1
|
Tamarelle J, Penaud B, Tyssandier B, Guichoux E, de Barbeyrac B, Peuchant O. Effects of azithromycin and doxycycline on the vaginal microbiota of women with urogenital Chlamydia trachomatis infection: a substudy of the Chlazidoxy randomized controlled trial. Clin Microbiol Infect 2023:S1198-743X(23)00193-3. [PMID: 37100225 DOI: 10.1016/j.cmi.2023.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 04/11/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVES Dysbiotic bacterial communities within the vagina are associated with Chlamydia trachomatis infection. We compared the effect of treatment with azithromycin and doxycycline on the vaginal microbiota in a cohort of women with a urogenital C. trachomatis infection randomly assigned to one of these treatments (Chlazidoxy trial). METHODS We analysed vaginal samples from 284 women (135 in the azithromycin group and 149 in the doxycycline group) collected at baseline and 6 weeks after treatment initiation. The vaginal microbiota was characterized using 16S rRNA gene sequencing and classified into community state types (CSTs). RESULTS At baseline, 75% (212/284) of the women had a high-risk microbiota (CST-III or CST-IV). A cross-sectional comparison 6 weeks after treatment showed that 15 phylotypes were differentially abundant, but this difference was not reflected at the CST (p=0.772) or diversity level (p=0.339). Between baseline and the 6-week visit, α-diversity (p=0.140) and transition probabilities between CSTs were not significantly different between the groups, and no phylotype was differentially abundant. CONCLUSION In women with urogenital C. trachomatis infection, the vaginal microbiota does not seem to be affected by azithromycin or doxycycline 6 weeks after treatment. Because the vaginal microbiota remains susceptible to C. trachomatis infection (with CST-III or CST-IV) following antibiotic treatment, women remain at risk of reinfection, which could originate from unprotected sexual intercourse or untreated anorectal C. trachomatis infection. This last consideration advocates for the use of doxycycline instead of azithromycin because of its higher anorectal microbiological cure rate.
Collapse
Affiliation(s)
- Jeanne Tamarelle
- Department of Fundamental Microbiology, University of Lausanne, Lausanne, Switzerland.
| | | | | | | | - Bertille de Barbeyrac
- Bordeaux University Hospital, Bacteriology department, French National Reference Center for bacterial STIs, F-33000 Bordeaux, France
| | - Olivia Peuchant
- Bordeaux University Hospital, Bacteriology department, French National Reference Center for bacterial STIs, F-33000 Bordeaux, France; Univ. Bordeaux, CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, F-33000, Bordeaux, France.
| |
Collapse
|
2
|
Viriot D, Lucas E, de Barbeyrac B, Bébéar C, Fouéré S, Dupin N, Bertolotti A, Berçot B, Cazanave C, Delmas G, Pillonel J, Lot F, Ngangro NN. Use of healthcare reimbursement data to monitor bacterial sexually transmitted infection testing in France, 2006 to 2020. Euro Surveill 2022; 27:2100618. [PMID: 36177869 PMCID: PMC9524053 DOI: 10.2807/1560-7917.es.2022.27.39.2100618] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BackgroundDiagnoses of bacterial sexually transmitted infections (STIs) have increased in France since the 2000s. The main strategy to control STI transmission is recommending/facilitating access to condom use, testing, and antibiotic treatments.AimThis study analyses the evolution of STI testing in the private sector in France from 2006 to 2020.MethodsNational health insurance reimbursement data were used to determine numbers and rates of individuals aged ≥ 15 years tested for diagnoses of chlamydia, gonorrhoea and syphilis in the private sector in France and to describe their evolution from 2006 to 2020.ResultsUpward tendencies in testing were observed from 2006 to 2019 for all three STIs. The highest testing rates were identified in people aged 25‒29-years old. The observed testing-increase from 2017 to 2019 was twice as high in young people (< 25 years old) as in older people. In 2019, chlamydia, gonorrhoea and syphilis testing rates were respectively 45.4 (+ 21% since 2017), 41.3 (+ 60%), and 47.2 (+ 22%) per 1,000 inhabitants. For all STIs combined, the number of tested individuals decreased by 37% between March and April 2020 during the first COVID-19 epidemic wave and lockdown in France.ConclusionImprovements found in STI testing rates may have resulted from better awareness, especially among young people and health professionals, of the importance of testing, following prevention campaigns. Nevertheless, testing levels remain insufficient considering increasing diagnoses. In 2020, the COVID-19 pandemic had a considerable impact on STI testing. Partner notification and offering diverse testing opportunities including self-sampling are essential to control STI epidemics particularly in exposed populations.
Collapse
Affiliation(s)
- Delphine Viriot
- Santé publique France (the French National Public Health Agency), Saint-Maurice, France
| | - Etienne Lucas
- Santé publique France (the French National Public Health Agency), Saint-Maurice, France
| | - Bertille de Barbeyrac
- French National Reference Centre for bacterial STI (Chlamydia, Mycoplasma), Bordeaux University Hospital, Bordeaux, France
| | - Cécile Bébéar
- French National Reference Centre for bacterial STI (Chlamydia, Mycoplasma), Bordeaux University Hospital, Bordeaux, France
| | | | - Nicolas Dupin
- French National Reference Centre for bacterial STI (Syphilis), APHP, Cochin University Hospital, Paris, France
| | - Antoine Bertolotti
- Inserm-CIC1410, La Reunion University Hospital, Saint Pierre, Reunion Island, France
| | - Béatrice Berçot
- French National Reference Centre for bacterial STI (Gonorrhea), APHP, Saint-Louis University Hospital, Paris, France
| | - Charles Cazanave
- French National Reference Centre for bacterial STI (Chlamydia, Mycoplasma), Bordeaux University Hospital, Bordeaux, France,Bordeaux University Hospital, Bordeaux, France
| | - Gilles Delmas
- Santé publique France (the French National Public Health Agency), Saint-Maurice, France
| | - Josiane Pillonel
- Santé publique France (the French National Public Health Agency), Saint-Maurice, France
| | - Florence Lot
- Santé publique France (the French National Public Health Agency), Saint-Maurice, France
| | | |
Collapse
|
3
|
Peuchant O, Lhomme E, Martinet P, Grob A, Baïta D, Bernier C, Gibaud SA, Le Hen I, Le Naour E, Trignol-Viguier N, Lanotte P, Lefebvre P, Vachée A, Girard T, Loubinoux J, Bébéar C, Ghezzoul B, Roussillon C, Kret M, de Barbeyrac B. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial. Lancet Infect Dis 2022; 22:1221-1230. [PMID: 35550262 DOI: 10.1016/s1473-3099(22)00148-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Anorectal infections with Chlamydia trachomatis are commonly found in women. Although the efficacy of doxycycline and azithromycin is comparable in the treatment of urogenital infection, their efficacies toward anorectal infection remain unclear. We therefore aimed to compare a single dose of azithromycin with a 7-day course of doxycycline for the treatment of anorectal C trachomatis infection in women with concurrent vaginal infection. METHODS We did a multicentre, open-label, randomised, controlled, superiority trial involving four sexually transmitted infection screening centres and three pregnancy termination centres in France. We included sexually active adult women (≥18 years) with a positive C trachomatis vaginal swab who agreed to provide self-collected anorectal swabs for C trachomatis detection. Participants were randomly assigned (1:1), using block sizes of six and eight and stratification by each investigating centre, to orally receive either azithromycin (a single 1-g dose, with or without food) or doxycycline (100 mg in the morning and evening at mealtimes for 7 days [ie, 100 mg of doxycycline twice per day for 7 days]). All laboratory staff who did the bacteriological analyses, but not the participants and the investigators, were masked to the treatment groups. The primary outcome was the microbiological anorectal cure rate defined as a C trachomatis-negative nucleic acid amplification test (NAAT) result in anorectal specimens 6 weeks after treatment initiation among women who had a baseline C trachomatis-positive anorectal NAAT result. The primary analysis was done in the modified intention-to-treat population, with multiple imputation, which included all women who underwent randomisation and had a C trachomatis-positive vaginal and anorectal NAAT result at baseline. Adverse events were reported in all women who underwent randomisation. This study is registered with ClinicalTrials.gov, number NCT03532464. FINDINGS Between Oct 19, 2018, and April 17, 2020, we randomly assigned a total of 460 participants to either the doxycycline group (n=230) or the azithromycin group (n=230). Four (1%) of 460 participants were excluded because they refused to take doxycycline or were found to be ineligible after randomisation. Among the 456 participants, 357 (78%) had a concurrent C trachomatis-positive anorectal NAAT result at baseline; 184 (52%) of 357 were in the doxycycline group and 173 (48%) were in the azithromycin group (ie, the modified intention-to-treat population). Microbiological anorectal cure occurred in 147 (94%) of 156 participants in the doxycycline group (28 missing values) versus 120 (85%) of 142 in the azithromycin group (31 missing values; adjusted odds ratio with imputation of missing values 0·43 [95% CI 0·21-0·91]; p=0·0274). Reported adverse events possibly related to treatment were notified in 53 (12%) of 456 women: 24 (11%) of 228 in the doxycycline group and 29 (13%) of 228 in the azithromycin group. Gastrointestinal disorders were the most frequently occurring, in 43 (9%) of 456 women: 17 (8%) of 228 in the doxycycline group and 26 (11%) of 228 in the azithromycin group. INTERPRETATION The microbiological anorectal cure rate was significantly lower among women who received a single dose of azithromycin than among those who received a 1-week course of doxycycline. This finding suggests that doxycycline should be the first-line therapy for C trachomatis infection in women. FUNDING French Ministry of Health. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
Collapse
Affiliation(s)
- Olivia Peuchant
- Laboratoire de Bactériologie, Centre National de Référence des Infections Sexuellement Transmissibles Bactériennes, CHU Bordeaux, Bordeaux, France
| | - Edouard Lhomme
- Pôle Santé Publique, Service d'information Médicale, CHU Bordeaux, Bordeaux, France
| | | | - Anne Grob
- CeGIDD, Département des Bouches du Rhône, Marseille, France
| | - Dounia Baïta
- Centre d'Orthogénie, CHU Bordeaux, Bordeaux, France
| | - Claire Bernier
- CeGIDD, Department des Maladies Infectieuses, INSERM UIC 1413, CHU Nantes, Nantes, France
| | | | | | | | | | | | | | - Anne Vachée
- Laboratoire de Bactériologie, CH Roubaix, Roubaix, France
| | - Thomas Girard
- Espace Santé Jeunes Guy Moquet, Hôpital Hôtel-Dieu, AP-HP, Paris, France
| | - Julien Loubinoux
- Service de Bactériologie, Hôpital Cochin, AP-HP Centre-Université de Paris, Paris, France
| | - Cécile Bébéar
- Laboratoire de Bactériologie, Centre National de Référence des Infections Sexuellement Transmissibles Bactériennes, CHU Bordeaux, Bordeaux, France
| | | | - Caroline Roussillon
- Direction de la Recherche Clinique et de l'innovation, Unité de Sécurité et Vigilance des Essais Cliniques, CHU Bordeaux, Bordeaux, France
| | - Marion Kret
- Pôle Santé Publique, Service d'information Médicale, CHU Bordeaux, Bordeaux, France
| | - Bertille de Barbeyrac
- Laboratoire de Bactériologie, Centre National de Référence des Infections Sexuellement Transmissibles Bactériennes, CHU Bordeaux, Bordeaux, France.
