and novel STs271-275, surfaced randomly in different parts of the country. The emergence of novel STs was registered in two regions, namely Minsk (ST271 and ST275) and Brest (ST271, ST272, ST273, and ST274). All the STs of detected CT strains were clustered into two Groups, I and III, which are characteristic of CT urogenital strains. No STs typical for Group II, specific to the LGV strains, were revealed. Our study contributes to better understanding the genetic diversity and molecular evolution of CT, one of the most important pathogens in public health worldwide.
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Shetty S, Kouskouti C, Schoen U, Evangelatos N, Vishwanath S, Satyamoorthy K, Kainer F, Brand A. Diagnosis of Chlamydia trachomatis genital infections in the era of genomic medicine. Braz J Microbiol 2021; 52:1327-1339. [PMID: 34164797 PMCID: PMC8221097 DOI: 10.1007/s42770-021-00533-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 05/17/2021] [Indexed: 11/02/2022] Open
Abstract
PURPOSE Chlamydial genital infections constitute significant sexually transmitted infections worldwide. The often asymptomatic status of C. trachomatis (CT) infections leads to an increased burden on human reproductive health, especially in middle- and low-income settings. Early detection and management of these infections could play a decisive role in controlling this public health burden. The objective of this review is to provide an insight into the evolution of diagnostic methods for CT infections through the development of new molecular technologies, emphasizing on -omics' technologies and their significance as diagnostic tools both for effective patient management and control of disease transmission. METHODS Narrative review of the diagnostic methodologies of CT infections and the impact of the introduction of -omics' technologies on their diagnosis by review of the literature. RESULTS Various methodologies are discussed with respect to working principles, required specifications, advantages, and disadvantages. Implementing the most accurate methods in diagnosis is highlighted as the cornerstone in managing CT infections. CONCLUSION Diagnostics based on -omics' technologies are considered to be the most pertinent modalities in CT testing when compared to other available methods. There is a need to modify these effective and accurate diagnostic tools in order to render them more available and feasible in all settings, especially aiming on turning them to rapid point-of-care tests for effective patient management and disease control.
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Affiliation(s)
- Seema Shetty
- Department of Microbiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Madhav Nagar, Manipal, 576104, Karnataka, India.
- United Nations University - Maastricht Economics and Social Research Institute On Innovation and Technology (UNU-MERIT), Maastricht, 6211, AX, The Netherlands.
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Christina Kouskouti
- Department of Obstetrics and Perinatal Medicine, Klinik Hallerwiese, St. Johannis-Muhlgasse 19, 90419, Nuremberg, Germany
- Division of Maternal and Fetal Medicine Department of Obstetrics and Gynaecology, Mt. Sinai Hospital University of Toronto, Toronto, ON, Canada
| | - Uwe Schoen
- BioMedHeliX (Pty) Ltd., 3 Conifer Road, Cape Town, 8005, South Africa
| | - Nikolaos Evangelatos
- United Nations University - Maastricht Economics and Social Research Institute On Innovation and Technology (UNU-MERIT), Maastricht, 6211, AX, The Netherlands
- Interdepartmental Division of Critical Care Medicine, University of Toronto, ON, Canada
- Dr. TMA Pai Endowment Chair in Research Policy in Biomedical Sciences and Public Health, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Shashidhar Vishwanath
- Department of Microbiology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Madhav Nagar, Manipal, 576104, Karnataka, India
- Manipal Centre for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Kapaettu Satyamoorthy
- Department of Cell and Molecular Biology, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Franz Kainer
- Department of Obstetrics and Perinatal Medicine, Klinik Hallerwiese, St. Johannis-Muhlgasse 19, 90419, Nuremberg, Germany
| | - Angela Brand
- United Nations University - Maastricht Economics and Social Research Institute On Innovation and Technology (UNU-MERIT), Maastricht, 6211, AX, The Netherlands
- Dr. TMA Pai Endowment Chair in Public Health Genomics, Department of Public Health Genomics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
- Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, 6229, GT, The Netherlands
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Harding-Esch EM, Holland MJ, Schémann JF, Sillah A, Sarr B, Christerson L, Pickering H, Molina-Gonzalez S, Sarr I, Andreasen AA, Jeffries D, Grundy C, Mabey DCW, Herrmann B, Bailey RL. Impact of a single round of mass drug administration with azithromycin on active trachoma and ocular Chlamydia trachomatis prevalence and circulating strains in The Gambia and Senegal. Parasit Vectors 2019; 12:497. [PMID: 31640755 PMCID: PMC6805539 DOI: 10.1186/s13071-019-3743-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mass drug administration (MDA) with azithromycin is a cornerstone of the trachoma elimination strategy. Although the global prevalence of active trachoma has declined considerably, prevalence persists or even increases in some communities and districts. To increase understanding of MDA impact, we investigated the prevalence of active trachoma and ocular C. trachomatis prevalence, organism load, and circulating strains at baseline and one-year post-MDA in The Gambia and Senegal. METHODS Pre- and one-year post-MDA, children aged 0-9 years were examined for clinical signs of trachoma in six Gambian and 12 Senegalese villages. Ocular swabs from each child's right conjunctiva were tested for evidence of ocular C. trachomatis infection and organism load (ompA copy number), and ompA and multi-locus sequence typing (MLST) was performed. RESULTS A total of 1171 children were examined at baseline and follow-up in The Gambia. Active trachoma prevalence decreased from 23.9% to 17.7%, whereas ocular C. trachomatis prevalence increased from 3.0% to 3.8%. In Senegal, 1613 and 1771 children were examined at baseline and follow-up, respectively. Active trachoma prevalence decreased from 14.9% to 8.0%, whereas ocular C. trachomatis prevalence increased from 1.8% to 3.6%. Higher organism load was associated with having active trachoma and severe inflammation. Sequence typing demonstrated that all Senegalese samples were genovar A, whereas Gambian samples were a mix of genovars A and B. MLST provided evidence of clustering at village and household levels and demonstrated differences of strain variant frequencies in Senegal, indicative of an "outbreak". MLST, including partial ompA typing, provided greater discriminatory power than complete ompA typing. CONCLUSIONS We found that one round of MDA led to an overall decline in active trachoma prevalence but no impact on ocular C. trachomatis infection, with heterogeneity observed between villages studied. This could not be explained by MDA coverage or number of different circulating strains pre- and post-MDA. The poor correlation between active trachoma and infection prevalence supports the need for further work on alternative indicators to clinical signs for diagnosing ocular C. trachomatis infection. MLST typing has potential molecular epidemiology utility, including better understanding of transmission dynamics, although relationship to whole-genome sequence variability requires further exploration.
