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Chlamydia trachomatis outbreak: when the virulence-associated genome backbone imports a prevalence-associated major antigen signature

Vítor Borges, Dora Cordeiro, Ana Isabel Salas, Zohra Lodhia, Cristina Correia, Joana Isidro, Cândida Fernandes, Ana Maria Rodrigues, Jacinta Azevedo, João Alves, João Roxo, Miguel Rocha, Rita Côrte-Real, Luís Vieira, View ORCID ProfileMaria José Borrego, João Paulo Gomes
doi: https://doi.org/10.1101/622324
Vítor Borges
Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
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Dora Cordeiro
National Reference Laboratory (NRL) for Curable Sexually Transmitted Infections (STIs), National Institute of Health, Lisbon, Portugal
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Ana Isabel Salas
National Reference Laboratory (NRL) for Curable Sexually Transmitted Infections (STIs), National Institute of Health, Lisbon, Portugal
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Zohra Lodhia
National Reference Laboratory (NRL) for Curable Sexually Transmitted Infections (STIs), National Institute of Health, Lisbon, Portugal
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Cristina Correia
National Reference Laboratory (NRL) for Curable Sexually Transmitted Infections (STIs), National Institute of Health, Lisbon, Portugal
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Joana Isidro
Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
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Cândida Fernandes
Sexually Transmitted Diseases Clinic, Dermatovenereology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
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Ana Maria Rodrigues
Sexually Transmitted Diseases Clinic, Dermatovenereology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
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Jacinta Azevedo
Sexually Transmitted Diseases Clinic, Lapa Health Centre, Lisbon, Portugal
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João Alves
Sexually Transmitted Diseases Clinic, Lapa Health Centre, Lisbon, Portugal
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João Roxo
CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
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Miguel Rocha
CheckpointLX, Grupo de Ativistas em Tratamentos, Lisbon, Portugal
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Rita Côrte-Real
Sexually Transmitted Diseases Clinic, Dermatovenereology Department, Centro Hospitalar e Universitário de Lisboa Central, Lisbon, Portugal
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Luís Vieira
Innovation and Technology Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal
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Maria José Borrego
National Reference Laboratory (NRL) for Curable Sexually Transmitted Infections (STIs), National Institute of Health, Lisbon, Portugal
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  • ORCID record for Maria José Borrego
  • For correspondence: m.jose.borrego@insa.min-saude.pt j.paulo.gomes@insa.min-saude.pt
João Paulo Gomes
Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
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  • For correspondence: m.jose.borrego@insa.min-saude.pt j.paulo.gomes@insa.min-saude.pt
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Abstract

Chlamydia trachomatis is the most prevalent sexually transmitted bacteria worldwide and the causative agent of blinding trachoma. Strains are classified based on ompA genotypes, which are strongly linked with differential tissue tropism and disease outcomes. A lymphogranuloma venereum (LGV) epidemics, characterized by ulcerative proctitis, has emerged in the last two decades (mainly L2b genotype), raising high concern especially due to its circulation among men who have sex with men (MSM). Here, we report an ongoing outbreak (mostly affecting HIV-positive MSM engaging in high-risk practices) caused by an L2b strain with a rather unique genome makeup that precluded the laboratory notification of this outbreak as LGV due to its non-LGV ompA signature. Homologous recombination mediated the transfer of a ~4.5Kbp fragment enrolling CT681/ompA and neighboring genes (CT677/rrf, CT678/pyrH, CT679/tsf, CT680/rpsB) from a serovar D/Da strain likely possessing the typical T1 clade genome backbone associated with most prevalent genotypes (E and F). The hybrid L2b/D-Da strain presents the adhesin and immunodominant antigen MOMP (coded by ompA) with an epitope repertoire typical of non-invasive genital strains, while keeping the genome-dispersed virulence fingerprint of a classical LGV (L2b) strain. As previously reported for inter-clade ompA exchange among non-LGV clades, this unprecedented C. trachomatis genomic mosaic involving a contemporary epidemiologically and clinically relevant LGV strain may have implications on its transmission, tissue tropism and pathogenic capabilities. The emergence of such variants with epidemic and pathogenic potential highlights the need of more oriented surveillance strategies focused on capturing the C. trachomatis evolution in action.

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Posted April 29, 2019.
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Chlamydia trachomatis outbreak: when the virulence-associated genome backbone imports a prevalence-associated major antigen signature
Vítor Borges, Dora Cordeiro, Ana Isabel Salas, Zohra Lodhia, Cristina Correia, Joana Isidro, Cândida Fernandes, Ana Maria Rodrigues, Jacinta Azevedo, João Alves, João Roxo, Miguel Rocha, Rita Côrte-Real, Luís Vieira, Maria José Borrego, João Paulo Gomes
bioRxiv 622324; doi: https://doi.org/10.1101/622324
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Chlamydia trachomatis outbreak: when the virulence-associated genome backbone imports a prevalence-associated major antigen signature
Vítor Borges, Dora Cordeiro, Ana Isabel Salas, Zohra Lodhia, Cristina Correia, Joana Isidro, Cândida Fernandes, Ana Maria Rodrigues, Jacinta Azevedo, João Alves, João Roxo, Miguel Rocha, Rita Côrte-Real, Luís Vieira, Maria José Borrego, João Paulo Gomes
bioRxiv 622324; doi: https://doi.org/10.1101/622324

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