| |
Collapse
|
4
|
Touati A, Herrmann B, Hénin N, Laurier-Nadalié C, Bébéar C, de Barbeyrac B, Peuchant O. Spread of clonal genovar E Chlamydia trachomatis among men who have sex with men. PLoS One 2021; 16:e0259274. [PMID: 34714865 PMCID: PMC8555804 DOI: 10.1371/journal.pone.0259274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/16/2021] [Indexed: 11/18/2022] Open
Abstract
In a previous study, we developed a Multi-Locus VNTRs Analysis (MLVA) typing system, called MLVA-5, for the discrimination of Chlamydia trachomatis genovar E strain. The results suggested the clonal spread of a MLVA-5 type 21 strain among men who have sex with men (MSM). We applied the MLVA-5 typing method on 157 French anorectal genovar E specimens and 19 Swedish specimens collected between 2010 and 2015. A total of 29 MLVA-5 types was obtained, with three predominant types among French samples: 78 specimens belonged to MLVA-5 type 21, two other types, 11 and 13, included 9 and 14 specimens, respectively. In 15 cases, one unique MLVA-5 type was observed for a single patient, 7 of which were new types not previously described. The distribution of MLVA-5 types according to sexual orientation showed that the 7 anorectal specimens from heterosexual patients belonged to 6 genotypes, and the 12 anorectal specimens from bisexual patients comprised eight types. The 95 anorectal specimens from MSM were distributed into 22 types, but 55 (57.9%) of them belonged to MLVA-5 type 21. Among the Swedish specimens from MSM, eight were from MLVA-type 21 (4 urines and 4 anorectal specimens). The results support the hypothesis of the spread of clonal genovar E strain among MSM.
Collapse
Affiliation(s)
- Arabella Touati
- Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, Bordeaux, France
- * E-mail:
| | - Björn Herrmann
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Nadège Hénin
- Infections Humaines à Mycoplasmes et Chlamydiae, EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Cécile Laurier-Nadalié
- Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, Bordeaux, France
| | - Cécile Bébéar
- Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, Bordeaux, France
- Infections Humaines à Mycoplasmes et Chlamydiae, EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Bertille de Barbeyrac
- Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, Bordeaux, France
- Infections Humaines à Mycoplasmes et Chlamydiae, EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Olivia Peuchant
- Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, CHU Bordeaux, Bordeaux, France
- Infections Humaines à Mycoplasmes et Chlamydiae, EA 3671, Univ. Bordeaux, Bordeaux, France
| |
Collapse
|
5
|
Le Roy C, Touati A, Balcon C, Garraud J, Molina JM, Berçot B, de Barbeyrac B, Pereyre S, Peuchant O, Bébéar C. Identification of 16S rRNA mutations in Mycoplasma genitalium potentially associated with tetracycline resistance in vivo but not selected in vitro in M. genitalium and Chlamydia trachomatis. J Antimicrob Chemother 2021; 76:1150-1154. [PMID: 33537731 DOI: 10.1093/jac/dkab016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Tetracyclines are widely used for the treatment of bacterial sexually transmitted infections (STIs) and recently have been used successfully for post-exposure prophylaxis of STIs in MSM. We investigated the in vitro and in vivo development of tetracycline resistance in Chlamydia trachomatis and Mycoplasma genitalium and evaluated 16S rRNA mutations associated with acquired resistance in other bacteria. METHODS In vitro selection of resistant mutants of reference strains of C. trachomatis and M. genitalium was undertaken by serial passage in medium containing subinhibitory concentrations of tetracycline or doxycycline, respectively. The 16S rRNA gene of the two microorganisms was amplified and sequenced at different passages, as were those of 43 C. trachomatis- and 106 M. genitalium-positive specimens collected in France from 2013 to 2019. RESULTS No tetracycline- or doxycycline-resistant strains of C. trachomatis and M. genitalium, respectively, were obtained after 30 serial passages. The tetracycline and doxycycline MICs were unchanged and analysis of the 16S rRNA gene, the molecular target of tetracyclines, of C. trachomatis and M. genitalium revealed no mutation. No mutation in the 16S rRNA gene was detected in C. trachomatis-positive specimens. However, six M. genitalium-positive specimens harboured a mutation potentially associated with tetracycline resistance without known prior tetracycline treatment for patients. CONCLUSIONS Tetracyclines did not select in vitro-resistant mutants of C. trachomatis or M. genitalium. However, 16S rRNA mutations either responsible for or associated with tetracycline resistance in other bacteria, including mycoplasma species, were identified in several M. genitalium-positive specimens.
Collapse
Affiliation(s)
- Chloé Le Roy
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France
| | - Arabella Touati
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, F-33000 Bordeaux, France
| | - Carla Balcon
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France
| | - Justine Garraud
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France
| | - Jean-Michel Molina
- Saint-Louis and Lariboisière Hospitals, APHP, Department of Infectious Diseases, Paris, France
| | - Béatrice Berçot
- Saint-Louis Hospital, APHP, Bacteriology Unit, National Reference Centre for Bacterial Sexually Transmitted Infections, Paris, France.,University of Paris, INSERM, IAME Unit, UMR1137, Paris, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France.,CHU Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, F-33000 Bordeaux, France
| | - Sabine Pereyre
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France.,CHU Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, F-33000 Bordeaux, France
| | - Olivia Peuchant
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France.,CHU Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, F-33000 Bordeaux, France
| | - Cécile Bébéar
- Univ. Bordeaux, INRAE, IHMC, EA, 3671, F-33000 Bordeaux, France.,CHU Bordeaux, Department of Bacteriology, National Reference Centre for Bacterial Sexually Transmitted Infections, F-33000 Bordeaux, France
| |
Collapse
|
6
|
Seth-Smith HMB, Bénard A, Bruisten SM, Versteeg B, Herrmann B, Kok J, Carter I, Peuchant O, Bébéar C, Lewis DA, Puerta T, Keše D, Balla E, Zákoucká H, Rob F, Morré SA, de Barbeyrac B, Galán JC, de Vries HJC, Thomson NR, Goldenberger D, Egli A. Ongoing evolution of Chlamydia trachomatis lymphogranuloma venereum: exploring the genomic diversity of circulating strains. Microb Genom 2021; 7. [PMID: 34184981 PMCID: PMC8461462 DOI: 10.1099/mgen.0.000599] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lymphogranuloma venereum (LGV), the invasive infection of the sexually transmissible infection (STI) Chlamydia trachomatis, is caused by strains from the LGV biovar, most commonly represented by ompA-genotypes L2b and L2. We investigated the diversity in LGV samples across an international collection over seven years using typing and genome sequencing. LGV-positive samples (n=321) from eight countries collected between 2011 and 2017 (Spain n=97, Netherlands n=67, Switzerland n=64, Australia n=53, Sweden n=37, Hungary n=31, Czechia n=30, Slovenia n=10) were genotyped for pmpH and ompA variants. All were found to contain the 9 bp insertion in the pmpH gene, previously associated with ompA-genotype L2b. However, analysis of the ompA gene shows ompA-genotype L2b (n=83), ompA-genotype L2 (n=180) and several variants of these (n=52; 12 variant types), as well as other/mixed ompA-genotypes (n=6). To elucidate the genomic diversity, whole genome sequencing (WGS) was performed from selected samples using SureSelect target enrichment, resulting in 42 genomes, covering a diversity of ompA-genotypes and representing most of the countries sampled. A phylogeny of these data clearly shows that these ompA-genotypes derive from an ompA-genotype L2b ancestor, carrying up to eight SNPs per isolate. SNPs within ompA are overrepresented among genomic changes in these samples, each of which results in an amino acid change in the variable domains of OmpA (major outer membrane protein, MOMP). A reversion to ompA-genotype L2 with the L2b genomic backbone is commonly seen. The wide diversity of ompA-genotypes found in these recent LGV samples indicates that this gene is under immunological selection. Our results suggest that the ompA-genotype L2b genomic backbone is the dominant strain circulating and evolving particularly in men who have sex with men (MSM) populations.
Collapse
Affiliation(s)
- Helena M B Seth-Smith
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland.,SIB Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Angèle Bénard
- Present address: Healthcare Systems Research Group, VHIR, Universitat Autònoma de Barcelona, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.,Wellcome Trust Sanger Institute, Cambridge, UK
| | - Sylvia M Bruisten
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AII), Location Academic Medical Centre, Amsterdam, The Netherlands
| | - Bart Versteeg
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Björn Herrmann
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jen Kok
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Olivia Peuchant
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - Cécile Bébéar
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - David A Lewis
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Teresa Puerta
- Unidad de ITS/VIH, Centro Sanitario Sandoval, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - Darja Keše
- University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Ljubljana, Slovenia
| | - Eszter Balla
- Bacterial STI Reference Laboratory, National Public Health Center (former National Center for Epidemiology), Budapest, Hungary
| | - Hana Zákoucká
- National Reference Laboratory for Diagnostics of Syphilis and Chlamydia Infections, National Institute of Public Health, Srobarova 48, 100 42, Prague 10, Czech Republic
| | - Filip Rob
- Department of Dermatovenereology, Second Faculty of Medicine, Charles University and Hospital Bulovka, Budinova 2, 180 81, Prague 8, Czech Republic
| | - Servaas A Morré
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.,Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, The Netherlands
| | - Bertille de Barbeyrac
- CHU Bordeaux, Department of Bacteriology, French National Reference Center for bacterial STIs, Bordeaux, France
| | - Juan Carlos Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain. CIBER en Epidemiología y Salud Pública (CIBERESP)
| | - Henry J C de Vries
- Department of Infectious Diseases, GGD Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity (AII), Location Academic Medical Centre, Amsterdam, The Netherlands
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute, Cambridge, UK.,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Goldenberger
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland
| | - Adrian Egli
- Clinical Bacteriology & Mycology, University Hospital Basel, University of Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| |
Collapse
|
7
|
Carrer M, de Barbeyrac B, Laurier-Nadalié C, Bébéar C, Touati A, Peuchant O. Towards the spread of the new L2b/D-Da hybrid Chlamydia trachomatis strain in men who have sex with men in France? Clin Infect Dis 2021; 73:1130-1131. [PMID: 33744938 DOI: 10.1093/cid/ciab253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mathilde Carrer
- CHU Bordeaux, Infectious and Tropical Diseases Department, Bordeaux, France
| | - Bertille de Barbeyrac
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
| | - Cécile Laurier-Nadalié
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Bébéar
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
| | - Arabella Touati
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Olivia Peuchant
- CHU Bordeaux, Department of Bacteriology, National Reference Centre for bacterial Sexually Transmitted Infections, Bordeaux, France.,Univ. Bordeaux, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA 3671 Mycoplasma and Chlamydial Infections in Humans, Bordeaux, France
| |
Collapse
|
8
|
Vorimore F, Aaziz R, de Barbeyrac B, Peuchant O, Szymańska-Czerwińska M, Herrmann B, Schnee C, Laroucau K. A New SNP-Based Genotyping Method for C. psittaci: Application to Field Samples for Quick Identification. Microorganisms 2021; 9:microorganisms9030625. [PMID: 33803059 PMCID: PMC8002925 DOI: 10.3390/microorganisms9030625] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 12/12/2022] Open
Abstract
Chlamydia (C.) psittaci is the causative agent of avian chlamydiosis and human psittacosis. In this study, we extracted single-nucleotide polymorphisms (SNPs) from the whole genome sequences of 55 C. psittaci strains and identified eight major lineages, most of which are host-related. A combined PCR/high-resolution melting (HRM) assay was developed to screen for eight phylogenetically informative SNPs related to the identified C. psittaci lineages. The PCR-HRM method was validated on 11 available reference strains and with a set of 118 field isolates. Overall, PCR-HRM clustering was consistent with previous genotyping data obtained by ompA and/or MLST analysis. The method was then applied to 28 C. psittaci-positive samples from animal or human cases. As expected, PCR-HRM typing results from human samples identified genotypes linked to ducks and pigeons, a common source of human exposure, but also to the poorly described Mat116-like genotype. The new genotyping method does not require time-consuming sequencing and allows a quick identification of the source of infection.
