Skip to main content
SpringerLink
Log in

Chlamydia trachomatis prevalence, genotype distribution and identification of the new Swedish variant in Southern Germany

  • Clinical and Epidemiological Study
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Purpose

In Germany, reliable data about the prevalence of urogenital Chlamydia trachomatis infections, causative genotypes, as well as corresponding clinical, demographic and behavioural information are sparse. We, therefore, performed a prospective prevalence study including 1,003 sexually active volunteers of a Southern German city.

Methods

Study participants completed a standardised questionnaire and provided first void urine samples for analysis. Our screening strategy included the performance of two nucleic acid amplification tests with different target genes, enabling the detection of the new Swedish variant of C. trachomatis (nvCT). Direct genotyping of positive specimens was performed by sequence analysis of the ompA gene.

Results and Conclusion

The overall prevalence of C. trachomatis infection was 4.2 % in women and 4.6 % in men. A relatively high prevalence of 8.3 % was found in men older than 25 years. Never using condoms was an independent risk factor for infection. The most common symptom was discharge; however, 64.5 % of infected females and all of the infected men were asymptomatic, supporting the need for screening programmes. The most frequently encountered genotypes were E (46.5 %), F (20.9 %) and K (14.0 %). Since the nvCT was detected in one female student, this is one of the rare studies that reports on the molecular identification of nvCT apart from Sweden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Land JA, Van Bergen JEAM, Morré SA, Postma MJ. Epidemiology of Chlamydia trachomatis infection in women and the cost-effectiveness of screening. Hum Reprod Update. 2010;16:189–204.

    Article  PubMed  CAS  Google Scholar 

  2. Peipert JF. Clinical practice. Genital chlamydial infections. N Engl J Med. 2003;349:2424–30.

    Article  PubMed  CAS  Google Scholar 

  3. Low N; SCREen project team. Publication of report on chlamydia control activities in Europe. Euro Surveill. 2008;13. pii: 18924.

    Google Scholar 

  4. Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL, Steece R, Markowitz LE, Devine OJ, Walsh CM, Wang S, Gunter DC, Irwin KL, DeLisle S, Berman SM. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections—2002. MMWR Recomm Rep. 2002;51:1–38.

    PubMed  Google Scholar 

  5. Gaydos C, Essig A. Chlamydiaceae. In: Versalovic J, Carroll KC, Funke G, Jorgensen JH, Landry ML, Warnock DW, editors. Manual of clinical microbiology. Washington: ASM Press; 2011. p. 986–1000.

    Google Scholar 

  6. Griesinger G, Gille G, Klapp C, von Otte S, Diedrich K. Sexual behaviour and Chlamydia trachomatis infections in German female urban adolescents, 2004. Clin Microbiol Infect. 2007;13:436–9.

    Article  PubMed  CAS  Google Scholar 

  7. Clad A, Prillwitz J, Hintz KC, Mendel R, Flecken U, Schulte-Mönting J, Petersen EE. Discordant prevalence of Chlamydia trachomatis in asymptomatic couples screened using urine ligase chain reaction. Eur J Clin Microbiol Infect Dis. 2001;20:324–8.

    PubMed  CAS  Google Scholar 

  8. Gille G, Meyer T, Mylonas I, Straube E. Chlamydia trachomatis-screening—Wunsch und Wirklichkeit. Mikrobiologe. 2011;21:63–6.

    Google Scholar 

  9. Ripa T, Nilsson PA. A Chlamydia trachomatis strain with a 377-bp deletion in the cryptic plasmid causing false-negative nucleic acid amplification tests. Sex Transm Dis. 2007;34:255–6.

    PubMed  Google Scholar 

  10. Ripa T, Nilsson P. A variant of Chlamydia trachomatis with deletion in cryptic plasmid: implications for use of PCR diagnostic tests. Euro Surveill. 2006;11:E061109.2.

    PubMed  CAS  Google Scholar 

  11. Unemo M, Clarke IN. The Swedish new variant of Chlamydia trachomatis. Curr Opin Infect Dis. 2011;24:62–9.

    Article  PubMed  Google Scholar 

  12. Herrmann B, Törner A, Low N, Klint M, Nilsson A, Velicko I, Söderblom T, Blaxhult A. Emergence and spread of Chlamydia trachomatis variant, Sweden. Emerg Infect Dis. 2008;14:1462–5.

