Journal articles: 'Pharyngeal chlamydia'

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Andersen, Arthur A. "Comparison of Pharyngeal, Fecal, and Cloacal Samples for the Isolation of Chlamydia Psittaci from Experimentally Infected Cockatiels and Turkeys." Journal of Veterinary Diagnostic Investigation 8, no. 4 (October 1996): 448–50. http://dx.doi.org/10.1177/104063879600800407.

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Direct comparisons were made of Chlamydial isolation rates from pharyngeal swabs, fecal samples, and cloacal swabs from cockatiels and pharyngeal and cloacal swabs from turkeys experimentally infected with Chlamydia psittaci. During pathogenesis studies, 133 paired specimens were collected from cockatiels and 118 paired specimens were collected from turkeys. Of the 51 cockatiel Chlamydial infections detected, 80.4% were positive by the pharyngeal swab sample, 45.1% were positive by the fecal swab sample, and 37.3% were positive by the cloacal swab sample. Of the 87 turkey infections detected, 93.1% were positive by the pharyngeal swab sample and 77.0% were positive by the cloacal swab. The pharyngeal swabs were the most reliable sample for isolation of chlamydia from live birds. However, no single sampling site yielded positive results from all infected birds. Specimens from multiple sites are recommended because a number of infected birds were identified by isolation from only 1 sample.

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Gaspari, Valeria, Antonella Marangoni, Antonietta D’Antuono, Greta Roncarati, Melissa Salvo, Claudio Foschi, and Maria Carla Re. "Pharyngeal Chlamydia and gonorrhea: a hidden problem." International Journal of STD & AIDS 30, no. 8 (May 2, 2019): 732–38. http://dx.doi.org/10.1177/0956462419838922.

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In this study we assessed the prevalence and predictors of pharyngeal infections due to Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in a cohort of patients attending an STI Clinic. From January 2016 to September 2018, 893 patients attending the STI Clinic of St Orsola-Malpighi Hospital (Bologna, Italy) and reporting unprotected oral sex were enrolled. A pharyngeal swab for the molecular detection of CT and NG was collected from each patient. Positive CT samples were further genotyped by an omp1 gene PCR. A total of 134 cases of gonorrhea (15%) and 34 chlamydial infections (3.8%) were detected in the pharyngeal site, with no significant differences between males (all men who have sex with men [MSM]) and females. More than 90% of the infections were completely asymptomatic, suggesting that symptoms were not predictors of a pharyngeal infection ( P = 0.7). On the contrary, a history of sexual contacts with a partner positive for CT and/or NG ( P < 0.0001), HIV positivity ( P = 0.01), and the presence of concurrent genital and/or rectal infections ( P < 0.0001) were significantly associated with CT/NG pharyngeal infections. Pharyngeal lymphogranuloma venereum cases were rare (prevalence: 0.4%), asymptomatic, and only found in MSM. Better knowledge about pharyngeal CT/NG infections could help to set up effective strategies for their prevention.

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Chan, Philip A., Ashley Robinette, Madeline Montgomery, Alexi Almonte, Susan Cu-Uvin, John R. Lonks, Kimberle C. Chapin, Erna M. Kojic, and Erica J. Hardy. "Extragenital Infections Caused byChlamydia trachomatisandNeisseria gonorrhoeae: A Review of the Literature." Infectious Diseases in Obstetrics and Gynecology 2016 (2016): 1–17. http://dx.doi.org/10.1155/2016/5758387.

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In the United States, sexually transmitted diseases due toChlamydia trachomatisandNeisseria gonorrhoeaecontinue to be a major public health burden. Screening of extragenital sites including the oropharynx and rectum is an emerging practice based on recent studies highlighting the prevalence of infection at these sites. We reviewed studies reporting the prevalence of extragenital infections in women, men who have sex with men (MSM), and men who have sex only with women (MSW), including distribution by anatomical site. Among women, prevalence was found to be 0.6–35.8% for rectal gonorrhea (median reported prevalence 1.9%), 0–29.6% for pharyngeal gonorrhea (median 2.1%), 2.0–77.3% for rectal chlamydia (median 8.7%), and 0.2–3.2% for pharyngeal chlamydia (median 1.7%). Among MSM, prevalence was found to be 0.2–24.0% for rectal gonorrhea (median 5.9%), 0.5–16.5% for pharyngeal gonorrhea (median 4.6%), 2.1–23.0% for rectal chlamydia (median 8.9%), and 0–3.6% for pharyngeal chlamydia (median 1.7%). Among MSW, the prevalence was found to be 0–5.7% for rectal gonorrhea (median 3.4%), 0.4–15.5% for pharyngeal gonorrhea (median 2.2%), 0–11.8% for rectal chlamydia (median 7.7%), and 0–22.0% for pharyngeal chlamydia (median 1.6%). Extragenital infections are often asymptomatic and found in the absence of reported risk behaviors, such as receptive anal and oral intercourse. We discuss current clinical recommendations and future directions for research.

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Lister, N. A., A. Smith, T. Read, and C. K. Fairley. "Testing men who have sex with men for Neisseria gonorrhoeae and Chlamydia trachomatis prior to the introduction of guidelines at an STD clinic in Melbourne." Sexual Health 1, no. 1 (2004): 47. http://dx.doi.org/10.1071/sh03005.

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Background: Guidelines for testing men who have sex with men (MSM) were published in 2002. They did not recommend asymptomatic screening for urethral gonorrhoea or pharyngeal screening for chlamydia. To determine if these guidelines were appropriate, we audited gonorrhoea and chlamydia testing of MSM at our centre. Methods: We carried out two audits at our Centre between August 2001 to July 2002. The first was an audit of testing MSM for gonorrhoea and/ or chlamydia over 12 days. The second was an audit of all positive tests over this 12-month period for gonorrhoea or chlamydia among MSM. Results: During the 12 selected days 89 of 286 men tested (31%) were MSM. Among the MSM testing positive for gonorrhoea and/ or chlamydia infection (15, 17%), symptomatic urethral infection was the most common (n = 8). No rectal and pharyngeal infections had site-specific symptoms. Based on the guidelines, 100 of the 334 tests ordered (30%) were not recommended according to the guidelines, and none of these 100 tests yielded a positive result. Over the 12-month audit period, 135 MSM were diagnosed with gonorrhoea and/ or chlamydia. For gonorrhoea, site specific symptoms were present in 42 of 43 cases of urethral infection (98%), six of 23 cases of rectal infection (26%), and no cases of pharyngeal infection had symptoms. For chlamydia, site-specific symptoms were present in 29 of 48 cases of urethral infection (60%), six of 33 cases of rectal infection (18%), and in one of the two cases of pharyngeal chlamydia identified. A substantial proportion of cases occurred in clients with HIV infection (21, 16%). Conclusions: These findings strongly support screening among MSM and in particular not testing asymptomatic MSM for urethral gonorrhoea or any MSM for pharyngeal Chlamydia.

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Goddard, Sian Louise, Preethi Rajagopal, and David James Templeton. "Increasing yield of pharyngeal Chlamydia trachomatis among male gay and bisexual clinic attendees in Sydney: an observational study." Sexual Health 14, no. 3 (2017): 282. http://dx.doi.org/10.1071/sh16181.

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Background The aim of the present study was to describe the temporal trends in Chlamydia trachomatis (CT) testing yield among gay and bisexual male (GBM) sexual health clinic attendees in Sydney. Methods: All CT testing occasions among GBM from January 2011 to December 2014 were reviewed. Yield was defined as the proportion of testing occasions where CT was detected. Results: In all, 2917 GBM were tested on 5445 occasions. CT was detected on 439 (8.1%; 95% confidence interval (CI) 7.4–8.8%) occasions. Pharyngeal, urethral and anorectal CT were detected on 74 (1.4%; 95% CI 1.1–1.7%), 109 (2.0%; 95% CI 1.7–2.4%) and 333 (6.1%; 95% CI 5.5–6.8%) occasions respectively. Over the study period, there was a significant increase in pharyngeal CT yield (from 0.70% to 1.6%; odds ratio (OR) 1.25; 95% CI 1.01–1.55; Ptrend = 0.043), which remained borderline significant (OR 1.22; 95% CI 0.99–1.52; P = 0.067) when adjusted for age. There was no change in yield of either urethral or anorectal infections. Almost half the pharyngeal CT (n = 35; 47.3%) occurred without concurrent anogenital infection. Excluding those who would have received anti-chlamydial treatment for another reason, 27.0% of pharyngeal and 4.6% of all CT infections would not have been treated without pharyngeal testing. Conclusions: A recent temporal increase was observed in the yield of pharyngeal CT without a concurrent increase in anogenital yield. Ongoing surveillance is warranted to inform testing guidelines for GBM.