Collapse
Affiliation(s)
- Fabien Vorimore
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (F.V.); (R.A.)
| | - Rachid Aaziz
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (F.V.); (R.A.)
| | - Bertille de Barbeyrac
- Mycoplasma and Chlamydia Infections in Humans, University of Bordeaux, 33076 Bordeaux, France; (B.d.B.); (O.P.)
| | - Olivia Peuchant
- Mycoplasma and Chlamydia Infections in Humans, University of Bordeaux, 33076 Bordeaux, France; (B.d.B.); (O.P.)
| | | | - Björn Herrmann
- Department of Clinical Microbiology, Uppsala University Hospital, 75185 Uppsala, Sweden;
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, 75123 Uppsala, Sweden
| | - Christiane Schnee
- Institute of Molecular Pathogenesis, Friedrich-Loeffler-Institut (Federal Research Institute for Animal Health), 07743 Jena, Germany;
| | - Karine Laroucau
- Laboratory for Animal Health, Bacterial Zoonosis Unit, ANSES Maisons-Alfort, Paris-Est University, 94706 Paris, France; (F.V.); (R.A.)
- Correspondence:
| |
Collapse
|
9
|
Touati A, Laurier-Nadalié C, Bébéar C, Peuchant O, de Barbeyrac B. Evaluation of four commercial real-time PCR assays for the detection of lymphogranuloma venereum in Chlamydia trachomatis-positive anorectal samples. Clin Microbiol Infect 2020; 27:909.e1-909.e5. [PMID: 32771642 DOI: 10.1016/j.cmi.2020.07.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/20/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by Chlamydia trachomatis (CT) genovars L. The identification of LGV is of therapeutic interest because treatment requires 3 weeks of doxycycline compared with 1 week for infection with a non-L strain. The aim of this study was to evaluate the performance of four commercial real-time PCR kits in comparison with the reference methods used for LGV diagnosis by the French National Reference Centre (NRC) for bacterial STIs. METHODS A total of 215 French CT-positive anorectal specimens collected consecutively in 2017 were used (66 LGV and 149 non-LGV). Among these, 92 were collected from symptomatic men who have sex with men (MSM) and 123 from asymptomatic MSM using pre-exposure prophylaxis. Four commercial assays were evaluated; a single-plex assay RealCycler CHSL kit (Progenie Molecular), tested on all the specimens, and three multiplex kits, the RealCycler Universal ULCGEN (Progenie Molecular), the Allplex Genital Ulcer Assay (Seegene) and the VIASURE Haemophilus ducreyi + CT LGV Real Time PCR Detection kit (CerTest Biotec), tested on the 92 samples from symptomatic MSM. Clinical performance was determined in comparison to the in-house real time PCR targeting the pmpH and the ompA gene sequencing. RESULTS Overall agreement ranged between 91.3% and 100% (95% CI 83.7-100%) with very good Kappa index values (>0.8). The clinical sensitivities and specificities varied between 91% and 100% (95% CI 80.8-100%), and 97% and 100% (95% CI 87.1-100%), respectively, with some kits performing better than others. DISCUSSION The four assays showed very good performance for the detection of LGV on anorectal specimens.
Collapse
Affiliation(s)
- Arabella Touati
- National Reference Centre for Bacterial Sexually Transmitted Infections, Department of Bacteriology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.
| | - Cécile Laurier-Nadalié
- National Reference Centre for Bacterial Sexually Transmitted Infections, Department of Bacteriology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Cécile Bébéar
- National Reference Centre for Bacterial Sexually Transmitted Infections, Department of Bacteriology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; USC EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Olivia Peuchant
- National Reference Centre for Bacterial Sexually Transmitted Infections, Department of Bacteriology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; USC EA 3671, Univ. Bordeaux, Bordeaux, France
| | - Bertille de Barbeyrac
- National Reference Centre for Bacterial Sexually Transmitted Infections, Department of Bacteriology, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; USC EA 3671, Univ. Bordeaux, Bordeaux, France
| |
Collapse
|
10
|
Peuchant O, Touati A, Laurier-Nadalié C, Hénin N, Cazanave C, Bébéar C, de Barbeyrac B. Prevalence of lymphogranuloma venereum among anorectal Chlamydia trachomatis-positive MSM using pre-exposure prophylaxis for HIV. Sex Transm Infect 2020; 96:615-617. [PMID: 32303577 DOI: 10.1136/sextrans-2019-054346] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 02/26/2020] [Accepted: 03/17/2020] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We evaluated the prevalence of lymphogranuloma venereum (LGV) in anorectal Chlamydia trachomatis-positive French men who have sex with men (MSM) using pre-exposure prophylaxis (PrEP) for HIV. Here, we describe the clinical, biological and behavioural characteristics of these patients. METHODS Laboratories throughout French metropolitan areas performing routine testing for C. trachomatis sent positive anorectal specimens to the National Reference Centre for bacterial STIs for LGV real-time PCR targeting the pmpH gene. Identification of the C. trachomatis genovar was performed by ompA gene sequencing. For each patient, clinical, biological and sexual behaviour data were collected after obtaining written informed consent. RESULTS In 2017, 486 anorectal C. trachomatis-positive specimens from MSM PrEP users were analysed. A strain of genovar L was detected in 91 cases (18.7%). Patients with LGV were significantly more symptomatic, had more sexual partners and more concurrent syphilis compared with their non-LGV counterparts. OmpA gene sequencing, successful in two-thirds of anorectal C. trachomatis-positive specimens, showed that the LGV cases were mainly of variant L2b (n=33), followed by genovar L2 (n=27) and genetic L2b ompA variants (n=16). In 11 cases, the results indicated the occurrence of genetic exchange between L and non-L genovars. CONCLUSIONS LGV was diagnosed in 18.7% of anorectal C. trachomatis-positive specimens from French MSM using PrEP. LGV testing should be carried out for MSM diagnosed with chlamydia and with a large number of sexual partners, high-risk practices and anorectal symptoms. These patients should be presumptively treated as having LGV. This is the first surveillance study of LGV among MSM PrEP users and monitoring should continue.
Collapse
Affiliation(s)
- Olivia Peuchant
- Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France .,INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Arabella Touati
- CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Laurier-Nadalié
- CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Nadege Hénin
- Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France
| | - Charles Cazanave
- Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France.,CHU de Bordeaux, Infectious and Tropical Diseases Department, Bordeaux, France
| | - Cécile Bébéar
- Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,INRA, USC EA3671, Mycoplasmal and Chlamydial Infections in Humans, Bordeaux, France.,CHU de Bordeaux, National Reference Center for bacterial Sexually Transmitted Infections, Bordeaux, France
| |
Collapse
|
11
|
Peuchant O, Lhomme E, Krêt M, Ghezzoul B, Roussillon C, Bébéar C, Perry F, de Barbeyrac B. Randomized, open-label, multicenter study of azithromycin compared with doxycycline for treating anorectal Chlamydia trachomatis infection concomitant to a vaginal infection (CHLAZIDOXY study). Medicine (Baltimore) 2019; 98:e14572. [PMID: 30762806 PMCID: PMC6408020 DOI: 10.1097/md.0000000000014572] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis can lead to a persistent infection in the lower gastrointestinal tract, suggesting a potential role of autoinoculation of cervical chlamydial infection from the rectal site, contributing to repeat infections. Moreover, around 75% of women with urogenital C. trachomatis have concurrent anorectal infection. Current treatment guidelines for urogenital C. trachomatis infection recommend either a single 1 g dose of azithromycin or doxycycline 100 mg twice daily for 7 days. Doxycycline appears to be more effective in treating anorectal infections as suggested in a population of men who have sex with men, but no randomized controlled trial (RCT) had directly compared azithromycin with doxycycline for the treatment of rectal infections. We propose an open-label RCT to compare the microbial cure obtained with a single 1 g dose of azithromycin versus 100 mg of doxycycline twice daily for 7 days, for the treatment of anorectal C. trachomatis infection concurrent to urogenital infection in women. METHODS AND STUDY DESIGN A total of 460 women with C. trachomatis urogenital infection will be enrolled in the study. Women will be asked to provide self-collected anorectal swabs and will be randomized to receive either a 1 g single dose of azithromycin or doxycycline 100 mg twice daily for 7 days. Clinical and biological data will be collected and patients will complete questionnaires about their sexual behavior. The primary outcome is the microbial cure rate, defined as a C. trachomatis negative nucleic acid amplification test (NAAT) result in the anorectal specimens 6 weeks after treatment initiation among women with a C. trachomatis positive urogenital and anorectal NAAT result at the baseline. The secondary outcome is autoinoculation from the rectum to the vagina, which will be evaluated based on the number of women with the same C. trachomatis genotype profile that will be identified in an anorectal-positive specimen obtained 6 weeks after treatment initiation and in a vaginal-positive specimen obtained four months after treatment. DISCUSSION The results of this trial will establish which treatment is more efficacious against anorectal infection and could affect recommendations for the treatment of urogenital C. trachomatis infection, taking into account concurrent anorectal infection. TRIAL REGISTRATION NUMBERS EudraCT number: 2017-002595-15. CLINICALTRIALS. GOV IDENTIFIER NCT03532464. Date of registration: May 31, 2018. WORLD HEALTH ORGANISATION INTERNATIONAL CLINICAL TRIALS REGISTRY NTC03532464. Secondary ID: CHUBX 2016/26. Date of registration: May 09, 2018.
