The Finnish New Variant of Chlamydia trachomatis with a Single Nucleotide Polymorphism in the 23S rRNA Target Escapes Detection by the Aptima Combo 2 Test

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Hokynar, K.; Rantakokko-Jalava, K.; Hakanen, A.; Havana, M.; Mannonen, L.; Jokela, P.; Kurkela, S.; Lappalainen, M.; Unemo, M.; Puolakkainen, M. The Finnish New Variant of Chlamydia trachomatis with a Single Nucleotide Polymorphism in the 23S rRNA Target Escapes Detection by the Aptima Combo 2 Test. Microorganisms 2019, 7, 227.

Title: The Finnish New Variant of Chlamydia trachomatis with a Single Nucleotide Polymorphism in the 23S rRNA Target Escapes Detection by the Aptima Combo 2 Test
Author: Hokynar, Kati; Rantakokko-Jalava, Kaisu; Hakanen, Antti; Havana, Marika; Mannonen, Laura; Jokela, Pia; Kurkela, Satu; Lappalainen, Maija; Unemo, Magnus; Puolakkainen, Mirja
Publisher: Multidisciplinary Digital Publishing Institute
Date: 2019-07-31
URI: http://hdl.handle.net/10138/304419
Abstract: In 2019, more than 200 cases of <i>Chlamydia trachomatis</i> negative/equivocal by the Aptima Combo 2 assay (AC2, target: 23S rRNA) with slightly elevated relative light units (RLUs), but positive by the Aptima <i>Chlamydia trachomatis</i> assay (ACT, target: 16S rRNA) have been detected in Finland To identify the cause of the AC2 CT false-negative specimens, we sequenced parts of the CT 23S rRNA gene in 40 specimens that were AC2 negative/equivocal but ACT positive. A single nucleotide polymorphism (SNP; C1515T in the <i>C. trachomatis</i> 23S rRNA gene) was revealed in 39 AC2/ACT discordant specimens. No decrease in the number of mandatorily notified <i>C. trachomatis</i> cases was observed nationally in Finland in 2010–2019. When RLUs obtained for AC2 negative specimens were retrospectively evaluated in 2011–2019, a continuous increase in the proportion of samples with RLUs 10–19 was observed since 2014, and a slight increase in the proportion of samples with RLUs 20–84 in 2017–2019, indicating that the Finnish new variant of <i>C. trachomatis</i> might have been spreading nationally for several years. This emphasizes that careful surveillance of epidemiology, positivity rate and test performance are mandatory to detect any changes affecting detection of infections.


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