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Allan-Blitz, Lao-Tzu, Segundo R. Leon, Claire C. Bristow, Kelika A. Konda, Silver K. Vargas, Juan A. Flores, Brandon J. Brown, Carlos F. Caceres, and Jeffrey D. Klausner. "High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima, Peru." International Journal of STD & AIDS 28, no. 2 (July 10, 2016): 138–44. http://dx.doi.org/10.1177/0956462416630909.

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Chlamydia trachomatis and Neisseria gonorrhoeae are among the most common sexually transmitted bacterial infections in the world. Data are limited, however, on the burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru. Data were gathered from self-collected anal or pharyngeal swabs from participants in Lima, Peru, and analyzed via cross-sectional methods. Prevalence ratios for the association between extra-genital infection with socio-demographic and sexual behaviors were determined. Overall, 127 (32.8%) participants had anal or pharyngeal infections. On multivariate modeling, anal infection was positively associated with practicing both receptive and insertive anal sex, when compared to insertive alone (PR = 2.49; 95% CI = 1.32–4.71), and negatively associated with any antibiotic use in the prior three months (PR = 0.60; 95% CI = 0.39–0.91). Pharyngeal infection was negatively associated with age greater than 30 years compared to 18–30 years (PR = 0.54; 95% CI = 0.30–0.96), and positively associated with gender identity of transgender women (PR = 2.12; 95% CI = 1.20–3.73). This study demonstrates considerable burden of extra-genital chlamydial and gonococcal infections among men who have sex with men and transgender women in Lima, Peru.

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Lister, Nichole A., Anthony Smith, and Christopher K. Fairley. "Introduction of screening guidelines for men who have sex with men at an STD clinic, the Melbourne Sexual Health Centre, Australia." Sexual Health 2, no. 4 (2005): 241. http://dx.doi.org/10.1071/sh05006.

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Background: A recent audit indicated that a substantial proportion of men who have sex with men (MSM) were not screened for rectal gonorrhoea and chlamydia at the Melbourne Sexual Health Clinic, Melbourne, Australia. In response, screening guidelines for MSM were introduced at the clinic using a computer reminder. The aim of this study was to evaluate the impact of the guidelines and alert on screening MSM for gonorrhoea and chlamydia. Methods: The medical records of MSM were reviewed for gonorrhoea and chlamydia screening by site (pharyngeal, urethral and rectal), four months before the implementation of the guidelines and alert (July to October 2002), and one year thereafter (beginning November 2002). Results: After the introduction of the guidelines there was a significant increase in rectal chlamydia testing (55% to 67%, P < 0.001), and significant reduction in pharyngeal chlamydia and gonorrhoea testing (65% to 28%, P < 0.001, and 83% to 76%, P = 0.015 respectively). The proportion of tests that were positive by any site did not change (7% to 7%). Conclusions: The introduction of a computer reminder for new guidelines was temporally associated with screening that conformed more closely to clinical guidelines.

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Maynard, Michaela, Hector R. Nunez, Jun Tao, Madeline Montgomery, Alexi Almonte, Genoviva Sowemimo-Coker, Christina Chu, Collette Sosnowy, Philip Chan, and Philip Chan. "963. Extragenital Chlamydia and Gonorrhea Among Females Visiting an STD Clinic." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S29—S30. http://dx.doi.org/10.1093/ofid/ofz359.065.

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Abstract Background Rates of chlamydia (CT) and gonorrhea (GC) are increasing in the United States. Annual screening for urogenital infection is recommended for sexually active females less than 25 years and older females at risk. CT and GC can be detected at pharyngeal and rectal sites and are commonly asymptomatic. Currently, extragenital screening is only recommended in men who have sex with men (MSM). Data among females on extragenital CT and GC are limited. Methods We reviewed all females presenting to a sexually transmitted diseases (STD) clinic in Providence, Rhode Island from May 2014 to December 2018. During this time, urogenital, pharyngeal, and rectal screenings were offered to all females presenting for care. We evaluated demographics, behaviors, and laboratory data on urogenital, pharyngeal and rectal CT/GC. Univariate and bivariate analyses were performed to determine the characteristics of demographic and behavioral variables associated with extragenital infection. Results During the study period, 2,672 females presented for STD screening. Median age was 26 years (interquartile range [IQR]: 33–22). Most patients (95%) reported engaging in sex with male partners. More than half (59%) had at least one extragenital (pharyngeal or rectal) test performed (77% pharyngeal only, 0.4% rectal only, 23% both). During the study period, there were 334 CT and 66 GC infections identified across all three anatomical sites. Of individuals with a positive CT result (N = 273), 85% (N = 233) had a positive urogenital, 19% (N = 53) a positive pharyngeal, and 18% (N = 48) a positive rectal specimen. Of individuals with a positive GC result (N = 50), 62% (N = 31) had a positive urogenital, 54% (N = 27) a positive pharyngeal, and 16% (N = 8) a positive rectal specimen. Among individuals with a positive CT or GC result, (N = 315), 17% (N = 55) had an extragenital infection in the absence of a positive urogenital result. No single risk factor was statistically associated with an extragenital CT or GC infection. Most individuals (82%) were asymptomatic at presentation. Conclusion In an STD clinic setting, a significant number of pharyngeal and rectal CT/GC infections may be missed in the absence of extragenital screening. Settings which engage at-risk females should consider implementation of routine CT/GC extragenital screening. Disclosures All Authors: No reported Disclosures.

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Karlsson, Andreas, Anders Österlund, and Annika Forssén. "Pharyngeal Chlamydia trachomatis is not uncommon any more." Scandinavian Journal of Infectious Diseases 43, no. 5 (February 7, 2011): 344–48. http://dx.doi.org/10.3109/00365548.2011.553243.

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Richardson, Daniel, Alice Pickering, Daniel Trotman, Kayleigh Nichols, Zoe Buss, John Devlin, and Fionnuala Finnerty. "Pharyngeal gonorrhoea in men who have sex with men." International Journal of STD & AIDS 32, no. 5 (February 3, 2021): 449–52. http://dx.doi.org/10.1177/0956462420975627.

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Pharyngeal gonorrhoea is important in the transmission dynamics of gonorrhoea, and generation of antimicrobial resistance and the performing of culture remains vital. We reviewed the notes of men who have sex with men (MSM) presenting to our clinic with a positive pharyngeal NAAT for gonorrhoea between January and December 2019. There were 383 cases of NAAT-positive pharyngeal gonorrhoea, and 28 (7%, 95% CI = 5.11–10.36) reported sore throat at presentation. Pharyngeal cultures were taken from 270/383 (70%), and 73/270 (27%) were culture positive with available antimicrobial sensitivities. Overall, the presence of pharyngeal symptoms was not associated with pharyngeal chlamydia (OR = 1.6, CI = 0.19–13.32, p = 0.7), HIV status (OR = 1.1, CI = 0.47–2.57, p = 0.8), positive cultures (OR = 1.9, CI = 0.78–4.62, p = 0.2) or age ( p = 0.3). Routine screening of MSM for pharyngeal gonorrhoea is important to maintain surveillance and measures need to be taken to improve pharyngeal culture sampling from MSM.

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Jebakumar, S. P., C. Storey, M. Lusher, J. Nelson, B. Goorney, and K. R. Haye. "Value of screening for oro-pharyngeal Chlamydia trachomatis infection." Journal of Clinical Pathology 48, no. 7 (July 1, 1995): 658–61. http://dx.doi.org/10.1136/jcp.48.7.658.

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Chow, Eric P. F., Shayne Camilleri, Christopher Ward, Sarah Huffam, Marcus Y. Chen, Catriona S. Bradshaw, and Christopher K. Fairley. "Duration of gonorrhoea and chlamydia infection at the pharynx and rectum among men who have sex with men: a systematic review." Sexual Health 13, no. 3 (2016): 199. http://dx.doi.org/10.1071/sh15175.