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Affiliation(s)
- Emma M. Harding-Esch
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Martin J. Holland
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
- Medical Research Council Laboratories, PO Box 273, Fajara, Banjul, The Gambia
| | | | - Ansumana Sillah
- National Eye Health Programme, Ministry of Health and Social Welfare, Kanifing, The Gambia
| | - Boubacar Sarr
- Programme National de Lutte Contre la Cécité, Ministère de la Santé, BP 3817, Dakar, Sénégal
| | - Linus Christerson
- Department of Clinical Microbiology, Uppsala University, Uppsala, Sweden
| | - Harry Pickering
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | | | - Isatou Sarr
- Medical Research Council Laboratories, PO Box 273, Fajara, Banjul, The Gambia
| | - Aura A. Andreasen
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - David Jeffries
- Medical Research Council Laboratories, PO Box 273, Fajara, Banjul, The Gambia
| | - Chris Grundy
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - David C. W. Mabey
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Bjorn Herrmann
- Department of Clinical Microbiology, Uppsala University, Uppsala, Sweden
| | - Robin L. Bailey
- London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
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Chin SA, Morberg DP, Alemayehu W, Melese M, Lakew T, Chen MC, Zhou Z, Doan T, Cevallos V, Lietman TM, Keenan JD. Diversity of Chlamydia trachomatis in Trachoma-Hyperendemic Communities Treated With Azithromycin. Am J Epidemiol 2018; 187:1840-1845. [PMID: 29617922 DOI: 10.1093/aje/kwy071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/26/2018] [Indexed: 11/13/2022] Open
Abstract
Prior studies have theorized that low chlamydial genetic diversity following mass azithromycin treatments for trachoma may create a population bottleneck that prevents the return of infection, but little empirical evidence exists to support this hypothesis. In this study, a single mass azithromycin distribution was administered to 21 communities in the Gurage Zone of Ethiopia in 2003. All children aged 1-5 years had conjunctival swabs performed before treatment and 2 and 6 months after treatment. All swabs positive for Chlamydia trachomatis at 2 months underwent typing of the gene encoding the major outer membrane protein (ompA) of C. trachomatis, as did the same number of swabs per community from the pretreatment and 6-month visits. Diversity of ompA types, expressed as the reciprocal of Simpson's index, was calculated for each community. In total, 15 ompA types belonging to the A and B genovars were identified. The mean diversity was 2.11 (95% confidence interval: 1.79, 2.43) before treatment and 2.16 (95% confidence interval: 1.76, 2.55) 2 months after treatment (P = 0.78, paired t test). Diversity of ompA was not associated with the prevalence of ocular chlamydia (P = 0.76) and did not predict subsequent changes in the prevalence of ocular chlamydia (P = 0.32). This study found no evidence to support the theory that ompA diversity is associated with transmission of ocular chlamydia.
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Affiliation(s)
- Stephanie A Chin
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Daniel P Morberg
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | | | | | | | - Michael C Chen
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Zhaoxia Zhou
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Vicky Cevallos
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
- Department of Epidemiology and Biostatistics and Institute for Global Health, University of California, San Francisco, San Francisco, California
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
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Patiño LH, Camargo M, Muñoz M, Ríos-Chaparro DI, Patarroyo MA, Ramírez JD. Unveiling the Multilocus Sequence Typing (MLST) Schemes and Core Genome Phylogenies for Genotyping Chlamydia trachomatis. Front Microbiol 2018; 9:1854. [PMID: 30186244 PMCID: PMC6113918 DOI: 10.3389/fmicb.2018.01854] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 07/24/2018] [Indexed: 11/21/2022] Open
Abstract
Multilocus sequence typing (MLST) has become a useful tool for studying the genetic diversity of important public health pathogens, such as Chlamydia trachomatis (Ct). Four MLST schemes have been proposed for Ct (data available from Chlamydiales MLST databases). However, the lack of a sole standardized scheme represents the greatest limitation regarding typing this species. This study was thus aimed at evaluating the usefulness of the four MLST schemes available for Ct, describing each molecular marker's pattern and its contribution toward a description of intra-specific genetic diversity and population structure. The markers for each scheme, showed a variable power of dicrimination, exhibiting in some cases over estimation in the determination of Sequence Types (STs). However, individual analysis of each locus's typing efficiency and discrimination power led to identifying 8 markers as having a suitable pattern for intra-specific typing. analyzing the 8 candidate markers gave a combination of 3 of these loci as an optimal scheme for identifying a large amount of STs, maximizing discrimination power whilst maintaining suitable typing efficiency. One scheme was compared against core genome phylogenies, finding a higher typing resolution through the last approach. These results confirm once again that although complete genome data, in particular from core genome MLST (cgMLST) allow a high resolution clustering for Ct isolates. There are combinations of molecular markers that could generate equivalent results, with the advantage of representing an easy implementation strategy and lower costs leading to contribute to the monitoring and molecular epidemiology of Ct.
