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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Concern regarding the alleged spread of hypervirulent lymphogranuloma venereum <italic>Chlamydia trachomatis</italic> strain in Europe</title><author><name sortKey="Seth Smith, Helena Mb" sort="Seth Smith, Helena Mb" uniqKey="Seth Smith H" first="Helena Mb" last="Seth-Smith">Helena Mb Seth-Smith</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="aff2">Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Galan, Juan C" sort="Galan, Juan C" uniqKey="Galan J" first="Juan C" last="Galán">Juan C. Galán</name><affiliation><nlm:aff id="aff3">Servicio de Microbiología, Hospital Universitario Ramón y Cajal. CIBER en Epidemiología y Salud Pública (CIBERESP). Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Goldenberger, Daniel" sort="Goldenberger, Daniel" uniqKey="Goldenberger D" first="Daniel" last="Goldenberger">Daniel Goldenberger</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Lewis, David A" sort="Lewis, David A" uniqKey="Lewis D" first="David A" last="Lewis">David A. Lewis</name><affiliation><nlm:aff id="aff4">Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia</nlm:aff></affiliation><affiliation><nlm:aff id="aff5">Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Peuchant, Olivia" sort="Peuchant, Olivia" uniqKey="Peuchant O" first="Olivia" last="Peuchant">Olivia Peuchant</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Bebear, Cecile" sort="Bebear, Cecile" uniqKey="Bebear C" first="Cecile" last="Bébéar">Cecile Bébéar</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="De Barbeyrac, Bertille" sort="De Barbeyrac, Bertille" uniqKey="De Barbeyrac B" first="Bertille" last="De Barbeyrac">Bertille De Barbeyrac</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Benard, Angele" sort="Benard, Angele" uniqKey="Benard A" first="Angele" last="Bénard">Angele Bénard</name><affiliation><nlm:aff id="aff7">Wellcome Trust Sanger Institute. Cambridge, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Carter, Ian" sort="Carter, Ian" uniqKey="Carter I" first="Ian" last="Carter">Ian Carter</name><affiliation><nlm:aff id="aff8">Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Kok, Jen" sort="Kok, Jen" uniqKey="Kok J" first="Jen" last="Kok">Jen Kok</name><affiliation><nlm:aff id="aff5">Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia</nlm:aff></affiliation><affiliation><nlm:aff id="aff8">Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Bruisten, Sylvia M" sort="Bruisten, Sylvia M" uniqKey="Bruisten S" first="Sylvia M" last="Bruisten">Sylvia M. Bruisten</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff10">Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Versteeg, Bart" sort="Versteeg, Bart" uniqKey="Versteeg B" first="Bart" last="Versteeg">Bart Versteeg</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Morre, Servaas A" sort="Morre, Servaas A" uniqKey="Morre S" first="Servaas A" last="Morré">Servaas A. Morré</name><affiliation><nlm:aff id="aff11">Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff12">Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Thomson, Nicholas R" sort="Thomson, Nicholas R" uniqKey="Thomson N" first="Nicholas R" last="Thomson">Nicholas R. Thomson</name><affiliation><nlm:aff id="aff7">Wellcome Trust Sanger Institute. Cambridge, United Kingdom</nlm:aff></affiliation><affiliation><nlm:aff id="aff13">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Egli, Adrian" sort="Egli, Adrian" uniqKey="Egli A" first="Adrian" last="Egli">Adrian Egli</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="aff2">Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="De Vries, Henry Jc" sort="De Vries, Henry Jc" uniqKey="De Vries H" first="Henry Jc" last="De Vries">Henry Jc De Vries</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff10">Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff14">Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28449734</idno><idno type="pmc">5476980</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476980</idno><idno type="RBID">PMC:5476980</idno><idno