First case of Chlamydia trachomatis L2b proctitis in a woman.

Since 2003, outbreaks of lymphogranuloma venereum (LGV) have been reported in European countries, North America, and Australia. Current LGV cases have been caused by Chlamydia trachomatis serovar L2. This sexually transmitted infection is predominantly found among men who have sex with men, specifically men who are seropositive for human immunodeficiency virus and have clinical signs of proctitis. The current outbreak has been almost exclusively attributed to a new variant, designated L2b. Although urogenital cases of LGV have been described in the heterosexual population, we report the first case of C. trachomatis L2b proctitis in a woman.

[Leptospirosis screening: performance of the Serion Elisa Classic Leptospira IgM KIT]. / Dépistage de la Leptospirose: performance de la trousse Sérion Elisa classic Leptospira IgM.

AIM OF THE STUDY: Evaluate the sensitivity and the specificity of anti-Leptospira IgM detection with the Serion Elisa classic kit in comparison to the Panbio Elisa kit. METHODS: Twenty-three sera of patients whom Taqman probe real time PCR is positive and 19 sera positive by the microscopic agglutination test (MAT) are studied for sensitivity. Specificity is evaluated with 49 pairs of sera negative by MAT and with sera positive in IgM to EBV, to syphilis, to Borrelia and positive to influenza virus antibodies. RESULTS: 14/23 (61%) of the sera positive by PCR and 27/30 (90%) of the sera positive at significant level by MAT are positive by Serion IgM Elisa. Serogroups Icterohaemorrhagiae, Grippotyphosa, Australis, Tarassovi, Canicola, Sejroe, Patoc and Cynopteri are detected. 40/49 sera (82%) negative by MAT are negative by Serion IgM Elisa. Agreement with the Panbio kit is 61% (30/49). Results are discrepant in 19/49 cases corresponding to a positive result by Panbio IgM and to a negative result by Serion IgM. Serological cross-reactions are more frequent with IgM to syphilis and to Borrelia than with IgM to EBV and to influenza virus antibodies. CONCLUSION: A similar sensitivity is observed between the two kits but specificity is higher with Serion. Positivity in IgM is 61% in cases of leptospirosis diagnosed by PCR.

[Evaluation of a in house serology reagent for the diagnosis of cat-scratch disease defined by PCR]. / Evaluation d'un réactif maison de sérologie pour le diagnostic de la maladie des griffes du chat définie par la PCR.

AIM OF THE STUDY: evaluate the sensitivity and the specificity of the cat scratch disease serology by indirect immunofluorescence assay, realized from an in-house antigenic suspension, with PCR defined cases. Describe the epidemiological characteristics of the cases. METHODS: the antigenic suspension is realized by culture of a Houston 1 ATCC 49882 B. henselae reference strain on horse blood agar suspended in egg formoled PBS. Real time PCR from clinical samples is performed by amplification of a 998-bp 16S rDNA sequence with Bart and r-BH primers. RESULTS: In 57 out of 92 (62%) positive patients in PCR, the serology is positive in IgG at low or significative level or positive in IgG with presence of IgM or shows a seroconversion. The specificity in serum samples from 40 control patients is 100%. The average age of the 165 positive patients in PCR is 27.6 years old (3-80). The localization of the lymph nodes is more often axillary (47%) than inguinal (32%) or cervical (16%). CONCLUSION: Our in-house indirect immunofluorescence assay for the cat scratch disease serology shows a sensitivity equivalent to other technics described in the literature, with an excellent specificity.

[Contribution of PCR for detection of Mycobacterium tuberculosis complex in respiratory and nonrespiratory specimens]. / Apport de la détection des mycobactéries du complexe tuberculosis par PCR dans des prélèvements pulmonaires et extrapulmonaires.