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Background Chlamydia and gonorrhoea are the two most common sexually transmissible infections (STI) among men who have sex with men (MSM) worldwide. Infections at the pharynx and rectum are usually asymptomatic; however, the natural history of these infections remains unknown. The aim of this study is to estimate the duration of both infections at the extragenital sites from published epidemiological cohort studies. Methods: English peer-reviewed articles were searched from 1 January 2000 to 12 March 2015 in three electronic databases (MEDLINE, EMBASE and Cochrane Central). The prevalence-to-incidence ratio from each study was calculated to reflect the duration of each infection. This review followed the PRISMA guidelines and was registered in PROSPERO (CRD42014007087). Results: There were 2585 records identified, with 1721 abstracts and 52 full-text articles screened, resulting in four studies fulfilling the inclusion criteria. Pharyngeal gonorrhoea (114–138 days) had a shorter duration of infection than rectal gonorrhoea (346 days). In addition, chlamydia had a longer duration of infection at the pharynx (667 days) and rectum (579 days) compared with gonorrhoea infection. Conclusions: Gonorrhoea has a shorter duration of infection than chlamydia, suggesting that annual STI screening will be more effective at diagnosing chlamydia than gonorrhoea. The current STI guidelines recommend screening gonorrhoea and chlamydia at least once a year in MSM; it would only detect ~30% of incident pharyngeal gonorrhoea cases, with a mean duration of 4 months.

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Templeton, David J., Phillip Read, Rajesh Varma, and Christopher Bourne. "Australian sexually transmissible infection and HIV testing guidelines for asymptomatic men who have sex with men 2014: a review of the evidence." Sexual Health 11, no. 3 (2014): 217. http://dx.doi.org/10.1071/sh14003.

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Men who have sex with men (MSM) in Australia and overseas are disproportionately affected by sexually transmissible infections (STIs), including HIV. Many STIs are asymptomatic, so regular testing and management of asymptomatic MSM remains an important component of effective control. We reviewed articles from January 2009–May 2013 to inform the 2014 update of the 2010 Australian testing guidelines for asymptomatic MSM. Key changes include: a recommendation for pharyngeal chlamydia (Chlamydia trachomatis) testing, use of nucleic acid amplification tests alone for gonorrhoea (Neisseria gonorrhoeae) testing (without gonococcal culture), more frequent (up to four times a year) gonorrhoea and chlamydia testing in sexually active HIV-positive MSM, time required since last void for chlamydia first-void urine collection specified at 20 min, urethral meatal swab as an alternative to first-void urine for urethral chlamydia testing, and the use of electronic reminders to increase STI and HIV retesting rates among MSM.

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LI, L., M. LUTHER, K. MACKLIN, D. PUGH, J. LI, J. ZHANG, J. ROBERTS, B. KALTENBOECK, and C. WANG. "Chlamydia gallinacea: a widespread emerging Chlamydia agent with zoonotic potential in backyard poultry." Epidemiology and Infection 145, no. 13 (August 3, 2017): 2701–3. http://dx.doi.org/10.1017/s0950268817001650.

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SUMMARYChlamydia gallinacea, a new chlamydial agent, has been reported in four European countries as well as Argentina and China. Experimentally infected chickens with C. gallinacea in previous study showed no clinical signs but had significantly reduced gains in body weight (6·5–11·4%). Slaughterhouse workers exposed to infected chickens have developed atypical pneumonia, indicating C. gallinacea is likely a zoonotic agent. In this study, FRET-PCR confirmed that C. gallinacea was present in 12·4% (66/531) of oral–pharyngeal samples from Alabama backyard poultry. Phylogenetic comparisons based on ompA variable domain showed that 16 sequenced samples represented 14 biotypes. We report for the first time the presence of C. gallinacea in North America, and this warrants further research on the organism's pathogenicity, hosts, transmission, and zoonotic potential.

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Vavala, Gabriella, Cameron Goldbeck, Claire C. Bristow, Chrysovalantis Stafylis, Paul C. Adamson, Dianna Polanco, Manuel A. Ocasio, et al. "Adolescents may accurately self-collect pharyngeal and rectal clinical specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae infection." PLOS ONE 16, no. 9 (September 27, 2021): e0255878. http://dx.doi.org/10.1371/journal.pone.0255878.

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Background The COVID-19 pandemic illuminated the benefits of telemedicine. Self-collected specimens are a promising alternative to clinician-collected specimens when in-person testing is not feasible. In this study, we assessed the adequacy of self-collected pharyngeal and rectal specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae among individuals undergoing chlamydia and gonorrhea screening. Methods We used data from a large cohort study that included male and female adolescents between the ages of 12–24 years. We considered self-collected specimens adequate for clinical use if the human synthase gene (a control target of the assay) was detected in the specimen. Results In total, 2,458 specimens were included in the analysis. The human synthase gene was detected in 99.2% (2,439/2,458) of all self-collected specimens, 99.5% (1,108/1,114) of the pharyngeal specimens, and 99.0% (1,331/1,344) of the rectal specimens. Conclusion Self-collected pharyngeal and rectal specimens demonstrated a very high proportion of human gene presence, suggesting that self-collection was accurate. A limitation of this study is that the sample adequacy control detects the presence or absence of the human hydroxymethylbilane synthase gene, but it does not indicate the specific anatomic origin of the human hydroxymethylbilane synthase gene. Self-collected specimens may be an appropriate alternative to clinician-collected specimens.

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Winter, Andrew J., Gerry Gilleran, Kirstine Eastick, and Jonathan D. C. Ross. "Comparison of a Ligase Chain Reaction-Based Assay and Cell Culture for Detection of Pharyngeal Carriage ofChlamydia trachomatis." Journal of Clinical Microbiology 38, no. 9 (2000): 3502–4. http://dx.doi.org/10.1128/jcm.38.9.3502-3504.2000.

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In 264 genitourinary medicine clinic attenders reporting recent fellatio, the prevalence of pharyngeal Chlamydia trachomatis determined by an expanded standard including cell culture and two in-house PCR tests was 1.5% in 194 women and zero in 70 men. The ligase chain reaction (Abbott LCx) had a specificity of 99.2% and a positive predictive value of 60%.

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Manavi, K., N. Hettiarachchi, and J. Hodson. "Comparison of doxycycline with azithromycin in treatment of pharyngeal chlamydia infection." International Journal of STD & AIDS 27, no. 14 (July 11, 2016): 1303–8. http://dx.doi.org/10.1177/0956462415614723.

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Tipple, C., S. C. Hill, and A. Smith. "Is screening for pharyngeal Chlamydia trachomatis warranted in high-risk groups?" International Journal of STD & AIDS 21, no. 11 (November 2010): 770–71. http://dx.doi.org/10.1258/ijsa.2010.009494.

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Li, Kingbherly L., Jose Carlo B. Valencia, Florida F. Taladtad, Mary Grace T. Hernaez, Vivienne V. Luzentales, Cybele Lara R. Abad, and Edsel Maurice T. Salvana. "372. Prevalence of Urethral, Rectal, and Pharyngeal Gonorrhea and Chlamydia among Newly Diagnosed Filipino HIV Patients." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S195. http://dx.doi.org/10.1093/ofid/ofz360.445.

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Abstract Background The Philippines has the fastest-growing HIV epidemic in the Asia-Pacific. Concurrent sexually-transmitted infections increase the risk of HIV transmission and complications. The prevalence of Neisseria gonorrheae (NG) and Chlamydia trachomatis (CT) infection among Filipino HIV patients is unknown and screening is not universal. A symptom-based approach likely underestimates the prevalence of NG and CT among men who have sex with men (MSM). We determined the rectal, pharyngeal, and urethral prevalence of gonorrhea and chlamydia infection in our patient population using nucleic acid testing (NAT). Methods This is a single-center, prospective cross-sectional study at Philippine General Hospital. Following ethical approval and informed consent, pharyngeal, rectal, and urine samples from newly-diagnosed, treatment-naïve HIV adult patients were tested using the Xpert® CT/NG assay (Cepheid, Sunnydale, CA). Patients with recent (≤21 days) antibiotic use with activity against NG or CT were excluded. Demographic and clinical data were also collected. Results 46 subjects were enrolled. Mean age was 31 years (range 19–49), 83% (38/46) were male, 96% (44/46) were asymptomatic, and 92% (35/38) of the males were MSM. Median CD4 count was 225 cells/μL (range 0–1,335). The overall prevalence of CT/NG was 33% (15/46). Table 1 shows the prevalence of CT and NG by site. Four patients had both genital and rectal CT. More patients had rectal NG/CT compared with urethral and pharyngeal sites. No gonorrhea was found in the urine specimens; no chlamydia was found in the pharynx. Conclusion The prevalence of CT and NG among newly diagnosed Filipino HIV patients at 33% is sufficiently high to warrant routine NAT screening. Urine testing alone will miss a significant number of cases in an MSM-predominant population. We recommend NAT screening of both urethral and rectal sites for newly-diagnosed Filipino HIV patients. Disclosures All authors: No reported disclosures.