type="doi">10.2807/1560-7917.ES.2017.22.15.30511</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">001318</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001318</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Concern regarding the alleged spread of hypervirulent lymphogranuloma venereum <italic>Chlamydia trachomatis</italic> strain in Europe</title><author><name sortKey="Seth Smith, Helena Mb" sort="Seth Smith, Helena Mb" uniqKey="Seth Smith H" first="Helena Mb" last="Seth-Smith">Helena Mb Seth-Smith</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="aff2">Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Galan, Juan C" sort="Galan, Juan C" uniqKey="Galan J" first="Juan C" last="Galán">Juan C. Galán</name><affiliation><nlm:aff id="aff3">Servicio de Microbiología, Hospital Universitario Ramón y Cajal. CIBER en Epidemiología y Salud Pública (CIBERESP). Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain</nlm:aff></affiliation></author><author><name sortKey="Goldenberger, Daniel" sort="Goldenberger, Daniel" uniqKey="Goldenberger D" first="Daniel" last="Goldenberger">Daniel Goldenberger</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Lewis, David A" sort="Lewis, David A" uniqKey="Lewis D" first="David A" last="Lewis">David A. Lewis</name><affiliation><nlm:aff id="aff4">Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia</nlm:aff></affiliation><affiliation><nlm:aff id="aff5">Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia</nlm:aff></affiliation></author><author><name sortKey="Peuchant, Olivia" sort="Peuchant, Olivia" uniqKey="Peuchant O" first="Olivia" last="Peuchant">Olivia Peuchant</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Bebear, Cecile" sort="Bebear, Cecile" uniqKey="Bebear C" first="Cecile" last="Bébéar">Cecile Bébéar</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="De Barbeyrac, Bertille" sort="De Barbeyrac, Bertille" uniqKey="De Barbeyrac B" first="Bertille" last="De Barbeyrac">Bertille De Barbeyrac</name><affiliation><nlm:aff id="aff6">University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</nlm:aff></affiliation></author><author><name sortKey="Benard, Angele" sort="Benard, Angele" uniqKey="Benard A" first="Angele" last="Bénard">Angele Bénard</name><affiliation><nlm:aff id="aff7">Wellcome Trust Sanger Institute. Cambridge, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Carter, Ian" sort="Carter, Ian" uniqKey="Carter I" first="Ian" last="Carter">Ian Carter</name><affiliation><nlm:aff id="aff8">Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Kok, Jen" sort="Kok, Jen" uniqKey="Kok J" first="Jen" last="Kok">Jen Kok</name><affiliation><nlm:aff id="aff5">Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia</nlm:aff></affiliation><affiliation><nlm:aff id="aff8">Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia</nlm:aff></affiliation></author><author><name sortKey="Bruisten, Sylvia M" sort="Bruisten, Sylvia M" uniqKey="Bruisten S" first="Sylvia M" last="Bruisten">Sylvia M. Bruisten</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff10">Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Versteeg, Bart" sort="Versteeg, Bart" uniqKey="Versteeg B" first="Bart" last="Versteeg">Bart Versteeg</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Morre, Servaas A" sort="Morre, Servaas A" uniqKey="Morre S" first="Servaas A" last="Morré">Servaas A. Morré</name><affiliation><nlm:aff id="aff11">Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff12">Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, the Netherlands</nlm:aff></affiliation></author><author><name sortKey="Thomson, Nicholas R" sort="Thomson, Nicholas R" uniqKey="Thomson N" first="Nicholas R" last="Thomson">Nicholas R. Thomson</name><affiliation><nlm:aff id="aff7">Wellcome Trust Sanger Institute. Cambridge, United Kingdom</nlm:aff></affiliation><affiliation><nlm:aff id="aff13">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff></affiliation></author><author><name sortKey="Egli, Adrian" sort="Egli, Adrian" uniqKey="Egli A" first="Adrian" last="Egli">Adrian Egli</name><affiliation><nlm:aff id="aff1">Clinical Microbiology, University Hospital Basel, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="aff2">Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="De