Rectal gonorrhoea in homosexual men: source of infection

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Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining
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Quantitative Examination of Antibiotic Susceptibility of Neisseria gonorrhoeae Aggregates Using ATP-utilization Commercial Assays and Live/Dead Staining

Published on: February 8, 2019

A McMillan1, H Young, A Moyes

  • 1Department of Genitourinary Medicine, Edinburgh Royal Infirmary NHS Trust, UK.

International Journal of STD & AIDS
|May 29, 2000
PubMed

Insights

Rectal gonorrhea in homosexual men often originates from the pharynx, not just sexual contact. Screening for both rectal and pharyngeal gonorrhea is crucial for men who have sex with men.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Microbiology

Background:

  • Rectal gonorrhea is a significant concern in men who have sex with men (MSM).
  • Understanding transmission routes is vital for effective prevention and control strategies.
  • The oropharynx is a potential reservoir for Neisseria gonorrhoeae.

Purpose of the Study:

  • To investigate the likely source of rectal gonorrhea infection in homosexual men.
  • To determine the relationship between rectal and pharyngeal gonorrhea in this population.
  • To assess the role of the oropharynx as a reservoir for rectal gonorrhea transmission.

Main Methods:

  • Retrospective study analyzing cases of rectal gonorrhea in homosexual men.
  • Contact tracing to identify probable sources of infection.
  • Microbiological analysis, including auxotyping and serotyping of Neisseria gonorrhoeae isolates.
  • Comparison of Neisseria gonorrhoeae strains between index cases and their contacts.

Main Results:

  • A probable source of infection was identified in 46 out of 155 cases of rectal gonorrhea.
  • The urethra was the primary infection site in 72% of contacts, while pharyngeal gonorrhea was found in 20%.
  • High concordance (25/26 cases) in Neisseria gonorrhoeae auxo/serotypes between contacts with urethral gonorrhea and index cases with rectal gonorrhea.
  • Strong agreement (11/12 isolates) in auxo/serotypes between pharyngeal isolates and index cases.

Conclusions:

  • The oropharynx is a significant reservoir for Neisseria gonorrhoeae, supporting its role in rectal gonorrhea acquisition among homosexual men.
  • Pharyngeal gonorrhea is an independent risk factor for Human Immunodeficiency Virus (HIV) acquisition.
  • Screening for both rectal and pharyngeal gonorrhea should be recommended for MSM, irrespective of unprotected receptive anal intercourse history.

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