title: Chlamydia trachomatis genovar distribution in clinical urogenital specimens from Tunisian patients: high prevalence of C. trachomatis genovar E and mixed infections.
abstract: BACKGROUND
  This epidemiological study was carried out in Sfax (south of Tunisia) and focused on genital Chlamydia trachomatis (C. trachomatis) genovar distribution.
  
  
  METHODS
  One hundred and thirty seven genital samples from 4067 patients (4.2%) attending the Habib Bourguiba University hospital of Sfax over 12 years (from 2000 to 2011) were found to be C. trachomatis PCR positive by the Cobas Amplicor system. These samples were genotyped by an in house reverse hybridization method.
  
  
  RESULTS
  One hundred and eight (78.8%) samples contained only one genovar and 29 (21.2%) samples contained two or three genovars. Genovar E was the most prevalent (70.8%) single genovar and it was detected in 90.6% of all the cases. Genovars J, C and L1-L3 were not detected in our samples whereas ocular genovars A and B were in 5 cases. All the five cases were mixed infections. Men had more mixed infections than women (p=0.02) and were more frequently infected by genovars F and K (p<0.05). No associations between current infection, infertility and the genovar distribution were observed. Patients coinfected with Neisseria gonorrhoeae were also significantly more frequently infected with mixed genovars (p=0.04).
  
  
  CONCLUSIONS
  In conclusion, we have reported a high prevalence of genovar E and of mixed infections in our study population. Such data could have implications for the control and vaccine development of C. trachomatis in Tunisia.
authors.affiliation: Department of Microbiology and research laboratory Microorganismes et Pathologie Humaine, Habib Bourguiba university hospital, medical school of Sfax, University of Sfax, Sfax, Tunisia.
authors.forename: Houda
authors.initials: H
authors.lastname: Gharsallah
authors.forename: Olfa
authors.initials: O
authors.lastname: Frikha-Gargouri
authors.forename: Hanen
authors.initials: H
authors.lastname: Sellami
authors.forename: Fatma
authors.initials: F
authors.lastname: Besbes
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.forename: Adnene
authors.initials: A
authors.lastname: Hammami
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology*; D002692:Chlamydia trachomatis / Q000472:pathogenicity*; D060085:Coinfection / Q000453:epidemiology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D014416:Tunisia / Q000453:epidemiology; D014566:Urogenital System / Q000382:microbiology*