The Melbourne Sexual Health Centre, Alfred Health, 580 Swanston St, Carlton, Melbourne, VIC, 3053, Australia.
Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
BMC Infect Dis. 2018 Feb 27;18(1):95. doi: 10.1186/s12879-018-3003-2.
We aimed to describe anatomic site-specific concordance of gonococcal infections in partnerships of men who have sex with men (MSM).
We conducted a cross-sectional analysis of data from MSM partnerships attending Melbourne Sexual Health Centre between March 2011 and February 2015. Logistic regression models (random effect) were used to examine the association between gonococcal infections of the urethra, rectum and pharynx. Gonococci were detected by culture at all anatomic sites.
The analysis included 495 partnerships. Of the men with urethral gonorrhoea, 33% (95% CI 18-52) had partners with pharyngeal gonorrhoea and 67% (95% CI 48-82) had partners with rectal gonorrhoea. The adjusted odds of having urethral gonorrhoea was 4.6 (95% CI 1.2-17.1) for a man whose partner had pharyngeal gonorrhoea, and 48.1 (95% CI 18.3-126.7) for a man whose partner had rectal gonorrhoea. Of the men with rectal gonorrhoea, 46% (95% CI 31-61) had a partner with urethral gonorrhoea and 23% (95% CI 12-37) had a partner with pharyngeal gonorrhoea. The adjusted odds of having rectal gonorrhoea was 63.9 (95% CI 24.7-165.6) for a man whose partner had urethral gonorrhoea. Of the men with pharyngeal gonorrhoea, 42% (95% CI 23-63) had a partner with rectal gonorrhoea and 23% (95% CI 9-44) had a partner with had a partner with pharyngeal gonorrhoea. The adjusted odds of having pharyngeal gonorrhoea was 8.9 (95% CI 3.2-24.6) for a man whose partner had rectal gonorrhoea. The crude odds of having pharyngeal gonorrhoea was 14.2 (95% CI 5.1-39.0) for a man whose partner had pharyngeal gonorrhoea.
These data provide the first estimates of concordance of anatomic site-specific gonococcal infections in MSM partnerships, and confirm that urethral gonorrhoea is contracted from both rectal and pharyngeal sites, and suggest that gonococci transmit between the rectum and pharynx. However, due to use of culture rather than NAAT, our analysis was not adequately powered to assess pharynx-to-pharynx transmission of gonococci.
本研究旨在描述男男性行为者（MSM）性伴侣间淋球菌感染的解剖部位特异性一致性。
我们对 2011 年 3 月至 2015 年 2 月期间在墨尔本性健康中心就诊的 MSM 性伴侣进行了横断面数据分析。采用 logistic 回归模型（随机效应）来检测尿道、直肠和咽部淋球菌感染之间的关联。所有解剖部位均通过培养检测淋球菌。
该分析共纳入 495 对性伴侣。患有尿道淋病的男性中，33%（95%CI 18-52）的性伴侣患有咽部淋病，67%（95%CI 48-82）的性伴侣患有直肠淋病。与没有伴侣患有咽淋病的男性相比，其伴侣患有咽淋病的男性患尿道淋病的调整优势比为 4.6（95%CI 1.2-17.1），与没有伴侣患有直肠淋病的男性相比，其伴侣患有直肠淋病的男性患尿道淋病的调整优势比为 48.1（95%CI 18.3-126.7）。患有直肠淋病的男性中，46%（95%CI 31-61）的性伴侣患有尿道淋病，23%（95%CI 12-37）的性伴侣患有咽淋病。与没有伴侣患有尿道淋病的男性相比，其伴侣患有尿道淋病的男性患直肠淋病的调整优势比为 63.9（95%CI 24.7-165.6）。患有咽淋病的男性中，42%（95%CI 23-63）的性伴侣患有直肠淋病，23%（95%CI 9-44）的性伴侣患有咽淋病。与没有伴侣患有直肠淋病的男性相比，其伴侣患有直肠淋病的男性患咽淋病的调整优势比为 8.9（95%CI 3.2-24.6）。与没有伴侣患有咽淋病的男性相比，其伴侣患有咽淋病的男性患咽淋病的调整优势比为 14.2（95%CI 5.1-39.0）。
这些数据首次提供了 MSM 性伴侣间特定解剖部位淋球菌感染一致性的估计值，证实了尿道淋病既来源于直肠部位，也来源于咽部部位，并且提示淋球菌在直肠和咽部之间传播。然而，由于使用培养而非 NAAT 进行分析，我们的分析没有足够的效力来评估淋球菌在咽部之间的传播。