Collapse
Affiliation(s)
- Olivia Peuchant
- University Bordeaux
- INRA, USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans
- CHU de Bordeaux, Bacteriology department, French National Reference Center for bacterial STI, Bordeaux, France
| | | | - Marion Krêt
- CHU de Bordeaux, Pôle de santé publique, CIC1401-EC
| | | | | | - Cécile Bébéar
- University Bordeaux
- INRA, USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans
- CHU de Bordeaux, Bacteriology department, French National Reference Center for bacterial STI, Bordeaux, France
| | - Frédéric Perry
- CHU de Bordeaux, Research and Clinical Study Department, Bordeaux, France
| | - Bertille de Barbeyrac
- University Bordeaux
- INRA, USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans
- CHU de Bordeaux, Bacteriology department, French National Reference Center for bacterial STI, Bordeaux, France
| |
Collapse
|
12
|
Seth-Smith HM, Galán JC, Goldenberger D, Lewis DA, Peuchant O, Bébéar C, de Barbeyrac B, Bénard A, Carter I, Kok J, Bruisten SM, Versteeg B, Morré SA, Thomson NR, Egli A, de Vries HJ. Concern regarding the alleged spread of hypervirulent lymphogranuloma venereum Chlamydia trachomatis strain in Europe. ACTA ACUST UNITED AC 2018; 22:30511. [PMID: 28449734 PMCID: PMC5476980 DOI: 10.2807/1560-7917.es.2017.22.15.30511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/12/2017] [Indexed: 12/04/2022]
Affiliation(s)
- Helena Mb Seth-Smith
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Juan C Galán
- Servicio de Microbiología, Hospital Universitario Ramón y Cajal. CIBER en Epidemiología y Salud Pública (CIBERESP). Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
| | | | - David A Lewis
- Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia.,Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia
| | - Olivia Peuchant
- University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France
| | - Cecile Bébéar
- University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France
| | - Bertille de Barbeyrac
- University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France
| | - Angele Bénard
- Wellcome Trust Sanger Institute. Cambridge, United Kingdom
| | - Ian Carter
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Jen Kok
- Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia.,Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia
| | - Sylvia M Bruisten
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.,Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart Versteeg
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Servaas A Morré
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.,Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, the Netherlands
| | - Nicholas R Thomson
- Wellcome Trust Sanger Institute. Cambridge, United Kingdom.,London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Adrian Egli
- Clinical Microbiology, University Hospital Basel, Basel, Switzerland.,Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Henry Jc de Vries
- STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.,Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.,Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
13
|
de Seynes C, de Barbeyrac B, Dutronc H, Ribes C, Crémer P, Dubois V, Fabre T, Dupon M, Dauchy FA. Contribution of a multiplex serological test for the preoperative diagnosis of prosthetic joint infection: a prospective study. Infect Dis (Lond) 2018; 50:609-615. [PMID: 29564939 DOI: 10.1080/23744235.2018.1453945] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Prosthetic joint infection (PJI) is a severe complication of orthopaedic surgery. Preoperative diagnosis, although sometimes difficult, is key to choose the relevant treatment. METHODS We conducted a prospective study aimed at evaluating the diagnostic performance of a multiplex serological test for the pre-operative diagnosis of PJI. Blood samples were collected between 1 July 2016 and 31 July 2017 among patients referred for suspected PJI that occurred at least six weeks prior. Infection diagnosis was confirmed using intraoperative bacteriological cultures during prosthetic exchange. RESULTS Seventy-one patients were included, with a median age of 73 years (interquartile range [IQR]: 66-81) and 40 (56%) were male. Twenty-six patients had aseptic loosening and 45 patients had PJI. Among the latter, median time since the last surgery was 96 weeks (IQR: 20-324). Intraoperative cultures found Staphylococcus spp, Streptococcus spp or both in 39, 5 and 1 patients, respectively. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 81.8, 95.4, 97.3 and 72.4%, respectively, for all patients and 87.5, 93.5, 94.6 and 85.3%, respectively, for staphylococcal infections. Patients with false negative (FN) results had a significantly lower blood lymphocyte count (p = .045). CONCLUSIONS Multiplex serological test performed well among patients with chronic staphylococcal prosthetic infection. This approach could contribute to PJI diagnosis especially in patients for whom the pre-operative analysis of joint fluid is not informative.
Collapse
Affiliation(s)
- Camille de Seynes
- a Department of Infectious and Tropical Diseases , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Bertille de Barbeyrac
- b Laboratory of Microbiology , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Hervé Dutronc
- a Department of Infectious and Tropical Diseases , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Clément Ribes
- c Department of Orthopaedic Surgery , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Paul Crémer
- c Department of Orthopaedic Surgery , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Véronique Dubois
- b Laboratory of Microbiology , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Thierry Fabre
- c Department of Orthopaedic Surgery , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Michel Dupon
- a Department of Infectious and Tropical Diseases , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| | - Frédéric-Antoine Dauchy
- a Department of Infectious and Tropical Diseases , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France.,d Centre de Référence Infections Ostéo-Articulaires Complexes du Grand Sud-Ouest (Crioac GSO) , Hôspital Pellegrin, CHU de Bordeaux , Bordeaux , France
| |
Collapse
|
14
|
Tamarelle J, de Barbeyrac B, Le Hen I, Thiébaut A, Bébéar C, Ravel J, Delarocque-Astagneau E. Vaginal microbiota composition and association with prevalent Chlamydia trachomatis infection: a cross-sectional study of young women attending a STI clinic in France. Sex Transm Infect 2018; 94:616-618. [DOI: 10.1136/sextrans-2017-053346] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/09/2017] [Accepted: 12/10/2017] [Indexed: 11/03/2022] Open
Abstract
ObjectivesNew molecular techniques have allowed describing groups of bacterial communities in the vagina (community state types (CST)) that could play an important role in Chlamydia trachomatis (CT) infection. Our aim was to describe the distribution of CST in a population of young women in France.MethodsA cross-sectional study was carried out in June 2015 among anonymous young women attending a STI clinic in Bordeaux, France. Participants provided a vaginal sample for CT screening and sociodemographic data. CT was diagnosed using the Aptima-combo 2 transcription-mediated-amplification assay. Vaginal microbiota composition was characterised using 16S rRNA gene amplicon sequencing.ResultsMicrobiota composition and CT status were available for 132 women. CST dominated by Lactobacillus crispatus (CST-I), L. iners (CST-III) and a diversity of anaerobes (CST-IV) represented 37.1%, 38.6% and 22.0% of the sample, respectively. Twenty-one out of 132 women were CT positive. Proportions of CT-positive women were higher for samples belonging to CST-III (21.6%) and CST-IV (17.2%) than to CST-I (8.2%).ConclusionsFive CST were found in 132 young women from a STI clinic in France. These CSTs were not significantly associated with CT but higher proportions of CT-positive women were found in CST-III and CST-IV, consistent with a previous study in the Netherlands. Though our study lacked statistical power and was cross-sectional, it is a necessary first step to understand the structure of the vaginal microbiota in French women with or without infection before performing in-depth longitudinal studies.
Collapse
|
15
|
Peuchant O, Touati A, Sperandio C, Hénin N, Laurier-Nadalié C, Bébéar C, de Barbeyrac B. Changing Pattern of Chlamydia trachomatis Strains in Lymphogranuloma Venereum Outbreak, France, 2010-2015. Emerg Infect Dis 2018; 22:1945-1947. [PMID: 27767927 PMCID: PMC5088033 DOI: 10.3201/eid2211.160247] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We describe a change in the molecular epidemiology of Chlamydia trachomatis strains involved in an outbreak of rectal lymphogranuloma venereum in France during January 2010-April 2015. Until 2012, the C. trachomatis L2b strain predominated; however, starting in 2013, most cases involved the L2 strain. We also identified 4 genetic L2b ompA variants.
Collapse
|
16
|
Tamarelle J, Thiébaut ACM, Sabin B, Bébéar C, Judlin P, Fauconnier A, Rahib D, Méaude-Roufai L, Ravel J, Morré SA, de Barbeyrac B, Delarocque-Astagneau E. Early screening for Chlamydia trachomatis in young women for primary prevention of pelvic inflammatory disease (i-Predict): study protocol for a randomised controlled trial. Trials 2017; 18:534. [PMID: 29132441 PMCID: PMC5683219 DOI: 10.1186/s13063-017-2211-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/24/2017] [Indexed: 11/21/2022] Open
Abstract
Background Genital infection with Chlamydia trachomatis (Ct) is the most common bacterial sexually transmitted infection, especially among young women. Mostly asymptomatic, it can lead, if untreated, to pelvic inflammatory disease (PID), tubal factor infertility and ectopic pregnancy. Recent data suggest that Ct infections are not controlled in France and in Europe. The effectiveness of a systematic strategy for Ct screening in under-25 women remains controversial. The main objective of the i-Predict trial (Prevention of Diseases Induced by Chlamydia trachomatis) is to determine whether early screening and treatment of 18- to-24-year-old women for genital Ct infection reduces the incidence of PID over 24 months. Methods/design This is a randomised prevention trial including 4000 eighteen- to twenty-four-year-old sexually active female students enrolled at five universities. The participants will provide a self-collected vaginal swab sample and fill in an electronic questionnaire at baseline and at 6, 12 and 18 months after recruitment. Vaginal swabs in the intervention arm will be analysed immediately for Ct positivity, and participants will be referred for treatment if they have a positive test result. Vaginal swabs from the control arm will be analysed at the end of the study. All visits to general practitioners, gynaecologists or gynaecology emergency departments for pelvic pain or other gynaecological symptoms will be recorded to evaluate the incidence of PID, and all participants will attend a final visit in a hospital gynaecology department. The primary endpoint measure will be the incidence of PID over 24 months. The outcome status (confirmed, probable or no PID) will be assessed by two independent experts blinded to group assignment and Ct status. Discussion This trial is expected to largely contribute to the development of recommendations for Ct screening in young women in France to prevent PID and related complications. It is part of a comprehensive approach to gathering data to facilitate decision-making regarding optimal strategies for Ct infection control. The control group of this randomised trial, following current recommendations, will allow better documentation of the natural history of Ct infection, a prerequisite to evaluating the impact of Ct screening. Characterisation of host immunogenetics will also allow identification of women at risk for complications. Trial registration ClinicalTrials.gov, NCT02904811. Registered on September 14, 2016. World Health Organisation International Clinical Trials Registry, NCT02904811. AOM, 15-0063 and P150950. Registered on September 26, 2016. A completed Standard Protocol Items : Recommendations for International Trials (SPIRIT) Checklist is available in additional file 1. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2211-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jeanne Tamarelle
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PhI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Anne C M Thiébaut
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PhI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Bénédicte Sabin
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PhI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France
| | - Cécile Bébéar
- French National Reference Centre for Chlamydia, USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans, University of Bordeaux, Campus Bordeaux Carreire, 146 rue Léo Saignat, 33076, Bordeaux cedex, France
| | - Philippe Judlin
- Service de Gynécologie Obstétrique, Centre Hospitalier Régional Universitaire de Nancy, 10 rue du Dr Heydenreich, 54000, Nancy, France
| | - Arnaud Fauconnier
- Research Unit EA 7285, Risk and safety in clinical medicine for women and perinatal health, Versailles-Saint-Quentin University (UVSQ), Montigny-le-Bretonneux, France.,Department of Gynaecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, Poissy, France
| | - Delphine Rahib
- Santé Publique France, 12 Rue du Val d'Osne, 94410, Saint-Maurice, France
| | - Layidé Méaude-Roufai
- Department of Clinical Research, URC HUPIFO, Hôpital Ambroise Paré, Assistance Publique - Hôpitaux de Paris (AP-HP), 9 avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France
| | - Jacques Ravel
- Institute for Genome Sciences, University of Maryland School of Medicine, 801 West Baltimore Street, Baltimore, MD, 21201, USA.,Department of Microbiology and Immunology, University of Maryland School of Medicine, 801 West Baltimore Street, Baltimore, MD, 21201, USA
| | - Servaas A Morré
- Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, Research School V-ICI, VU University Medical Centre, De Boelelaan 1118, 1081HV, Amsterdam, The Netherlands.,Institute for 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 (UM), Universiteitssingel 50, 6229 ER, Maastricht, The Netherlands
| | - Bertille de Barbeyrac
- French National Reference Centre for Chlamydia, USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans, University of Bordeaux, Campus Bordeaux Carreire, 146 rue Léo Saignat, 33076, Bordeaux cedex, France
| | - Elisabeth Delarocque-Astagneau
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PhI), Inserm, UVSQ, Institut Pasteur, Université Paris-Saclay, 2 avenue de la source de la Bièvre, 78180, Montigny-le-Bretonneux, France.
