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Fredlund, Hans
Publications (10 of 43) Show all publications
Dahlberg, J., Hadad, R., Elfving, K., Larsson, I., Isaksson, J., Magnuson, A., . . . Herrmann, B. (2018). Ten years transmission of the new variant of Chlamydia trachomatis in Sweden: prevalence of infections and associated complications. Sexually Transmitted Infections, 94(2), 100-104
Open this publication in new window or tab >>Ten years transmission of the new variant of Chlamydia trachomatis in Sweden: prevalence of infections and associated complications
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2018 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 94, no 2, p. 100-104Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: In 2006, a new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. It has a deletion in the plasmid resulting in failed detection by the single target systems from Abbott and Roche used at that time, whereas the third system used, from Becton Dickinson (BD), detects nvCT. The proportion of nvCT was initially up to 65% in counties using Abbott/Roche systems. This study analysed the proportion of nvCT from 2007 to 2015 in four selected counties and its impact on chlamydia-associated complications.

METHODS: C. trachomatis-positive specimens collected from 2007 to 2015 were analysed by a specific PCR to identify nvCT cases. Genotyping was performed by multilocus sequence typing (MLST) and ompA sequencing. Ectopic pregnancy and pelvic inflammatory disease records were extracted from the national registers.

RESULTS: In total, 5101 C. trachomatis-positive samples were analysed. The nvCT proportion significantly decreased in the two counties using Roche systems, from 56% in 2007 to 6.5% in 2015 (p<0.001). In the two counties using BD systems, a decrease was also seen, from 19% in 2007 to 5.2% in 2015 (p<0.001). Fifteen nvCT cases from 2015 and 102 cases from 2006 to 2009 had identical MLST profiles. Counties using Roche/Abbott systems showed higher mean rates of ectopic pregnancy and pelvic inflammatory disease compared with counties using BD systems.

CONCLUSIONS: The nvCT proportion has decreased in all counties and converged to a low prevalence irrespective of previous rates. Genotyping showed that nvCT is clonal and genetically stable. Failing detection only marginally affected complication rates.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
Keywords
chlamydia trachomatis, ectopic pregnancy, epidemiology, pelvic inflammatory disease, plasmid
National Category
Microbiology in the medical area Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-61756 (URN)10.1136/sextrans-2016-052992 (DOI)000428207800007 ()28724744 (PubMedID)2-s2.0-85042848044 (Scopus ID)
Note

Funding Agencies:

Uppsala University Hospital  

Örebro County Council Research Committee  

Foundation for Medical Research at Örebro University Hospital, Sweden  

Available from: 2017-10-25 Created: 2017-10-25 Last updated: 2022-12-15Bibliographically approved
Lucidarme, J., Scott, K. J., Ure, R., Smith, A., Lindsay, D., Stenmark, B., . . . Borrow, R. (2016). An international invasive meningococcal disease outbreak due to a novel and rapidly expanding serogroup W strain, Scotland and Sweden, July to August 2015. Eurosurveillance, 21(45), 15-23, Article ID 30395.
Open this publication in new window or tab >>An international invasive meningococcal disease outbreak due to a novel and rapidly expanding serogroup W strain, Scotland and Sweden, July to August 2015
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2016 (English)In: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 21, no 45, p. 15-23, article id 30395Article in journal (Refereed) Published
Abstract [en]

The 23rd World Scout Jamboree in 2015 took place in Japan and included over 33,000 scouts from 162 countries. Within nine days of the meeting ending, six cases of laboratory-confirmed invasive serogroup W meningococcal disease occurred among scouts and their close contacts in Scotland and Sweden. The isolates responsible were identical to one-another by routine typing and, where known (4 isolates), belonged to the ST-11 clonal complex (cc11) which is associated with large outbreaks and high case fatality rates. Recent studies have demonstrated the need for high-resolution genomic typing schemes to assign serogroup W cc11 isolates to several distinct strains circulating globally over the past two decades. Here we used such schemes to confirm that the Jamboree-associated cases constituted a genuine outbreak and that this was due to a novel and rapidly expanding strain descended from the strain that has recently expanded in South America and the United Kingdom. We also identify the genetic differences that define the novel strain including four point mutations and three putative recombination events involving the horizontal exchange of 17, six and two genes, respectively. Noteworthy outcomes of these changes were antigenic shifts and the disruption of a transcriptional regulator.