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Affiliation(s)
- Luz H. Patiño
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
- Ph.D. Programme in Biomedical and Biological Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Milena Camargo
- Ph.D. Programme in Biomedical and Biological Sciences, Universidad del Rosario, Bogotá, Colombia
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
| | - Marina Muñoz
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Dora I. Ríos-Chaparro
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
| | - Manuel A. Patarroyo
- Molecular Biology and Immunology Department, Fundación Instituto de Inmunología de Colombia (FIDIC), Bogotá, Colombia
- School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
| | - Juan D. Ramírez
- Grupo de Investigaciones Microbiológicas-UR (GIMUR), Programa de Biología, Facultad de Ciencias Naturales y Matemáticas, Universidad del Rosario, Bogotá, Colombia
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Urogenital Chlamydia trachomatis multilocus sequence types and genovar distribution in chlamydia infected patients in a multi-ethnic region of Saratov, Russia. PLoS One 2018; 13:e0195386. [PMID: 29641543 PMCID: PMC5895025 DOI: 10.1371/journal.pone.0195386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 03/21/2018] [Indexed: 11/19/2022] Open
Abstract
Background This is the first report to characterize the prevalence and genovar distribution of genital chlamydial infections among random heterosexual patients in the multi-ethnic Saratov Region, located in Southeast Russia. Methods Sixty-one clinical samples (cervical or urethral swabs) collected from a random cohort of 856 patients (7.1%) were C. trachomatis (CT) positive in commercial nucleic acid amplification tests (NAATs) and duplex TaqMan PCRs. Results Sequence analysis of the VDII region of the ompA gene revealed seven genovars of C. trachomatis in PCR-positive patients. The overall genovars were distributed as E (41.9%), G (21.6%), F (13.5%), K (9.5%), D (6.8%), J (4.1%), and H (2.7%). CT-positive samples were from males (n = 12, 19.7%), females (n = 42, 68.8%), and anonymous (n = 7, 11.5%) patients, with an age range of 19 to 45 years (average 26.4), including 12 different ethnic groups representative of this region. Most patients were infected with a single genovar (82%), while 18% were co-infected with either two or three genovars. The 1156 bp-fragment of the ompA gene was sequenced in 46 samples to determine single nucleotide polymorphisms (SNP) among isolates. SNP-based subtyping and phylogenetic reconstruction revealed the presence of 13 variants of the ompA gene, such as E (E1, E2, E6), G (G1, G2, G3, G5), F1, K, D (D1, Da2), J1, and H2. Differing genovar distribution was identified among urban (E>G>F) and rural (E>K) populations, and in Slavic (E>G>D) and non-Slavic (E>G>K) ethnic groups. Multilocus sequence typing (MLST) determined five sequences types (STs), such as ST4 (56%, 95% confidence interval, CI, 70.0 to 41.3), ST6 (10%, 95% CI 21.8 to 3.3), ST9 (22%, 95% CI 35.9 to 11.5), ST10 (2%, 95% CI 10.7 to 0.05) and ST38 (10%, 95% CI 21.8 to 3.3). Thus, the most common STs were ST4 and ST9. Conclusion C. trachomatis is a significant cause of morbidity among random heterosexual patients with genital chlamydial infections in the Saratov Region. Further studies should extend this investigation by describing trends in a larger population, both inside and outside of the Saratov Region to clarify some aspects for the actual application of C. trachomatis genotype analysis for disease control.
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Smelov V, Vrbanac A, van Ess EF, Noz MP, Wan R, Eklund C, Morgan T, Shrier LA, Sanders B, Dillner J, de Vries HJC, Morre SA, Dean D. Chlamydia trachomatis Strain Types Have Diversified Regionally and Globally with Evidence for Recombination across Geographic Divides. Front Microbiol 2017; 8:2195. [PMID: 29180986 PMCID: PMC5693916 DOI: 10.3389/fmicb.2017.02195] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/25/2017] [Indexed: 11/17/2022] Open
Abstract
Chlamydia trachomatis (Ct) is the leading cause of bacterial sexually transmitted diseases worldwide. The Ct Multi Locus Sequence Typing (MLST) scheme is effective in differentiating strain types (ST), deciphering transmission patterns and treatment failure, and identifying recombinant strains. Here, we analyzed 323 reference and clinical samples, including 58 samples from Russia, an area that has not previously been represented in Ct typing schemes, to expand our knowledge of the global diversification of Ct STs. The 323 samples resolved into 84 unique STs, a 3.23 higher typing resolution compared to the gold standard single locus ompA genotyping. Our MLST scheme showed a high discriminatory index, D, of 0.98 (95% CI 0.97-0.99) confirming the validity of this method for typing. Phylogenetic analyses revealed distinct branches for the phenotypic diseases of lymphogranuloma venereum, urethritis and cervicitis, and a sub-branch for ocular trachoma. Consistent with these findings, single nucleotide polymorphisms were identified that significantly correlated with each phenotype. While the overall number of unique STs per region was comparable across geographies, the number of STs was greater for Russia with a significantly higher ST/sample ratio of 0.45 (95% CI: 0.35-0.53) compared to Europe or the Americas (p < 0.009), which may reflect a higher level of sexual mixing with the introduction of STs from other regions and/or reassortment of alleles. Four STs were found to be significantly associated with a particular geographic region. ST23 [p = 0.032 (95% CI: 1-23)], ST34 [p = 0.019 (95% CI: 1.1-25)]; and ST19 [p = 0.001 (95% CI: 1.7-34.7)] were significantly associated with Netherlands compared to Russia or the Americas, while ST 30 [p = 0.031 (95% CI: 1.1-17.8)] was significantly associated with the Americas. ST19 was significantly associated with Netherlands and Russia compared with the Americans [p = 0.001 (95% CI: 1.7-34.7) and p = 0.006 (95% CI: 1.5-34.6), respectively]. Additionally, recombinant strains were ubiquitous in the data set [106 (32.8%)], although Europe had a significantly higher number than Russia or the Americas (p < 0.04), the majority of which were from Amsterdam [43 (87.8%) of 49)]. The higher number of recombinants in Europe indicates selective pressure and/or adaptive diversification that will require additional studies to elucidate.
