title: Identification of a dominant Chlamydia trachomatis strain in patients attending sexual transmitted infection clinic and female sex workers in Tunisia using a high resolution typing method.
abstract: The distribution of Chlamydia trachomatis genotypes in Tunisia was previously studied using the reverse hybridization method. In this study, we used multilocus sequence typing (MLST) to describe Chlamydia trachomatis genetic diversity among heterosexual populations in Tunisia. The obtained sequence types (STs) were compared with those from a heterosexual population from Amsterdam, the Netherlands.
  
  
  
  Clinical Tunisian patients and female sex workers provided 107 Chlamydia trachomatis positive samples that were used for MLST. Samples from 256 heterosexuals visiting the Amsterdam STI clinic were included as a reference group. Six highly variable genetic regions including the ompA gene were amplified and sequenced. The ST numbers were derived from a Chlamydia typing database (http://mlstdb.uu.se) and used to draw minimum spanning trees.
  
  
  
  ompA sequencing detected 7 genotypes among the Tunisian populations of which genotype E was the most prevalent (66.3%). This genotype E resolved into 23 different STs and among these the ST3 was predominant (53.5%). MLST displayed 43 STs, of which 28 (65%) were new in the database. Minimum spanning tree analysis of all Tunisian samples identified 4 clusters of which one formed a clonal cluster with samples presenting the most prevalent ST3. When comparing samples from the Tunisian and Dutch populations in one minimum spanning tree, there was little overlap between the Chlamydia trachomatis samples.
  
  
  
  The CT-hrMLST scheme allowed us to identify that the Tunisian distribution was dominated by one genotype E (ST3) strain which is also highly prevalent in many other countries worldwide.
authors: Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia. Electronic address: houda_gharsallah@yahoo.fr.
authors: Houda
authors: H
authors: Gharsallah
authors: Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. Electronic address: reinierbom@gmail.com.
authors: Reinier J M
authors: RJM
authors: Bom
authors: Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. Electronic address: sbruisten@ggd.amsterdam.nl.
authors: Sylvia M
authors: SM
authors: Bruisten
authors: Public Health Laboratory, Public Health Service of Amsterdam (GGD Amsterdam), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. Electronic address: mhimschoot@ggd.amsterdam.nl.
authors: Michelle
authors: M
authors: Himschoot
authors: Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia; Biopesticides Team, Centre of Biotechnology of Sfax, Road of Sidi Mansour Km 6, 3018 Sfax, Tunisia. Electronic address: olfafrikhagagouri@ymail.com.
authors: Olfa
authors: O
authors: Frikha-Gargouri
authors: Department of Microbiology and research laboratory "Microorganismes et Pathologies Humaines", Habib Bourguiba University Hospital, Medical School of Sfax, Avenue Majida Boulila 3000, University of Sfax, Tunisia. Electronic address: adnene.hammami@rns.tn.
authors: Adnene
authors: A
authors: Hammami
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000145:classification* / Q000235:genetics*; D016000:Cluster Analysis; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D020010:Heterosexuality; D006801:Humans; D008297:Male; D058885:Multilocus Sequence Typing; D009426:Netherlands / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D060386:Sex Workers; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
keywords: Chlamydia trachomatis; Epidemiology; Genotyping; Multilocus sequence typing; STI