| | | |
Collapse
|
17
|
Desclaux A, Touati A, Neau D, Laurier-Nadalié C, Bébéar C, de Barbeyrac B, Cazanave C. Extra-rectal lymphogranuloma venereum in France: a clinical and molecular study. Sex Transm Infect 2017; 94:3-8. [PMID: 28698211 DOI: 10.1136/sextrans-2017-053126] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/18/2017] [Accepted: 05/20/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe a series of extrarectal lymphogranuloma venereum (LGV) cases diagnosed in France. METHODS Consecutive LGV cases confirmed at the French Reference Centre for chlamydiae with an extrarectal sample from January 2010 to December 2015 were included. The first part of the study consisted of a retrospective case note review and analysis. In a second part, the complete ompA gene sequence of our samples was determined. RESULTS There were 56 cases overall: 50 cases of genital LGV and six cases of pharyngeal LGV. Subjects were all men, median age 39 years, 27/53 were HIV-positive, 47/51 reported having sex with other men, 43/49 reported multiple sexual partners (a mean 25 in the last 6 months). Median time from symptom onset to diagnosis was 21 days. Subjects most commonly presented with inguinal adenopathy alone (19 of 50 genital cases) and adenopathy with genital ulcer (17 of 50). Three pharyngeal cases were symptomatic. Fever was reported in 11 cases. Inguinal abscess was reported in 22 of 42 cases presenting with lymphadenopathy. Co-infections were frequent: eight cases of syphilis, four non-LGV Chlamydia trachomatis infections, one case of gonorrhoea. Cure was always achieved with doxycycline therapy but prolonged treatment was necessary in eight cases with inguinal abscess. Genotyping according to ompA sequencing showed the co-circulation of genovars L2 (16 of 42 strains successfully typed) and L2b (24 of 42). There was no association between HIV status and disease severity or genovar distribution. CONCLUSION In the span of 6 years, 56 extrarectal LGV cases were confirmed through genotyping in France. Extrarectal LGV seemed to share a common epidemiological background with rectal disease in terms of affected population and genovar distribution. HIV prevalence was lower than expected.
Collapse
Affiliation(s)
- Arnaud Desclaux
- CHU Bordeaux, Service des Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France
| | - Arabella Touati
- Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France.,Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| | - Didier Neau
- CHU Bordeaux, Service des Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France.,Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| | - Cécile Laurier-Nadalié
- Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France.,Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| | - Cécile Bébéar
- Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France.,Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France.,Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| | - Charles Cazanave
- CHU Bordeaux, Service des Maladies Infectieuses et Tropicales, F-33000 Bordeaux, France.,Univ. Bordeaux, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France.,Institut National de la Recherche Agronomique, USC EA 3671, Infections humaines à mycoplasmes et chlamydiae, F-33000 Bordeaux, France
| |
Collapse
|
18
|
Kersaudy-Rahib D, Lydié N, Leroy C, March L, Bébéar C, Arwidson P, de Barbeyrac B. Chlamyweb Study II: a randomised controlled trial (RCT) of an online offer of home-based Chlamydia trachomatis sampling in France. Sex Transm Infect 2017; 93:188-195. [PMID: 28377422 DOI: 10.1136/sextrans-2015-052510] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 05/20/2016] [Accepted: 05/28/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The number of cases of Chlamydia trachomatis (Ct) diagnosed has increased in the past 15 years in France as well as in other European countries. This paper reports a randomised controlled trial (RCT) to evaluate whether the offer of home-based testing over the internet increased the number of young people tested for chlamydia compared with the current testing strategy and to estimate the number and risks factors of the infected population. This RCT took place as an element of the Chlamyweb Study-a study aiming to evaluate an intervention (the Chlamyweb Intervention) involving the offer of a free self-sampling kit online to sexually active men and women aged 18-24 years in France. METHODS Participants in the Chlamyweb RCT (n=11 075) received either an offer of a free self-sampling kit (intervention group) or were invited to be screened in primary care settings (control group). Risks ratios were used to compare screening rates between the intervention and control groups. Risk factors were analysed for infected people in the intervention group. RESULTS The screening frequency was about three times higher among young people who received a self-sampling kit than those who only received a tailored recommendation to be screened (29.2% vs 8.7%). Although rates of screening among men were lower than among women (23.9% vs 33.9%), the intervention effect was greater among men (adjusted risk ratios (aRR)=4.55 vs aRR=2.94). Ct positivity (6.8%) was similar to that observed in STI clinics. It was higher in women (8.3%) than in men (4.4%). CONCLUSIONS These results invite us to consider the establishment of a large home-based screening programme, although additional studies including economic assessments are needed to evaluate the most appropriate combination of strategies in the French context. TRIAL REGISTRAION NUMBER AFFSAPS n° IDRCB 0211-A01000-41; Results.
Collapse
Affiliation(s)
| | - Nathalie Lydié
- Sexual Health Unit, Santé publique France, Saint-Maurice, France
| | - Chloé Leroy
- Univ. Bordeaux and INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre (NRC) for Chlamydial Infections, Bordeaux, France
| | - Laura March
- Sexual Health Unit, Santé publique France, Saint-Maurice, France
| | - Cécile Bébéar
- Univ. Bordeaux and INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre (NRC) for Chlamydial Infections, Bordeaux, France
| | - Pierre Arwidson
- Sexual Health Unit, Santé publique France, Saint-Maurice, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux and INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre (NRC) for Chlamydial Infections, Bordeaux, France
| |
Collapse
|
19
|
Lydié N, de Barbeyrac B, Bluzat L, Le Roy C, Kersaudy-Rahib D. Chlamyweb Study I: rationale, design and acceptability of an internet-based chlamydia testing intervention. Sex Transm Infect 2017; 93:179-187. [PMID: 28258251 DOI: 10.1136/sextrans-2015-052511] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 08/08/2016] [Accepted: 09/03/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES In recent years, the internet has widely facilitated Chlamydia trachomatis home-sampling. In France (2012), the Chlamyweb Study evaluated an intervention (Chlamyweb) involving home-based self-sampling via the internet. One element of the study consisted of a randomised controlled trial (RCT), which is reported in detail elsewhere. The focus of this paper, however, is on describing the Chlamyweb Intervention and reporting on the non-RCT element of the evaluation of that intervention by the Chlamyweb Study. This involves (1) describing the design and roll-out of the Chlamyweb Intervention, (2) comparing the socio-behavioural profiles of the participants in the intervention with a nationally representative general population sample and (3) examining the factors that influence the acceptance and return of a self-sampling kit supplied to participants in the course of the intervention. METHODS Self-sampling kits were offered to sexually active people aged 18-24 years living on the mainland French. Participants' characteristics were compared with the general population to describe recruited and participant populations. Multivariate analyses by conditional logistic regression were performed to determine factors that were predictors of kit acceptation and use. RESULTS 7215 people aged 18-24 years were included. Compared with the general population, Chlamyweb reached larger proportions of women, younger people and people with several partners in the previous year. 3372 (46.7%) agreed to receive a self-sampling kit and 2084 (61.8%) returned it, with more women doing so than men. The participation rate was associated with age, place of birth, occupational status, number of partners and condom use, differently for men and women. CONCLUSION The offer of easy-to-use, self-sampling kits free of charge appeared to be a logistically feasible strategy for testing in France and reached a large and diverse population including individuals who have limited access to the traditional healthcare system. TRIAL REGISTRATION NUMBER AFFSAPS n° IDRCB 0211-A01000-41; pre-results.
Collapse
Affiliation(s)
- Nathalie Lydié
- Sexual Health Unit, Santé publique France, Saint-Maurice, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux & INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre (NRC) for Chlamydial Infections, Bordeaux, France
| | - Lucile Bluzat
- Sexual Health Unit, Santé publique France, Saint-Maurice, France
| | - Chloé Le Roy
- Univ. Bordeaux & INRA, USC EA 3671 Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre (NRC) for Chlamydial Infections, Bordeaux, France
| | | |
Collapse
|
20
|
Peuchant O, de Diego S, Le Roy C, Frantz-Blancpain S, Hocké C, Bébéar C, de Barbeyrac B. Comparison of three real-time PCR assays for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in young pregnant women. Diagn Microbiol Infect Dis 2015; 83:335-7. [PMID: 26423658 DOI: 10.1016/j.diagmicrobio.2015.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 11/29/2022]
Abstract
We compared 3 commercial real-time PCR assays, the Abbott RealTime CT/NG, the cobas® 4800 CT/NG, and the Cepheid Xpert® CT/NG, for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae in vaginal swabs collected prospectively from pregnant women aged <25 years. The overall agreement among 2 assays ranged from 98.9% to 99.5% with a kappa score between 0.94 and 0.97 for C. trachomatis. For N. gonorrhoeae, the overall agreement was 100%. All kits allowed prompt and specific results for C. trachomatis and N. gonorrhoeae in young pregnant women.
