Heterogeneity of Chlamydia trachomatis L2 strains involved in the current outbreak of Lymphogranuloma venereum

Abstract number: 1733_1351

Meyer T., Stellbrink H.J., Fenske S., Stary G., Geusau A., von Krosigk A., Plettenberg A.

Objectives: Since 2003 an outbreak of lymphogranuloma venereum (LGV) among men having sex with men (MSM) was recognized, which has been reported first in Rotterdam, and then was also detected in other European countries and in North America. The disease mainly represented with anal/rectal symptoms, less frequently with genital/inguinal manifestations, and rarely with oral/pharyngeal lesions. The aim of the study was to analyse whether one or multiple Chlamydia trachomatis strains are involved in the current LGV outbreak.

Methods:C. trachomatis infections were diagnosed by detection of bacterial DNA using PCR (TaqMan, Roche) and SDA (ProbeTec, Becton-Dickinson). C. trachomatis genotypes (serotypes) were identified by sequence analysis of the VS4 region of outer membrane protein (Omp) 1. To characterise different strains of LGV genotypes the VS1 and VS2 region of Omp1 were also analysed.

Results: Between July 2003 and October 2006 we have identified 126 patients with LGV, confirmed by detection of genotype L2. Most of these patients resided in Hamburg (n = 65), followed by Berlin (n = 29), Munich (n = 19), and Vienna (n = 10). The majority of the patients were infected with HIV (n = 69), only two patients were HIV negative. Of the remaining 55 patients no information about HIV-status was available. Most of the patients had anal or rectal disease manifestations (98/126, 77.8%). Inguinal lesions (genital ulcer or inguinal lymph node swellings) occurred in 11/126 (8.7%) of the patients. In one patient LGV manifested as oral ulcerative lesion. For 16 patients we did not receive informations about disease manifestations. In 10 patients with anorectal symptoms the same L2 sequence was identified, which was 100% identical to L2b, previously described in Amsterdam. The L2b sequence was also identified in one patient with inguinal disease manifestation, but in another 4 patients with genital or inguinal lesions the L2 sequence was different from L2b.

Conclusion: Sequence analysis of Omp1 regions indicates that more than one L2 strain is involved in the current LGV outbreak. Our preliminary data may further indicate preferential association of individual L2 strains with different disease manifestations.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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