Vries, Henry Jc" sort="De Vries, Henry Jc" uniqKey="De Vries H" first="Henry Jc" last="De Vries">Henry Jc De Vries</name><affiliation><nlm:aff id="aff9">STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff10">Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation><affiliation><nlm:aff id="aff14">Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands</nlm:aff></affiliation></author></analytic><series><title level="j">Eurosurveillance</title><idno type="ISSN">1025-496X</idno><idno type="eISSN">1560-7917</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Petrovay, F" uniqKey="Petrovay F">F Petrovay</name></author><author><name sortKey="Balla, E" uniqKey="Balla E">E Balla</name></author><author><name sortKey="Erd Si, T" uniqKey="Erd Si T">T Erdősi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Somboonna, N" uniqKey="Somboonna N">N Somboonna</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Euro Surveill</journal-id><journal-id journal-id-type="iso-abbrev">Euro Surveill</journal-id><journal-id journal-id-type="publisher-id">ES</journal-id><journal-title-group><journal-title>Eurosurveillance</journal-title></journal-title-group><issn pub-type="ppub">1025-496X</issn><issn pub-type="epub">1560-7917</issn><publisher><publisher-name>European Centre for Disease Prevention and Control (ECDC)</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28449734</article-id><article-id pub-id-type="pmc">5476980</article-id><article-id pub-id-type="publisher-id">17-00177</article-id><article-id pub-id-type="doi">10.2807/1560-7917.ES.2017.22.15.30511</article-id><article-id pub-id-type="publisher-id">30511</article-id><article-categories><subj-group subj-group-type="heading"><subject>Letter</subject></subj-group></article-categories><title-group><article-title>Concern regarding the alleged spread of hypervirulent lymphogranuloma venereum <italic>Chlamydia trachomatis</italic> strain in Europe</article-title><alt-title alt-title-type="right-running"><underline><ext-link ext-link-type="uri" xlink:href="http://www.eurosurveillance.org">www.eurosurveillance.org</ext-link></underline> – Seth-Smith et al.</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Seth-Smith</surname><given-names>Helena MB</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Galán</surname><given-names>Juan C</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Goldenberger</surname><given-names>Daniel</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lewis</surname><given-names>David A</given-names></name><xref ref-type="aff" rid="aff4"><sup>4</sup></xref><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Peuchant</surname><given-names>Olivia</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bébéar</surname><given-names>Cecile</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>de Barbeyrac</surname><given-names>Bertille</given-names></name><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bénard</surname><given-names>Angele</given-names></name><xref ref-type="aff" rid="aff7"><sup>7</sup></xref></contrib><contrib contrib-type="author"><name><surname>Carter</surname><given-names>Ian</given-names></name><xref ref-type="aff" rid="aff8"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kok</surname><given-names>Jen</given-names></name><xref ref-type="aff" rid="aff5"><sup>5</sup></xref><xref ref-type="aff" rid="aff8"><sup>8</sup></xref></contrib><contrib contrib-type="author"><name><surname>Bruisten</surname><given-names>Sylvia M</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref><xref ref-type="aff" rid="aff10"><sup>10</sup></xref></contrib><contrib contrib-type="author"><name><surname>Versteeg</surname><given-names>Bart</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref></contrib><contrib contrib-type="author"><name><surname>Morré</surname><given-names>Servaas A</given-names></name><xref ref-type="aff" rid="aff11"><sup>11</sup></xref><xref ref-type="aff" rid="aff12"><sup>12</sup></xref></contrib><contrib contrib-type="author"><name><surname>Thomson</surname><given-names>Nicholas R</given-names></name><xref ref-type="aff" rid="aff7"><sup>7</sup></xref><xref