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New Chlamydia trachomatis L2 Strains Identified in a Recent Outbreak of Lymphogranuloma Venereum in Vienna, Austria

Stary, Georg MD*; Meyer, Thomas PhD; Bangert, Christine MD*; Kohrgruber, Norbert MD*; Gmeinhart, Bernd MD*; Kirnbauer, Reinhard MD*; Jantschitsch, Christian MD; Rieger, Armin MD*; Stary, Angelika MD§; Geusau, Alexandra MD*

Sexually Transmitted Diseases: April 2008 - Volume 35 - Issue 4 - p 377-382
doi: 10.1097/OLQ.0b013e31815d6df8
Article

Background: Since 2003, an ongoing outbreak of lymphogranuloma venereum (LGV), caused by Chlamydia trachomatis biovar L2b, has been reported among men who have sex with men.

Methods: Twenty-four samples positive for C. trachomatis were analyzed for specific biovars and genovariants by genotyping of the variable segment (VS) 4, VS2 and VS1 regions of the outer membrane protein (omp) A. In addition we assessed the patients’ sociodemographic background and clinical signs and symptoms.

Results: Twenty-four men who have sex with men presented with either anorectal or inguinal symptoms and tested positive for C. trachomatis DNA. Of these, the L2 genotype accounted for 15 patients, with a high coinfection rate with HIV (73.3%) and other sexually transmitted infections (53.4%). Analysis of the VS1, VS2, and VS4 regions of the ompA gene revealed the variant L2b in 8 patients. In 4 patients, 3 new L2 sequences were identified with nucleotide changes in the VS1, VS2, and VS4 region, respectively, defining new strains designated L2c, d, e.

Conclusions: This outbreak of LGV represents the further spread of C. trachomatis L2 infection. Sequence analysis of ompA regions shows heterogeneity of L2 variants, suggesting more than 1 source of the LGV infections diagnosed in Vienna.

This study describes an outbreak of lymphogranuloma venereum in Vienna with novel variants of the genotype L2 of Chlamydia trachomatis and analyzes clinical manifestations and socioepidemiologic data of the lymphogranuloma venereum patients.

From the *Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria; †Labor Arndt und Partner, Hamburg, Germany; ‡Department of Dermatology, Division of Special and Environmental Dermatology, Medical University of Vienna, and §Outpatient Center for the Diagnosis of Infectious Venerodermatological Diseases, Vienna, Austria

We thank Prof. Dr. Georg Stingl for critically reading the manuscript. The work for this article was performed at the DIAID of the Department of Dermatology without additional funding.

Received for publication July 25, 2007, and accepted September 28, 2007.

Correspondence: Georg Stary, MD, Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. E-mail: georg.stary@meduniwien.ac.at.

© Copyright 2008 American Sexually Transmitted Diseases Association