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Affiliation(s)
- Vitaly Smelov
- International Agency for Research on Cancer, World Health Organization, Lyon, France
- Karolinska Institute, Stockholm, Sweden
- North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - Alison Vrbanac
- UCSF Benioff Children’s Hospital Oakland Research Institute, Oakland, CA, United States
| | - Eleanne F. van Ess
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, Netherlands
| | - Marlies P. Noz
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, Netherlands
| | - Raymond Wan
- UCSF Benioff Children’s Hospital Oakland Research Institute, Oakland, CA, United States
| | | | - Tyler Morgan
- UCSF Benioff Children’s Hospital Oakland Research Institute, Oakland, CA, United States
| | - Lydia A. Shrier
- Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - Blake Sanders
- UCSF Benioff Children’s Hospital Oakland Research Institute, Oakland, CA, United States
| | | | - Henry J. C. de Vries
- Center for Infection and Immunology Amsterdam, Academic Medical Center, Amsterdam, Netherlands
- Department of Dermatology, Academic Medical Center, Amsterdam, Netherlands
- STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, Netherlands
| | - Servaas A. Morre
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, Netherlands
- Institute of Public Health Genomics, Department of Genetics and Cell Biology, Research Institute GROW (School for Oncology and Developmental Biology), Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht, Netherlands
| | - Deborah Dean
- UCSF Benioff Children’s Hospital Oakland Research Institute, Oakland, CA, United States
- Department of Bioengineering, University of California, Berkeley, Berkeley, CA, United States
- Department of Bioengineering, University of California, San Francisco, San Francisco, CA, United States
- Departments of Medicine and Pediatrics, University of California, San Francisco, San Francisco, CA, United States
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Kai S, Wada K, Sadahira T, Araki M, Ishii A, Watanabe T, Monden K, Uno S, Araki T, Nasu Y. Antimicrobial susceptibilities of Chlamydia trachomatis isolated from the urethra and pharynx of Japanese males. J Infect Chemother 2017; 23:512-516. [PMID: 28476331 DOI: 10.1016/j.jiac.2017.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 03/21/2017] [Accepted: 04/09/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Sexually transmitted infections due to Chlamydia trachomatis (C. trachomatis) are a worldwide public health problem. The aim of this study was to investigate the drug susceptibilities of C. trachomatis strains isolated from the urethra and pharynx of Japanese males. METHODS Urethral and pharyngeal swabs were collected between 2013 and 2014 from Japanese males with urethritis. Using a McCoy cell line, 18 chlamydial strains were isolated from urethra in 18 patients and 7 from the pharynx in 7 of the 18 patients. The minimum inhibitory concentrations (MICs) of levofloxacin (LVFX) and azithromycin (AZM) were measured using the standard method of the Japanese Society of Chemotherapy. RESULTS The MICs of LVFX and AZM against urethral chlamydial strains were 0.125-0.5 μg/mL and 0.125-0.25 μg/mL, respectively. In pharyngeal strains, the MICs of LVFX and AZM were 0.125-0.25 μg/mL and 0.125-0.25 μg/mL, respectively. In 7 patients with chlamydial strains isolated from both the urethra and pharynx, the MICs of LVFX between these strains were identical in 3 of 6 patients (no growth was observed for one pharyngeal strain), while the MICs of AZM between these strains were identical in all 6 patients (not performed for one patient). CONCLUSIONS Our data suggest that C. trachomatis strains isolated from the urethra and pharynx of Japanese males are susceptible to LVFX and AZM. Although measuring the MICs of chlamydial strains is labor intensive, it is a significant surveillance tool for treating chlamydial infections and preventing the spread of STIs.
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Affiliation(s)
- Seiji Kai
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Department of Urology, Hiroshima City Hiroshima Citizens Hospital, 7-33, Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Koichiro Wada
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Takuya Sadahira
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Motoo Araki
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Ayano Ishii
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Toyohiko Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Koichi Monden
- Araki Urology Clinic, 390-1 3F, Sasaoki, Kurashiki, 710-0834, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Satoshi Uno
- Hirashima Clinic, 1041-4, Higashi-hirashima, Higashi-ku, Okayama, 709-0631, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tohru Araki
- Araki Urology Clinic, 390-1 3F, Sasaoki, Kurashiki, 710-0834, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yasutomo Nasu
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan; Okayama Urological Research Group (OURG), 2-5-1, Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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Rawre J, Juyal D, Dhawan B. Molecular typing of Chlamydia trachomatis: An overview. Indian J Med Microbiol 2017; 35:17-26. [PMID: 28303813 DOI: 10.4103/ijmm.ijmm_16_341] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Urogenital infection due to Chlamydia trachomatis (CT) is one of the most common bacterial sexually transmitted infections (STIs) and is a major public health problem worldwide. Molecular characterisation of CT is important for understanding the pathophysiological mechanisms of chlamydial disease and its transmission dynamics in sexual networks. Traditionally, strain typing of CT was based on serotyping methods characterising the major outer membrane protein (MOMP). With the advent of polymerase chain reaction and sequencing the era of molecular typing began. Molecular characterization of CT strains is based on sequence analysis of ompA gene encoding MOMP. However, in due course of time, improvements were made to enhance the discriminatory power of sequencing and quality of epidemiological information. New high-resolution genotyping methods using multiple loci such as multilocus sequence typing (MLST) and multiple loci variable number of tandem repeats (MLVA) were developed but were unable to differentiate mixed infections (MIs). The development of DNA-hybridisation methods emerged as a major breakthrough in detecting MIs. Although MLST and MLVA are more discriminative than other genotyping methods, they are laborious and expensive. DNA microarray technique is an affordable alternative for genotyping. Since recombination is widespread in the CT genome, ompA is not a reliable marker for phylogenetic studies; hence, whole genome sequencing may provide maximum phylogenetic resolution of CT strains. A descriptive review is provided of the various molecular CT typing methods. The vital information gained can be used for formulating screening programmes, targeted prevention and optimising therapeutic measures aiming to reduce disease transmission.
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Affiliation(s)
- Jyoti Rawre
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Juyal
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Rodríguez-Domínguez M, González-Alba JM, Puerta T, Martínez-García L, Menéndez B, Cantón R, Del Romero J, Galán JC. Spread of a new Chlamydia trachomatis variant from men who have sex with men to the heterosexual population after replacement and recombination in ompA and pmpH genes. Clin Microbiol Infect 2017; 23:761-766. [PMID: 28323193 DOI: 10.1016/j.cmi.2017.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/08/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Sexually transmitted infections are frequently related to outbreaks in high-risk populations due to the dense sexual networks. We wanted to determine the dissemination of a Chlamydia trachomatis variant characterized by the pmpH-recombinant gene between L and G genotypes, which was previously described in a high-risk population. METHODS A total of 449 samples were analysed in two periods ranging from 2009 to 2015 for detection of the pmpH-recombinant gene. For those samples yielding positive amplification, a sampling was selected for phylogenetic reconstructions based on sequencing of five chromosomal genes. RESULTS Globally this variant was found in 113 of the 449 samples (25%). During the first years (2009-13), this variant was found almost exclusively in rectal samples (30/112 samples) of men who have sex with men and in only one non-rectal sample (1/63). In 2014, this variant was also found in urethral and pharyngeal samples (1/24 and 1/7, respectively). However, in 2015, an epidemiological change was observed as the proportion of this variant had increased in rectal samples (20/51; 39%) and non-rectal samples, including cervical samples (51/142; 36.4%). The molecular characterization revealed the replacement of the ompA gene belonging to subtype G in samples recovered from 2009 to 2013 by the ompA gene belonging to subtype J after 2013. CONCLUSIONS Our data would support the evidence that subtype J could be a 'subtype bridge' between different sexual networks, as subtype J has been found in men who have sex with men and heterosexual populations in similar proportions. This work reveals the necessity of implementing molecular surveillance in extra-rectal samples to help us understand the gaps in transmission.