AIM OF THE STUDY: To evaluate the sensitivity of PCR versus culture of complex tuberculosis mycobacteria and to determine the delay between PCR results and identification of mycobacteria in culture. MATERIALS AND METHODS: Ninety-nine pulmonary and 66 extrapulmonary specimens were analyzed. Samples were inoculated on liquid (MGIT, Bactec) and solid media (Coletsos) and respectively incubated 6 and 12 weeks. Identification was performed by reverse hybridization of PCR products to their complementary probes immobilized on membrane strips (Genotype MTBC, HAIN). Specimens DNA detection was realized by PCR (Cobas Amplicor Mycobacterium tuberculosis test, Roche). RESULTS: Sensitivity of PCR for acid fast bacilli smear positive pulmonary (50/50) and extrapulmonary (7/7) specimens was 100%. Delay between PCR result and identification was 11 days for pulmonary specimens and 8 days for extrapulmonary specimens. Sensitivity of PCR for smear negative samples was, respectively, of 78.7% (37/47) and 51.8% (29/56) for pulmonary and extrapulmonary specimens. In case of PCR positive result of a smear negative sample, a gap of respectively 13 and 12 days was obtained for pulmonary and extrapulmonary specimens compared to identification. CONCLUSION: Positive PCR result for respiratory specimens allows a gap of 11 to 13 days in diagnosis in comparison with identification of mycobacteria in culture.

[Retrospective study of Lyme borreliosis positive serologies in 2003]. / Etude rétrospective des sérologies de borréliose de Lyme positives en 2003.

PURPOSES OF THE STUDY: To estimate the percentage of positive sera for Lyme borreliosis antibodies, to precise the characteristics of clinical cases diagnosed from serological data and to determine their geographical distribution in France. MATERIALS AND METHODS: Studied sera were those received by the Pasteur-Cerba laboratory in 2003. IgG and IgM isotypes were detected using the Dade Behring kits. Antibody specificity was analysed with the Meridian's western blot. RESULTS: 1504/16 176 (9%) sera were positive for IgG isotype, and 978/3298 (29%) for IgM. The specificity was confirmed by western blot in 49% cases for IgG and in 54% for IgM. The highest positive serology rates were found in eastern and centre regions and in Aquitaine. Forty-two cases have been investigated leading to the identification of 16 borreliosis cases, each suffering of an erythema migrans. Five of them had neurological signs. Patient mean age was 40 years. 87% of patients had risk factors and 69% reported previous tick bites, mainly on lower limbs. CONCLUSION: A low rate of positive borreliosis sera was found, suggesting that serology prescription should be limited to patients suffering of compatible clinical signs, as recommended by the EUCALB. Erythema migrans was the most frequent clinical manifestation and neurological signs were present in 30% of cases. Finally, the geographical case distribution was similar to that provided by the study of the Sentinelle network in 1999-2000.

[Comparison of two reverse hybridization methods for mycobacterial identification in clinical practice]. / Comparaison de deux techniques d'hybridation moléculaire dans l'identification de mycobactéries en pratique courante.

AIM OF THE STUDY: To evaluate the performance of two commercial methods for identification of Mycobacterium species: InnoLiPA Mycobacteria first version (Innogenetics) versus Genotype MTBC and Genotype Mycobacterium (HAIN) on, respectively, 2123 and 2164 distinct isolates. MATERIALS AND METHODS: Both techniques are based on the reverse hybridization of PCR products to their complementary probes immobilized on membrane strips. The InnoLiPA assay targets the 16S-23S rRNA spacer region. The HAIN test is composed of two kits: Genotype MTBC, for identification of tuberculosis complex mycobacteria, is based on gyrB DNA sequence polymorphism. Genotype Mycobacterium kit targets the 23S rDNA for identification of mycobacteria other than tuberculosis (MOTT) and tuberculosis complex mycobacteria. Both assays identify complex tuberculosis mycobacteria and respectively, eight and 12 species of MOTT. Moreover, the Genotype MTBC allows species differentiation within the M. tuberculosis complex. RESULTS: Eighty-eight percent and 95% of mycobacteria were identified by InnoLiPA and HAIN, respectively. Hybridization remained negative for 11% of isolates with InnoLiPA and 4% with HAIN. An identification of MOTT was obtained by conventional identification in all cases after the use of InnoLiPA. MOTT and one M. tuberculosis was obtained after HAIN procedure. Unidentified species were complementary to a specific probe in 5% of the cases with InnoLiPA and 17% with HAIN. CONCLUSION: HAIN identifies more mycobacteria species than does InnoLiPA and allows identification in the M. tuberculosis complex. However, failure in identification occurs only with MOTT with InnoLiPA when one M. tuberculosis was found among mycobacteria non identified with HAIN.