    Article  PubMed  Google Scholar 

  13. Reischl U, Drosten C, Geißdörfer W, Göbel U, Hoffmann KS, Mauch H, Meyer Th, Moter A, von Müller L, Panning M, Rabenau HF, Reiter-Owona I, Roth A, Weitz M. Nukleinsäure-amplifikationstechniken (NAT). In: Podbielski A, Herrmann M, Kniehl E, Mauch H, Rüssmann H, editors. MIQ: Qualitätsstandards in der Mikrobiologisch-Infektiologischen Diagnostik. Munich: Fishcher; 2011. p. 22–38.

    Google Scholar 

  14. Møller JK, Pedersen LN, Persson K. Comparison of Gen-probe transcription-mediated amplification, Abbott PCR, and Roche PCR assays for detection of wild-type and mutant plasmid strains of Chlamydia trachomatis in Sweden. J Clin Microbiol. 2008;46:3892–5.

    Article  PubMed  Google Scholar 

  15. Seth-Smith HM, Harris SR, Persson K, Marsh P, Barron A, Bignell A, Bjartling C, Clark L, Cutcliffe LT, Lambden PR, Lennard N, Lockey SJ, Quail MA, Salim O, Skilton RJ, Wang Y, Holland MJ, Parkhill J, Thomson NR, Clarke IN. Co-evolution of genomes and plasmids within Chlamydia trachomatis and the emergence in Sweden of a new variant strain. BMC Genomics. 2009;10:239. doi:10.1186/1471-2164-10-239.

    Article  PubMed  Google Scholar 

  16. Jurstrand M, Falk L, Fredlund H, Lindberg M, Olcén P, Andersson S, Persson K, Albert J, Bäckman A. Characterization of Chlamydia trachomatis omp1 genotypes among sexually transmitted disease patients in Sweden. J Clin Microbiol. 2001;39:3915–9.

    Article  PubMed  CAS  Google Scholar 

  17. Simms I, Talebi A, Rhia J, Horner P, French RS, Sarah R, Macintosh M. The English National Chlamydia Screening Programme: variations in positivity in 2007/2008. Sex Transm Dis. 2009;36:522–7.

    Article  PubMed  Google Scholar 

  18. European Centre for Disease Prevention and Control (ECDC). Chlamydia control in Europe. ECDC Guidance. 2009. p. 1–18. http://ecdc.europa.eu/en/publications/Publications/0906_GUI_Chlamydia_Control_in_Europe.pdf

  19. Klavs I, Rodrigues LC, Wellings K, Kese D, Hayes R. Prevalence of genital Chlamydia trachomatis infection in the general population of Slovenia: serious gaps in control. Sex Transm Dis. 2004;80:121–3.

    Article  CAS  Google Scholar 

  20. van Bergen J, Götz HM, Richardus JH, Hoebe CJPA, Broer J, Coenen AJT; PILOT CT study group. Prevalence of urogenital Chlamydia trachomatis increases significantly with level of urbanisation and suggests targeted screening approaches: results from the first national population based study in the Netherlands. Sex Transm Infect. 2005;81:17–23.

    Article  PubMed  Google Scholar 

  21. Novak DP, Karlsson RB. Simplifying chlamydia testing: an innovative Chlamydia trachomatis testing approach using the internet and a home sampling strategy: population based study. Sex Transm Infect. 2006;82:142–7.

    Article  PubMed  CAS  Google Scholar 

  22. Paget WJ, Zbinden R, Ritzler E, Zwahlen M, Lengeler C, Stürchler D, Matter HCP; Swiss Sentinel Surveillance Network of Gynecologists. National laboratory reports of Chlamydia trachomatis seriously underestimate the frequency of genital chlamydial infections among women in Switzerland. Sex Transm Dis. 2002;29:715–20.

    Article  PubMed  Google Scholar 

  23. Gille G, Klapp C, Diedrich K, Schäfer A, Moter A, Griesinger G, Kirschner R. Chlamydien—eine heimliche Epidemie unter Jugendlichen. Prävalenzbeobachtung bei jungen Mädchen in Berlin. Dtsch Ärztebl. 2005;102:2021–5.

    Google Scholar 

  24. Baud D, Jaton K, Bertelli C, Kulling J-P, Greub G. Low prevalence of Chlamydia trachomatis infection in asymptomatic young Swiss men. BMC Infect Dis. 2008;8:45. doi:10.1186/1471-2334-8-45.

    Article  PubMed  Google Scholar 

  25. Sakem B, Michel R, Nydegger UE, Radjenovic D, Wydler M, Risch M, Risch L. Diagnostic relevance of simultaneous testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Infection. 2011;39:231–7.