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Affiliation(s)
- M Rodríguez-Domínguez
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - J M González-Alba
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - T Puerta
- Centro Sanitario Sandoval, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - L Martínez-García
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Red Española de Investigación en Patología Infecciosa, Madrid, Spain
| | - B Menéndez
- Centro Sanitario Sandoval, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain; Laboratorio de Microbiología, Centro Sandoval, Madrid, Spain
| | - R Cantón
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; Red Española de Investigación en Patología Infecciosa, Madrid, Spain
| | - J Del Romero
- Centro Sanitario Sandoval, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - J C Galán
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain; CIBER en Epidemiología y Salud Pública, Madrid, Spain; Unidad de Resistencia a Antibióticos y Virulencia Bacteriana, Madrid, Spain.
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11
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Danielewski JA, Phillips S, Kong FYS, Smith KS, Hocking JS, Guy R, Fairley CK, Garland SM, Tabrizi SN. A snapshot of Chlamydia trachomatis genetic diversity using multilocus sequence type analysis in an Australian metropolitan setting. Eur J Clin Microbiol Infect Dis 2017; 36:1297-1303. [PMID: 28220321 DOI: 10.1007/s10096-017-2935-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 02/02/2017] [Indexed: 12/01/2022]
Abstract
High-resolution screening methodologies which enable the differentiation of Chlamydia trachomatis at the strain level, directly from clinical samples, can provide the detailed information required for epidemiological questions such as the dynamics of treatment failure. In addition, they give a detailed snapshot of circulating C. trachomatis genetic variation, data which are currently lacking for the Australian population. In the context of two Australian clinical trials, we assessed the genetic diversity of C. trachomatis and compared these to strains circulating globally. We used high-resolution multilocus sequence typing (MLST) of five highly variable genetic regions of C. trachomatis to examine variation in Australia. Samples with established genovars were drawn from a pool of 880 C. trachomatis-positive samples from two clinical studies, whereby 76 sample pairs which remained C. trachomatis-positive for the same genovar after treatment underwent MLST analysis to distinguish between treatment failure and reinfection. MLST analysis revealed a total of 25 sequence types (STs), six new allele variants and seven new STs not described anywhere else in the world, when compared to those in the international C. trachomatis MLST database. Of the eight most common global STs, seven were found in Australia (four derived from men who have sex with men (MSM) and three from heterosexuals). Newly identified STs were predominantly found in samples from the MSM population. In conclusion, MLST provided a diverse C. trachomatis strain profile, with novel circulating STs, and could be used to identify local sexual networks to focus on interventions such as testing and partner notification to prevent reinfection.
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Affiliation(s)
- J A Danielewski
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Locked Bag 300, Parkville, 3052, VIC, Australia. .,Murdoch Childrens Research Institute, Melbourne, VIC, Australia.
| | - S Phillips
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Locked Bag 300, Parkville, 3052, VIC, Australia.,Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - F Y S Kong
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - K S Smith
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - J S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - R Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - C K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, VIC, Australia.,Central Clinical School, Monash University, Melbourne, VIC, Australia
| | - S M Garland
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Locked Bag 300, Parkville, 3052, VIC, Australia.,Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
| | - S N Tabrizi
- Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Locked Bag 300, Parkville, 3052, VIC, Australia.,Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia
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12
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Gharsallah H, Bom RJM, Bruisten SM, Himschoot M, Frikha-Gargouri O, Hammami A. Identification of a dominant Chlamydia trachomatis strain in patients attending sexual transmitted infection clinic and female sex workers in Tunisia using a high resolution typing method. INFECTION GENETICS AND EVOLUTION 2016; 44:444-449. [PMID: 27497657 DOI: 10.1016/j.meegid.2016.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Revised: 07/11/2016] [Accepted: 08/03/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND The distribution of Chlamydia trachomatis genotypes in Tunisia was previously studied using the reverse hybridization method. In this study, we used multilocus sequence typing (MLST) to describe Chlamydia trachomatis genetic diversity among heterosexual populations in Tunisia. The obtained sequence types (STs) were compared with those from a heterosexual population from Amsterdam, the Netherlands. METHODS Clinical Tunisian patients and female sex workers provided 107 Chlamydia trachomatis positive samples that were used for MLST. Samples from 256 heterosexuals visiting the Amsterdam STI clinic were included as a reference group. Six highly variable genetic regions including the ompA gene were amplified and sequenced. The ST numbers were derived from a Chlamydia typing database (http://mlstdb.uu.se) and used to draw minimum spanning trees. RESULTS ompA sequencing detected 7 genotypes among the Tunisian populations of which genotype E was the most prevalent (66.3%). This genotype E resolved into 23 different STs and among these the ST3 was predominant (53.5%). MLST displayed 43 STs, of which 28 (65%) were new in the database. Minimum spanning tree analysis of all Tunisian samples identified 4 clusters of which one formed a clonal cluster with samples presenting the most prevalent ST3. When comparing samples from the Tunisian and Dutch populations in one minimum spanning tree, there was little overlap between the Chlamydia trachomatis samples. CONCLUSION The CT-hrMLST scheme allowed us to identify that the Tunisian distribution was dominated by one genotype E (ST3) strain which is also highly prevalent in many other countries worldwide.