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Koedijk, F. D. H., J. E. A. M. van Bergen, N. H. T. M. Dukers-Muijrers, A. P. van Leeuwen, C. J. P. A. Hoebe, and M. A. B. van der Sande. "The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006–2010." International Journal of STD & AIDS 23, no. 9 (September 2012): 626–31. http://dx.doi.org/10.1258/ijsa.2012.011378.

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National surveillance data from 2006 to 2010 of the Dutch sexually transmitted infection (STI) centres were used to analyse current practices on testing extragenital sites for chlamydia and gonorrhoea in men who have sex with men (MSM) and women. In MSM, 76.0% and 88.9% were tested at least at one extragenital site (pharyngeal and/or anorectal) for chlamydia and gonorrhoea, respectively; for women this was 20.5% and 30.2%. Testing more than one anatomic site differed by STI centre, ranging from 2% to 100%. In MSM tested at multiple sites, 63.0% and 66.5% of chlamydia and gonorrhoea diagnoses, respectively, would have been missed if screened at the urogenital site only, mainly anorectal infections. For women tested at multiple sites, the proportions of missed chlamydia and gonorrhoea diagnoses would have been 12.9% and 30.0%, respectively. Testing extragenital sites appears warranted, due to the numerous infections that would have been missed. Adding anorectal screening to urogenital screening for all MSM visiting an STI centre should be recommended. Since actual testing practices differ by centre, there is a need for clearer guidelines. Routine gonorrhoea and chlamydia screening at multiple sites in STI centres should be investigated further as this might be a more effective approach to reduce transmission than current practice.

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Latimer, Rosie Louise, Lenka Vodstrcil, Vesna De Petra, Christopher K. Fairley, Tim RH Read, Deborah Williamson, Michelle Doyle, Eric PF Chow, and Catriona Bradshaw. "Extragenital Mycoplasma genitalium infections among men who have sex with men." Sexually Transmitted Infections 96, no. 1 (June 19, 2019): 10–18. http://dx.doi.org/10.1136/sextrans-2019-054058.

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ObjectivesThere are limited data on the prevalence of Mycoplasma genitalium (Mgen) coinfection with rectal chlamydia (Chlamydia trachomatis (CT)) and rectal gonorrhoea (Neisseria gonorrhoeae (NG)) infections and few studies examining the prevalence of pharyngeal Mgen in men who have sex with men (MSM). Using transcription-mediated amplification assay, this study aimed to determine the proportion of rectal CT and rectal NG infections in MSM who are coinfected with rectal Mgen, and the proportion of MSM with Mgen detected in the pharynx in order to inform clinical practice.MethodsThis was a cross-sectional study conducted at Melbourne Sexual Health Centre in Australia. Consecutively collected rectal swabs from MSM that tested positive for CT (n=212) or NG (n=212), and consecutively collected pharyngeal samples (n=480) from MSM were tested for Mgen using the Aptima Mycoplasma genitalium Assay (Hologic, San Diego). Samples were linked to demographic data and symptom status.ResultsRectal Mgen was codetected in 27 of 212 rectal CT (13%, 95% CI 9 to 18) and in 29 of 212 rectal NG (14%, 95% CI 9 to 19) samples, with no difference in the proportion positive for Mgen. MSM with rectal CT/Mgen coinfection had more sexual partners than those with rectal CT monoinfection (mean 6 vs 11, p=0.06). MSM with rectal NG/Mgen coinfection were more likely to be HIV-positive than those with rectal NG monoinfection (OR=2.96, 95% CI 1.21 to 7.26, p=0.023). MSM with rectal CT/Mgen coinfection were more likely to be using pre-exposure prophylaxis than MSM with rectal NG/Mgen coinfection (OR 0.25, 95% CI 0.10 to 0.65, p=0.002). Pharyngeal Mgen was uncommon and detected in 8 of 464 samples (2%, 95% CI 1% to 3%). Pharyngeal Mgen was associated with having a rectal STI (OR=10.61, 95% CI 2.30 to 48.87, p=0.002), and there was a borderline association with being HIV-positive (p=0.079).ConclusionThese data indicate one in seven MSM treated for rectal CT or rectal NG will have undiagnosed Mgen that is potentially exposed to azithromycin during treatment of these STIs. Rectal Mgen coinfection was associated with specific risk factors which may inform testing practices. Pharyngeal Mgen was uncommon.

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Hiransuthikul, Akarin, Rena Janamnuaysook, Thanthip Sungsing, Jureeporn Jantarapakde, Deondara Trachunthong, Steve Mills, Ravipa Vannakit, Praphan Phanuphak, and Nittaya Phanuphak. "High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI." Sexually Transmitted Infections 95, no. 7 (April 13, 2019): 534–39. http://dx.doi.org/10.1136/sextrans-2018-053835.

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ObjectiveComprehensive data on Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections to guide screening services among transgender women (TGW) are limited. We studied the burden of CT/NG infections in pharyngeal, rectal and urethral sites of Thai TGW and determined missed CT/NG diagnoses if selected site screening was performed.MethodsThai TGW were enrolled to the community-led test and treat cohort. CT/NG screening was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification test. CT/NG prevalence in each anatomical site was analysed, along with the relationships of CT/NG among the three anatomical sites.ResultsOf 764 TGW included in the analysis, 232 (30.4%) had CT/NG infections at any anatomical site, with an overall incidence of 23.7 per 100 person-years. The most common CT/NG infections by anatomical site were rectal CT (19.5%), rectal NG (9.6%) and pharyngeal NG (8.1%). Among 232 TGW with CT/NG infections at any anatomical site, 22%–94.4% of infections would have been missed if single anatomical site testing was conducted, depending on the selected site. Among 668 TGW who tested negative at pharyngeal site, 20.4% had either rectal or urethral infections. Among 583 TGW who tested negative at the rectal site, 8.7% had either pharyngeal or urethral infections. Among 751 TGW who tested negative at the urethral site, 19.2% had either pharyngeal or rectal infections.ConclusionAlmost one-third of Thai TGW had CT/NG infections. All-site screening is highly recommended to identify these infections, but if not feasible rectal screening provides the highest yield of CT/NG diagnoses. Affordable molecular technologies and/or CT/NG screening in pooled samples from different anatomical sites are urgently needed.Trial registration numberNCT03580512.

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Tapsall, John, Phillip Read, Christopher Carmody, Christopher Bourne, Sanghamitra Ray, Athena Limnios, Theo Sloots, and David Whiley. "Two cases of failed ceftriaxone treatment in pharyngeal gonorrhoea verified by molecular microbiological methods." Journal of Medical Microbiology 58, no. 5 (May 1, 2009): 683–87. http://dx.doi.org/10.1099/jmm.0.007641-0.

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Diagnostic, genotypic and antibiotic-resistance determinants of Neisseria gonorrhoeae were analysed by molecular methods to verify the failure of ceftriaxone treatment in two cases of pharyngeal gonorrhoea. Monoplex assays were needed to define competitive inhibition of a positive Chlamydia PCR in a duplex assay. Different penA changes were detected in the N. gonorrhoeae isolated from the two cases. These were associated with raised ceftriaxone MICs of 0.03 and 0.016 mg l−1, which may have contributed to the treatment failures in these cases.

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Cosentino, Lisa A., Claire S. Danby, Lorna K. Rabe, Ingrid Macio, Leslie A. Meyn, Harold C. Wiesenfeld, and Sharon L. Hillier. "Use of Nucleic Acid Amplification Testing for Diagnosis of Extragenital Sexually Transmitted Infections." Journal of Clinical Microbiology 55, no. 9 (July 5, 2017): 2801–7. http://dx.doi.org/10.1128/jcm.00616-17.

