Preliminary report of an outbreak of lymphogranuloma venereum in homosexual men in the Netherlands, with implications for other countries in western Europe

Götz, Hannelore M; Nieuwenhuis, R F; Ossewaarde, T.; Thio, H. Bing; Meijden, Willem van der; Dees, Jan; Zwart, Onno de

doi:10.2807/esw.08.04.02367-en

Cited by 34 publications

(38 citation statements)

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“…A possible explanation for this difference in the epidemiology of cppB-lacking N. gonorrhoeae strains might be that these strains are circulating in certain networks of people practicing unsafe sex in particular urban societies, such as Amsterdam and Rotterdam. The investigation of a cluster of lymphogranuloma venereum proctitis in men having sex with men in Rotterdam revealed such a network with connections to neighboring countries in Western Europe (9). It would be worthwhile to further investigate this difference in the proportions of N. gonorrhoeae lacking the cppB gene in the two largest cities of The Netherlands compared to the rest of the country by culturing and DNA fingerprinting of N. gonorrhoeae strains and combining these data with background information for patients, such as sexual behavior, contacts, and site of infection.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Conventional and Real-Time PCR Assays Using Two Targets for Confirmation of Results of the COBAS AMPLICOR Chlamydia trachomatis / Neisseria gonorrhoeae Test for Detection of Neisseria gonorrhoeae in Clinical Samples

et al. 2005

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Two conventional PCR-enzyme immunoassays (PCR-EIAs) and two real-time PCR assays (LightCycler system; Roche Diagnostics) were evaluated as confirmation assays with cppB and 16S rRNA genes as targets. Of 765 male and female genitourinary and nasopharyngeal specimens positive for Neisseria gonorrhoeae in the COBAS AMPLICOR Chlamydia trachomatis/Neisseria gonorrhoeae PCR test (Roche Diagnostics), 229 (30%) were confirmed positive; 13 of these (5.7%) were lacking the cppB gene. Of the 534 samples (70%) that could not be confirmed, 81 (15%) showed a positive crossing point. However, melting curve analysis revealed an aberrant melting temperature in the LightCycler 16S rRNA assay; therefore, these samples were considered non-N. gonorrhoeae Neisseria species. Both of the 16S rRNA assays performed well, with positive predictive values of 99.1% and 100% for the PCR-EIAs and the real-time assays, respectively, and a negative predictive value of 99.8% for both. The cppB assays were compromised by the absence of the cppB gene in 5.7% of the N. gonorrhoeae-positive samples, resulting in negative predictive values of 96.8% and 97.6% for the PCR-EIAs and the real-time assays, respectively. Therefore, the 16S rRNA gene is preferable to the cppB gene as a target for confirmation assays. The melting curve analysis of the real-time assays provides useful additional information.Chlamydia trachomatis and Neisseria gonorrhoeae are the two most common causes of sexually transmitted infections (STI). Infection by these microorganisms can lead to clinical syndromes ranging from mild urethritis to pelvic inflammatory disease. However, both organisms can also cause asymptomatic infections in women and men; these infections can proceed in women to an ascending infection of the fallopian tubes (3,10,14). The outcome of the ascending infection can be reduced fertility, infertility, or even extrauterine pregnancies. Therefore, early diagnosis is necessary to prevent these complications and control the spread of infection.Several studies have shown that nucleic acid amplification tests are superior to conventional tests for the detection of C. trachomatis and N. gonorrhoeae (4,5,8). Because these organisms are regularly found together, the COBAS AMPLICOR Chlamydia trachomatis/Neisseria gonorrhoeae (CA CT/NG) multiplex PCR test (Roche Diagnostics, Mannheim, Germany) provides a useful platform for STI evaluation. An internal control greatly reduces false-negative results. The CA CT component has proven to be a useful diagnostic tool for the detection of C. trachomatis in cervical scraping and urine specimens (13,22,23). The CA NG component, however, lacks specificity, as some non-N. gonorrhoeae Neisseria species (NgNS) (8, 16) and even lactobacilli (23) have been reported to give falsepositive results. Therefore, confirmation by a second, more specific PCR assay is required, especially in low-prevalence communities (8,15,22). This second PCR assay should be convenient and fast to ensure that the delay introduced by required confirmation is kept ...