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Affiliation(s)
- Houda Gharsallah
- Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia.
| | - Reinier J M Bom
- Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.
| | - Sylvia M Bruisten
- Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.
| | - Michelle Himschoot
- Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands.
| | - Olfa Frikha-Gargouri
- Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia; Biopesticides Team, Centre of Biotechnology of Sfax, Road of Sidi Mansour Km 6, 3018 Sfax, Tunisia.
| | - Adnene Hammami
- Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia.
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Isaksson J, Gallo Vaulet L, Christerson L, Ruettger A, Sachse K, Entrocassi C, Castro É, Rodríguez Fermepin M, Herrmann B. Comparison of multilocus sequence typing and multilocus typing microarray of Chlamydia trachomatis strains from Argentina and Chile. J Microbiol Methods 2016; 127:214-218. [DOI: 10.1016/j.mimet.2016.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/05/2016] [Accepted: 06/05/2016] [Indexed: 11/17/2022]
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Batteiger BE, Wan R, Williams JA, He L, Ma A, Fortenberry JD, Dean D. Novel Chlamydia trachomatis strains in heterosexual sex partners, Indianapolis, Indiana, USA. Emerg Infect Dis 2015; 20:1841-7. [PMID: 25340463 PMCID: PMC4214310 DOI: 10.3201/2011.140604] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Use of multilocus sequence typing may help identify new strains in at-risk populations. Chlamydia trachomatis causes a high number of sexually transmitted infections worldwide, but reproducible and precise strain typing to link partners is lacking. We evaluated multilocus sequence typing (MLST) for this purpose by detecting sequence types (STs) concordant for the ompA genotype, a single-locus typing standard. We tested samples collected during April 2000–October 2003 from members of established heterosexual partnerships (dyads) in the Indianapolis, Indiana, USA, area who self-reported being coital partners within the previous 30 days. C. trachomatis DNA from 28 dyads was tested by MLST; sequences were aligned and analyzed for ST and phylogenetic relationships. MLST detected 9 C. trachomatis STs, 4 unique to Indianapolis; STs were identical within each dyad. Thirteen unique strains were identified; 9 (32%) dyads harbored novel recombinant strains that phylogenetically clustered with strains comprising the recombinants. The high rate of novel C. trachomatis recombinants identified supports the use of MLST for transmission and strain diversity studies among at-risk populations.
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15
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Rodriguez-Dominguez M, Gonzalez-Alba JM, Puerta T, Menendez B, Sanchez-Diaz AM, Canton R, del Romero J, Galan JC. High Prevalence of Co-Infections by Invasive and Non-Invasive Chlamydia trachomatis Genotypes during the Lymphogranuloma Venereum Outbreak in Spain. PLoS One 2015; 10:e0126145. [PMID: 25965545 PMCID: PMC4428631 DOI: 10.1371/journal.pone.0126145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/29/2015] [Indexed: 12/16/2022] Open
Abstract
The evolution of Chlamydia trachomatis is mainly driven by recombination events. This fact can be fuelled by the coincidence in several European regions of the high prevalence of non-invasive urogenital genotypes and lymphogranuloma venereum (LGV) outbreaks. This scenario could modify the local epidemiology and favor the selection of new C. trachomatis variants. Quantifying the prevalence of co-infection could help to predict the potential risk in the selection of new variants with unpredictable results in pathogenesis or transmissibility. In the 2009-2013 period, 287 clinical samples with demonstrated presence of C. trachomatis were selected. They were divided in two groups. The first group was constituted by 137 samples with C. trachomatis of the LGV genotypes, and the second by the remaining 150 samples in which the presence of LGV genotypes was previously excluded. They were analyzed to detect the simultaneous presence of non-LGV genotypes based on pmpH and ompA genes. In the first group, co-infections were detected in 10.9% of the cases whereas in the second group the prevalence was 14.6%, which is the highest percentage ever described among European countries. Moreover, bioinformatic analyses suggested the presence among men who have sex with men of a pmpH-recombinant variant, similar to strains described in Seattle in 2002. This variant was the result of genetic exchange between genotypes belonging to LGV and members of G-genotype. Sequencing of other genes, phylogenetically related to pathotype, confirmed that the putative recombinant found in Madrid could have a common origin with the strains described in Seattle. Countries with a high prevalence of co-infections and high migration flows should enhance surveillance programs in at least their vulnerable population.
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Affiliation(s)
- Mario Rodriguez-Dominguez
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Jose Maria Gonzalez-Alba
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Teresa Puerta
- Centro Sanitario Sandoval, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - Blanca Menendez
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
- Laboratorio de Microbiología, Centro Sandoval, Madrid, Spain
| | - Ana Maria Sanchez-Diaz
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | - Rafael Canton
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- Red Española de Investigación en Patología Infecciosa (REIPI), Madrid, Spain
| | - Jorge del Romero
- Centro Sanitario Sandoval, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - Juan Carlos Galan
- Servicio de Microbiología Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Unidad de Resistencia a Antibióticos y Virulencia Bacteriana (RYC-CSIC), Madrid, Spain
- * E-mail:
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16
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Stefanelli P, Sulis G, Renna G, Gargiulo F, Zanotti P, Capelli M, De Francesco MA, Donato F, Pecorelli S, Matteelli A. Chlamydia trachomatis genotypes in school adolescents, Italy. Infection 2015; 43:739-41. [PMID: 25940434 DOI: 10.1007/s15010-015-0787-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/25/2015] [Indexed: 10/23/2022]
Abstract
Chlamydia trachomatis genogroups using ompA and multilocus sequence typing (MLST) were determined in consecutive isolates from school students aged 18 or older in the district of Brescia, Italy, 2012-2013. Among 40 samples, 4 ompA genovars and 18 STs were identified. Genovar E predominated (70 %) including five STs derived from ST59 (29 % of all isolates). This study, combining ompA and MLST typing of C. trachomatis school teenagers, suggests limited mixing and sexual interchange in this population.
