ABSTRACT
This study presents the serotype distribution and the antibiotic resistance profile of 953 colonising group B Streptococcus (GBS) recovered from women of child bearing age (15 to 49 years) between 2005 and 2012 in the Lisbon and Tagus Valley region, Portugal. Overall, serotypes Ia, II, III, and V were the most common, accounting 752 of the 953 isolates (about 80%). However, there were changes in GBS distribution, in particular in the two last years of the study. Of note, the proportion of serotype IV isolates increased from 1% (2/148) in 2006 to 20% (19/97) in 2012. Also, considerable proportions of serotype IV isolates from 2010 to 2012 were respectively resistant to erythromycin (9/43; 21%) or clindamycin (6/43; 14%). The identification of nine serotype IV isolates presenting a novel association with the clonal complex (CC) 17 lineage, involving a putative capsular switch, may accentuate their virulence potential and ecological success. Molecular analysis of this subgroup of isolates revealed the presence of rib, IS (insertion sequence) 861 and GBSi1 group II intron within the C5a peptidase gene (scpB) laminin-binding protein gene (lmb) region, reflecting high clonality and a putative common origin. A close surveillance of the emergent type IV/CC17 isolates is crucial considering the potential impact over GBS treatment guidelines and capsular vaccine development.
Subject(s)
Drug Resistance, Microbial/genetics , Streptococcal Infections/epidemiology , Streptococcus agalactiae/classification , Streptococcus agalactiae/isolation & purification , Adolescent , Adult , Antigens, Bacterial/genetics , Child , Clindamycin/administration & dosage , DNA, Bacterial/genetics , Erythromycin/administration & dosage , Female , Genotype , Humans , Microbial Sensitivity Tests , Middle Aged , Molecular Epidemiology , Population Surveillance , Portugal/epidemiology , Sequence Analysis, DNA , Serotyping , Streptococcal Infections/drug therapy , Streptococcal Infections/microbiology , Streptococcus agalactiae/drug effects , Streptococcus agalactiae/genetics , Young AdultABSTRACT
Chlamydia trachomatis, serovar L2, is the causative agent of lymphogranuloma venereum (LGV), which during recent years has been responsible for various outbreaks reported among men who have sex with men (MSM) in Western Europe, America, Canada and Australia. Samples from nine patients with chronic proctitis, seen at a local hospital were sent to us for identification of C. trachomatis serovar L2. The presence of C. trachomatis serovar L DNA was identified by realtime polymerase chain reaction (PCR) in two patients. They both had high positive C. trachomatis antibody titres (>/=10,000) and were found to be infected with serovar L2b by sequencing after amplification of the omp 1 gene by a nested PCR technique. These two individuals met the diagnostic criteria for LGV serovar L2b infection and, to our knowledge, these are the first cases described in Portugal.
Subject(s)
Chlamydia trachomatis/classification , Chlamydia trachomatis/isolation & purification , Lymphogranuloma Venereum/diagnosis , Lymphogranuloma Venereum/microbiology , Proctitis/microbiology , Adult , Antibodies, Bacterial/blood , Chlamydia trachomatis/immunology , DNA, Bacterial/analysis , HIV Infections/complications , Homosexuality, Male , Humans , Incidence , Lymphogranuloma Venereum/epidemiology , Male , Middle Aged , Polymerase Chain Reaction , Portugal , Proctitis/diagnosis , Proctitis/epidemiology , Rectal Diseases/diagnosis , Rectal Diseases/epidemiology , Rectal Diseases/microbiology , SerotypingABSTRACT
We describe two cases of lymphogranuloma venereum (LGV) in men who have sex with men in Portugal in 2008. These first two confirmed cases of LGV L2b proctitis in Portugal highlight the need for an enhanced surveillance programme in Portugal.