Collapse
Affiliation(s)
- Olivia Peuchant
- Univ. Bordeaux, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France.
| | - Sabrina de Diego
- Univ. Bordeaux, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France
| | - Chloé Le Roy
- Univ. Bordeaux, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France
| | | | - Claude Hocké
- Centre Hospitalier Universitaire de Bordeaux, Service de Gynécologie Obstétrique, Bordeaux, France
| | - Cécile Bébéar
- Univ. Bordeaux, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France
| | - Bertille de Barbeyrac
- Univ. Bordeaux, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; INRA, USC EA 3671 Infections Humaines à Mycoplasmes et à Chlamydiae, Bordeaux, France; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France
| |
Collapse
|
21
|
Hulin V, Oger S, Vorimore F, Aaziz R, de Barbeyrac B, Berruchon J, Sachse K, Laroucau K. Host preference and zoonotic potential of Chlamydia psittaci and C. gallinacea in poultry. Pathog Dis 2015; 73:1-11. [PMID: 25663344 DOI: 10.1093/femspd/ftv005] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2015] [Indexed: 11/13/2022] Open
Abstract
Chlamydia psittaci and C. gallinacea are obligate intracellular bacteria infecting poultry. We conducted a survey in two poultry slaughterhouses that were processing either exclusively ducks (A) or various poultry species except ducks (B). Cloacal swabs were collected from all incoming poultry flocks in the course of a week, and blood samples and pharyngeal swabs were taken from workers. Swabs were examined using PCR and sera were analyzed with two immunoassays. PCR testing revealed the presence of C. psittaci in 9/38 duck flocks and the complete absence of C. gallinacea in these flocks (slaughterhouse A), whereas 16/33 Chlamydiaceae-positive poultry flocks handled in slaughterhouse B harbored C. gallinacea only. In an episode of psittacosis in slaughterhouse A, where one PCR-positive worker presented clinical signs, seroconversions were detected in 10 workers. In contrast, serological responses of slaughterhouse B workers to C. psittaci were generally low. This is in line with the almost complete absence of C. psittaci in handled flocks, where in additional sampling campaigns the agent was detected only once in the course of a year. Our study indicates that C. psittaci has a certain preference for ducks, whereas C. gallinacea was the predominant chlamydial agent in chickens and guinea fowl flocks.
Collapse
Affiliation(s)
- Virginie Hulin
- Paris-Est University, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, 94701 Maisons-Alfort, France
| | - Sabrina Oger
- Regional hospital, Les Oudairies, 85000 La Roche-sur-Yon, France
| | - Fabien Vorimore
- Paris-Est University, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, 94701 Maisons-Alfort, France
| | - Rachid Aaziz
- Paris-Est University, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, 94701 Maisons-Alfort, France
| | - Bertille de Barbeyrac
- National Reference Center for Chlamydia, University of Bordeaux, 33076 Bordeaux, France
| | | | - Konrad Sachse
- OIE Reference Laboratory for Chlamydiosis, Friedrich-Loeffler-Institut (Federal Research Institute for Animal Health), 07743 Jena, Germany
| | - Karine Laroucau
- Paris-Est University, Anses, Animal Health Laboratory, Bacterial Zoonoses Unit, 94701 Maisons-Alfort, France
| |
Collapse
|
22
|
Vorimore F, Thébault A, Poisson S, Cléva D, Robineau J, de Barbeyrac B, Durand B, Laroucau K. Chlamydia psittaci in ducks: a hidden health risk for poultry workers. Pathog Dis 2014; 73:1-9. [PMID: 25854003 DOI: 10.1093/femspd/ftu016] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 11/13/2022] Open
Abstract
Chlamydia psittaci is a zoonotic pathogen associated primarily with avian chlamydiosis also referred as psittacosis. Human psittacosis can lead to severe cases of respiratory disease. The mule duck is one of the main bird hybrids associated with human cases of psittacosis in France. In order to better understand the epidemiology of avian chlamydiosis, monitoring studies were performed in both breeder flocks and mule duck flocks. Surveys conducted in one professional duck bredding organization revealed little shedding in breeder flocks, whereas heavy but asymptomatic C. psittaci shedding was observed in most of the mule duck flocks, mostly when birds were reared in open range conditions on farms. Human cases of psittacosis linked to duck breeder flocks and their progeny led to detection of heavy shedders in all the suspected flocks despite no birds showing clinical signs. Offspring of one of the infected female flocks was analyzed and also proved to be infected by C. psittaci. Field studies suggest that C. psittaci infections in duck farms involve horizontal and probably vertical transmission but that the environment also plays an important role in maintaining infection on farms. In the light of the widespread occurrence of C. psittaci on duck farms, it has become urgent to clearly identify sources of contamination in order to take appropriate field management measures to minimize worker exposure.
Collapse
Affiliation(s)
- Fabien Vorimore
- University of Paris-Est, ANSES, Animal Health Laboratory, Bacterial Zoonoses Unit, F-94706 Maisons-Alfort, France
| | - Anne Thébault
- University of Paris-Est, ANSES, DERNS, F-94701 Maisons-Alfort, France
| | - Sonia Poisson
- University of Paris-Est, ANSES, DERNS, F-94701 Maisons-Alfort, France
| | | | | | - Bertille de Barbeyrac
- University of Bordeaux, French National Reference Centre for Chlamydial Infections, F-33076 Bordeaux, France
| | - Benoit Durand
- University of Paris-Est, ANSES, Epidemiology Unit, F-94701 Maisons-Alfort, France
| | - Karine Laroucau
- University of Paris-Est, ANSES, Animal Health Laboratory, Bacterial Zoonoses Unit, F-94706 Maisons-Alfort, France
| |
Collapse
|
23
|
Cazanave C, Lawson-Ayayi S, Hessamfar M, Neau D, Dupon M, Morlat P, Dabis F, de Barbeyrac B, Bébéar C, Pereyre S. Prevalence of Mycoplasma genitalium Among HIV-Infected Women, Agence Nationale de Recherches sur le SIDA et les hépatites virales CO3 Aquitaine Cohort, France. Sex Transm Dis 2013; 40:653-4. [DOI: 10.1097/01.olq.0000431360.03712.1b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Dauchy FA, Dutronc H, Lawson-Ayayi S, Wirth G, Hofmann P, de Barbeyrac B, Fabre T, Dupon M. Characteristics of prosthetic joint infections leading to bacteremia: A case–control study. ACTA ACUST UNITED AC 2013; 45:863-7. [DOI: 10.3109/00365548.2013.810812] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
25
|
Le Roy C, Papaxanthos A, Liesenfeld O, Mehats V, Clerc M, Bébéar C, de Barbeyrac B. Swabs (dry or collected in universal transport medium) and semen can be used for the detection of Chlamydia trachomatis using the cobas 4800 system. J Med Microbiol 2012; 62:217-222. [PMID: 23118476 DOI: 10.1099/jmm.0.048652-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In this prospective study, the fully automated cobas 4800 CT/NG and the cobas TaqMan CT tests were compared for Chlamydia trachomatis detection in urine and in genital specimens collected with Copan flocked swabs in culture media. A protocol was also established for the highly sensitive detection of C. trachomatis in semen specimens using the cobas 4800 CT/NG test. A total of 708 consecutive urogenital samples (293 male urine samples and 356 vaginal, 45 cervical and 14 urethral swabs) obtained from the Bacteriology Department, as well as 100 consecutive semen samples collected from patients attending the Reproduction Biology Department, Bordeaux University Hospital, France, from July to September 2010, were analysed. Positive and negative agreements between the cobas 4800 CT/NG and cobas TaqMan CT tests were 92.7 % [95 % confidence interval (CI), 82.7-97.1 %] and 99.2 % (95 % CI, 98.2-99.7 %), respectively, with an overall agreement of 98.7 % (699/708). The clinical sensitivity of the cobas 4800 CT/NG assay for C. trachomatis ranged from 90.9 to 100 % depending on specimen type, with an overall prevalence of 7.2 % (51/708). The clinical specificity ranged from 99.1 to 100 % depending on specimen type. Dilution of 25 µl semen samples in cobas PCR medium proved to be the most sensitive protocol with the lowest inhibition rate. In conclusion, the cobas 4800 CT/NG test was found to be an effective method for detection of C. trachomatis in semen, male urine and genital swab samples collected dry or in universal transport medium.
Collapse
Affiliation(s)
- Chloé Le Roy
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France.,Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France
| | | | - Oliver Liesenfeld
- Medical and Scientific Affairs, Roche Molecular Systems, 4300 Hacienda Drive, Pleasanton, CA 94588, USA
| | - Virginie Mehats
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France.,Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France
| | - Maïthé Clerc
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France.,Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France
| | - Cécile Bébéar
- CHU de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France.,INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France.,Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France
| | - Bertille de Barbeyrac
- CHU de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France.,INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France.,Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, 33076 Bordeaux, France
| |
Collapse
|
26
|
Harris SR, Clarke IN, Seth-Smith HMB, Solomon AW, Cutcliffe LT, Marsh P, Skilton RJ, Holland MJ, Mabey D, Peeling RW, Lewis DA, Spratt BG, Unemo M, Persson K, Bjartling C, Brunham R, de Vries HJC, Morré SA, Speksnijder A, Bébéar CM, Clerc M, de Barbeyrac B, Parkhill J, Thomson NR. Whole-genome analysis of diverse Chlamydia trachomatis strains identifies phylogenetic relationships masked by current clinical typing. Nat Genet 2012; 44:413-9, S1. [PMID: 22406642 PMCID: PMC3378690 DOI: 10.1038/ng.2214] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Accepted: 02/06/2012] [Indexed: 11/16/2022]
Abstract
Chlamydia trachomatis is responsible for both trachoma and sexually transmitted infections causing substantial morbidity and economic cost globally. Despite this, our knowledge of its population and evolutionary genetics is limited. Here we present a detailed whole genome phylogeny from representative strains of both trachoma and lymphogranuloma venereum (LGV) biovars from temporally and geographically diverse sources. Our analysis demonstrates that predicting phylogenetic structure using the ompA gene, traditionally used to classify Chlamydia, is misleading because extensive recombination in this region masks true relationships. We show that in many instances ompA is a chimera that can be exchanged in part or whole, both within and between biovars. We also provide evidence for exchange of, and recombination within, the cryptic plasmid, another important diagnostic target. We have used our phylogenetic framework to show how genetic exchange has manifested itself in ocular, urogenital and LGV C. trachomatis strains, including the epidemic LGV serotype L2b.