Place, publisher, year, edition, pages
Stockholm, Sweden: European Centre for Disease Prevention and Control (ECDC), 2016
National Category
Infectious Medicine
Research subject
Infectious Diseases
Identifiers
urn:nbn:se:oru:diva-53923 (URN)10.2807/1560-7917.ES.2016.21.45.30395 (DOI)000387768600003 ()27918265 (PubMedID)2-s2.0-84996606598 (Scopus ID)
Funder
Wellcome trust
Note

Funding Agencies:

European Union

Meningitis Research Foundation

Available from: 2016-12-13 Created: 2016-12-13 Last updated: 2022-09-15Bibliographically approved
Smith-Palmer, A., Oates, K., Webster, D., Taylor, S., Scott, K. J., Smith, G., . . . McMenamin, J. (2016). Outbreak of Neisseria meningitidis capsular group W among scouts returning from the World Scout Jamboree, Japan, 2015. Eurosurveillance, 21(45), 8-14, Article ID 30392.
Open this publication in new window or tab >>Outbreak of Neisseria meningitidis capsular group W among scouts returning from the World Scout Jamboree, Japan, 2015
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2016 (English)In: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 21, no 45, p. 8-14, article id 30392Article in journal (Refereed) Published
Abstract [en]

The 23rd World Scout Jamboree was held in Japan from 28 July to 8 August 2015 and was attended by over 33,000 scouts from 162 countries. An outbreak of invasive meningococcal disease capsular group W was investigated among participants, with four confirmed cases identified in Scotland, who were all associated with one particular scout unit, and two confirmed cases in Sweden; molecular testing showed the same strain to be responsible for illness in both countries. The report describes the public health action taken to prevent further cases and the different decisions reached with respect to how wide to extend the offer of chemoprophylaxis in the two countries; in Scotland, chemoprophylaxis was offered to the unit of 40 participants to which the four cases belonged and to other close contacts of cases, while in Sweden chemoprophylaxis was offered to all those returning from the Jamboree. The report also describes the international collaboration and communication required to investigate and manage such multinational outbreaks in a timely manner.

Place, publisher, year, edition, pages
European Centre for Disease Prevention and Control (ECDC), 2016
National Category
Infectious Medicine
Research subject
Infectious Diseases
Identifiers
urn:nbn:se:oru:diva-53922 (URN)10.2807/1560-7917.ES.2016.21.45.30392 (DOI)000387768600002 ()27918267 (PubMedID)2-s2.0-84996841706 (Scopus ID)
Funder
Wellcome trust
Note

Funding Agency:

European Union 

Available from: 2016-12-13 Created: 2016-12-13 Last updated: 2022-09-15Bibliographically approved
Malm, K., Andersson, S., Fredlund, H., Norrgren, H., Biague, A., Månsson, F., . . . Unemo, M. (2015). Analytical evaluation of nine serological assays for diagnosis of syphilis. Journal of the European Academy of Dermatology and Venereology, 29(12), 2369-2376
Open this publication in new window or tab >>Analytical evaluation of nine serological assays for diagnosis of syphilis
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2015 (English)In: Journal of the European Academy of Dermatology and Venereology, ISSN 0926-9959, E-ISSN 1468-3083, Vol. 29, no 12, p. 2369-2376Article in journal (Refereed) Published
Abstract [en]

Background: The diagnosis of syphilis is most frequently dependent on antibody detection with serological assays. Assays for both treponemal and non-treponemal antibodies are needed to provide a sensitive and specific diagnosis. For decades, a first screening has been done with non-treponemal assays, followed by treponemal. However, in recent years, following laboratory automation, the reverse sequence screening algorithms have been developed, using a treponemal assay as the initial screening test.

Objective: To evaluate serological assays for treponemal and non-treponemal antibodies, to use in reverse algorithm screening of syphilis.

Material and methods: Six treponemal assays (one IgM-specific assay), two non-treponemal assays and one novel dual point-of-care (POC) assay for serological diagnosis of syphilis were evaluated. Serum samples from Guinea-Bissau and Sweden were examined, as well as two performance panels and samples from blood donors. Sensitivity and specificity were calculated for each assay, using different assays as gold standard test.