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ABSTRACT Nucleic acid amplification testing (NAAT) is the preferred method to detect Chlamydia trachomatis and Neisseria gonorrhoeae , but no commercial tests are cleared by the U.S. Food and Drug Administration for use with extragenital swab samples. This study evaluated the performance of the Gen-Probe Aptima Combo2 assay (Aptima) and the Cepheid Xpert CT/NG assay (Xpert) to detect C. trachomatis and N. gonorrhoeae in rectal and pharyngeal samples from 224 men and 175 women reporting a history of anal receptive sexual intercourse. Discordant results between the NAATs were repeated using the assays APTIMA CT or APTIMA GC, which target alternate primers, as the confirmatory tests. C. trachomatis was detected from 59 rectal swabs and 8 pharyngeal samples, with 97.7% and 99.5% agreement between the two test systems, respectively. For C. trachomatis , Xpert was 95% sensitive (95% CI, 86 to 99%) and Aptima was 92% sensitive (95% CI, 81 to 97%) from rectal swabs, while both systems were 100% sensitive from pharyngeal samples. N. gonorrhoeae was detected from 30 rectal and 40 pharyngeal samples, with 99.5% and 97.5% agreement between the two test systems. The sensitivity of Xpert for N. gonorrhoeae from rectal swabs was 100% (95% CI, 88 to 100%) versus 93% (95% CI, 78 to 99%) for Aptima. From pharyngeal swab samples, Xpert was 98% sensitive (95% CI, 87 to 99.9%) versus 93% (95% CI, 80 to 98%) for Aptima. For C. trachomatis , neither system was >95% sensitive from the rectum, though both were >99.5% specific. For N. gonorrhoeae , Xpert had higher sensitivity than Aptima, but with more false positives from pharyngeal samples.

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Cope, A., W. Lo, and G. Kudesia. "Strand displacement amplification for Chlamydia trachomatis detection in rectal pharyngeal and eye swabs." Journal of Clinical Virology 36 (January 2006): S50. http://dx.doi.org/10.1016/s1386-6532(06)80893-0.

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Uehara, Shinya, Koichiro Wada, Ayano Ishii, Shinichi Sako, Toyohiko Watanabe, Koichi Monden, Toru Araki, and Hiromi Kumon. "PREVALENCE OF PHARYNGEAL CHLAMYDIA TRACHOMATIS AND NISSERIA GONORRHOEAE AMONG HETEROSEXUAL MEN IN JAPAN." Journal of Urology 181, no. 4S (April 2009): 64–65. http://dx.doi.org/10.1016/s0022-5347(09)60190-7.

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Wada, Koichiro, Shinya Uehara, Ritsuko Mitsuhata, Reiko Kariyama, Hiroyuki Nose, Ayano Ishii, Toyohiko Watanabe, et al. "Prevalence of pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae among heterosexual men in Japan." Journal of Infection and Chemotherapy 18, no. 5 (2012): 729–33. http://dx.doi.org/10.1007/s10156-012-0410-y.

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Árvai, Mariann, Eszter Ostorházi, Noémi Mihalik, Sarolta Kárpáti, and Márta Marschalkó. "Purulent keratoconjunctivitis due to Neisseria gonorrhoeae and Chlamydia trachomatis coinfection." Orvosi Hetilap 154, no. 21 (May 2013): 834–37. http://dx.doi.org/10.1556/oh.2013.29620.

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Gonococcal conjunctivitis is a rare infection induced by Neisseria gonorrhoeae and it usually manifests as a hyperacute purulent conjunctivitis. Ocular access of the infectious secretion during sexual intercourse is the way of transmission among adults. Inclusion conjunctivitis caused by the serovars D-K of Chlamydia trachomatis also affects the sexually active population. Authors present a case of a 33-year-old homosexual man who was treated for late latent syphilis formerly. Clinical symptoms were yellow purulent discharge for 3 weeks without any urological or upper respiratory tract symptoms. Conjunctival Neisseria gonorrhoeae and Chlamydia trachomatis infection was identified using cultures and polymerase chain reaction; pharyngeal swab culture and polymerase chain reaction showed positive results for both pathogens. The patient was probably under influence of party drugs at the time of sexual abuse when he became infected. After parenteral and oral cephalosporin and azithomycin therapy the patient had complete recovery within three weeks. Orv. Hetil., 2013, 154, 834–837.

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Straub, Diane M., and Angela Tetlow. "1538. Pilot Study of Self-collected Pharyngeal Testing for Chlamydia and Gonorrhea in the Setting of COVID19 Restrictions." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S769. http://dx.doi.org/10.1093/ofid/ofaa439.1718.

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Abstract Background Given that many youth and young adults utilize multiple orifices during sexual activity, testing for STIs from multiple anatomical sites can increase rates of diagnosis. However, during the COVID pandemic, obtaining oral swabs by clinical staff was deemed an unacceptable COVID transmission risk and was discontinued in our clinic. To circumvent this obstacle to diagnosis, clinic staff developed a workaround of obtaining patient collected pharyngeal swabs for STI testing. This abstract reviews the results of this pilot intervention. Methods Patients presenting to an urban youth family planning/STI clinic who desired STI testing and ever engaged in oral sex were offered pharyngeal testing for chlamydia (CT) and gonorrhea (GC). Patients were instructed on how to obtain an oral sample, and subsequently sent outside of the clinic to obtain their individual sample. Chart review was conducted by clinic staff of a two month period during which this protocol was in place, and the following variables were collected: gender, sexual orientation, race/ethnicity, and STD testing results by anatomic site. Simple descriptive statistical analysis were used. Results 146 patients received a GC/CT test from > 1 anatomical site, with 34 patients having > 1 positive result. All pharyngeal samples were self-collected. Four patients were positive for GC/CT from throat samples only (12% of positive tests). All were biologically female, including one transgender FTM. Sexual orientation was split evenly between bisexual and heterosexual. Reported race/ethnicity included two African-American, one white, and one “Filipino”. For comparison, of the overall subsample of patients with positive GC/CT results, patients identified as 53% female, 44% male, and 3% FTM; 74% “straight”, 15% bisexual, 9% “gay”, and 3% did not disclose; 29% white, 50% African-American, 21% unknown as other; and 11% Hispanic. Twelve patients were positive for GC/CT from the throat and either rectum and/or urine/vagina/endocervix (35% of positive tests). Conclusion Our experience demonstrates that obstacles created by the COVID crisis can be circumvented with creative strategies. We were able to pick up 12% and 35% of total infections by self-collected pharyngeal swabs in throat only and throat plus other sites, respectively. Disclosures All Authors: No reported disclosures

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Bristow, Claire C., Cristina Espinosa da Silva, Alicia H. Vera, Jesus E. Gonzalez-Fagoaga, Gudelia Rangel, and Heather A. Pines. "Prevalence of bacterial sexually transmitted infections and coinfection with HIV among men who have sex with men and transgender women in Tijuana, Mexico." International Journal of STD & AIDS 32, no. 8 (February 3, 2021): 751–57. http://dx.doi.org/10.1177/0956462420987757.

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We estimated the prevalence of syphilis and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections, as well as human immunodeficiency virus (HIV) coinfection among cisgender men who have sex with cisgender men (MSM) and transgender women (TW) in Tijuana, Mexico. MSM and TW ( N = 212) recruited via respondent-driven and venue-based sampling for HIV testing underwent sexually transmitted infection (STI) testing and completed interviewer-administered surveys in this study (2017–2018). Treponemal rapid tests were used at the point-of-care with positives undergoing confirmatory testing following the reverse syphilis-testing algorithm. Nucleic acid amplification testing of urine and swabs (rectal and pharyngeal) was used to detect CT/NG at three anatomic sites. Chi-squared tests were used to compare STI prevalence by HIV status. Sexually transmitted infection prevalence was 39.6% overall but higher for newly diagnosed HIV-positive (55.7%; N = 88) than HIV-negative (28.2%; N = 124) participants ( p-value < 0.0001). Among newly diagnosed HIV-positive participants, the prevalence of syphilis was 35.2% (31/88), CT infection was 27.3% (24/88; nine urethral; 16 rectal; four pharyngeal), and NG infection was 26.1% (23/88; six urethral; 19 rectal; nine pharyngeal). Among HIV-negative participants, the prevalence of syphilis was 12.1% (15/124), CT infection was 13.7% (17/124; seven urethral; nine rectal; two pharyngeal), and NG infection was 9.7% (12/124; three urethral; seven rectal; seven pharyngeal). Over 60% of all CT (25/41) and NG (26/35) infections in the full sample occurred extragenitally in the absence of urethral infections, and over 80% of rectal (30/37) and pharyngeal (16/18) infections were asymptomatic. The high prevalence of syphilis, CT, and NG infections among MSM and TW in Tijuana suggests STI screening that includes extragenital tests, particularly at HIV diagnosis, may help curb HIV/STI transmission.

