Prevalence Of Pharyngeal Gonorrhea Research Articles

P04.05 High prevalence of rectal gonorrhoea among men reporting contact with men with gonorrhoea: implications for epidemiological treatment

Background: This study aimed to determine the prevalence of gonorrhoea and factors associated with rectal gonorrhoea among men reporting sexual contact with men with gonorrhoea. Methods: Men who presented to Melbourne Sexual Health Centre reporting sexual contact with a male with gonorrhoea were prospectively identified between March 2011 and December 2013. These men were screened for pharyngeal and rectal gonorrhoea using culture. The prevalence of gonorrhoea among contacts was compared to that among all men who have sex with men (MSM) screened at the clinic over the same period. Results: Among 363 contacts of gonorrhoea the prevalence of rectal gonorrhoea was 26.4 % (95 % CI: 21.8 %-31.0 %) compared to 3.9 % (95 % CI: 3.7 %-4.2 %) among clinic attendees (p<0.001). The prevalence of pharyngeal gonorrhoea among contacts was 9.4 % (95 % CI: 6.4 %-12.4 %) compared to 2.1 % (95 % CI: 1.9 %-2.4 %) among clinic attendees (p<0.001). Among contacts who reported not always using condoms during receptive anal sex with casual partners, rectal gonorrhoea was cultured in 42.4 % compared with 12.7 % among contacts reporting no receptive anal sex (p<0.001) and 20.2 % among those reporting always using condoms (p<0.001). On multivariate analysis rectal gonorrhoea was associated with inconsistent condom use during receptive anal sex with casual partners (adjusted odds ratio (AOR): 4.16; 95 % CI: 1.87-9.26) and a reported past history of gonorrhoea (AOR: 1.77; 95 % CI: 1.01-3.14). Conclusions: The high proportion of positive cases of gonorrhoea among contacts in this study supports epidemiological treatment of MSM presenting as contacts of gonorrhoea.

High prevalence of rectal gonorrhoea among men reporting contact with men with gonorrhoea: Implications for epidemiological treatment.

BackgroundThis study aimed to determine the prevalence of gonorrhoea and factors associated with rectal gonorrhoea among men reporting sexual contact with men with gonorrhoea.MethodsMen who presented to Melbourne Sexual Health Centre reporting sexual contact with a male with gonorrhoea were prospectively identified between March 2011 and December 2013. These men were screened for pharyngeal and rectal gonorrhoea using culture. The prevalence of gonorrhoea among contacts was compared to that among all men who have sex with men (MSM) screened at the clinic over the same period.ResultsAmong 363 contacts of gonorrhoea the prevalence of rectal gonorrhoea was 26.4 % (95 % CI: 21.8 %-31.0 %) compared to 3.9 % (95 % CI: 3.7 %-4.2 %) among clinic attendees (p < 0.001). The prevalence of pharyngeal gonorrhoea among contacts was 9.4 % (95 % CI: 6.4 %-12.4 %) compared to 2.1 % (95 % CI: 1.9 %-2.4 %) among clinic attendees (p < 0.001). Among contacts who reported not always using condoms during receptive anal sex with casual partners, rectal gonorrhoea was cultured in 42.4 % compared with 12.7 % among contacts reporting no receptive anal sex (p < 0.001) and 20.2 % among those reporting always using condoms (p < 0.001). On multivariate analysis rectal gonorrhoea was associated with inconsistent condom use during receptive anal sex with casual partners (adjusted odds ratio (AOR): 4.16; 95 % CI: 1.87-9.26) and a reported past history of gonorrhoea (AOR: 1.77; 95 % CI: 1.01-3.14).ConclusionsThe high proportion of positive cases of gonorrhoea among contacts in this study supports epidemiological treatment of MSM presenting as contacts of gonorrhoea.

Prevalence of pharyngeal infection by Neisseria gonorrhoeae among human immunodeficiency virus-positive men who have sex with men in downtown Madrid, 2011

The prevalence of pharyngeal gonorrhoea in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) is not entirely known. We cultured the pharynx of 264 asymptomatic HIV-positive MSM in downtown Madrid. A questionnaire on sexual and drug use risk behaviours was also administered. Gonococci were isolated in 25 (9.5%). Among the whole study population, 65% had a history of sexual intercourse with two or more partners on a single day and 26% were involved in group sex with other men. Only 29% regularly used condoms in all sexual encounters and 63% used condoms only in insertive anal intercourse. When asked about oral sex, 89% of patients engaged in insertive and/or receptive oral sex and 86% recognized that they did not regularly request the use of condoms when practising "fellatio" on a partner. Cocaine, crystal methamphetamine or alcohol use and a previous history of ≥1 sexually transmitted infection were significantly more common among culture-positive patients. Gonococcal colonization of the pharynx was self-limited in patients that were not treated and re-cultured a mean 18.5 ± 5.2 days after diagnosis. Asymptomatic pharyngeal gonorrhoea is common among HIV-positive MSM and may contribute to the increasing epidemic of gonorrhoea in Madrid.

