Details:

Alternative Title:
Sex Transm Dis
Publisher's site:
http://dx.doi.org/10.1097/OLQ.0000000000001170
Personal Author:
Abara, Winston E. ; Llata, Eloisa L. ; Schumacher, Christina ; Carlos-Henderson, Juli ; Peralta, Angela M. ; ... More +
Abara, Winston E. ; Llata, Eloisa L. ; Schumacher, Christina ; Carlos-Henderson, Juli ; Peralta, Angela M. ; Huspeni, Dawn ; Kerani, Roxanne P. ; Elder, Heather ; Toevs, Kim ; Pathela, Preeti ; Asbel, Lenore ; Nguyen, Trang Q. ; Bernstein, Kyle T. ; Torrone, Elizabeth A. ; Kirkcaldy, Robert D. Less -
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:
[+]
Adult Chlamydia Infections Chlamydia Trachomatis Gonorrhea Homosexuality, Male Humans Male Neisseria Gonorrhoeae Pharyngeal Diseases Pharynx Prevalence Rectal Diseases Rectum Urethra Urethritis
Source:
Sex Transm Dis. 47(6):361-368
Pubmed ID:
32413018
Pubmed Central ID:
PMC10207946
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHSUnited States/
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:65968a02ee6896b503ffbf49d08edce9cd90874925ba5c2bc90c0effb5f37b5c
Download URL:
https://stacks.cdc.gov/view/cdc/128972/cdc_128972_DS1.pdf
File Type:

Supporting Files

• 	nihms-1897442.nxml	xml
  	NIHMS1897442-supplement-supp_table_1.docx	docx
  	NIHMS1897442-supplement-supp_table_2.docx	docx

More +