Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
Central Clinical School, Monash University, Melbourne, Victoria, Australia.
Sex Transm Infect. 2022 Feb;98(1):11-16. doi: 10.1136/sextrans-2020-054632. Epub 2021 Jan 12.
Chlamydia and gonorrhoea are common sexually transmitted infections that infect the oropharynx, anorectum and urethra in men who have sex with men (MSM). This study aimed to examine the pattern of infection at more than one site (multisite) for chlamydia and gonorrhoea among MSM.
This was a retrospective study of MSM attending the Melbourne Sexual Health Centre for the first time between 2018 and 2019. We included MSM aged ≥16 years who had tested for and at all three sites (oropharynx, anorectum and urethra). We compared infections that occurred at a single site (termed single-site infection) and those that occurred at more than one site (termed multisite infections).
Of the 3938 men who were tested for chlamydia and gonorrhoea, 498/3938 men (12.6%, 95% CI 11.5% to 13.6%) had chlamydia at any site, of whom 400/498 (80.3%, 95% CI 78.9% to 81.2%) had single-site chlamydia infection, and 98/498 (19.7%, 95% CI 16.2% to 23.1%) had multisite infections. A similar proportion of men had gonorrhoea at any site (447/3938, 11.4%, 95% CI 10.3% to 12.2%), but among these 447 men, single-site infection was less common (256/447, 57.3%, 95% CI 52.6% to 61.7%, p<0.001) and multisite infection (191/447, 42.7%, 95% CI 38.2% to 47.3%, p<0.001) was more common than chlamydia. There were also marked differences by anatomical site. Urethral infection commonly occurred as single sites (75/122, 61.5%, 95% CI 52.8% to 70.1%) for chlamydia but uncommonly occurred for gonorrhoea (12/100, 12.0%, 95% CI 5.6% to 18.3%, p<0.001). In contrast, anorectal infection uncommonly occurred as multisite infection for chlamydia (98/394, 24.9%, 95% CI 20.6% to 29.1%) but was common (184/309, 59.5%, 95% CI 54.0% to 64.9%, p<0.001) for gonorrhoea.
The markedly different pattern of site-specific infection for chlamydia and gonorrhoea infections among the same MSM suggests significant differences in the transmissibility between anatomical sites and the duration of each infection at each site.
衣原体和淋病是常见的性传播感染，可感染男男性行为者（MSM）的口咽、肛门直肠和尿道。本研究旨在调查 MSM 中同时在多个部位（多部位）感染衣原体和淋病的模式。
这是一项回顾性研究，纳入了 2018 年至 2019 年期间首次在墨尔本性健康中心就诊的 MSM。我们纳入了年龄≥16 岁且在口咽、肛门直肠和尿道三个部位均接受过 和 检测的 MSM。我们比较了仅在一个部位发生的感染（称为单部位感染）和发生在多个部位的感染（称为多部位感染）。
在接受衣原体和淋病检测的 3938 名男性中，498/3938 名男性（12.6%，95%CI 11.5%至 13.6%）在任何部位感染了衣原体，其中 400/498 名男性（80.3%，95%CI 78.9%至 81.2%）为单部位衣原体感染，98/498 名男性（19.7%，95%CI 16.2%至 23.1%）为多部位感染。同样比例的男性在任何部位感染了淋病（447/3938，11.4%，95%CI 10.3%至 12.2%），但在这些 447 名男性中，单部位感染较为少见（256/447，57.3%，95%CI 52.6%至 61.7%，p<0.001），多部位感染（191/447，42.7%，95%CI 38.2%至 47.3%，p<0.001）比淋病更为常见。各解剖部位之间也存在显著差异。尿道感染常见于衣原体的单部位感染（75/122，61.5%，95%CI 52.8%至 70.1%），但少见见于淋病（12/100，12.0%，95%CI 5.6%至 18.3%，p<0.001）。相比之下，肛门直肠感染少见见于衣原体的多部位感染（98/394，24.9%，95%CI 20.6%至 29.1%），但常见于淋病（184/309，59.5%，95%CI 54.0%至 64.9%，p<0.001）。
同一 MSM 中衣原体和淋病感染的部位特异性感染模式明显不同，提示不同解剖部位的传染性和每个部位每个感染的持续时间存在显著差异。