Collapse
Affiliation(s)
- Simon R Harris
- Pathogen Genomics, The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Peuchant O, Le Roy C, Herrmann B, Clerc M, Bébéar C, de Barbeyrac B. MLVA subtyping of genovar E Chlamydia trachomatis individualizes the Swedish variant and anorectal isolates from men who have sex with men. PLoS One 2012; 7:e31538. [PMID: 22363667 PMCID: PMC3283677 DOI: 10.1371/journal.pone.0031538] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 01/12/2012] [Indexed: 01/22/2023] Open
Abstract
This study describes a new multilocus variable number tandem-repeat (VNTR) analysis (MLVA) typing system for the discrimination of Chlamydia trachomatis genovar D to K isolates or specimens. We focused our MLVA scheme on genovar E which predominates in most populations worldwide. This system does not require culture and therefore can be performed directly on DNA extracted from positive clinical specimens. Our method was based on GeneScan analysis of five VNTR loci labelled with fluorescent dyes by multiplex PCR and capillary electrophoresis. This MLVA, called MLVA-5, was applied to a collection of 220 genovar E and 94 non-E genovar C. trachomatis isolates and specimens obtained from 251 patients and resulted in 38 MLVA-5 types. The genetic stability of the MLVA-5 scheme was assessed for results obtained both in vitro by serial passage culturing and in vivo using concomitant and sequential isolates and specimens. All anorectal genovar E isolates from men who have sex with men exhibited the same MLVA-5 type, suggesting clonal spread. In the same way, we confirmed the clonal origin of the Swedish new variant of C. trachomatis. The MLVA-5 assay was compared to three other molecular typing methods, ompA gene sequencing, multilocus sequence typing (MLST) and a previous MLVA method called MLVA-3, on 43 genovar E isolates. The discriminatory index was 0.913 for MLVA-5, 0.860 for MLST and 0.622 for MLVA-3. Among all of these genotyping methods, MLVA-5 displayed the highest discriminatory power and does not require a time-consuming sequencing step. The results indicate that MLVA-5 enables high-resolution molecular epidemiological characterisation of C. trachomatis genovars D to K infections directly from specimens.
Collapse
Affiliation(s)
- Olivia Peuchant
- Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- CHU de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France
| | - Chloé Le Roy
- Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
| | - Björn Herrmann
- Section of Clinical Bacteriology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Maithé Clerc
- Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
| | - Cécile Bébéar
- Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- CHU de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France
| | - Bertille de Barbeyrac
- Université de Bordeaux, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- INRA, USC Mycoplasmal and Chlamydial Infections in Humans, French National Reference Centre for Chlamydial Infections, Bordeaux, France
- CHU de Bordeaux, Laboratoire de Bactériologie, Bordeaux, France
- * E-mail:
| |
Collapse
|
28
|
de Barbeyrac B, Benali L, Clerc M, Garapon S, Bébéar C, Gromb S. Authors reply to: Min Karen Lo et al., “A response to: Chlamydia Trachomatis infection in children: Do not forget perinatal acquisition.” [J Forensic Legal Med 2010;17:450]. J Forensic Leg Med 2011; 18:187. [DOI: 10.1016/j.jflm.2011.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
29
|
Peuchant O, Duvert JP, Clerc M, Raherison S, Bébéar C, Bébéar CM, de Barbeyrac B. Effects of antibiotics on Chlamydia trachomatis viability as determined by real-time quantitative PCR. J Med Microbiol 2011; 60:508-514. [DOI: 10.1099/jmm.0.023887-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The objective of this study was to determine the effect of antibiotics on Chlamydia trachomatis viability by using a quantitative real-time PCR assay that measured DNA replication and mRNA transcription of the structural omp1 and omp2 genes, 16S rRNA and the groEL1 gene with and without antibiotics. Ofloxacin, moxifloxacin, azithromycin and doxycycline were tested against the serovar D and L2 reference strains and a derivative mutant resistant to fluoroquinolones, L2-OFXR, obtained by in vitro selection. Using DNA quantification, the antibiotic MIC was calculated when the number of DNA copies was equal to that of the chlamydial inoculum at time zero. This method allowed the easy determination of MICs by DNA quantification of the four selected genes and gave similar results to those obtained by immunofluorescence staining without biased interpretation. By using cDNA quantification, the lowest antibiotic concentration for which no RNA was transcribed corresponded to the minimum bactericidal concentration. C. trachomatis still transcribed the16S rRNA and groEL1 genes, even at concentrations well above the MIC, showing a bacteriostatic effect for all antibiotics tested. This method allows the study of antibiotic activity on growth and viability of C. trachomatis by DNA and RNA quantification at the same time without additional cell-culture passaging.
Collapse
Affiliation(s)
- Olivia Peuchant
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Jean Philippe Duvert
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Maïthé Clerc
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Sophie Raherison
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Christiane Bébéar
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Cécile M. Bébéar
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Bertille de Barbeyrac
- Laboratoire de Bactériologie EA 3671, Infections Humaines à Mycoplasmes et Chlamydiae, Centre National de Référence des Infections à Chlamydiae, Université Victor Segalen Bordeaux 2, Bordeaux, France
| |
Collapse
|
30
|
Christerson L, de Vries HJC, de Barbeyrac B, Gaydos CA, Henrich B, Hoffmann S, Schachter J, Thorvaldsen J, Vall-Mayans M, Klint M, Herrmann B, Morré SA. Typing of lymphogranuloma venereum Chlamydia trachomatis strains. Emerg Infect Dis 2011; 16:1777-9. [PMID: 21029543 PMCID: PMC3294511 DOI: 10.3201/eid1611.100379] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We analyzed by multilocus sequence typing 77 lymphogranuloma venereum Chlamydia trachomatis strains from men who have sex with men in Europe and the United States. Specimens from an outbreak in 2003 in Europe were monoclonal. In contrast, several strains were in the United States in the 1980s, including a variant from Europe.
Collapse
|
31
|
de Barbeyrac B, Benali L, Clerc M, Garapon S, Bébéar C, Gromb S. Chlamydia trachomatis infection in children: do not forget perinatal acquisition: a case report of a 7-year old girl, C. trachomatis infected, presumed sexually assaulted. J Forensic Leg Med 2010; 17:96-8. [PMID: 20129430 DOI: 10.1016/j.jflm.2009.07.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 07/01/2009] [Accepted: 07/19/2009] [Indexed: 10/20/2022]
Abstract
A 7-year old girl suspected of having been sexually abused owing to the presence of anal condyloma was found to be infected by Chlamydia trachomatis. Microbiological analysis and anamnesis were consistent with the infection having been acquired at birth. This case confirms that untreated infection acquired at birth can persist for months or years and highlights the value of examining those involved in the suspicion of sexual abuse of the child.
Collapse
Affiliation(s)
- Bertille de Barbeyrac
- Laboratoire de Bactériologie, Centre National de référence des Infections à chlamydiae, Université Victor Segalen, Bordeaux, France.
| | | | | | | | | | | |
Collapse
|
32
|
Raherison S, Clerc M, Trombert S, Cado S, Normandin F, Bébéar C, de Barbeyrac B. Real-time High Resolution Melting PCR for identification of the Swedish variant of Chlamydia trachomatis. J Microbiol Methods 2009; 78:101-3. [DOI: 10.1016/j.mimet.2009.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2009] [Revised: 04/28/2009] [Accepted: 04/29/2009] [Indexed: 11/25/2022]
|
33
|
Dauchy FA, Dupon M, Dutronc H, de Barbeyrac B, Lawson-Ayayi S, Dubuisson V, Souillac V. Association between psoas abscess and prosthetic hip infection: a case-control study. Acta Orthop 2009; 80:198-200. [PMID: 19404803 PMCID: PMC2823166 DOI: 10.3109/17453670902947424] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE The relationship between prosthetic hip infection and a psoas abscess is poorly documented. We determined the frequency of prosthetic hip infections associated with psoas abscesses and identified their determinants. METHODS We conducted a 2-year observational study. Data from patients with psoas abscesses that were associated with prosthetic hip infections were examined in a case-control study. RESULTS Of 106 patients admitted to the Infectious Diseases Department with prosthetic hip infection, 13 also had a psoas abscess (12%; 95% CI: 6-19). By conditional logistic regression analysis, psoas abscesses were observed more frequently in cases of hematogenous prosthetic infections (OR = 93, p = 0.06) and in patients with a history of neoplasm (OR = 20, p = 0.03). INTERPRETATION Our results suggest that the presence of psoas abscesses is a frequent but under-diagnosed complication of prosthetic hip infection. We recommend that an abdominal CT scan be performed on patients with hematogenous prosthetic hip infection or with a history of neoplasm.
Collapse
Affiliation(s)
- Frédéric-Antoine Dauchy
- Department of Infectious Diseases Tropical Medicine, Hôpital Pellegrin, CHU de Bordeaux, Université Bordeaux 2France
| | - Michel Dupon
- Department of Infectious Diseases Tropical Medicine, Hôpital Pellegrin, CHU de Bordeaux, Université Bordeaux 2France
| | - Hervé Dutronc
- Department of Infectious Diseases Tropical Medicine, Hôpital Pellegrin, CHU de Bordeaux, Université Bordeaux 2France
| | | | - Sylvie Lawson-Ayayi
- Institut de Santé Publique d’Epidémiologie et de Développement (ISPED), Institut National de la Santé et de la Recherche Médicale Unité 593 (INSERM)France
| | - Vincent Dubuisson
- Department of General Surgery, Hôpital Pellegrin, CHU de BordeauxFrance
| | - Vincent Souillac
- Department of Orthopaedic Surgery, Hôpital Pellegrin, CHU de Bordeaux, Université Bordeaux 2France
| |
Collapse
|
34
|
Laroucau K, de Barbeyrac B, Vorimore F, Clerc M, Bertin C, Harkinezhad T, Verminnen K, Obeniche F, Capek I, Bébéar C, Durand B, Zanella G, Vanrompay D, Garin-Bastuji B, Sachse K. Chlamydial infections in duck farms associated with human cases of psittacosis in France. Vet Microbiol 2008; 135:82-9. [PMID: 18947944 DOI: 10.1016/j.vetmic.2008.09.048] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Five severe cases of psittacosis in individuals associated with duck farms were notified in France between January and March 2006. Diagnostic examination included serology and/or molecular detection by PCR from respiratory samples. As a consequence, we investigated all duck flocks (n=11) that were housed in the three farms where human infections occurred. While serology by complement fixation test was negative for all samples, cloacal and/or tracheal chlamydial excretion was detected by PCR in all three units. Notably, one duck flock was tested strongly positive in 2 of the 3 affected farms, and Chlamydophila (C.) psittaci strains were isolated from cloacal and/or tracheal swab samples from both farms. Human samples and duck isolates exhibited the same PCR-RFLP restriction pattern, which appeared to be an intermediate between genotypes A and B. Analysis of ompA gene sequences and comparison to those of the type strains showed that the isolates could not be strictly assigned to any of the generally accepted genotypes of C. psittaci. Further analysis by MLVA of the PCR-positive human samples revealed two distinct patterns, which were related to previously isolated C. psittaci duck strains.