ref-type="aff" rid="aff13"><sup>13</sup></xref></contrib><contrib contrib-type="author"><name><surname>Egli</surname><given-names>Adrian</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>de Vries</surname><given-names>Henry JC</given-names></name><xref ref-type="aff" rid="aff9"><sup>9</sup></xref><xref ref-type="aff" rid="aff10"><sup>10</sup></xref><xref ref-type="aff" rid="aff14"><sup>14</sup></xref></contrib><aff id="aff1"><label>1</label>Clinical Microbiology, University Hospital Basel, Basel, Switzerland</aff><aff id="aff2"><label>2</label>Applied Microbiology Research, Department of Biomedicine, University of Basel, Basel, Switzerland</aff><aff id="aff3"><label>3</label>Servicio de Microbiología, Hospital Universitario Ramón y Cajal. CIBER en Epidemiología y Salud Pública (CIBERESP). Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain</aff><aff id="aff4"><label>4</label>Western Sydney Sexual Health Centre, Western Sydney Local Health District, Parramatta, New South Wales, Australia</aff><aff id="aff5"><label>5</label>Marie Bashir Institute for Infectious Diseases and Biosecurity & Sydney Medical School-Westmead, Sydney, Australia</aff><aff id="aff6"><label>6</label>University of Bordeaux, INRA, USC ES 3671, French National Reference Centre for chlamydiae, Bordeaux, France</aff><aff id="aff7"><label>7</label>Wellcome Trust Sanger Institute. Cambridge, United Kingdom</aff><aff id="aff8"><label>8</label>Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology and Medical Research, Westmead Hospital, Westmead, New South Wales, Australia</aff><aff id="aff9"><label>9</label>STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands</aff><aff id="aff10"><label>10</label>Amsterdam Infection and Immunity Institute (AI&II), Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands</aff><aff id="aff11"><label>11</label>Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center Amsterdam, Amsterdam, the Netherlands</aff><aff id="aff12"><label>12</label>Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research Institute GROW, University of Maastricht, Maastricht, the Netherlands</aff><aff id="aff13"><label>13</label>London School of Hygiene and Tropical Medicine, London, United Kingdom</aff><aff id="aff14"><label>14</label>Department of Dermatology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands</aff></contrib-group><author-notes><fn id="afn1"><p><bold>Correspondence:</bold> Henry John de Vries (<email xlink:href="h.j.devries@amc.nl">h.j.devries@amc.nl</email>)</p></fn></author-notes><pub-date pub-type="ppub"><day>13</day><month>4</month><year>2017</year></pub-date><volume>22</volume><issue>15</issue><elocation-id>30511</elocation-id><history><date date-type="received"><day>06</day><month>3</month><year>2017</year></date><date date-type="accepted"><day>12</day><month>4</month><year>2017</year></date></history><permissions><copyright-statement>This article is copyright of The Authors, 2017.</copyright-statement><copyright-year>2017</copyright-year><copyright-holder>The Authors</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.</license-p></license></permissions><kwd-group><title>Keywords: </title><kwd>lymphogranuloma venereum</kwd><kwd><italic>Chlamydia trachomatis</italic></kwd><kwd>male homosexuality</kwd><kwd>bacterial outer membrane proteins</kwd><kwd>genotype</kwd></kwd-group></article-meta></front><body><p><bold>To the editor:</bold> A recent surveillance and outbreak report published in <italic>Eurosurveillance</italic> by Petrovay et al. on the ‘Emergence of the lymphogranuloma venereum L2c genovariant, Hungary, 2012 to 2016’ [<xref rid="r1" ref-type="bibr">1</xref>] provides an observation of the first European cases of a genotype of <italic>Chlamydia trachomatis</italic> associated with severe haemorrhagic proctitis. The authors of this paper diagnosed the strains as lymphogranuloma venereum (LGV)-associated and performed partial sequencing of the <italic>ompA</italic> gene (ca 1,070 bp), which is a standard typing method for <italic>C. trachomatis</italic>. The <italic>ompA</italic> gene sequence obtained was compared with those from reference isolates, and reported to be 100% concordant with the <italic>ompA</italic> sequence belonging to an L2-D recombinant strain described in 2011 [<xref rid="r2" ref-type="bibr">2</xref>]. This strain was named ‘L2c’, as it was found to possess a chimeric genome, not because it has a novel <italic>ompA</italic>-genotype. We would like to point out that the <italic>ompA</italic> gene sequence of this L2-D recombinant strain, and by implication those of the Hungarian isolates, is identical to that of archetypal L2 strains, for example the reference strain L2/434 [<xref rid="r3" ref-type="bibr">3</xref>].