Results: The Macro-Vue RPR Card test was the most sensitive non-treponemal test and the TrepSure Anti-Treponema EIA Screen and the SeroDia TP-PA were the most sensitive and specific treponemal assays. Among the automated assays, both the Liaison Treponema Screen and Architect Syphilis TP showed high sensitivity, however, the former had clearly higher specificity.

Conclusions: In resourced settings, where the reverse sequence algorithm is preferred for screening, an automated treponemal immunoassay for initial screening subsequently followed by the TrepSure test or TP-PA assay as a second treponemal assay appear highly effective. Finally, a quantitative highly sensitive non-treponemal assay, e.g. the Macro-Vue RPR Card test, could then be used as a supplementary test to evaluate activity of the syphilis infection.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Dermatology and Venereal Diseases
Research subject
Dermatology and Venerology
Identifiers
urn:nbn:se:oru:diva-47858 (URN)10.1111/jdv.13237 (DOI)000367682300012 ()26370737 (PubMedID)2-s2.0-84959356033 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee

Foundation for Medical Research at Örebro University Hospital, Örebro, Sweden

Available from: 2016-02-01 Created: 2016-02-01 Last updated: 2024-01-11Bibliographically approved
Rumyantseva, T., Golparian, D., Nilsson, C. S., Johansson, E., Falk, M., Fredlund, H., . . . Unemo, M. (2015). Evaluation of the new AmpliSens multiplex real-time PCR assay for simultaneous detection of Neisseriagonorrhoeae, Chlamydiatrachomatis, Mycoplasmagenitalium, and Trichomonasvaginalis. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 123(10), 879-886
Open this publication in new window or tab >>Evaluation of the new AmpliSens multiplex real-time PCR assay for simultaneous detection of Neisseriagonorrhoeae, Chlamydiatrachomatis, Mycoplasmagenitalium, and Trichomonasvaginalis
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2015 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 123, no 10, p. 879-886Article in journal (Refereed) Published
Abstract [en]

In this study, we performed an evaluation of the new CE-marked multiplex real-time AmpliSens N.gonorrhoeae/C.trachomatis/M.genitalium/T.vaginalis-MULTIPRIME-FRT PCR assay compared to APTIMA tests, i.e., APTIMA COMBO 2assay, APTIMA Trichomonasvaginalis assay (FDA-approved), and two different APTIMA Mycoplasmagenitalium assays (research use only; one of them only used for discrepancy analysis). Vaginal swabs (n=209) and first-void urine (FVU) specimens from females (n=498) and males (n=554), consecutive attendees (n=1261) at a dermatovenerological clinic in Sweden, were examined. The sensitivity of the AmpliSens PCR assay for detection of C.trachomatis (6.3% prevalence), M.genitalium (5.7% prevalence), N.gonorrhoeae (0.3% prevalence), and T.vaginalis (0.08% prevalence) was 97.5% (95% confidence interval (CI): 91.2-99.6%), 81.9% (95% CI: 70.7-89.7%), 100% (95% CI: 40.2-100%) and 100% (95% CI: 16.5-100%), respectively. The specificity of the AmpliSens PCR assay was 100% (95% CI: 99.6-100%) for all agents. The analytical sensitivity and specificity for N.gonorrhoeae detection was excellent, i.e., 55 international gonococcal strains detected and 135 isolates of 13 non-gonococcal Neisseria species were negative. In conclusion, the multiplex real-time AmpliSens N.gonorrhoeae/C.trachomatis/M.genitalium/T.vaginalis-MULTIPRIME-FRT PCR assay demonstrated high sensitivity and excellent specificity for the detection of C.trachomatis, N.gonorrhoeae, and T.vaginalis, and excellent specificity but suboptimal sensitivity for M.genitalium detection.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
Keywords
Sexually transmitted infections, AmpliSens, APTIMA COMBO 2 assay, APTIMA Trichomonasvaginalis assay, APTIMA Mycoplasmagenitalium assay
National Category
Immunology in the medical area
Research subject
Immunology
Identifiers
urn:nbn:se:oru:diva-46285 (URN)10.1111/apm.12430 (DOI)000362127600009 ()26299582 (PubMedID)2-s2.0-84942371426 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee

