title: Correlation between Ureaplasma subgroup 2 and genitourinary tract disease outcomes revealed by an expanded multilocus sequence typing (eMLST) scheme.
abstract: The multilocus sequence typing (MLST) scheme of Ureaplasma based on four housekeeping genes (ftsH, rpL22, valS, and thrS) was described in our previous study; here we introduced an expanded MLST (eMLST) scheme with improved discriminatory power, which was developed by adding two putative virulence genes (ureG and mba-np1) to the original MLST scheme. To evaluate the discriminatory power of eMLST, a total of 14 reference strains of Ureaplasma serovars and 269 clinical strains (134 isolated from symptomatic patients and 135 obtained from asymptomatic persons) were investigated. Our study confirmed that all 14 serotype strains could successfully be differentiated into 14 eMLST STs (eSTs), while some of them could not even be differentiated by the MLST, and a total of 136 eSTs were identified among the clinical isolates we investigated. In addition, phylogenetic analysis indicated that two genetically significantly distant clusters (cluster I and II) were revealed and most clinical isolates were located in cluster I. These findings were in accordance with and further support for the concept of two well-known genetic lineages (Ureaplasma parvum and Ureaplasma urealyticum) in our previous study. Interestingly, although both clusters were associated with clinical manifestation, the sub-group 2 of cluster II had pronounced and adverse effect on patients and might be a potential risk factor for clinical outcomes. In conclusion, the eMLST scheme offers investigators a highly discriminative typing tool that is capable for precise epidemiological investigations and clinical relevance of Ureaplasma.
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Yingying
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Ruan
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Tiejun
authors.initials: T
authors.lastname: Song
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Jingjuan
authors.initials: J
authors.lastname: Song
authors.affiliation: Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Yunsong
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Clinical Laboratory, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Biomedical Research Center, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Xinyou
authors.initials: X
authors.lastname: Xie
mesh_terms: D000483:Alleles; D005798:Genes, Bacterial; D020043:Genes, Essential; D006801:Humans; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D011110:Polymorphism, Genetic; D065288:Serogroup; D014509:Ureaplasma / Q000145:classification* / Q000235:genetics* / Q000472:pathogenicity; D016869:Ureaplasma Infections / Q000175:diagnosis* / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology*; D014774:Virulence / Q000235:genetics
references.citation: Pediatr Res. 2009 May;65(5 Pt 2):84R-90R
references.pmid: 19190528
references.citation: Infect Genet Evol. 2011 Jul;11(5):1121-8
references.pmid: 21511055
references.citation: Eur J Clin Microbiol Infect Dis. 2014 Apr;33(4):537-44
references.pmid: 24072679
references.citation: Clin Microbiol Rev. 2005 Oct;18(4):757-89
references.pmid: 16223956
references.citation: J Clin Microbiol. 2011 Sep;49(9):3325-8
references.pmid: 21795510
references.citation: Nature. 2000 Oct 12;407(6805):757-62
references.pmid: 11048724
references.citation: J Clin Microbiol. 2000 Mar;38(3):1175-9
references.pmid: 10699016
references.citation: Infect Immun. 1991 Mar;59(3):1170-1
references.pmid: 1997418
references.citation: Appl Environ Microbiol. 2004 Feb;70(2):913-20
references.pmid: 14766571
references.citation: J Clin Microbiol. 2010 Aug;48(8):2715-23
references.pmid: 20554828
references.citation: Bioinformatics. 2005 May 15;21(10):2531-3
references.pmid: 15713735
references.citation: Bioinformatics. 2009 Jun 1;25(11):1451-2
references.pmid: 19346325
references.citation: J Clin Microbiol. 1999 Dec;37(12):3883-7
references.pmid: 10565901
references.citation: Food Microbiol. 2013 May;34(1):164-73
references.pmid: 23498194
references.citation: J Clin Microbiol. 1997 May;35(5):1199-202
references.pmid: 9114407
references.citation: Bioinformatics. 2001 Dec;17(12):1230-1
references.pmid: 11751234
references.citation: Infect Genet Evol. 2008 Dec;8(6):764-71
references.pmid: 18707024
references.citation: Pediatr Infect Dis J. 2001 Sep;20(9):854-9
references.pmid: 11734763
references.citation: Mol Biol Evol. 2005 May;22(5):1208-22
references.pmid: 15703242
references.citation: J Clin Microbiol. 2005 Sep;43(9):4852-4
references.pmid: 16145157
references.citation: Pediatr Infect Dis J. 1987 Sep;6(9):825-8
references.pmid: 3670950
references.citation: Annu Rev Microbiol. 2006;60:561-88
references.pmid: 16774461
references.citation: Mol Biol Evol. 2011 Oct;28(10):2731-9
references.pmid: 21546353
references.citation: J Bacteriol. 1993 Jun;175(11):3253-8
references.pmid: 8501029
references.citation: Bioinformatics. 2006 Oct 15;22(20):2493-9
references.pmid: 16895925
references.citation: Trends Microbiol. 2004 Aug;12(8):373-7
references.pmid: 15276613
references.citation: BMC Microbiol. 2012 May 30;12:88
references.pmid: 22646228
references.citation: PLoS One. 2013 Apr 26;8(4):e62746
references.pmid: 23638142
references.citation: Biol Reprod. 2010 Sep;83(3):415-26
references.pmid: 20519696
references.citation: Arch Gynecol Obstet. 2014 Feb;289(2):407-12
references.pmid: 23912532
references.citation: J Clin Microbiol. 1988 Nov;26(11):2465-6
references.pmid: 3069867
references.citation: Int J Syst Evol Microbiol. 2002 Mar;52(Pt 2):587-597
references.pmid: 11931172
references.citation: PLoS One. 2012;7(7):e41480
references.pmid: 22859988
references.citation: Int J Antimicrob Agents. 2013 Oct;42(4):322-8
references.pmid: 23988720
references.citation: J Chemother. 2012 Apr;24(2):81-6
references.pmid: 22546762