Clinical Microbiology Department, Groupe Hospitalier Paris Saint-Joseph, Paris, France.
Department of Medical-Surgical Proctology, Léopold Bellan Institute, GH Paris Saint-Joseph, Paris, France.
Infect Dis Now. 2023 Oct;53(8):104771. doi: 10.1016/j.idnow.2023.104771. Epub 2023 Aug 19.
The aim was to describe the clinical characteristics of symptomatic anoproctitis and the occurrence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG) infections in a prospective cohort of MSM patients.
From February 2018 to January 2020, all consecutive patients presenting at the Leopold Bellan Proctology Institute of Saint-Joseph Hospital, Paris, France with symptoms of anoproctitis were tested on rectal samples for C. trachomatis (CT), N. gonorrhoeae (NG), M. genitalium (MG). Clinical, microbiological, biological data, STI risk factors, medical history and treatments were collected.
Three hundred and sixty-five patients were included for suspected infective anoproctitis. CT was detected in 84/365 (23%) patients, NG in 45/365 (12%) and MG in 46/315 patients (15%), associated with macrolide resistance in 28/46 MG strains (61%). The most frequent symptoms were rectal pains, rectal bleeding, purulent discharge in 253 (79%), 191 (60%), and 164 (51%) of cases respectively. In comparison with MG infections, ulcerations, erythematous proctitis, rectorragia and false needs were more frequently described in CT infections, while purulent proctitis, functional pain and purulent discharge were more often observed in NG and CT anoproctitis.
We found a high prevalence rate of STIs due to CT, NG, while MG detection was associated with a high rate of macrolide resistance in a cohort of MSM patients. Our results confirm that in cases of symptomatic anoproctitis, MG should be tested in association with other STI pathogens.
本研究旨在描述有症状肛直肠炎的临床特征，以及沙眼衣原体（CT）、淋病奈瑟菌（NG）和生殖支原体（MG）感染在男男性行为者（MSM）患者中的发生率。
2018 年 2 月至 2020 年 1 月，所有因肛直肠炎症状就诊于法国巴黎圣约瑟夫医院利奥波德·贝兰肛肠病研究所的连续患者均接受直肠样本检测，以检测沙眼衣原体（CT）、淋病奈瑟菌（NG）和生殖支原体（MG）。收集临床、微生物学、生物学数据、性传播感染（STI）风险因素、病史和治疗情况。
共纳入 365 例疑似感染性肛直肠炎患者。365 例患者中，84 例（23%）检测到 CT，45 例（12%）检测到 NG，46 例（15%）检测到 MG，其中 28 株（61%）MG 株对大环内酯类耐药。最常见的症状是直肠疼痛、直肠出血、脓性分泌物，分别在 253 例（79%）、191 例（60%）和 164 例（51%）患者中出现。与 MG 感染相比，CT 感染更常出现溃疡、红斑性直肠炎、直肠出血和假性排便感，而 NG 和 CT 肛直肠炎更常出现脓性直肠炎、功能性疼痛和脓性分泌物。
在 MSM 患者中，我们发现 CT、NG 引起的 STI 发生率较高，而 MG 检测与大环内酯类耐药率较高相关。我们的结果证实，在有症状肛直肠炎的情况下，应与其他 STI 病原体一起检测 MG。
