Distinct Transmission Networks of Chlamydia trachomatis in Men Who Have Sex with Men and Heterosexual Adults in Amsterdam, The Netherlands

Bom, Reinier J. M.; Helm, Jürgen; Loeff, Maarten F. Schim van der; Rooijen, Martijn S. van; Heijman, Titia; Matser, Amy; Vries, Henry J. C. de; Bruisten, Sylvia M.

doi:10.1371/journal.pone.0053869

Cited by 44 publications

(72 citation statements)

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“…The obtained index was well above 0.95, an "ideal" cutoff value for a molecular typing method (38). The lower D for the predominating clusters in Table 1 is explained by the inclusion of some epidemiologically related samples, especially among MSM who may be connected via extended international sexual networks (15,19).…”

Section: Discussionmentioning

confidence: 99%

“…The third scheme was developed by Klint et al (10); it is intended for short-term clinical epidemiology and outbreak investigations and is based on five highly variable genomic loci (hctB [CT046], CT058, CT144, CT172, and pbpB [CT682]). The MLST scheme has been slightly modified to facilitate rational processing with only 1% loss of discriminatory capacity (13), and the current setup can be found at the Uppsala University C. trachomatis MLST database (http: //mlstdb.bmc.uu.se).Since its development in 2007, the scheme has been applied to a variety of clinical specimens, including samples from cases of urogenital chlamydia (7,(13)(14)(15)(16)(17)(18)(19)(20)(21), LGV (22,23), and trachoma (24). It has been useful for different purposes: (i) identification of clonal spread of LGV (22) …”

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confidence: 99%

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“…Since its development in 2007, the scheme has been applied to a variety of clinical specimens, including samples from cases of urogenital chlamydia (7,(13)(14)(15)(16)(17)(18)(19)(20)(21), LGV (22,23), and trachoma (24). It has been useful for different purposes: (i) identification of clonal spread of LGV (22) and the new variant of C. trachomatis (16,17); (ii) differentiation of strains within the predominating serotype, E (7,17); (iii) differentiation of strains infecting men who have sex with men (MSM) and heterosexuals (15,19); (iv) investigation of the role of tissue tropism (21); and (v) molecular epidemiology and antibiotic treatment of trachoma (24).…”

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confidence: 99%

“…It has been useful for different purposes: (i) identification of clonal spread of LGV (22) and the new variant of C. trachomatis (16,17); (ii) differentiation of strains within the predominating serotype, E (7,17); (iii) differentiation of strains infecting men who have sex with men (MSM) and heterosexuals (15,19); (iv) investigation of the role of tissue tropism (21); and (v) molecular epidemiology and antibiotic treatment of trachoma (24). At present, our database comprises 415 unique sequence types (STs) derived from 2,089 C. trachomatis specimens.…”

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Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries

et al. 2015

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eThe Uppsala University Chlamydia trachomatis multilocus sequence type (MLST) database (http://mlstdb.bmc.uu.se) is based on five target regions (non-housekeeping genes) and the ompA gene. Each target has various numbers of alleles-hctB, 89; CT058, 51; CT144, 30; CT172, 38; and pbpB, 35-derived from 13 studies. Our aims were to perform an overall analysis of all C. trachomatis MLST sequence types (STs) in the database, examine STs with global spread, and evaluate the phylogenetic capability by using the five targets. A total of 415 STs were recognized from 2,089 specimens. The addition of 49 ompA gene variants created 459 profiles. ST variation and their geographical distribution were characterized using eBURST and minimum spanning tree analyses. There were 609 samples from men having sex with men (MSM), with 4 predominating STs detected in this group, comprising 63% of MSM cases. Four other STs predominated among 1,383 heterosexual cases comprising, 31% of this group. The diversity index in ocular trachoma cases was significantly lower than in sexually transmitted chlamydia infections. Predominating STs were identified in 12 available C. trachomatis whole genomes which were compared to 22 C. trachomatis full genomes without predominating STs. No specific gene in the 12 genomes with predominating STs could be linked to successful spread of certain STs. Phylogenetic analysis showed that MLST targets provide a tree similar to trees based on whole-genome analysis. The presented MLST scheme identified C. trachomatis strains with global spread. It provides a tool for epidemiological investigations and is useful for phylogenetic analyses. Chlamydia trachomatis is one of the most common sexually transmitted infections (STIs) worldwide (1), and besides urogenital infections, it also causes lymphogranuloma venereum (LGV), which is a rare but more invasive sexually transmitted disease. In addition, C. trachomatis causes the eye infection trachoma, which is the major infectious cause of preventable blindness worldwide. Severe sequelae from urogenital chlamydia infections include ectopic pregnancy and infertility (2). In spite of testing, treatment, partner notification, and counseling, huge public health efforts have not been able to control urogenital chlamydia infections. Current knowledge about the role of repeated infections and transmission in sexual networks is still limited and needs to be extended to achieve a reduction in the rate of infections.In this context, it is important to have adequate tools for genotyping to understand the epidemiology of chlamydia infections. Traditional typing of C. trachomatis was based on serotyping of the major outer membrane protein (MOMP) and, later on, genotyping of the ompA gene, which encodes MOMP. However, neither MOMP nor ompA provides sufficient discriminatory power for epidemiological purposes (3). In most countries, almost half of all urogenital chlamydia infections are of serotype E, and within this serotype the ompA E/Bour genotype predominates (4-8). Therefore, other typ...