</p><p>Petrovay et al. found that the <italic>pmpH</italic>-genotype of the Hungarian strains reflect that of an LGV strain, containing a diagnostic 36 bp deletion. Unfortunately this locus does not discriminate between L2 strains and L2-D. As the authors appear not to have checked for concordance between their strains and the L2-D recombinant strain in other genomic loci, it is not possible to determine whether the strains reflect the appearance of this L2-D recombinant, or rather a circulating L2 LGV strain. Thus, it is premature to assume that these Hungarian LGV strains reflect the presence of the ‘hypervirulent’ L2-D recombinant strain, despite the described clinical symptoms. We find it more likely that the authors have observed a resurgence in cases with <italic>ompA</italic>-genotype L2, as described last year [<xref rid="r4" ref-type="bibr">4</xref>].</p><p>For the <italic>Chlamydia</italic> community, it is important to recognise that the use of the term ‘L2c genotype’ in the case of the L2-D recombinant strain is a misnomer, as the <italic>ompA</italic>-genotype of this strain is an archetypal L2. This nomenclature was also the source of confusion in a recent paper from Slovenia describing the presence of ‘L2c’ [<xref rid="r5" ref-type="bibr">5</xref>], again with further analysis now showing that the <italic>ompA</italic>-genotype of this strain is also identical to L2. The distinct L2c <italic>ompA</italic>-genotype was described in a 2008 publication, and has 2 nucleotide differences to that of L2 [<xref rid="r6" ref-type="bibr">6</xref>].</p><p>Given the high level of recombination observed in <italic>C. trachomatis</italic> [<xref rid="r7" ref-type="bibr">7</xref>], typing techniques based on a few loci can never give a full indication of the underlying genomic background: only whole genome sequencing and detailed phylogenetic analysis can provide this. Therefore we would recommend that future publications are absolutely clear as to which genotyping method they have used in strain descriptions, for example a common target such as the <italic>ompA</italic>-genotype. Furthermore, <italic>Chlamydia</italic> researchers should be aware of this awkwardness of nomenclature, should thoroughly compare their <italic>ompA</italic> sequences against a database of known L2 <italic>ompA</italic>-genotypes (L2: AM884176; L2a: AB915594, L2b: AM884177; L2c: EF460796; L2d: EF460797; L2e: EF460798; L2f: EU676181; L2g: EU676180; L2bV1: JX971936; L2bV2: KU518893; L2bV3: KU518894; L2bV4: KU518892) [<xref rid="r3" ref-type="bibr">3</xref>,<xref rid="r6" ref-type="bibr">6</xref>,<xref rid="r8" ref-type="bibr">8</xref>-<xref rid="r10" ref-type="bibr">10</xref>], and report their findings more fully.</p><p>As it stands, the description of the Hungarian strains as ‘L2c’ is inaccurate in the sense of the <italic>ompA</italic>-genotype. Importantly, it is not possible to make any conclusions about the European appearance of this ‘hypervirulent’ L2-D recombinant strain without further sequencing of additional genomic loci, ideally whole genome sequencing, or investigations into in vitro phenotypes.</p></body><back><ack><title>Acknowledgements</title><p>No funding was given for this article.</p></ack><notes><fn-group><fn fn-type="COI-statement"><p><bold>Conflict of interest:</bold> None declared.</p></fn><fn fn-type="con"><p><bold>Authors’ contributions:</bold> HSS, JCG and HdV wrote the first draft of the manuscript. DG, DAL, OP, CB, BdB, AB, IC, JK, SMB, BV, SAM, NT and AE each contributed to the draft. 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