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Anogenital infection with Neisseria meningitidis in homosexual men
Abstract:
Among monosexual men anal infection with Neisseria meningitidis was more prevalent (15 of 731 men) than expected and significantly more prevalent than urethral infection with N. meningitidis (three of 669 men, P less than 0.01). Anal infection was also significantly more prevalent among homosexual men than among heterosexual women (two of 1,197 women, P less than 0.001). These differences in rates of prevalence may be best explained by a preference of meningococci for anal mucosa and by the common homosexual practice of oral-anal sexual contact. Serogrouping of the 17 anal and three urethral isolates revealed a broad representation of serogroups often found in meningococcal pharyngeal carriage in the community. Of 14 patients who returned for a test-of-cure culture within seven days of treatment with an antibiotic regimen recommended for anogenital gonococcal infection, each was culture-negative for N. meningitidis. Minor and symptoms in three men and profuse urethral discharges in two men resolved with treatment.
Insights
Neisseria meningitidis anal infections were more common in men than urethral infections. This suggests meningococci may favor anal mucosa, potentially linked to sexual practices.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Neisseria meningitidis is a bacterium primarily known for causing meningitis and sepsis.
- Rectal carriage and infection with N. meningitidis are less commonly studied than pharyngeal carriage.
Purpose of the Study:
- To investigate the prevalence of anal Neisseria meningitidis infection among men.
- To compare anal infection rates with urethral infection rates and prevalence in other populations.
Main Methods:
- Cross-sectional study analyzing N. meningitidis infection prevalence in men.
- Comparison of infection rates between different groups (homosexual men, heterosexual women).
- Serogrouping of isolates and test-of-cure cultures after antibiotic treatment.
Main Results:
- Anal Neisseria meningitidis infection was significantly more prevalent in men (15/731) than urethral infection (3/669).
- Anal infection was also more prevalent in homosexual men compared to heterosexual women (2/1197).
- Antibiotic treatment for anogenital gonorrhea was effective in eradicating N. meningitidis.
Conclusions:
- The findings suggest a potential tropism of N. meningitidis for anal mucosa.
- Sexual practices, particularly oral-anal contact, may contribute to the observed prevalence.
- N. meningitidis can be effectively treated with standard anogenital infection regimens.