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Section: Discussionmentioning

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries

et al. 2015

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Perceived HIV Status is a Key Determinant of Unprotected Anal Intercourse Within Partnerships of Men Who Have Sex With Men in Amsterdam

et al. 2014

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The practice of unprotected anal intercourse (UAI) involves at least two partners. We examined the associations between insertive or receptive UAI and perceived HIV seroconcordance and partnership type in self-perceived HIV-negative and self-perceived HIV-positive men who have sex with men (MSM). MSM (age ≥ 18 years) were recruited for a cross-sectional survey at the sexually transmitted infections clinic in Amsterdam, the Netherlands, in 2008-2009. Participants completed a questionnaire concerning partnerships in the preceding 6 months. Associations were quantified via multinomial logistic regression models using generalized estimating equations. The outcomes were 'no, or safe anal intercourse', 'insertive UAI', and 'receptive UAI'. We included 5,456 partnerships from 1,890 self-perceived HIV-negative men and 1,861 partnerships from 558 self-perceived HIV-positive men. Within the partnerships, perceived HIV status of the partner was an important determinant of UAI (p < 0.001). Among HIV-negative men, perceived HIV discordance was negatively associated with receptive UAI compared with no or safe UAI (OR 0.57; 95 % CI 0.36-0.92); when the partners were more familiar with each other, the risk of receptive UAI was increased relative to no or safe anal intercourse. Among HIV-positive men, perceived HIV discordance was negatively associated with insertive UAI (OR 0.05; 95 % CI 0.03-0.08). Within partnerships, perceived HIV status of the partner was one of the strongest determinants of UAI among self-perceived HIV-negative and HIV-positive MSM, and discordant serostatus was negatively associated with UAI. The findings suggest that serosorting is one of the main strategies when engaging in UAI.

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Minimum spread of the new Swedish variant of Chlamydia trachomatis and distribution of C. trachomatis ompA genotypes in three geographically distant areas of Spain, 2011–2012

et al. 2014

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The ompA genotype was identified in 565 (90.5%) episodes. Eleven genotypes were detected, of which nine were found in all three regions. Only one nvCT strain was detected (0.4%), despite the predominance of genotype E (41%). Other frequent genotypes were genotypes D (19%), F (13%), G (11 %), and J (7%). Genotype L2b, causing lymphogranuloma venereum, was detected in men who have sex with men (MSM) in all three regions. Genotypes E and F were more frequent in women and heterosexual men, and genotypes D, G, J and L2b in MSM. In men, the main factor causing differences in the distribution of C. trachomatis was sexual behavior (MSM versus heterosexual men), while the distribution of C. trachomatis genotypes was similar in women and heterosexual men.

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Distinct Transmission Networks of Chlamydia trachomatis in Men Who Have Sex with Men and Heterosexual Adults in Amsterdam, The Netherlands

Cited by 44 publications

References 26 publications

Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries

Global Multilocus Sequence Type Analysis of Chlamydia trachomatis Strains from 16 Countries

Perceived HIV Status is a Key Determinant of Unprotected Anal Intercourse Within Partnerships of Men Who Have Sex With Men in Amsterdam

Minimum spread of the new Swedish variant of Chlamydia trachomatis and distribution of C. trachomatis ompA genotypes in three geographically distant areas of Spain, 2011–2012

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