Servicio de Microbiología and CIBER en Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Clin Microbiol Infect. 2014 Mar;20(3):219-25. doi: 10.1111/1469-0691.12256. Epub 2013 Jun 4.
The lymphogranuloma venereum (LGV) outbreak described in the Netherlands in 2003, increased the interest in the genotyping of Chlamydia trachomatis. Although international surveillance programmes were implemented, these studies slowly decreased in the following years. Now data have revealed a new accumulation of LGV cases in those European countries with extended surveillance programmes. Between March 2009 and November 2011, a study was carried out to detect LGV cases in Madrid. The study was based on screening of C. trachomatis using commercial kits, followed by real-time pmpH-PCR discriminating LGV strains, and finally ompA gene was sequenced for phylogenetic reconstruction. Ninety-four LGV infections were identified. The number of cases increased from 10 to 30 and then to 54 during 2009-2011. Incidence of LGV was strongly associated with men who have sex with men; but in 2011, LGV cases were described in women and heterosexual men. Sixty-nine patients were also human immunodeficiency virus (HIV) positive, with detectable viral loads at the moment of LGV diagnosis, suggesting a high-risk of co-transmission. In fact, in four patients the diagnosis of HIV was simultaneous with LGV infection. The conventional treatment with doxycycline was prescribed in 75 patients, although in three patients the treatment failed. The sequencing of the ompA gene permitted identification of two independent transmission nodes. One constituted by 25 sequences identical to the L2b variant, and a second node including 37 sequences identical to L2. This epidemiological situation characterized by the co-circulation of two LGV variants has not been previously described, reinforcing the need for screening and genotyping of LGV strains.
2003 年在荷兰描述的淋巴肉芽肿性尿道炎 (LGV) 爆发增加了对沙眼衣原体基因分型的兴趣。尽管实施了国际监测计划，但这些研究在随后的几年中逐渐减少。现在的数据显示，在扩大监测计划的欧洲国家，LGV 病例有新的积累。2009 年 3 月至 2011 年 11 月，在马德里进行了一项检测 LGV 病例的研究。该研究基于使用商业试剂盒筛查沙眼衣原体，然后使用实时 pmpH-PCR 区分 LGV 株，最后对 ompA 基因进行测序进行系统发育重建。鉴定出 94 例 LGV 感染。2009-2011 年期间，病例数量从 10 例增加到 30 例，然后增加到 54 例。LGV 的发病率与男男性行为者密切相关；但在 2011 年，也在女性和异性恋男性中描述了 LGV 病例。69 例患者还感染了人类免疫缺陷病毒 (HIV)，在 LGV 诊断时可检测到病毒载量，表明存在高共传播风险。事实上，在 4 例患者中，HIV 诊断与 LGV 感染同时发生。在 75 例患者中开具了多西环素的常规治疗，但在 3 例患者中治疗失败。ompA 基因的测序允许识别两个独立的传播节点。一个由 25 个与 L2b 变体相同的序列组成，第二个节点包括 37 个与 L2 相同的序列。这种以前未描述过的由两种 LGV 变体共同循环的流行病学情况，加强了对 LGV 菌株进行筛查和基因分型的必要性。