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Section: Discussionmentioning

confidence: 99%

Evaluation of Conventional and Real-Time PCR Assays Using Two Targets for Confirmation of Results of the COBAS AMPLICOR Chlamydia trachomatis / Neisseria gonorrhoeae Test for Detection of Neisseria gonorrhoeae in Clinical Samples

et al. 2005

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“…The lymphogranuloma venereum (LGV) 2 serovars L1, L2, and L3 are also sexually transmitted but are associated with a more invasive disease known as lymphogranuloma venereum (4). Although LGV is uncommon in the developed world, there have been recent outbreaks of LGV proctitis in the Netherlands and Western Europe (5,6).…”

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confidence: 99%

Localization of TLR2 and MyD88 to Chlamydia trachomatis Inclusions

O’Connell

Ионова

Quayle

et al. 2006

Journal of Biological Chemistry

108

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Chlamydia trachomatis is an obligate intracellular Gram-negative pathogen and the etiologic agent of significant ocular and genital tract diseases. Chlamydiae primarily infect epithelial cells, and the inflammatory response of these cells to the infection directs both the innate and adaptive immune response. This study focused on determining the cellular immune receptors involved in the early events following infection with the L2 serovar of C. trachomatis. We found that dominant negative MyD88 inhibited interleukin-8 (IL-8) secretion during a productive infection with chlamydia. Furthermore, expression of Toll-like receptor (TLR)-2 was required for IL-8 secretion from infected cells, whereas the effect of TLR4/MD-2 expression was minimal. Cell activation was dependent on infection with live, replicating bacteria, because infection with UV-irradiated bacteria and treatment of infected cells with chloramphenicol, but not ampicillin, abrogated the induction of IL-8 secretion. Finally, we show that both TLR2 and MyD88 co-localize with the intracellular chlamydial inclusion, suggesting that TLR2 is actively engaged in signaling from this intracellular location. These data support the role of TLR2 in the host response to infection with C. trachomatis. Our data further demonstrate that TLR2 and the adaptor MyD88 are specifically recruited to the bacterial or inclusion membrane during a productive infection with chlamydia and provide the first evidence that intracellular TLR2 is responsible for signal transduction during infection with an intracellular bacterium.Chlamydia trachomatis is an obligate intracellular bacterial pathogen associated with a variety of human diseases. The species of C. trachomatis can be divided into biovars, such as the trachoma biovar and the lymphogranuloma venereum biovar; these are further divided into serovars. In the developing world, serovars A-C are associated with trachoma, one of the oldest diseases caused by C. trachomatis infection, and the leading cause of preventable blindness in the world (reviewed in Ref. 1). Serovars D-K are also of the trachoma biovar and are all associated with genital tract disease as well as conjunctivitis and infant pneumonia. The World Health Organization reported 89 million new cases of genital Chlamydia infections in 1995, demonstrating the extent of this infection worldwide and hinting at the economic burden it has on healthcare (2). In 2003, 877,478 cases of infection with C. trachomatis were reported to the CDC from 50 states and the District of Columbia (3), making it the most common bacterial sexually transmitted infection. The lymphogranuloma venereum (LGV) 2 serovars L1, L2, and L3 are also sexually transmitted but are associated with a more invasive disease known as lymphogranuloma venereum (4). Although LGV is uncommon in the developed world, there have been recent outbreaks of LGV proctitis in the Netherlands and Western Europe (5, 6).The unique developmental cycle of the chlamydiae sets them apart from other bacterial species. C. trachomatis ...

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“…The local lymph nodes are involved with pain, swelling, necrosis and perforation [12,49]. Since the recognition of the ongoing outbreak of LGV among MSM in Rotterdam, Holland [50], infections have been reported from many parts of Europe, North America and Australia [12,31,49] and LGV has become endemic among MSM in some areas of the UK [3]. From our experiences 14-16% of patients with symptomatic rectal chlamydia had LGV, a figure increasing to 30% in the case of HIV-positive patients [19] (Table 2c).…”

Section: Ano-rectal Non-lgv Chlamydia and Lgvmentioning

confidence: 99%

Sexually Transmitted Infections (STI) in Men Who Have Sex with Men (MSM)~!2009-08-10~!2009-09-28~!2009-12-24~!

Bratt¹,

Edlund²,

Cullberg³

et al. 2010

TOIDJ

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Preliminary report of an outbreak of lymphogranuloma venereum in homosexual men in the Netherlands, with implications for other countries in western Europe

Abstract: In mid-December 2003, a cluster of lymphogranuloma venereum (LGV) cases was reported to the Municipal Health Service in Rotterdam

Cited by 34 publications

References 0 publications

Evaluation of Conventional and Real-Time PCR Assays Using Two Targets for Confirmation of Results of the COBAS AMPLICOR Chlamydia trachomatis / Neisseria gonorrhoeae Test for Detection of Neisseria gonorrhoeae in Clinical Samples

Evaluation of Conventional and Real-Time PCR Assays Using Two Targets for Confirmation of Results of the COBAS AMPLICOR Chlamydia trachomatis / Neisseria gonorrhoeae Test for Detection of Neisseria gonorrhoeae in Clinical Samples

Localization of TLR2 and MyD88 to Chlamydia trachomatis Inclusions

Sexually Transmitted Infections (STI) in Men Who Have Sex with Men (MSM)~!2009-08-10~!2009-09-28~!2009-12-24~!

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