Foundation for Medical Research at Orebro University Hospital, Sweden

Available from: 2015-10-23 Created: 2015-10-23 Last updated: 2024-03-04Bibliographically approved
Törös, B., Hedberg, S. T., Unemo, M., Jacobsson, S., Hill, D. M. C., Olcén, P., . . . Mölling, P. (2015). Genome-based characterization of emergent invasive Neisseria meningitidis serogroup Y isolates in Sweden from 1995 to 2012. Journal of Clinical Microbiology, 53(7), 2154-2162
Open this publication in new window or tab >>Genome-based characterization of emergent invasive Neisseria meningitidis serogroup Y isolates in Sweden from 1995 to 2012
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2015 (English)In: Journal of Clinical Microbiology, ISSN 0095-1137, E-ISSN 1098-660X, Vol. 53, no 7, p. 2154-2162Article in journal (Refereed) Published
Abstract [en]

Invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup Y has increased in Europe, especially in Scandinavia. In Sweden, serogroup Y is now the dominating serogroup, and in 2012, the serogroup Y disease incidence was 0.46/100,000 population. We previously showed that a strain type belonging to sequence type 23 was responsible for the increased prevalence of this serogroup in Sweden. The objective of this study was to investigate the serogroup Y emergence by whole-genome sequencing and compare the meningococcal population structure of Swedish invasive serogroup Y strains to those of other countries with different IMD incidence. Whole-genome sequencing was performed on invasive serogroup Y isolates from 1995 to 2012 in Sweden (n = 186). These isolates were compared to a collection of serogroup Y isolates from England, Wales, and Northern Ireland from 2010 to 2012 (n = 143), which had relatively low serogroup Y incidence, and two isolates obtained in 1999 in the United States, where serogroup Y remains one of the major causes of IMD. The meningococcal population structures were similar in the investigated regions; however, different strain types were prevalent in each geographic region. A number of genes known or hypothesized to have an impact on meningococcal virulence were shown to be associated with different strain types and subtypes. The reasons for the IMD increase are multifactorial and are influenced by increased virulence, host adaptive immunity, and transmission. Future genome-wide association studies are needed to reveal additional genes associated with serogroup Y meningococcal disease, and this work would benefit from a complete serogroup Y meningococcal reference genome.

National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
Research subject
Microbiology
Identifiers
urn:nbn:se:oru:diva-45585 (URN)10.1128/JCM.03524-14 (DOI)000358287700023 ()25926489 (PubMedID)2-s2.0-84932634694 (Scopus ID)
Note

Funding Agencies:

Meningitis Research Foundation

Wellcome Trust

European Union

Örebro County Council Research Committee

Available from: 2015-08-18 Created: 2015-08-18 Last updated: 2024-01-11Bibliographically approved
Unemo, M., Ringlander, J., Wiggins, C., Fredlund, H., Jacobsson, S. & Cole, M. (2015). High In Vitro Susceptibility to the Novel Spiropyrimidinetrione ETX0914 (AZD0914) among 873 Contemporary Clinical Neisseria gonorrhoeae Isolates from 21 European Countries from 2012 to 2014. Antimicrobial Agents and Chemotherapy, 59(9), 5220-5225
Open this publication in new window or tab >>High In Vitro Susceptibility to the Novel Spiropyrimidinetrione ETX0914 (AZD0914) among 873 Contemporary Clinical Neisseria gonorrhoeae Isolates from 21 European Countries from 2012 to 2014
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2015 (English)In: Antimicrobial Agents and Chemotherapy, ISSN 0066-4804, E-ISSN 1098-6596, Vol. 59, no 9, p. 5220-5225Article in journal (Refereed) Published
Abstract [en]

Resistance in Neisseria gonorrhoeae against all antimicrobials available for the treatment of gonorrhea has emerged. The first gonococcal strains with high-level resistance to ceftriaxone, the last option for first-line empirical antimicrobial monotherapy, were recently described. Consequently, new treatment options are essential. In this study, the in vitro activity of the novel spiropyrimidinetrione ETX0914 (AZD0914), a DNA topoisomerase II inhibitor, was investigated among contemporary consecutive clinical N. gonorrhoeae isolates obtained in 21 European countries and compared to the activities of antimicrobials currently or previously recommended for treatment. Consecutive clinical N. gonorrhoeae isolates (n = 873) cultured in 21 European countries from 2012 to 2014 were examined for their susceptibility to ETX0914. The MICs of ETX0914 were determined using the agar dilution method. For comparison, the MICs of ceftriaxone, cefixime, azithromycin, and ciprofloxacin were determined using Etest or the agar dilution method. For ETX0914, the MIC range, modal MIC, MIC50, and MIC90 were <= 0.002 to 0.25 mg/liter, 0.125 mg/liter, 0.064 mg/liter, and 0.125 mg/liter, respectively. The MIC values were substantially lower than those of the fluoroquinolone ciprofloxacin and most other antimicrobials examined. No cross-resistance with any other examined antimicrobial was observed. In conclusion, the in vitro susceptibility to the novel spiropyrimidinetrione ETX0914 (AZD0914) among 873 contemporary clinical isolates from 21 European countries was high, and no cross-resistance to antimicrobials currently or previously used for gonorrhea treatment was indicated. Additional studies investigating the in vitro and in vivo induction and mechanisms of ETX0914 resistance in gonococci, pharmacokinetics/pharmacodynamics in modeling/simulations and in humans, and performance in randomized controlled gonorrhea treatment trials are essential.

