ObjectivesNew molecular techniques have allowed describing groups of bacterial communities in the vagina (community state types (CST)) that could play an important role in Chlamydia trachomatis (CT) infection. Our aim was to describe the distribution of CST in a population of young women in France.MethodsA cross-sectional study was carried out in June 2015 among anonymous young women attending a STI clinic in Bordeaux, France. Participants provided a vaginal sample for CT screening and sociodemographic data. CT was diagnosed using the Aptima-combo 2 transcription-mediated-amplification assay. Vaginal microbiota composition was characterised using 16S rRNA gene amplicon sequencing.ResultsMicrobiota composition and CT status were available for 132 women. CST dominated by Lactobacillus crispatus (CST-I), L. iners (CST-III) and a diversity of anaerobes (CST-IV) represented 37.1%, 38.6% and 22.0% of the sample, respectively. Twenty-one out of 132 women were CT positive. Proportions of CT-positive women were higher for samples belonging to CST-III (21.6%) and CST-IV (17.2%) than to CST-I (8.2%).ConclusionsFive CST were found in 132 young women from a STI clinic in France. These CSTs were not significantly associated with CT but higher proportions of CT-positive women were found in CST-III and CST-IV, consistent with a previous study in the Netherlands. Though our study lacked statistical power and was cross-sectional, it is a necessary first step to understand the structure of the vaginal microbiota in French women with or without infection before performing in-depth longitudinal studies.

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ᰔWe read with extreme interest the article by Moncada et al.(2) about the use of self-collected glans and rectal swabs for the detection of Chlamydia trachomatis in symptomatic and asymptomatic men who have sex with men (MSM). Indeed, our data complete and confirm those of Moncada et al., as we obtained similar results from a large population of asymptomatic men, including heterosexuals and MSM. We evaluated self-collected glans swabs (GS) and first-catch urine (FCU) from asymptomatic heterosexual men and MSM attending the screening center (anonymous and free of charge) in Bordeaux, France, from February to December 2007. Patients were less than 30 years old and had at least one risk factor. Each patient provided a self-collected GS using a flocked swab (Copan Italia S.p.A., Italy) and an FCU specimen (approximately 10 ml). Initially, swabs were placed into 500 l of M4RT transport medium (method 1). Later, a pooling strategy that consisted of discharging GS into 500 l of FCU (GS plus FCU; method 2) was evaluated. Both samples (GS versus FCU or GS plus FCU versus FCU) were simultaneously tested for C. trachomatis using the real-time PCR assay COBAS TaqMan CT test, CTM CT (Roche Diagnostics). Pairs of specimens with only one positive PCR result were retested by CTM CT assay and by an in-house real-time PCR assay targeting the omp1 gene. A patient was considered to be infected by C. trachomatis when both specimens were positive or when one specimen was positive by both PCR tests.A total of 344 men were tested using the method 1 collection procedure (1). GS and FCU PCR results were positive and concordant in 15 cases, but for 19 cases, they were discordant. After analysis of discrepancies, 27 patients (7.8%) were considered infected. The sensitivity was 89% (24/27) for FCU and 67% (18/27) for GS. The higher sensitivity of the FCU PCR may reflect the very low number of bacteria collected from GS, as shown by the difference of cycle threshold means of at least 4 between FCU (33.2) and PS (38.5), given by the CTM CT assay. The low bacterial load could also explain the discrepancies observed between both specimen results and their nonreproducibility, as three positive FCU specimens and four positive GS were not confirmed by alternate PCR testing.As GS allowed the detection of C. trachomatis infection in three patients who had a negative FCU PCR and to improve the performance of the assay, we tried a pooling strategy collection (method 2) on 259 consecutive men. GS plus FCU and FCU PCR results were positive and concordant in 17 cases, but for 10 cases, they were discordant. After analysis of discrepancies, 19 patients (7.3%) were considered infected. The sensitivity (94.7%; 18/19) was identical for FCU specimens and for GS discharged in FCU, with similar cycle threshold means between both specimens. Thus, pooling GS in FCU did not seem to increase the detection rate of this organism.To conclude, as with Moncada et al. and others (2, 3), we described a poor sensitivity with GS for the detection of C. trachomatis in asympt...

We retrospectively analyzed 1802 nonrectal Chlamydia trachomatis-positive specimens to determine if the L strains responsible for rectal Lymphogranuloma venereum in men who have sex with men could spread to the heterosexual population. No evidence for Lymphogranuloma venereum transmission among heterosexuals in France was observed in 2013. L2b strains seem to be restricted to the men who have sex with men population.

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