Collapse
Affiliation(s)
- Karine Laroucau
- Bacterial Zoonoses Unit, French Food Safety Agency (AFSSA), Maisons-Alfort, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
Since 2003, an ongoing lymphogranuloma venereum (LGV) proctitis outbreak has been reported in industrialised countries with a new variant designated L2b. Only men who have sex with men (MSM) are affected and most are HIV co-infected; delayed or incorrect diagnoses are frequent. We report a rare clinical case of LGV primary stage called "bubonulus" with penile adenopathy and secondary local acute lymphoedema in an MSM seropositive man. This is the first case described of this clinical presentation with a L2b genovar strain, occurring immediately after use of a sex toy. It suggests that this presentation is favoured by host immunity and behavioural factors. These factors may also play a part in the new outbreak of LGV.
Collapse
Affiliation(s)
- Nathalie Spenatto
- CIDDIST Hôpital La Grave, Place Lange, 31059 Toulouse Cedex 9, France.
| | | | | | | |
Collapse
|
36
|
Goldschmidt P, Afghani T, Nadeem M, Ali-Khan W, Chaumeil C, de Barbeyrac B. Clinical and microbiological diagnosis of trachoma in children living in rural areas in the district of Attock, Punjab, Pakistan. Ophthalmic Epidemiol 2006; 13:335-42. [PMID: 17060112 DOI: 10.1080/09286580600943796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Trachoma is a sight-threatening process triggered by infection of the conjunctiva with Chlamydiae. When this infection becomes chronic and is associated with poverty it triggers trachoma, the prime cause of infectious blindness in the world. Since the 1958 report indicating that the highest incidence of trachoma in Pakistan was found in the province of Punjab, no new trials have been published. In the present study, we assessed the prevalence of trachoma in 3968 children living in 11 rural villages in the district of Attock, Punjab, Pakistan. The children with trachoma were sampled to detect C. trachomatis by PCR. METHODS Children in rural villages in the district of Attock were examined for trachoma in February 2004. Samples were obtained by scraping, and DNA was extracted (MagnaPure-LC Robot) and amplified to detect C. trachomatis (Amplicor-Roche). The quality of sampling was assessed by quantifying the number of cells by real-time PCR. RESULTS The prevalence of trachoma was 3.7% (0 to 6.2%). PCR was positive in 20% of samples from trachomatous children and the number of cells was always > 100/sample. The income levels, illiteracy, use of latrines, water supply, and the presence of animals close to dwellings were similar in all the villages. In Sujjenda, the prevalence was doubled in the warmest season. CONCLUSIONS Trachoma was diagnosed in 3.7% of the children aged < 10 years. The low rates for positive PCR may be due to loss of the plasmid, the involvement of other Chlamydiae, or their absence in chronic infections. The results obtained here underestimate the prevalence of trachoma because most of the mothers (and babies) were not tested in the district of Attock.
Collapse
Affiliation(s)
- Pablo Goldschmidt
- Laboratoire du Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
| | | | | | | | | | | |
Collapse
|
37
|
Herida M, Kreplack G, Cardon B, Desenclos JC, de Barbeyrac B. First Case of Urethritis Due toChlamydia trachomatisGenovar L2b. Clin Infect Dis 2006; 43:268-9. [PMID: 16779763 DOI: 10.1086/505310] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
38
|
de Barbeyrac B, Papaxanthos-Roche A, Mathieu C, Germain C, Brun JL, Gachet M, Mayer G, Bébéar C, Chene G, Hocké C. Chlamydia trachomatis in subfertile couples undergoing an in vitro fertilization program: a prospective study. Eur J Obstet Gynecol Reprod Biol 2006; 129:46-53. [PMID: 16701936 DOI: 10.1016/j.ejogrb.2006.02.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 01/10/2006] [Accepted: 02/08/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The objectives were to estimate the prevalence of Chlamydia trachomatis infection in subfertile couples and to study the relationship between markers of C. trachomatis infection and male infertility as well as pregnancy rates after in vitro fertilization (IVF). STUDY DESIGN All consecutive couples consulting for infertility and IVF in Pellegrin Hospital were screened for C. trachomatis by direct (PCR test) and serological methods. RESULTS Two hundred and seventy-seven couples were included in the study (mean age in years: 35 for men, 32 for women; mean duration of infertility: 4 years). The most frequent indication for IVF was tubal factor in 33%, endometriosis in 6%, dysovarian function in 12%, male infertility in 36% and others in 13%. C. trachomatis PCR was positive in 1.2% of men, 95% confidence interval (CI95%): (0.2%; 3.3%) and in 2.7% of women, CI95%: (1.1%; 5.5%). When combining all chlamydial markers, 17.3% of men, CI95%: (12.7%; 22.8%) and 20.4% of women, CI95%: (15.6%; 25.9%) had at least one positive marker. The presence of positive markers was not associated with altered semen characteristics. Couples with positive markers had a pregnancy rate of 23.1% (12 out of 52) compared with 20.2% (24 out of 119) among those with negative markers. CONCLUSION In this population, the presence of past or current C. trachomatis infection was associated with neither semen characteristics nor outcome of IVF in subfertile couples.
Collapse
Affiliation(s)
- Bertille de Barbeyrac
- Service de Bactériologie, Hôpital Pellegrin, Centre Hospitalier Universitaire, Bordeaux, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Ménard A, Clerc M, Subtil A, Mégraud F, Bébéar C, de Barbeyrac B. Development of a real-time PCR for the detection of Chlamydia psittaci. J Med Microbiol 2006; 55:471-473. [PMID: 16533998 DOI: 10.1099/jmm.0.46335-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | - Agathe Subtil
- Unité de Biologie des Interactions Cellulaires, Institut Pasteur, CNRS URA 2582, Paris, France
| | | | | | | |
Collapse
|
40
|
Liassine N, Caulfield A, Ory G, Restellini A, de Barbeyrac B, Sitavanc R, Descombes MC, Luescher D. First confirmed case of lymphogranuloma venereum (LGV) in Switzerland. ACTA ACUST UNITED AC 2005; 10:E050714.4. [PMID: 16785660 DOI: 10.2807/esw.10.28.02748-en] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In April 2005, a 31 year old man in Geneva presented with anorectal syndrome
Collapse
Affiliation(s)
- Nadia Liassine
- Bioanalytique-Riotton, Unilabs group, Geneva, Switzerland.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Herida M, Sednaoui P, Couturier E, Neau D, Clerc M, Scieux C, Kreplak G, Goulet V, Hamers FF, de Barbeyrac B. Rectal lymphogranuloma venereum, France. Emerg Infect Dis 2005; 11:505-6. [PMID: 15789493 PMCID: PMC3298250 DOI: 10.3201/eid1103.040621] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Magid Herida
- Institut de Veille Sanitaire, Saint-Maurice, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Perpoint T, Lina G, Poyart C, de Barbeyrac B, Traineau R, Jeanne M, Vandenesch F, Etienne J. Two Cases of Fatal Shock after Transfusion of Platelets Contaminated by Staphylococcus aureus: Role of Superantigenic Toxins. Clin Infect Dis 2004; 39:e106-9. [PMID: 15546071 DOI: 10.1086/425499] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2004] [Accepted: 07/14/2004] [Indexed: 11/03/2022] Open
Abstract
We detected Staphylococcus aureus superantigenic toxins in the platelet infusion bags that had been used for 2 patients who subsequently developed transfusion-associated Staphylococcus aureus infection. Both patients, who were immunodeficient, developed manifestations of toxic shock syndrome and septic shock, and they died soon after the onset of infection.
Collapse
Affiliation(s)
- Thomas Perpoint
- Centre National de Référence des Staphylocoques, INSERM E0230, Institute Fédératif de Recherche 62, Lyon, France
| | | | | | | | | | | | | | | |
Collapse
|
43
|
Melin AM, Allery A, Perromat A, Bébéar C, Déléris G, de Barbeyrac B. Fourier transform infrared spectroscopy as a new tool for characterization of mollicutes. J Microbiol Methods 2004; 56:73-82. [PMID: 14706752 DOI: 10.1016/j.mimet.2003.09.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Fourier transform infrared (FT-IR) spectroscopy is a convenient physico-chemical technique to investigate various cell materials. Bacteria of class Mollicutes, identified by conventional methods, as Mycoplasma, Acholeplasma and Ureaplasma genera were characterized using this method. A data set of 74 independent experiments corresponding to fourteen reference strains of Mollicutes was examined by FT-IR spectroscopy to attempt a spectral characterization based on the biomolecular structures. In addition to the separation of Mollicutes within the lipidic region into five main clusters corresponding to the three phylogenetic groups tested, FT-IR spectroscopy allowed a fine discrimination between strains belonging to the same species by using selective spectral windows, particularly in the 1200-900 cm(-1) saccharide range. The results obtained by FT-IR were in good agreement with both taxonomic and phylogenetic classifications of tested strains. Thus, this technique appears to be a useful tool and an accurate mean for a rapid characterization of Mollicutes observed in humans.
Collapse
|
44
|
Ngandjio A, Clerc M, Fonkoua MC, Thonnon J, Lunel F, Bébéar C, Bianchi A, de Barbeyrac B. Restriction endonuclease patterns of the omp1 gene of reference Chlamydia trachomatis strains and characterization of isolates from Cameroonian students. J Med Microbiol 2004; 53:47-50. [PMID: 14663104 DOI: 10.1099/jmm.0.05333-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Eighteen reference strains of Chlamydia trachomatis were differentiated by omp1 PCR- and nested PCR-based RFLP analysis, using two restriction digestions, one with AluI and the other with the three enzymes HpaII, EcoRI and HinfI. AluI digestion allowed the differentiation of 12 different profiles after CT1/CT5 PCR and 13 different profiles after the nested PCR. The triple hydrolysis permitted the identification of 15 different patterns. In all, 16/18 reference strains were clearly identified. These reference patterns were successfully used to genotype 34 of 35 (28 strains and 7 clinical specimens) samples from infected students, collected during a screening programme in Yaounde (Cameroon). Genotypes D, Da, E, F, G and J were found. The most prevalent omp1 genotype was E (n = 14; 40 %), followed by F (n = 7; 20 %). As RFLP patterns of reference strains are essential for typing clinical isolates, they will greatly facilitate C. trachomatis characterization in many resource-limited laboratories.
Collapse
Affiliation(s)
- Antoinette Ngandjio
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Maithe Clerc
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Marie Christine Fonkoua
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Jocelyn Thonnon
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Françoise Lunel
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Christiane Bébéar
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Anne Bianchi
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| | - Bertille de Barbeyrac
- Centre Pasteur du Cameroun, Yaounde, Cameroon 2Laboratoire de Bactériologie, Centre National de Référence des infections à Chlamydia, Université de Bordeaux II, Zone Nord, Bât. 2B, 146 Rue Léo Saignat, 33076 Bordeaux, France 3Institut Alfred Fournier, Paris, France 4Laboratoire Départemental, Conseil Général de Seine Saint Denis, France
| |
Collapse
|