    Article  PubMed  CAS  Google Scholar 

  26. Böhm I, Gröning A, Sommer B, Müller H-W, Krawczak M, Glaubitz R. A German Chlamydia trachomatis screening program employing semi-automated real-time PCR: results and perspectives. J Clin Virol. 2009;46:S27–32.

    Article  PubMed  Google Scholar 

  27. Lysén M, Osterlund A, Rubin CJ, Persson T, Persson I, Herrmann B. Characterization of ompA genotypes by sequence analysis of DNA from all detected cases of Chlamydia trachomatis infections during 1 year of contact tracing in a Swedish County. J Clin Microbiol. 2004;42:1641–7.

    Article  PubMed  Google Scholar 

  28. Byrne GI. Chlamydia trachomatis strains and virulence: rethinking links to infection prevalence and disease severity. J Infect Dis. 2010;201:S126–33.

    Article  PubMed  Google Scholar 

  29. Klint M, Hadad R, Christerson L, Loré B, Anagrius C, Österlund A, Larsson I, Sylvan S, Fredlund H, Unemo M, Herrmann B. Prevalence trends in Sweden for the new variant of Chlamydia trachomatis. Clin Microbiol Infect. 2011;17:683–9.

    Article  PubMed  CAS  Google Scholar 

  30. Bjartling C, Osser S, Johnsson A, Persson K. Clinical manifestations and epidemiology of the new genetic variant of Chlamydia trachomatis. Sex Transm Dis. 2009;36:529–35.

    Article  PubMed  Google Scholar 

  31. Westh H, Jensen JS. Low prevalence of the new variant of Chlamydia trachomatis in Denmark. Sex Transm Infect. 2008;84:546–7.

    Article  PubMed  CAS  Google Scholar 

  32. Savage EJ, Ison CA, van de Laar MJ; ESSTI network. Results of a Europe-wide investigation to assess the presence of a new variant of Chlamydia trachomatis. Euro Surveill. 2007;12:E3–4.

    PubMed  CAS  Google Scholar 

  33. Niemi S, Hiltunen-Back E, Puolakkainen M. Chlamydia trachomatis genotypes and the Swedish new variant among urogenital Chlamydia trachomatis strains in Finland. Infect Dis Obstet Gynecol. 2011;2011:481890. doi:10.1155/2011/481890.

    Article  PubMed  Google Scholar 

  34. Reischl U, Straube E, Unemo M. The Swedish new variant of Chlamydia trachomatis (nvCT) remains undetected by many European laboratories as revealed in the recent PCR/NAT ring trial organised by INSTAND e.V., Germany. Euro Surveill. 2009;14. pii: 19302.

Download references

Acknowledgments

We thank Eberhard Straube (Institute of Medical Microbiology, Friedrich Schiller University Jena) for providing the control DNA of the nvCT. Special thanks go to Cornelia Otto and Stephanie Kurz (Public Health Departments of Ulm and Neu-Ulm), Christine Meißle (Health Care School, University Hospital Ulm), Katja Schlaupitz (General Practice, Neu-Ulm), Alexander Rauh (German Armed Forces Hospital, Ulm) and Anne-Marie Albuszies (TÜV SÜD Life Service GmbH) for the recruitment of study participants and sample collection. We thank Corinna Foddis, Sonja Rothenberger, Carola Maier and Beate Wirths (Institute of Medical Microbiology and Hygiene, University Hospital Ulm) for their expert technical assistance.

Conflict of interest

This study was supported by Hain Life science and Roche Diagnostics who provided test kits and financial support in part.

Author information

Authors and Affiliations

  1. Institute of Medical Microbiology and Hygiene, University Hospital Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany

    N. Fieser, U. Simnacher, Y. Tausch, S. Werner-Belak, H. von Baum & A. Essig

  2. Gaertner and Colleagues Laboratories, Elisabethenstrasse 11, 88212, Ravensburg, Germany

    N. Fieser

  3. Gynaecological Practice, Hauptstrasse 36, 89250, Senden, Germany

    S. Ladenburger-Strauß

  4. Institute of Medical Microbiology and Hygiene, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 93053, Regensburg, Germany

    U. Reischl

Authors
  1. N. Fieser
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Simnacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. Tausch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Werner-Belak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S. Ladenburger-Strauß
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H. von Baum
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. U. Reischl
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Essig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. Fieser.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fieser, N., Simnacher, U., Tausch, Y. et al. Chlamydia trachomatis prevalence, genotype distribution and identification of the new Swedish variant in Southern Germany. Infection 41, 159–166 (2013). https://doi.org/10.1007/s15010-012-0301-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-012-0301-2

Keywords

Search

Navigation