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Affiliation(s)
- Paola Stefanelli
- Department of Infectious, Parasitic and Immuno-mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
| | - Giorgia Sulis
- University Division of Infectious and Tropical Diseases, Spedali Civili General Hospital, University of Brescia, Brescia, Italy
| | - Giovanna Renna
- Department of Infectious, Parasitic and Immuno-mediated Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Franco Gargiulo
- Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy
| | - Paola Zanotti
- University Division of Infectious and Tropical Diseases, Spedali Civili General Hospital, University of Brescia, Brescia, Italy
| | - Michela Capelli
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - Maria Antonia De Francesco
- Department of Molecular and Translational Medicine, Institute of Microbiology, University of Brescia, Brescia, Italy
| | - Francesco Donato
- Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - Sergio Pecorelli
- Clinic of Obstetrics and Gynaecology, Spedali Civili General Hospital, University of Brescia, Brescia, Italy
| | - Alberto Matteelli
- University Division of Infectious and Tropical Diseases, Spedali Civili General Hospital, University of Brescia, Brescia, Italy
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Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries. J Clin Microbiol 2015; 53:2172-9. [PMID: 25926497 DOI: 10.1128/jcm.00249-15] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/21/2015] [Indexed: 11/20/2022] Open
Abstract
The Uppsala University Chlamydia trachomatis multilocus sequence type (MLST) database (http://mlstdb.bmc.uu.se) is based on five target regions (non-housekeeping genes) and the ompA gene. Each target has various numbers of alleles-hctB, 89; CT058, 51; CT144, 30; CT172, 38; and pbpB, 35-derived from 13 studies. Our aims were to perform an overall analysis of all C. trachomatis MLST sequence types (STs) in the database, examine STs with global spread, and evaluate the phylogenetic capability by using the five targets. A total of 415 STs were recognized from 2,089 specimens. The addition of 49 ompA gene variants created 459 profiles. ST variation and their geographical distribution were characterized using eBURST and minimum spanning tree analyses. There were 609 samples from men having sex with men (MSM), with 4 predominating STs detected in this group, comprising 63% of MSM cases. Four other STs predominated among 1,383 heterosexual cases comprising, 31% of this group. The diversity index in ocular trachoma cases was significantly lower than in sexually transmitted chlamydia infections. Predominating STs were identified in 12 available C. trachomatis whole genomes which were compared to 22 C. trachomatis full genomes without predominating STs. No specific gene in the 12 genomes with predominating STs could be linked to successful spread of certain STs. Phylogenetic analysis showed that MLST targets provide a tree similar to trees based on whole-genome analysis. The presented MLST scheme identified C. trachomatis strains with global spread. It provides a tool for epidemiological investigations and is useful for phylogenetic analyses.
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Versteeg B, Himschoot M, van den Broek IVF, Bom RJM, Speksnijder AGCL, Schim van der Loeff MF, Bruisten SM. Urogenital Chlamydia trachomatis strain types, defined by high-resolution multilocus sequence typing, in relation to ethnicity and urogenital symptoms among a young screening population in Amsterdam, The Netherlands. Sex Transm Infect 2015; 91:415-22. [PMID: 25688105 DOI: 10.1136/sextrans-2014-051790] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/20/2015] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Previous studies found conflicting results regarding associations between urogenital Chlamydia trachomatis infections and ethnicity or urogenital symptoms among at-risk populations using either ompA-based genotyping or high-resolution multilocus sequence typing (MLST). This study applied high-resolution MLST on samples of individuals from a selected young urban screening population to assess the relationship of C. trachomatis strain types with ethnicity and self-reported urogenital symptoms. Demographic and sexual risk behaviour characteristics of the identified clusters were also analysed. METHODS We selected C. trachomatis-positive samples from the Dutch Chlamydia Screening Implementation study among young individuals in Amsterdam, the Netherlands. All samples were typed using high-resolution MLST. Clusters were assigned using minimum spanning tree analysis and were combined with epidemiological data of the participants. RESULTS We obtained full MLST data for C. trachomatis-positive samples from 439 participants and detected nine ompA genovars. MLST analysis identified 175 sequence types and six large clusters; in one cluster, participants with Surinamese/Antillean ethnicity were over-represented (58.8%) and this cluster predominantly consisted of genovar I. In addition, we found one cluster with an over-representation of participants with Dutch ethnicity (90.0%) and which solely consisted of genovar G. No association was observed between C. trachomatis clusters and urogenital symptoms. CONCLUSIONS We found an association between urogenital C. trachomatis clusters and ethnicity among young screening participants in Amsterdam, the Netherlands. However, no association was found between C. trachomatis clusters and self-reported urogenital symptoms.
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Affiliation(s)
- Bart Versteeg
- Public Health Laboratory, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Michelle Himschoot
- Public Health Laboratory, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Ingrid V F van den Broek
- Epidemiology and Surveillance Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Reinier J M Bom
- Public Health Laboratory, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands Condomerie, Amsterdam, The Netherlands
| | - Arjen G C L Speksnijder
- Public Health Laboratory, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands Department of Research and Education, Naturalis Biodiversity Center, Leiden, The Netherlands
| | - Maarten F Schim van der Loeff
- Department of Research, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands Center for Infections and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The etherlands
| | - Sylvia M Bruisten
- Public Health Laboratory, Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands Center for Infections and Immunity Amsterdam (CINIMA), Academic Medical Center, University of Amsterdam, Amsterdam, The etherlands
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Hocking JS, Guy R, Walker J, Tabrizi SN. Advances in sampling and screening for chlamydia. Future Microbiol 2013; 8:367-86. [PMID: 23464373 DOI: 10.2217/fmb.13.3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection in the developed world, with diagnosis rates continuing to increase each year. As chlamydia is largely asymptomatic, screening and treatment is the main way to detect cases and reduce transmission. Recent advances in self-collected specimens and laboratory tests has made chlamydia screening easier to implement as well as possible in nonclinical settings. This review will discuss new approaches to specimen collection and how these have expanded opportunities for reaching target populations for chlamydia screening. Furthermore, it will discuss how advanced molecular microbiological methods can be used with self-collected specimens to further our knowledge of the epidemiology of chlamydia and the dynamics of transmission.