P3.152 Prevalence of Neisseria Gonorrhoeae Infection in Two Distinct Men-Who-Have-Sex-With-Men (MSM) Populations in Slovenia in 2012

ObjectivesInfection with Neisseria gonorrhoeae represents a serious public health problem. According to the national reported incidence surveillance system in Slovenia, gonorrhoea is disproportionately more common in the MSM population. However,...

Unprotected fellatio between female sex workers and their clients in Sydney, Australia

ObjectivesTo assess the frequency and predictors of inconsistent condom use for fellatio at work by female sex workers (FSW) in Sydney and the prevalence of pharyngeal gonorrhoea and other sexually...

The use and performance of oral–throat rinses to detect pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections

Gonococcal and chlamydial infections in the pharynx can occur as a consequence of oral sex. Currently, diagnosis of these infections typically requires a swab specimen to be collected from the posterior pharynx. However, we assessed the diagnostic adequacy of using commercial mouthwash or water as an oral–throat rinse and subsequent testing with a nucleic acid amplification test (Gen-Probe APTIMA Combo 2 assay; Gen-Probe, San Diego, CA). Mouthwash and water samples, spiked with varying amounts of gonorrhea and chlamydia, remained positive for both organisms for up to 2 weeks after storage at room temperature and 37 °C. A clinical trial compared the test performance of oral–throat rinses to pharyngeal swabs among 561 (250 mouthwash, 311 water) gay and other men who have sex with men. Participants were also surveyed to assess the acceptability, preference, and feasibility of oral–throat rinses in a clinical setting. The prevalence of pharyngeal gonorrhea and chlamydia were 9.5% (53/556) and 1.4% (8/561), respectively. Compared with the pharyngeal swab, mouthwash oral–throat rinses had a sensitivity and specificity for the detection of gonorrhea of 72% and 99.1%, respectively, whereas water had 82% and 99.7%, respectively. Chlamydia prevalence was too low for reliable assessments of test performance. Study participants found oral–throat rinses acceptable, preferable, and feasible when compared with pharyngeal swabs. Further study is needed to investigate discordant results and improve the sensitivity of oral–throat rinses.

5 SCREENING FOR PHAPYNCEAL CONDRLEA IN IRAN TENNAGERS

Studies of adult VD clinics, world-wide, report that the prevalence of pharyngeal gonorrhea (GC) varies from 1.3% to 5.7%, but the incidence among adolescents has not been delineated. A retrospective chart review was conducted to assess the usefulness of pharyngeal cultures in GC screening with urban adolescents. The study population was teenagers who visited the Adolescent Clinic and were cultured for GC; they were routinely cultured at all 3 sites (cervix or urethra, rectum and pharynx) regardless of their history of sexual practice. From Dec. 1979 to Oct. 1930, documented cultures at 3 sites were recorded for 546 patients (no record of sexual practice was available). This population was predominantly urban, black (95%) and female (90%); the age range was 11 to 22 years. Positive cultures were confirmed by fluorescent antibody reaction followed by sugar fermentation (for doubtful reactions).The overall occurrence of GC was 14.7%. Pharyngeal GC was detected in 2.7% of the study population, representing 12 females and 3 males (mean age 15.1, range 12-19). Of the 80/546 patients with GC, 15% had only pharyngeal GC. History was available for 11 of these 12 patients: none had pharyngeal symptoms. Five were detected at a routine family-planning visit and six had genital-tract symptoms.Particularly in the context of routine screening in a general adolescent clinic, the occurrence of pharyngeal GC is sufficiently high to merit study of indications for pharyngeal culture of teenage patients. A positive history of fellatio/cunnilingus may be an adequate indicator, as reported for adults. Alternatively, it may prove appropriate to culture adolescents routinely for pharyngeal GC, regardless of stated sexual practice.