McMillan A, Young H, Moyes A
Department of Genitourinary Medicine, Edinburgh Royal Infirmary NHS Trust, UK.
Int J STD AIDS. 2000 May;11(5):284-7. doi: 10.1177/095646240001100502.
The objective of this retrospective study was to determine the possible source of infection in homosexual men with rectal gonorrhoea: the probable source of rectal gonorrhoea was identified in 46/155 cases. Although the urethra was the site of infection in 33 (72%) of these contacts, only pharyngeal gonorrhoea was identified in 9 (20%) men. In 25/26 cases, there was concordance in the auxo/serotypes of Neisseria gonorrhoeae between contacts with urethral gonorrhoea and the index men with rectal gonorrhoea. Eleven out of 12 pharyngeal isolates were of the same auxo/serotype as the index cases. This study supports the hypothesis that rectal gonorrhoea in homosexual men can be acquired from the oropharynx. Because infection at this site is an independent risk factor for acquisition of HIV, screening for rectal and pharyngeal gonorrhoea should be offered to men who have sex with men, even when there is no history of unprotected receptive anal intercourse.
在155例病例中的46例确定了直肠淋病的可能来源。虽然在这些性接触者中有33例（72%）感染部位是尿道，但仅在9例（20%）男性中发现了咽部淋病。在25/26例病例中，患有尿道淋病的性接触者与患有直肠淋病的索引病例之间，淋病奈瑟菌的营养型/血清型具有一致性。12例咽部分离株中有11例与索引病例的营养型/血清型相同。本研究支持这样的假说，即男同性恋者的直肠淋病可能源于口咽部。由于该部位的感染是获得性免疫缺陷病毒（HIV）感染的一个独立危险因素，即使没有无保护的被动肛交史，也应对男男性行为者进行直肠和咽部淋病筛查。
