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Lodhia Z, Cordeiro D, Correia C, João I, Carreira T, Vieira L, Nunes A, Ferreira R, Schäfer S, Aliyeva E, Portugal C, Monge I, Pessanha MA, Toscano C, Côrte-Real R, Antunes M, Gomes JP, Borges V, José Borrego M. Distribution of Chlamydia trachomatis ompA-genotypes over three decades in Portugal. Sex Transm Infect 2024:sextrans-2024-056166. [PMID: 39266216 DOI: 10.1136/sextrans-2024-056166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 09/02/2024] [Indexed: 09/14/2024] Open
Abstract
OBJECTIVES Chlamydia trachomatis is classified into 15 major genotypes, A to L3, based on the diversity of ompA gene. Here, we evaluated and characterised the distribution and diversity of ompA-genotypes over 32 years (1990-2021) in Portugal. METHODS The collection of the Portuguese National Reference Laboratory for Sexually Transmitted Infections includes 5824 C. trachomatis-positive samples that were successfully ompA-genotyped between 1990 and 2021. An in-depth analysis of ompA-genotypes distribution across the years, as well as by biological sex, age and anatomical site of infection was performed. RESULTS ompA-genotype E was consistently the most frequently detected across the years, with a median frequency of 34.6%, followed by D/Da (17.6%), F (14.3%) and G (10.7%). The prevalence of lymphogranuloma venereum (LGV) genotypes (mostly L2, 62.0%, followed by L2b, 32.1%) increased since 2016, reaching the highest value in 2019 (20.9%). LGV, G and Da genotypes were associated with biological sex, specifically with being male, and were the most frequent among anorectal specimens (37.7%, 19.4% and 17.7%, respectively). Notably, LGV ompA-genotypes represented 38.9% of the male anorectal specimens since 2016, and were also detected among oropharynx and urogenital samples. ompA-genotype E was the most frequently detected at the oropharynx (28.6%) and urogenital (33.9%) sites during the study period, followed by D/Da (17.4%) and F (16.0%) in the urogenital specimens, and by G (26.1%) and D/Da (25.7%) in oropharynx specimens. Our data also highlight the emergence of the recombinant L2b/D-Da strain since 2017 (representing between 2.0% and 15.5% of LGV cases per year) and the non-negligible detection of ompA-genotype B in urogenital and anorectal specimens. CONCLUSIONS This study provides a comprehensive landscape of C. trachomatis molecular surveillance in Portugal, highlighting the continued relevance of ompA-genotyping as a complement to rapid LGV-specific detection tests. It also contributes to a deeper understanding of C. trachomatis epidemiology, diversity and pathogenicity.
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Affiliation(s)
- Zohra Lodhia
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Dora Cordeiro
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Cristina Correia
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Inês João
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Teresa Carreira
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Alexandra Nunes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
- Animal and Veterinary Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University-Lisbon University Centre, Lisboa, Lisboa, Portugal
| | - Rita Ferreira
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Sandra Schäfer
- Clinical Pathology Department, Unidade Local de Saúde Amadora Sintra, Amadora, Portugal
| | - Elzara Aliyeva
- Clinical Pathology Department, Unidade Local de Saúde Amadora Sintra, Amadora, Portugal
| | - Clara Portugal
- Clinical Pathology Department, Unidade Local de Saúde Amadora Sintra, Amadora, Portugal
| | - Isabel Monge
- Clinical Pathology Department, Unidade Local de Saúde Amadora Sintra, Amadora, Portugal
| | - Maria Ana Pessanha
- Laboratory of microbiology and molecular biology, Department of Clinical Pathology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Lisboa, Portugal
| | - Cristina Toscano
- Laboratory of microbiology and molecular biology, Department of Clinical Pathology, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Lisboa, Portugal
| | - Rita Côrte-Real
- Laboratory of Molecular Biology, Department of Clinical Pathology, Unidade Local de Saúde São José - Centro Clínico Académico de Lisboa, Lisboa, Lisboa, Portugal
| | - Marília Antunes
- Centro de Estatística e Aplicações, Faculdade de Ciências, Universidade de Lisboa, Lisboa, Lisboa, Portugal
| | - Joao Paulo Gomes
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
- Animal and Veterinary Research Centre (CECAV), Faculty of Veterinary Medicine, Lusófona University-Lisbon University Centre, Lisboa, Lisboa, Portugal
| | - Vítor Borges
- Genomics and Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
| | - Maria José Borrego
- National Reference Laboratory (NRL) for Sexually Transmitted Infections (STI), Department of Infectious Diseases, National Institute of Health (Instituto Nacional de Saúde Doutor Ricardo Jorge, INSA, IP), Lisboa, Lisboa, Portugal
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Tang Y, Yang X, Duan L, Zhan W, Chen K, Chai H, Liu P, Chen M, Zhao H, Liang L, Wei M, Luo M. Genetic and clinical characteristics of genital Chlamydia trachomatis infection in Guangzhou, China. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2022; 101:105285. [PMID: 35447370 DOI: 10.1016/j.meegid.2022.105285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/14/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Genital Chlamydia trachomatis (CT) is one of the most common agents of sexually transmitted infections and can cause severe disorders. This study aimed to analyse the genetic and clinical characteristics of genital CT infection among women in Guangzhou, China. METHODS From September 2020 to August 2021, a total of 8955 female patients were enrolled in this study. The presence of genital CT was detected by real-time PCR, and 273 positive samples were randomly selected for further genetic and clinical characteristics analysis. RESULTS The positive rate of genital CT infection was 7.5% (670/8955), with the highest rate in women aged 21-30 years. A total of 8 genotypes were identified: DH, J, K, and recombinant genotype Ba/D. The predominant genotype was J (n = 78, 28.6%), followed by E (n = 63, 23.1%), F (n = 48, 17.6%), and D (n = 38, 13.9%). Abnormal vaginal discharge (n = 165, 61.8%), cervical columnar epithelial ectopy (n = 124, 46.4%), vaginal itching (n = 77, 28.8%), and lower abdominal pain (n = 61, 22.8%) were the predominant symptoms. Additionally, genotype G infection exhibited a significantly higher rate of abnormal vaginal discharge (P = 0.03) and genotype D infection exhibited a higher white blood cell count (P = 0.01) than the other genotypes. Phylogenetic analysis revealed a total of 20 variants with 25 mutation positions and the H2 variant in four patients was first discovered in our study. CONCLUSIONS Genotypes J, E, F, and D were the major genotypes of genital CT in Guangzhou, and they manifested as abnormal vaginal discharge, cervical columnar epithelial ectopy, vaginal itching, and lower abdominal pain. The present study provides guidance for future integrated interventions to reduce the burden of genital CT infection and accelerate the development of vaccines.
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Affiliation(s)
- Yuan Tang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Xiaohan Yang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Lei Duan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Wenli Zhan
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Keyi Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Huiying Chai
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Pan Liu
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Minchai Chen
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Hongyu Zhao
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Lihua Liang
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China
| | - Mengru Wei
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China
| | - Mingyong Luo
- Medical Genetic Centre, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou 511442, People's Republic of China; Medical Genetic Centre, Guangdong Women and Children Hospital, Guangzhou 511442, People's Republic of China.
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