Background Outbreaks of Lymphogranuloma venereum (LGV) in sexual networks of men who have sex with men (MSM) are reported in several countries in Europe. Although accurate laboratory diagnosis is required to provide adequate patient management, the laboratory identification of LGV can be problematic.
Objective To establish a fast and reliable testing algorithm for the identification of Chlamydia trachomatis L serovars.
Methods Previously, anal specimens from MSM suspected to be positive for C trachomatis were tested with a testing algorithm using commercial molecular amplification assays. Confirmed C trachomatis samples were then analysed in batches by RFLP to identify the L serovars. From September 2010 onwards, the Abbott CT/NG Real Time PCR has been used for the detection of C trachomatis in biological specimens collected at or referred to the ITM for Chlamydial infection diagnosis. Furthermore, confirmation of C trachomatis and identification of the L serovar types are performed with an in-house Real Time PCR assay. This assay uses DNA extract obtained with the Abbott assay. The selection of the primers and test procedure is based on the publication by Chen et al. and includes two specific probes for the detection of the L and the non L serovars.
Results Out of a total of 940 samples tested with the new methods, we detected 58 (6.2%) positive samples for C trachomatis and of those 12 (20.7%) were L serovars. Eight were detected in specimens collected from the anus, two in urethral specimens, one in urine, and one in a vaginal specimen. All non vaginal specimens were collected from men. With the Abbott CT/NG Real Time PCR for screening and the in house RT PCR assay for confirmation, we were able to confirm positive results for C trachomatis and to distinguish the L serovar from the non L serovar types within 2 days after specimen reception. In addition the in house RT PCR assay was more sensitive, more discriminative and at least 4 times cheaper compared to the RFLP method.
Conclusion The detection of L serovar of C trachomatis can be done on a routine basis at a very acceptable cost and test around time. The L serovar types may be more frequent in Belgium then initially thought, they are present in various biological specimens and possibly in women.
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