Place, publisher, year, edition, pages
American Society for Microbiology, 2015
National Category
Microbiology in the medical area Pharmacology and Toxicology
Research subject
Microbiology
Identifiers
urn:nbn:se:oru:diva-47016 (URN)10.1128/AAC.00786-15 (DOI)000364343900017 ()26077246 (PubMedID)2-s2.0-84940951189 (Scopus ID)
Note

Funding Agencies:

Örebro County Council Research Committee

Foundation for Medical Research at Örebro University Hospital, Sweden

Available from: 2015-12-09 Created: 2015-12-09 Last updated: 2024-01-11Bibliographically approved
Idahl, A., Jurstrand, M., Olofsson, J. I. & Fredlund, H. (2015). Mycoplasma genitalium serum antibodies in infertile couples and fertile women. Sexually Transmitted Infections, 91(8), 589-591
Open this publication in new window or tab >>Mycoplasma genitalium serum antibodies in infertile couples and fertile women
2015 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 91, no 8, p. 589-591Article in journal (Refereed) Published
Abstract [en]

Objectives: The association between Mycoplasma genitalium (M. genitalium) serum antibodies and infertility in women and men, as well as infertility subtypes, was investigated.

Methods: Stored serum was obtained from two patient cohorts: infertile couples (239 women and 243 men) attending a gynaecological outpatient clinic between October 1997 and February 2001 and 244 age-matched spontaneously pregnant women. An enzyme immunoassay was used to detect serum immunoglobulin G (IgG) antibodies to M. genitalium in these samples. Patient's Chlamydia trachomatis seropositivity had been previously determined. Risks were calculated using multivariate logistic regression.

Results: M. genitalium serum IgG was more common among women of infertile couples (5.4%) than among fertile controls (1.6%) (OR (95% CI) 3.45 (1.10 to 10.75)), adjusting for C. trachomatis IgG (adjusted OR=3.00 (0.95 to 9.47)). Of the women with tubal factor infertility (TFI) 9.1% had M. genitalium IgG compared with 4.6% of women without TFI (OR=2.07 (0.60 to 7.05)); (AOR=1.20 (0.32 to 74.40)). In patients IgG positive to both microorganisms the OR for having TFI was increased (OR=4.86 (1.22 to 19.36)) compared with those positive to C. trachomatis IgG only (AOR=3.14 (1.58 to 6.20)). No associations were found with other infertility diagnoses. Only two men of the infertile couples were M. genitalium IgG positive (0.8%).

Conclusions: M. genitalium serum IgG was associated with infertility in women, however insignificant after adjustment for C. trachomatis IgG, but not with infertility subtypes within this study. M. genitalium IgG seroprevalence among men was very low and not associated with male factor infertility.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2015
National Category
Infectious Medicine
Research subject
Infectious Diseases
Identifiers
urn:nbn:se:oru:diva-47167 (URN)10.1136/sextrans-2015-052011 (DOI)000365344800013 ()25921018 (PubMedID)2-s2.0-84951570337 (Scopus ID)
Available from: 2015-12-21 Created: 2015-12-21 Last updated: 2023-12-08Bibliographically approved
Törös, B., Hedberg, S. T., Jacobsson, S., Fredlund, H., Olcén, P. & Mölling, P. (2013). Evaluation of molecular typing methods for identification of outbreak-associated Neisseria meningitidis isolates. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 121(6), 503-510
Open this publication in new window or tab >>Evaluation of molecular typing methods for identification of outbreak-associated Neisseria meningitidis isolates
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2013 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 121, no 6, p. 503-510Article in journal (Refereed) Published
Abstract [en]

