Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, Malmö, Sweden
Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, Malmö, Sweden.
Sex Transm Infect. 2024 Oct 17;100(7):430-434. doi: 10.1136/sextrans-2023-056044.
While is reported as a common rectal infection among men who have sex with men (MSM), published data refer predominantly to urethral infections. Currently, most guidelines recommend testing from urine in men with symptomatic, non-gonococcal urethritis. Macrolide resistance-associated mutations (MRMs) among have increased during the last decade especially among MSM. We aim to demonstrate the prevalence and anatomical distribution of infection and MRM in urine and rectal specimens among MSM in Sweden.
In this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for , presence of MRM, , , HIV and syphilis.
The overall prevalence of was 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among -positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p<0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28). was significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with 6.7% (41 of 609) with , 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.
In this study, among MSM, most infections with were detected as rectal mono infections. The prevalence of among MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.
虽然 被报道为男男性行为者（MSM）中常见的直肠感染，但已发表的数据主要涉及尿道感染。目前，大多数指南建议对有症状、非淋球菌性尿道炎的男性进行尿液 检测。在过去十年中， 中与大环内酯类药物耐药相关的突变（MRMs），尤其是在 MSM 中，有所增加。我们旨在展示瑞典 MSM 中尿液和直肠标本中 感染和 MRM 的流行率和解剖分布。
在这项 2019 年的横断面研究中，对在瑞典南部一家性传播感染诊所就诊的有症状和无症状的 MSM 的配对尿液和直肠样本进行了 、存在 MRM、 、 、HIV 和梅毒的筛查。
的总体流行率为 10.5%（64/609），直肠样本为 7.6%（46/609），尿液样本为 3.9%（24/609）（p=0.007）。在 阳性病例中，分别有 62.5%（40/64）和 28.1%（18/64）为单一直肠和单一尿道感染（p<0.0001）。两个部位均有感染的比例为 9.4%（6/64）。MRM 的流行率为 67.9%（19/28）。 与 HIV 显著相关（OR 2.60，95%CI 1.14-5.88，p=0.02）。在这些 MSM 中，7.4%（45/609）感染了 ，6.7%（41/609）感染了 ，7.1%（43/609）感染了 HIV，0.7%（4/609）感染了梅毒。
在这项研究中，在 MSM 中，大多数 感染被检测为直肠单感染。在 MSM 中，直肠样本中 的流行率（7.6%）几乎是尿液样本（3.9%）的两倍。大环内酯类药物耐药的流行率很高，尿液和直肠样本之间没有差异。
