title: New Chlamydia trachomatis L2 strains identified in a recent outbreak of lymphogranuloma venereum in Vienna, Austria.
abstract: 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.
authors.affiliation: Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria. georg.stary@meduniwien.ac.at
authors.forename: Georg
authors.initials: G
authors.lastname: Stary
authors.forename: Thomas
authors.initials: T
authors.lastname: Meyer
authors.forename: Christine
authors.initials: C
authors.lastname: Bangert
authors.forename: Norbert
authors.initials: N
authors.lastname: Kohrgruber
authors.forename: Bernd
authors.initials: B
authors.lastname: Gmeinhart
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kirnbauer
authors.forename: Christian
authors.initials: C
authors.lastname: Jantschitsch
authors.forename: Armin
authors.initials: A
authors.lastname: Rieger
authors.forename: Angelika
authors.initials: A
authors.lastname: Stary
authors.forename: Alexandra
authors.initials: A
authors.lastname: Geusau
mesh_terms: D000328:Adult; D001317:Austria / Q000453:epidemiology; D001425:Bacterial Outer Membrane Proteins / Q000737:chemistry / Q000235:genetics; D001483:Base Sequence; D002692:Chlamydia trachomatis / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D004196:Disease Outbreaks; D005838:Genotype; D018451:Homosexuality, Male; D006801:Humans; D008219:Lymphogranuloma Venereum / Q000453:epidemiology* / Q000382:microbiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA
chemical_list: D001425:Bacterial Outer Membrane Proteins