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Affiliation(s)
- Jane S Hocking
- Centre for Women's Health, Gender & Society, University of Melbourne, Victoria, Australia
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van der Helm JJ, Bom RJM, Grünberg AW, Bruisten SM, Schim van der Loeff MF, Sabajo LOA, de Vries HJC. Urogenital Chlamydia trachomatis infections among ethnic groups in Paramaribo, Suriname; determinants and ethnic sexual mixing patterns. PLoS One 2013; 8:e68698. [PMID: 23874730 PMCID: PMC3714285 DOI: 10.1371/journal.pone.0068698] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 06/01/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about the epidemiology of urogenital Chlamydia trachomatis infection (chlamydia) in Suriname. Suriname is a society composed of many ethnic groups, such as Creoles, Maroons, Hindustani, Javanese, Chinese, Caucasians, and indigenous Amerindians. We estimated determinants for chlamydia, including the role of ethnicity, and identified transmission patterns and ethnic sexual networks among clients of two clinics in Paramaribo, Suriname. METHODS Participants were recruited at two sites a sexually transmitted infections (STI) clinic and a family planning (FP) clinic in Paramaribo. Urine samples from men and nurse-collected vaginal swabs were obtained for nucleic acid amplification testing. Logistic regression analysis was used to identify determinants of chlamydia. Multilocus sequence typing (MLST) was performed to genotype C. trachomatis. To identify transmission patterns and sexual networks, a minimum spanning tree was created, using full MLST profiles. Clusters in the minimum spanning tree were compared for ethnic composition. RESULTS Between March 2008 and July 2010, 415 men and 274 women were included at the STI clinic and 819 women at the FP clinic. Overall chlamydia prevalence was 15% (224/1508). Age, ethnicity, and recruitment site were significantly associated with chlamydia in multivariable analysis. Participants of Creole and Javanese ethnicity were more frequently infected with urogenital chlamydia. Although sexual mixing with other ethnic groups did differ significantly per ethnicity, this mixing was not independently significantly associated with chlamydia. We typed 170 C. trachomatis-positive samples (76%) and identified three large C. trachomatis clusters. Although the proportion from various ethnic groups differed significantly between the clusters (P = 0.003), all five major ethnic groups were represented in all three clusters. CONCLUSION Chlamydia prevalence in Suriname is high and targeted prevention measures are required. Although ethnic sexual mixing differed between ethnic groups, differences in prevalence between ethnic groups could not be explained by sexual mixing.
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Gravningen K, Furberg AS, Simonsen GS, Wilsgaard T. Early sexual behaviour and Chlamydia trachomatis infection - a population based cross-sectional study on gender differences among adolescents in Norway. BMC Infect Dis 2012; 12:319. [PMID: 23174009 PMCID: PMC3538636 DOI: 10.1186/1471-2334-12-319] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/20/2012] [Indexed: 11/14/2022] Open
Abstract
Background Early sexual behaviour has been shown to differ significantly between genders, but few studies have addressed this topic to explain the commonly observed differences in chlamydia rates between adolescent girls and boys. Our study aimed to determine chlamydia prevalence in adolescents aged 15–20 years in a high-incidence area in Norway, and to identify gender-specific early sexual behaviours associated with infection. Methods A population based cross-sectional study was conducted among all high school students in five towns in Finnmark county in 2009, using a web-based questionnaire and real-time Chlamydia trachomatis PCR in first-void urine samples (participation rate 85%, 800 girls/818 boys, mean age 17.2 years). Crude and multivariable logistic regression models were applied with chlamydia test result as dependent variable. Results Prevalence of chlamydia infection was 5.7% (95% confidence interval, CI, 4.4–7.3%). Girls were twice as likely to be infected as boys (7.3%, 5.3–9.7 vs 3.9%, 2.3–6.0). Girls reported earlier sexual debut, older partners, higher lifetime number of partners, and were poorer condom users. In girls, higher maternal education (odds ratio, OR, 2.2, 95% CI 1.1–4.4), ≥2 sexual partners past 6 months (OR 3.6, 1.8–7.3), and partner meeting venue at a private party, bar or disco (OR 5.0, 1.1–22.7) increased the odds of infection in the multivariable model. In boys, condom use at first intercourse (OR 0.06, 0.01–0.42) decreased the odds of infection, while having an older last sexual partner (OR 3.7, 1.3–11.0) increased the odds. In all participants, the risk of infection increased if residence outside the family home during school year (OR 2.0, 1.2–3.6), and decreased if condom was used at last intercourse (OR 0.2, 0.1–0.8). Conclusions We detected significant gender differences in chlamydia prevalence and sexual behaviours, and accordingly differing independent risk factors for chlamydia infection. We suggest that accumulation of essentially different experiences in the early sexually active years contribute to gender disparities in chlamydia risk in individuals this age. Gender-specific approaches may be the best alternative to control chlamydia infection in age group 15–20 years.
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Affiliation(s)
- Kirsten Gravningen
- Department of Microbiology and Infection Control, pb 56, University Hospital of North Norway, Tromsø, N-9038, Norway.
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Chlamydia trachomatis strains show specific clustering for men who have sex with men compared to heterosexual populations in Sweden, the Netherlands, and the United States. J Clin Microbiol 2012; 50:3548-55. [PMID: 22915612 DOI: 10.1128/jcm.01713-12] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
High-resolution genotyping of Chlamydia trachomatis improves the characterization of strains infecting different patient groups and sexual networks. In this study, multilocus sequence typing (MLST) and ompA sequence determination were used for an analysis of C. trachomatis strains from 203 men who have sex with men (MSM) from Sweden, the Netherlands, and the United States. The results obtained were compared with data from 153 heterosexual women from Sweden and the Netherlands. The overlap in MLST/ompA profiles between MSM from Sweden and the Netherlands was 68%, while the overlap between heterosexual populations from these countries was only 18%. The distribution of genotypes in MSM from the United States was less similar to that in MSM from the European countries, with 45% and 46% overlaps for MSM in Sweden and the Netherlands, respectively. Minimum-spanning-tree analysis of MLST/ompA sequence types identified two large clusters that contained almost exclusively samples from MSM and comprised 74% of all MSM samples. Three other clusters were predominated by samples from women but also contained MSM specimens. Of 19 detected variants of the MLST target CT144, three variants were highly associated with MSM. Our study supports the hypotheses of both tissue tropism as well as epidemiological network structures as explanations for the linkage between specific genetic variants and sexual orientation.
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