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Speers, David John, I.-Ly Joanna Chua, Justin Manuel, and Lewis Marshall. "Detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pooled rectal, pharyngeal and urine specimens in men who have sex with men." Sexually Transmitted Infections 94, no. 4 (October 24, 2017): 293–97. http://dx.doi.org/10.1136/sextrans-2017-053303.

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ObjectivesScreening of men who have sex with men (MSM) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) requires sampling from anorectal and pharyngeal sites in addition to urogenital sampling. Due to the cost of testing multiple anatomical sites individually testing of pooled specimens has potential merit. The Cepheid GeneXpert CT/NG assay (GeneXpert), which also has potential for point-of-care nucleic acid testing in the sexual health clinic, has not been assessed for pooled specimen testing.MethodsWe prospectively compared GeneXpert testing of pooled pharyngeal and rectal swabs with urine samples to standard of care testing of individual specimens from 107 participants using the Roche cobas 4800 CT/NG assay (cobas) for CT and NG in high-risk MSM attending an inner city sexual health clinic.ResultsWe found testing of pooled pharyngeal, rectal and urine samples by the GeneXpert to have 100% agreement for NG and 94% overall agreement for CT when compared with individual specimen testing by cobas. For CT testing, 14 cases were detected for both tests, 4for cobas only, 2 for GeneXpert only and 89 participants were negative for both tests.ConclusionsPooled specimen CT and NG testing by the GeneXpert was accurate when compared with single specimen testing and has potential for screening MSM for CT and NG. The role of pooled specimen testing with the GeneXpert as a point-of-care nucleic acid test in MSM requires further investigation.

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Desclaux, Arnaud, Arabella Touati, Didier Neau, Cécile Laurier-Nadalié, Cécile Bébéar, Bertille de Barbeyrac, and Charles Cazanave. "Extra-rectal lymphogranuloma venereum in France: a clinical and molecular study." Sexually Transmitted Infections 94, no. 1 (July 11, 2017): 3–8. http://dx.doi.org/10.1136/sextrans-2017-053126.

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ObjectivesTo describe a series of extrarectal lymphogranuloma venereum (LGV) cases diagnosed in France.MethodsConsecutive LGV cases confirmed at the French Reference Centre for chlamydiae with an extrarectal sample from January 2010 to December 2015 were included. The first part of the study consisted of a retrospective case note review and analysis. In a second part, the complete ompA gene sequence of our samples was determined.ResultsThere were 56 cases overall: 50 cases of genital LGV and six cases of pharyngeal LGV. Subjects were all men, median age 39 years, 27/53 were HIV-positive, 47/51 reported having sex with other men, 43/49 reported multiple sexual partners (a mean 25 in the last 6 months). Median time from symptom onset to diagnosis was 21 days. Subjects most commonly presented with inguinal adenopathy alone (19 of 50 genital cases) and adenopathy with genital ulcer (17 of 50). Three pharyngeal cases were symptomatic. Fever was reported in 11 cases. Inguinal abscess was reported in 22 of 42 cases presenting with lymphadenopathy. Co-infections were frequent: eight cases of syphilis, four non-LGV Chlamydia trachomatis infections, one case of gonorrhoea. Cure was always achieved with doxycycline therapy but prolonged treatment was necessary in eight cases with inguinal abscess. Genotyping according to ompA sequencing showed the co-circulation of genovars L2 (16 of 42 strains successfully typed) and L2b (24 of 42). There was no association between HIV status and disease severity or genovar distribution.ConclusionIn the span of 6 years, 56 extrarectal LGV cases were confirmed through genotyping in France. Extrarectal LGV seemed to share a common epidemiological background with rectal disease in terms of affected population and genovar distribution. HIV prevalence was lower than expected.

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Hiransuthikul, Akarin, Thanthip Sungsing, Jureeporn Jantarapakde, Deondara Trachunthong, Stephen Mills, Ravipa Vannakit, Praphan Phanuphak, and Nittaya Phanuphak. "Correlations of chlamydia and gonorrhoea among pharyngeal, rectal and urethral sites among Thai men who have sex with men: multicentre community-led test and treat cohort in Thailand." BMJ Open 9, no. 6 (June 2019): e028162. http://dx.doi.org/10.1136/bmjopen-2018-028162.

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ObjectiveRoutine screening forChlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) infections in sexually exposed anatomical sites may be challenging in resource-limited settings. The objective of this study was to determine the proportion of missed CT/NG diagnoses if a single anatomical site screening was performed among men who have sex with men (MSM) by examining the pattern of anatomical sites of CT/NG infections.MethodsThai MSM were enrolled to the community-led test and treat cohort. Screening for CT/NG infections was performed from pharyngeal swab, rectal swab and urine using nucleic acid amplification testing. The correlations of CT/NG among the three anatomical sites were analysed.ResultsAmong 1610 MSM included in the analysis, 21.7% had CT and 15.5% had NG infection at any anatomical site. Among those tested negative for CT or NG infection at either pharyngeal, rectal or urethral site, 8%–19% had CT infection and 7%–12% had NG infection at the remaining two sites. Of the total 349 CT infections, 85.9%, 30.6% and 67.8% would have been missed if only pharyngeal, rectal or urethral screening was performed, respectively. Of the total 249 NG infection, 55.7%, 39.6% and 77.4% would have been missed if only pharyngeal, rectal or urethral screening was performed, respectively. The majority of each anatomical site of CT/NG infection was isolated to their respective site, with rectal site having the highest proportion of isolation: 78.9% of rectal CT and 62.7% of rectal NG infection.ConclusionsA high proportion of CT/NG infections would be missed if single anatomical site screening was performed among MSM. All-site screening is highly recommended, but if not feasible, rectal screening provides the highest yield of CT/NG diagnoses. Effort in lowering the cost of the CT/NG screening test or developing affordable molecular technologies for CT/NG detection is needed for MSM in resource-limited settings.Trial Registration NumberNCT03580512; Results.

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Bristow, Claire C., Sheldon R. Morris, Susan J. Little, Sanjay R. Mehta, and Jeffrey D. Klausner. "Meta-analysis of the Cepheid Xpert® CT/NG assay for extragenital detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections." Sexual Health 16, no. 4 (2019): 314. http://dx.doi.org/10.1071/sh18079.

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Background Most studies evaluating extragenital testing performance for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) detection by the Xpert® CT/NG show high per cent agreement with comparison assays; however, the precision around positive per cent agreement is low and thus the values that have been reported are not highly informative. Therefore, a systematic review was conducted and data from five studies were combined to better assess positive per cent agreement. Methods: The literature indexed on PubMed.gov was searched. Included studies were those that were an evaluation of the Xpert CT/NG assay with rectal and/or pharyngeal specimen types compared with another nucleic acid amplification test (NAAT), the Aptima transcription mediated amplification assay. A full Bayesian method was used for bivariate fixed-effect meta-analysis of positive and negative per cent agreement and pooled estimates (and 95% confidence intervals (CI)) were presented for each. Results: The pooled positive and negative per cent agreement for detection of CT in rectal specimens was 89.72% (95% CI: 84.97%, 93.64%) and 99.23% (95% CI: 98.74%, 99.60%), and in pharyngeal specimens, they were 89.96% (95% CI: 66.38%, 99.72%) and 99.62% (95% CI: 98.95%, 99.95%) respectively. For NG detection in rectal specimens, the pooled positive and negative per cent agreement was 92.75% (95% CI: 87.91%, 96.46%) and 99.75% (95% CI: 99.46%, 99.93%), and in pharyngeal specimens, they were 92.51% (95% CI: 85.84%, 97.18%) and 98.56% (95% CI: 97.69%, 99.23%) respectively. Conclusions: It was found that the Xpert CT/NG assay performed similarly to the Aptima transcription mediated amplification assay for the detection of CT and NG in extragenital specimens. The Xpert assay has the benefit of providing faster results at the point-of-care, thus reducing the turnaround time for results, potentially enabling same-day treatment.

