HIV/AIDS, STI and Bloodborne Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, , Berlin, Germany.
Sex Transm Infect. 2014 Feb;90(1):46-51. doi: 10.1136/sextrans-2012-050929. Epub 2013 Aug 6.
To determine the prevalence of pharyngeal and rectal Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) in Germany and describe associations between these infections, sexual practices and other factors to provide an evidence base for screening recommendations.
We conducted a cross-sectional study in 22 sentinel sites of sexually transmitted infections across Germany. Pharyngeal and rectal swabs were collected and tested for CT and NG with a nucleic acid amplification test (NAAT). Information on HIV status, number of sex partners and sexual practices was collected and linked to NAAT results.
Overall, 2247 MSM were screened for pharyngeal or rectal CT and NG infections; median age was 34 years (range 16-83). Prevalence of CT was 1.5% in pharyngeal and 8.0% in rectal specimens. Prevalence of NG was 5.5% in pharyngeal and 4.6% in rectal specimens. Local symptoms were reported in 5.1% of pharyngeal and 11.9% of rectal infections. Altogether 90.8% of rectal or pharyngeal infections would remain undetected if only symptomatic cases were tested. Rectal infection was significantly more likely in men reporting multiple partners (2-5 partners, OR=1.85; 6-10 partners, OR=2.10; >11 partners, OR=2.95), men diagnosed with HIV (OR=1.60) and men practising receptive anal intercourse without a condom (OR=1.54). Pharyngeal infection was more likely in men reporting multiple partners (6-10 partners, OR=2.88; >11 partners, OR=4.96), and men diagnosed with HIV (OR=1.78).
Pharyngeal and rectal infections in sexually active MSM can remain undetected and thus transmissible if swabbing is not offered routinely. Screening should be offered particularly to MSM diagnosed with HIV and MSM reporting multiple partners.
确定德国男男性行为者（MSM）中咽和直肠沙眼衣原体（CT）和淋病奈瑟菌（NG）感染的流行率，并描述这些感染与性行为及其他因素之间的关联，为筛查建议提供依据。
我们在德国 22 个性传播感染哨点进行了一项横断面研究。采集咽和直肠拭子，采用核酸扩增试验（NAAT）检测 CT 和 NG。收集并链接 HIV 状态、性伴侣数量和性行为信息到 NAAT 结果。
共对 2247 名 MSM 进行了咽或直肠 CT 和 NG 感染的筛查；中位年龄为 34 岁（范围 16-83）。咽拭子 CT 感染率为 1.5%，直肠拭子 CT 感染率为 8.0%。咽拭子 NG 感染率为 5.5%，直肠拭子 NG 感染率为 4.6%。5.1%的咽感染和 11.9%的直肠感染有局部症状。如果仅检测有症状的病例，将有 90.8%的直肠或咽感染未被发现。报告有 2-5 个性伴侣（OR=1.85）、6-10 个性伴侣（OR=2.10）和>11 个性伴侣（OR=2.95）、诊断为 HIV（OR=1.60）和使用无保护措施肛交（OR=1.54）的男性更有可能发生直肠感染。报告有 6-10 个性伴侣（OR=2.88）和>11 个性伴侣（OR=4.96）和诊断为 HIV（OR=1.78）的男性更有可能发生咽感染。
如果不常规进行拭子检测，活跃的 MSM 中咽和直肠感染可能会被漏检，从而具有传染性。筛查应特别针对诊断为 HIV 的 MSM 和报告有多个性伴侣的 MSM 提供。