It is essential in an outbreak investigation that strain characterization of Neisseria meningitidis is performed in a rapid and accurate manner. This study evaluated two new molecular typing methods, multiple- locus variable number tandem repeat analysis (MLVA) and repetitive sequence-based PCR (rep-PCR) (DiversiLab; bioMe´rieux) and compared them with current recommended methodologies. This retrospective study included 36 invasive N. meningitidis serogroup C isolates collected in Sweden 2001 through 2009 and previously subjected to outbreak investigation. All strains were typed with highly variable- MLVA (HV-MLVA) and rep-PCR. The isolates were further characterized by multilocus sequence typing (MLST) and sequencing of the fetA, fHbp, penA, porA and porB genes. The results showed that HVMLVA had the highest index of diversity (0.99) and rep-PCR had the highest congruence (40%) with the currently recommended typing methods. The HV MLVA correlated best to the spatiotemporal connections and had the overall highest Adjusted Wallace coefficients, suggesting that HV-MLVA can predict the results of the other typing methods in the study. We therefore suggest that after initial confirmation of species, serogroup and genosubtype, HV-MLVA should be used asthe most discriminatorymethod for first hand investigation of N. meningitidis serogroup C isolates.

Keywords
Neisseria meningitidis, molecular typing, repetitive sequence-based PCR, MLVA, epidemiology.
National Category
Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
Research subject
Microbiology
Identifiers
urn:nbn:se:oru:diva-36111 (URN)10.1111/apm.12022 (DOI)000319427100004 ()2-s2.0-84878255174 (Scopus ID)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2023-12-08Bibliographically approved
Jurstrand, M., Fredlund, H. & Unemo, M. (2013). The new variant of Chlamydia trachomatis was present as early as 2003 in Orebro County, Sweden, but remained undetected until 2006. Sexually Transmitted Infections, 89(7), 607-608
Open this publication in new window or tab >>The new variant of Chlamydia trachomatis was present as early as 2003 in Orebro County, Sweden, but remained undetected until 2006
2013 (English)In: Sexually Transmitted Infections, ISSN 1368-4973, E-ISSN 1472-3263, Vol. 89, no 7, p. 607-608Article in journal (Refereed) Published
Abstract [en]

Objectives In 2006, a new variant of Chlamydia trachomatis (nvCT) was reported in Sweden. Because of a cryptic plasmid deletion, the nvCT was undetectable in several of the genetic diagnostic systems used worldwide at the time. This study aimed to evaluate whether the nvCT was present in specimens obtained from patients attending the outpatient sexually transmitted infection (STI) clinic at orebro University Hospital, orebro, Sweden already in 2002-2003. Methods In 2012, archival (-20 degrees C freezer) urogenital specimens (2002 (n=1083) and in 2003 (n=1143)) obtained from men (2002 (n=398) and 2003 (n=486)) and women (2002 (n=301) and 2003 (n=408)) were analysed with Cobas TaqMan CT test V.2.0. All C trachomatis positive specimens were subsequently examined using a duplex PCR assay that simultaneously detects the deletion on the nvCT cryptic plasmid and the ompA gene of C trachomatis genotype E. Results In total, 68 patients (9.7%) in 2002 and 61 (6.8%) in 2003 were C trachomatis positive. The duplex PCR assay identified 26 C trachomatis genotype E positive patients in 2002 (38%) and 25 in 2003 (41%). No nvCT was found in 2002, but one specimen obtained from a 23-year-old man in June 2003 was positive for the nvCT. Conclusions The nvCT was present as early as 2003 in orebro County, Sweden, which concurs with previously reported statistical estimations of its emergence. Accordingly, the nvCT spread undetected for at least 3years, explaining the high proportion (38%) in orebro County when it was first detected in late 2006.

Keywords
Chlamydia Trachomatis, Epidemiology (General), Diagnosis
National Category
Infectious Medicine
Research subject
Infectious Diseases
Identifiers
urn:nbn:se:oru:diva-32360 (URN)10.1136/sextrans-2013-051018 (DOI)000325542900020 ()2-s2.0-84891555025 (Scopus ID)
Available from: 2013-11-14 Created: 2013-11-12 Last updated: 2024-01-11Bibliographically approved
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