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Badman, Steven G., Sara F. E. Bell, Judith A. Dean, Jime Lemoire, Luke Coffey, Joseph Debattista, Andrew M. Redmond, Owain D. Williams, Charles F. Gilks, and David M. Whiley. "Reduced sensitivity from pooled urine, pharyngeal and rectal specimens when using a molecular assay for the detection of chlamydia and gonorrhoea near the point of care." Sexual Health 17, no. 1 (2020): 15. http://dx.doi.org/10.1071/sh19028.

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Background The aim of this study was to compare the performance of pooled self-collected urogenital, pharyngeal and anorectal specimens to that of individual specimen results for the molecular detection of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) near the point of care (POC) for diagnostic sensitivity. Methods: Clients (mostly men who have sex with men) attending an urban community testing service and three sex-on-premises venues in Brisbane, Australia, were offered CT and NG testing by trained lay providers. Participants provided three self-collected specimens (urine, pharyngeal and rectal) for testing by GeneXpert (Cepheid, Sunnyvale, CA, USA). If any of the individual specimens from a participant were positive, all three specimens were pooled and retested. Results: Of the 388 participants who provided three individual anatomical specimens, 76 (19.6%) were found to be positive for CT and/or NG at one or more sites. The pooling approach failed to detect five CT rectal and four NG pharyngeal infections. The overall performance (sensitivity) of the pooling approach compared with individual specimen testing and Cohen’s κ were 90.0% and 0.86 respectively for CT and 89.7% and 0.89 respectively for NG. Conclusions: Reduced sensitivity was observed when using pooled specimens for the detection of CT and NG using GeneXpert near the POC, similar to results reported in laboratory-based CT and NG pooling studies. These data suggest specimen pooling is feasible near to the POC, potentially saving time and costs when screening at-risk populations for CT and NG. Our data also suggest a reduction in pooled urine could improve overall test sensitivity.

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Caragol, Laura, Christopher Voegeli, Christie Mettenbrink, Karen Wendel, and Cornelis Rietmeijer. "Extragenital Gonorrhea and Chlamydia Testing Among Women Reporting Extragenital Exposure at an Urban STD Clinic: Is It Worth the Cost?" Open Forum Infectious Diseases 4, suppl_1 (2017): S104—S105. http://dx.doi.org/10.1093/ofid/ofx163.097.

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Abstract Background Current guidelines only recommend screening for gonorrhea (GC) and chlamydia (CT) at extragenital sites of exposure in men who have sex with men (MSM). With Medicaid reimbursement for GC/CT nucleic acid amplification testing (NAAT) at approximately $48/test, expanding testing to women requires a value assessment. We report the prevalence of extragenital GC/CT in women with extragenital exposure, determine the proportion of disease missed by urogenital NAAT, and estimate additional cost per infection identified by extragenital testing in women vs MSM. Methods We conducted a retrospective analysis of women undergoing extragenital NAAT for GC and CT at Denver Metro Health Clinic. Data were analyzed for all women with extragenital testing from 9/11/2015 to 7/8/2016, and for MSM from 9/3/2013 to 7/8/2016. Statistical Package for the Social Sciences and Excel programs were used for data analysis. Results In a total 804 female visits, the mean age was 29 (13–67years); 46% were White non-Hispanic; 37% were Hispanic; and 15% were Black. In women, the prevalence of extragenital GC and CT was 2% (16/804) and 5% (38/804), respectively. The rate of GC infection in women was the same at genital and pharyngeal sites (2%, 16/804) but lower at the rectum (0.25%, 2/804). Female chlamydia rates were 11% genital (85/804), 4% pharyngeal (30/804), and 1.4% rectal (11/804). If only urogenital testing had been performed in women, 27% (6/22) of GC infections and 14% (14/99) of CT infections would have been missed. Overall, isolated extragenital infection accounted for 18% (20/111, 95% CI 12–26%) and 65% (943/1453, 95% CI 62–67%) of the combined GC and CT burden in women and MSM, respectively. On average, 40 women and five MSM were screened with extragenital tests to identify one isolated extragenital infection. Estimated additional Medicaid costs for isolated extragenital infection identified in women was $3,851 and in men was $480 for pharyngeal and rectal testing. Conclusion Urogenital screening misses a significant number of extragenital infections in women. However, given the high cost of extragenital screening in women, further work is needed to determine whether screening can be limited to the pharynx or if risk factors can be used to target screening for cost savings. Disclosures All authors: No reported disclosures.

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Beymer, Matthew R., Michelle A. DeVost, Robert E. Weiss, Rhodri Dierst-Davies, Chelsea L. Shover, Raphael J. Landovitz, Corinne Beniasians, et al. "Does HIV pre-exposure prophylaxis use lead to a higher incidence of sexually transmitted infections? A case-crossover study of men who have sex with men in Los Angeles, California." Sexually Transmitted Infections 94, no. 6 (February 27, 2018): 457–62. http://dx.doi.org/10.1136/sextrans-2017-053377.

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BackgroundPre-exposure prophylaxis (PrEP) is an effective method for reducing HIV incidence among at-risk populations. However, concerns exist over the potential for an increase in STIs following PrEP initiation. The objective of this study is to compare the STI incidence before and after PrEP initiation within subjects among a cohort of men who have sex with men in Los Angeles, California.MethodsThe present study used data from patients who initiated PrEP services at the Los Angeles LGBT Center between October 2015 and October 2016 (n=275). A generalised linear mixed model was used with a case-crossover design to determine if there was a significant difference in STIs within subjects 365 days before (before-PrEP period) and 365 days after PrEP initiation (after-PrEP period).ResultsIn a generalised linear mixed model, there were no significant differences in urethral gonorrhoea (P=0.95), rectal gonorrhoea (P=0.33), pharyngeal gonorrhoea (P=0.65) or urethral chlamydia (P=0.71) between periods. There were modest increases in rectal chlamydia (rate ratio (RR) 1.83; 95% CI 1.13 to 2.98; P=0.01) and syphilis diagnoses (RR 2.97; 95% CI 1.23 to 7.18; P=0.02).ConclusionsThere were significant increases in rectal chlamydia and syphilis diagnoses when comparing the periods directly before and after PrEP initiation. However, only 28% of individuals had an increase in STIs between periods. Although risk compensation appears to be present for a segment of PrEP users, the majority of individuals either maintain or decrease their sexual risk following PrEP initiation.

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Munson, Erik, David Wenten, Sheila Jhansale, Mary Kay Schuknecht, Nicki Pantuso, Joshua Gerritts, Aaron Steward, Kimber L. Munson, Maureen Napierala, and Deb Hamer. "Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis." Journal of Clinical Microbiology 55, no. 1 (September 14, 2016): 321–25. http://dx.doi.org/10.1128/jcm.01625-16.

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ABSTRACTOf 1,493 encounters of males at a sexually transmitted infection (STI) clinic in a community with a high prevalence of STI,Chlamydia trachomatiswas detected in 8.7% andNeisseria gonorrhoeaewas detected in 6.6%. AdditionalTrichomonas vaginalisandMycoplasma genitaliumscreening found 17.4% and 23.9% of the encounters, respectively, to be positive for STI. STI agents were detected in 13.7% of urine specimens; addition of pharyngeal and rectal collections to the analysis resulted in detection of STI agents in 19.0% and 23.9% of encounters, respectively. A total of 101 (23.8%) encounters of identified STI involved sole detection ofM. genitalium. Expansion of the STI analyte panel (includingM. genitalium) and additional specimen source sampling within a comprehensive STI screening program increase identification of male STI carriers.

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Winceslaus, S. J. "Response to Tipple et al: Is screening for pharyngeal Chlamydia trachomatis warranted in high-risk groups?" International Journal of STD & AIDS 22, no. 7 (July 2011): 419. http://dx.doi.org/10.1258/ijsa.2011.011061.

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Wikström, Arne, Maria Rotzén-Östlund, and Lena Marions. "Occurrence of pharyngeal Chlamydia trachomatis is uncommon in patients with a suspected or confirmed genital infection." Acta Obstetricia et Gynecologica Scandinavica 89, no. 1 (January 2010): 78–81. http://dx.doi.org/10.3109/00016340903370130.

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Rooijen, M. S. van, N. Nassir, R. Bom, H. J. C. de Vries, S. Bruisten, and A. P. van Dam. "P3.271 Identical Multilocus Sequence Typing (MLST) Analysis in Sequential Samples from Patients with Pharyngeal Chlamydia Infections." Sexually Transmitted Infections 89, Suppl 1 (July 2013): A233.2—A233. http://dx.doi.org/10.1136/sextrans-2013-051184.0727.

