CDC STACKS serves as an archival repository of CDC-published products including scientific findings, journal articles, guidelines, recommendations, or other public health information authored or co-authored by CDC or funded partners.
As a repository, CDC STACKS retains documents in their original published format to ensure public access to scientific information.
i
Extragenital Gonorrhea and Chlamydia Positivity and the Potential for Missed Extragenital Gonorrhea With Concurrent Urethral Chlamydia Among Men Who Have Sex With Men Attending Sexually Transmitted Disease Clinics—Sexually Transmitted Disease Surveillance Network, 2015–2019
-
6 2020
-
-
Source: Sex Transm Dis. 47(6):361-368
Details:
-
Alternative Title:Sex Transm Dis
-
Personal Author:
-
Description:Background:
Extragenital gonorrhea (GC) and chlamydia (CT) are usually asymptomatic and only detected through screening. Ceftriaxone plus azithromycin is the recommended GC treatment; monotherapy (azithromycin or doxycycline) is recommended for CT. In urethral CT-positive/urethral GC-negative persons who are not screened extragenitally, CT monotherapy can lead to GC undertreatment and may foster the development of gonococcal antimicrobial resistance. We assessed urethral and extragenital GC and CT positivity among men who have sex with men (MSM) attending sexually transmitted disease clinics.
Methods:
We included visit data for MSM tested for GC and CT at 30 sexually transmitted disease clinics in 10 jurisdictions during January 1, 2015, and June 30, 2019. Using an inverse-variance random effects model to account for heterogeneity between jurisdictions, we calculated weighted test visit positivity estimates and 95% confidence intervals (CI) for GC and CT at urethral and extragenital sites, and extragenital GC among urethral CT-positive/GC-negative test visits.
Results:
Of 139,718 GC and CT test visits, we calculated overall positivity (GC, 16.7% [95% CI, 14.4–19.1]; CT, 13.3% [95% CI, 12.7–13.9]); urethral positivity (GC, 7.5% [95% CI, 5.7–9.3]; CT, 5.2% [95% CI, 4.6–5.8]); rectal positivity (GC, 11.8% [95% CI, 10.4–13.2]; CT, 12.6% [95% CI, 11.8–13.4]); and pharyngeal positivity (GC, 9.1% [95% CI, 7.9–10.3]; CT, 1.8% [95% CI, 1.6–2.0]). Of 4566 urethral CT-positive/GC-negative test visits with extragenital testing, extragenital GC positivity was 12.5% (95% CI, 10.9–14.1).
Conclusions:
Extragenital GC and CT were common among MSM. Without extragenital screening of MSM with urethral CT, extragenital GC would have been undetected and undertreated in approximately 13% of these men. Undertreatment could potentially select for antimicrobial resistance. These findings underscore the importance of extragenital screening in MSM.
-
Subjects:
-
Source:
-
Pubmed ID:32413018
-
Pubmed Central ID:PMC10207946
-
Document Type:
-
Funding:
-
Volume:47
-
Issue:6
-
Collection(s):
-
Main Document Checksum:
-
Download URL:
-
File Type: