Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain.
BMJ Open. 2013 Jun 20;3(6):e002330. doi: 10.1136/bmjopen-2012-002330.
To determine the prevalence of anorectal Chlamydia trachomatis serovars in a group of men who have sex with men (MSM) with high risk sexual behaviour, attendees at a sexually transmitted infection (STI) unit from a region in Northwest Spain.
Retrospective and descriptive study of all swabs obtained from all MSM attendees at an STI unit, from 2007 to 2011. Retrospective ethical approval was granted by the Ethical Regional Committee of Clinical Investigation of the Principality of Asturias.
The STI clinic in Oviedo, Spain, offers screening and free-of-charge treatment to about 3646 patients per year.
303 symptomatic and asymptomatic consecutive and unselected MSM patients (mean age 36.7 and range 21-55 years) were evaluated for anorectal chlamydial infection.
C trachomatis DNA extraction and detection in all rectal and in 36 urethral swabs. Characterisation of C trachomatis genotypes through sequencing of ompA gene amplicons and further phylogenetic tree analysis.
We found 40 (13. 2%) positive rectal samples. The distribution of genotypes was E (37. 5%) followed by G (25%), D (12. 5%), J (10%) and L2b (5%).25 (62.5%, 95% CI 46.2 to 78.7) of the chlamydia-infected MSM showed clinical manifestations while 15 (37.5%, 95% CI 21.25 to 53.75) reported no symptoms. Concurrent infection with other STIs was documented in 27 (67.5%, 95% CI 51.7 to 83.2) patients. The most frequently reported clinical symptom was anal ulcer (7 cases, 17.5%; 95% CI 4.47 to 30.52). E genotype was mostly detected in asymptomatic patients. There were non-E genotypes detected in 21 (84%, 95% CI 63.9 to 95.5) of 25 symptomatic patients (p<0.001).
The first two confirmed cases of lymphogranuloma venereum (LGV) in MSM in Asturias are reported, probably indicating the increase of this infection. The Spanish C trachomatis laboratory-based surveillance system may underlie an underestimated number of chlamydial infections. Whenever mild and atypical symptoms exist, laboratory evaluation would contribute to the early implementation of appropriate therapy and prevent LGV dissemination.
在西班牙西北部一个性传播感染（STI）单位，调查一组有高危性行为的男男性接触者（MSM）中肛门直肠沙眼衣原体血清型的流行情况。
对 2007 年至 2011 年间在 STI 单位就诊的所有 MSM 患者的所有拭子进行回顾性和描述性研究。阿斯图里亚斯公国临床研究伦理区域委员会批准了回顾性伦理审查。
西班牙奥维耶多的 STI 诊所，每年为约 3646 名患者提供筛查和免费治疗。
303 名有症状和无症状的连续和未选择的 MSM 患者（平均年龄 36.7 岁，范围 21-55 岁）接受肛门直肠淋病奈瑟菌感染评估。
所有直肠和 36 个尿道拭子中 C 沙眼衣原体 DNA 的提取和检测。通过扩增 ompA 基因片段并进一步进行系统发育树分析来鉴定 C 沙眼衣原体基因型。
我们发现 40 例（13.2%）直肠样本阳性。基因型分布为 E（37.5%），其次是 G（25%）、D（12.5%）、J（10%）和 L2b（5%）。25 例（62.5%，95%CI 46.2-78.7）感染淋病奈瑟菌的 MSM 出现临床症状，而 15 例（37.5%，95%CI 21.25-53.75）无任何症状。在 27 例（67.5%，95%CI 51.7-83.2）患者中记录了并发其他 STI 的感染。最常报告的临床症状是肛门溃疡（7 例，17.5%；95%CI 4.47-30.52）。E 基因型主要在无症状患者中检测到。在 25 例有症状患者中（p<0.001）检测到 21 例（84%，95%CI 63.9-95.5）非 E 基因型。
报告了阿斯图里亚斯首例确诊的男男性接触者中发生的性病淋巴肉芽肿（LGV），可能表明这种感染的增加。西班牙沙眼衣原体基于实验室的监测系统可能会导致对淋病奈瑟菌感染的数量低估。只要存在轻度和非典型症状，实验室评估将有助于早期实施适当的治疗，并防止 LGV 的传播。