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Allan-Blitz, Lao-Tzu, Kelika A. Konda, Gino M. Calvo, Silver K. Vargas, Segundo R. Leon, Eddy R. Segura, Carlos F. Caceres, and Jeffrey D. Klausner. "High incidence of extra-genital gonorrheal and chlamydial infections among high-risk men who have sex with men and transgender women in Peru." International Journal of STD & AIDS 29, no. 6 (November 29, 2017): 568–76. http://dx.doi.org/10.1177/0956462417744098.

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Extra-genital Neisseria gonorrhoeae and Chlamydia trachomatis infections are associated with antimicrobial resistance and HIV acquisition. We analyzed data from a cohort of men who have sex with men (MSM) and transgender women followed quarterly for two years in Peru. Incident cases were defined as positive N. gonorrhoeae or C. trachomatis nucleic acid tests during follow-up. Repeat positive tests were defined as reinfection among those with documented treatment. We used generalized estimating equations to calculate adjusted incidence rate ratios (aIRRs). Of 404 participants, 22% were transgender. Incidence rates of rectal N. gonorrhoeae and C. trachomatis infection were 28.1 and 37.3 cases per 100 person-years, respectively. Incidence rates of pharyngeal N. gonorrhoeae and C. trachomatis infection were 21.3 and 9.6 cases per 100 person-years, respectively. Incident HIV infection was associated with incident rectal (aIRR = 2.43; 95% CI 1.66–3.55) N. gonorrhoeae infection. Identifying as transgender versus cisgender MSM was associated with incident pharyngeal N. gonorrhoeae (aIRR = 1.85; 95% CI 1.12–3.07) infection. The incidence of extra-genital N. gonorrhoeae and C. trachomatis infections was high in our population. The association with incident HIV infection warrants evaluating the impact of rectal N. gonorrhoeae screening and treatment on HIV transmission.

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Park, Jason, Julia L. Marcus, Mark Pandori, Ameera Snell, Susan S. Philip, and Kyle T. Bernstein. "Sentinel Surveillance for Pharyngeal Chlamydia and Gonorrhea Among Men Who Have Sex With Men—San Francisco, 2010." Sexually Transmitted Diseases 39, no. 6 (June 2012): 482–84. http://dx.doi.org/10.1097/olq.0b013e3182495e2f.

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Peters, Remco P. H., Jan Henk Dubbink, Lisette van der Eem, Stephan P. Verweij, Myrte L. A. Bos, Sander Ouburg, David A. Lewis, Helen Struthers, James A. McIntyre, and Servaas A. Morré. "Cross-Sectional Study of Genital, Rectal, and Pharyngeal Chlamydia and Gonorrhea in Women in Rural South Africa." Sexually Transmitted Diseases 41, no. 9 (September 2014): 564–69. http://dx.doi.org/10.1097/olq.0000000000000175.

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Jenkins, Wiley D., Laurette L. Nessa, and Ted Clark. "Cross-sectional study of pharyngeal and genital chlamydia and gonorrhoea infections in emergency department patients: Table 1." Sexually Transmitted Infections 90, no. 3 (December 23, 2013): 246–49. http://dx.doi.org/10.1136/sextrans-2013-051358.

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Papp, John R., Katherine Ahrens, Christi Phillips, Charlotte K. Kent, Susan Philip, and Jeffrey D. Klausner. "The use and performance of oral–throat rinses to detect pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections." Diagnostic Microbiology and Infectious Disease 59, no. 3 (November 2007): 259–64. http://dx.doi.org/10.1016/j.diagmicrobio.2007.05.010.

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Voirin, Nicolas, Camille Allam, Caroline Charre, Christine Fernandez, Matthieu Godinot, Fatima Oria, Aymeric Pansu, Christian Chidiac, Hélène Salord, and Laurent Cotte. "Optimizing Strategies for Chlamydia trachomatis and Neisseria gonorrhoeae Screening in Men Who Have Sex With Men: A Modeling Study." Clinical Infectious Diseases 70, no. 9 (June 14, 2019): 1966–72. http://dx.doi.org/10.1093/cid/ciz510.

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Abstract Background International guidelines recommend the systematic screening for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections in all men who have sex with men (MSM) who have engaged in unprotected sex. However, the optimal screening strategy remains unclear. We developed a modeling approach to optimize NG/CT screening strategy in MSM. Methods A compartmental model of NG/CT screening and infection was implemented. NG/CT anal, pharyngeal, and urine (APU) samples from MSM attending the sexually transmitted infections clinic were used to estimate the screening rate, prevalence, and incidence in a base case scenario. Different screening strategies (scenarios; S) were then evaluated: APU samples every 12 months (S1); APU samples every 3 months (S2); APU samples every 6 months (S3); anal and pharyngeal (AP) samples every 6 months (S4); and AP samples every 3 months (S5). Results We analyzed 2973 triplet APU samples from 1255 patients. We observed 485 NG and 379 CT diagnoses. NG/CT prevalence and incidence estimates were 12.0/11.1% and 40/29 per 100 person-years, respectively, in the base case scenario. As compared to S2, the reference strategy, the proportions of missed NG/CT diagnoses were 42.0/41.2% with S1, 21.8/22.5% with S3, 25.6/28.3% with S4, and 6.3/10.5% with S5, respectively. As compared to S2, S1 reduced the cost of the analysis by 74%, S3 by 50%, S4 by 66%, and S5 by 33%. The numbers needed to screen for catching up the missed NG/CT diagnoses were 49/67 with S1, 62/82 with S3, 71/87 with S4, and 143/118 with S5. Conclusions S5 appears to be the best strategy, missing only 6.3/10.5% of NG/CT diagnoses, for a cost reduction of 33%.

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Crosby, Richard A., Laura F. Salazar, Brandon Hill, and Leandro Mena. "A comparison of HIV-risk behaviors between young black cisgender men who have sex with men and young black transgender women who have sex with men." International Journal of STD & AIDS 29, no. 7 (January 19, 2018): 665–72. http://dx.doi.org/10.1177/0956462417751811.

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This study compared sexually transmitted infection (STI)-associated risks between young Black cisgender men who have sex with men (YBMSM) and young Black transwomen who have sex with men (YBTWSM). Comparisons pertained to: (1) prevalence of infections; (2) sexual risk; (3) partner-related risks; and (4) socioeconomic marginalization. YBMSM (n = 577) and YBTWSM (n = 32) were recruited from an STI clinic in the USA. Volunteers completed a computer-assisted self-interview and medical records were abstracted for STI/HIV information. Significantly greater prevalence of pharyngeal Chlamydia ( P < .001) and pharyngeal gonorrhea ( P = .04) occurred among YBTWSM; however, both associations were moderated and only significant for HIV-uninfected volunteers. YBTWSM had more oral sex partners and more frequent engagement in oral sex. The number of new sex partners for anal receptive sex was greater in YBTWSM. YBTWSM were more likely to exchange sex for money/drugs ( P < .001), have sex with men recently in prison ( P < .001), who were “anonymous” ( P = .004), or who were “one night stands” ( P < .001). YBTWSM were more likely to depend on sex partners for money food, etc. ( P < .001), to miss meals due to lack of money ( P = .01), and to report having ever being incarcerated ( P = .009). Compared to cisgender YBMSM, YBTWSM experience multiple risk factors relative to the acquisition/transmission of STIs and HIV.

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KESSLER, HARALD H., KAREN PIERER, DORIS STUENZNER, PIET AUER-GRUMBACH, EVA-MARIA HALLER, and EGON MARTH. "Rapid Detection of Chlamydia trachomatis in Conjunctival, Pharyngeal, and Urethral Specimens With a New Polymerase Chain Reaction Assay." Sexually Transmitted Diseases 21, no. 4 (July 1994): 191–95. http://dx.doi.org/10.1097/00007435-199407000-00002.

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Hamasuna, Ryoichi, Tetsuro Matsumoto, Ryoichi Hamasuna, Satoshi Takahashi, Shinya Uehara, Tetsuro Matsumoto, Satoshi Takahashi, and Shinya Uehara. "Should urologists care for the pharyngeal infection of Neisseria gonorrhoeae or Chlamydia trachomatis when we treat male urethritis?" Journal of Infection and Chemotherapy 18, no. 3 (2012): 410–13. http://dx.doi.org/10.1007/s10156-011-0355-6.

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Journal articles on the topic 'Pharyngeal chlamydia'

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