1887

Abstract

A recent outbreak of lymphogranuloma venereum (LGV) within the men who have sex with men (MSM) community and their requirement for extended therapy has highlighted the need for laboratory tests that differentiate LGV- from non-LGV-associated serovars of . Two previously described methods were evaluated against 495 clinical specimens referred to the Sexually Transmitted Bacteria Reference Laboratory (London, UK): (i) PCR amplification of a 1.1 kb region of the gene followed by restriction enzyme digestion ( RFLP-PCR); and (ii) real-time PCR targeting a 36 bp deletion present within the polymorphic membrane protein H gene of LGV-associated serovars ( real-time PCR). For specimens that could be categorized using both methods, a 94.7 % (390/412) concordance was achieved. Eighty-three specimens were found to be untypeable by RFLP-PCR due to a failure to amplify the 1.1 kb fragment. Of these 83 untypeable specimens, 19 were determined to be an LGV-associated serovar by real-time PCR. Despite the high level of concordance, there were differences found in the technical complexity of the two methods. The real-time PCR exhibited greater sensitivity, a more rapid turnaround time and a lower technical requirement. Whilst the RFLP-PCR was not as robust as a laboratory diagnostic method, it did enable serovar-level identification. LGV infection remains an important threat to the health of high-risk MSM in Europe. In conclusion, the two methods for the detection of LGV from clinical samples were found not only to have a high concordance (94.7 %) but also to be complementary, and could be used in an integrated way to aid LGV detection.

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2008-08-01
2019-10-17
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References

  1. Alexander, S., Martin, I. & Ison, C. ( 2007; ). Confirming the Chlamydia trachomatis status of referred rectal specimens. Sex Transm Infect 83, 327–329.[CrossRef]
    [Google Scholar]
  2. BASHH ( 2006; ). National Guideline for the Management of Lymphogranuloma venereum (LGV). Available at: http://www.bashh.org/guidelines/2007/lgv_gdl_revised_final2_1106.pdf.
  3. Chen, C. Y., Chi, K. H., Alexander, S., Martin, I. M., Liu, H., Ison, C. A. & Ballard, R. C. ( 2007; ). The molecular diagnosis of lymphogranuloma venereum: evaluation of a real-time multiplex polymerase chain reaction test using rectal and urethral specimens. Sex Transm Dis 34, 451–455.
    [Google Scholar]
  4. Halse, T. A., Musser, K. A. & Limberger, R. J. ( 2006; ). A multiplexed real-time PCR assay for rapid detection of Chlamydia trachomatis and identification of serovar L-2, the major cause of lymphogranuloma venereum in New York. Mol Cell Probes 20, 290–297.[CrossRef]
    [Google Scholar]
  5. Jebbari, H., Alexander, S., Ward, H., Evans, B., Solomou, M., Thornton, A., Deans, G., White, J., French, P. D. & Ison, C. A. ( 2007; ). Update on lymphogranuloma venereum in the UK. Sex Transm Infect 83, 324–326.[CrossRef]
    [Google Scholar]
  6. Lan, J., Walboomers, J. M. M., Roosendaal, R., Doornum, G. J. J., Maclaren, D. M., Meijer, C. J. L. M. & Brule, A. J. C. ( 1993; ). Direct detection and genotyping of Chlamydia trachomatis in cervical scrapes by using polymerase chain reaction and restriction fragment length polymorphism analysis. J Clin Microbiol 31, 1060–1065.
    [Google Scholar]
  7. Lan, J., Ossewaarde, J. M., Walboomers, J. M. M., Meijer, C. J. L. M. & Brule, A. J. C. ( 1994; ). Improved PCR sensitivity for direct genotyping of Chlamydia trachomatis serovars by using a nested PCR. J Clin Microbiol 32, 528–530.
    [Google Scholar]
  8. McLean, C. A., Stoner, B. P. & Workowski, K. A. ( 2007; ). Treatment of lymphogranuloma venereum. Clin Infect Dis 44 (Suppl. 3), S147–S152.[CrossRef]
    [Google Scholar]
  9. Morre, S. A., Spaargaren, J., Fennema, J. S., de Vries, H. J., Coutinho, R. A. & Pena, A. S. ( 2005; ). Real-time polymerase chain reaction to diagnose lymphogranuloma venereum. Emerg Infect Dis 11, 1311–1312.[CrossRef]
    [Google Scholar]
  10. Richardson, D. & Goldmeier, D. ( 2007; ). Lymphogranuloma venereum: an emerging cause of proctitis in men who have sex with men. Int J STD AIDS 18, 11–14.[CrossRef]
    [Google Scholar]
  11. van de Laar, M. J. ( 2006; ). The emergence of LGV in western Europe: what do we know, what can we do? Euro Surveill 11, 146–148.
    [Google Scholar]
  12. Ward, H., Martin, I., Macdonald, N., Alexander, S., Simms, I., Fenton, K., French, P., Dean, G. & Ison, C. ( 2007; ). Lymphogranuloma venereum in the United Kingdom. Clin Infect Dis 44, 26–32.[CrossRef]
    [Google Scholar]
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