Verma Rachna, Gupta Somesh, Gupta Niharika, Singh Rajendra, Mala Rajni, Sood Seema
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Sex Transm Dis AIDS. 2024 Jul-Dec;45(2):116-119. doi: 10.4103/ijstd.ijstd_80_23. Epub 2024 Dec 13.
Anorectal and pharyngeal infections with (NG) are common in men who have sex with men (MSM). However, they are often asymptomatic and found in the absence of reported risk behavior and concurrent genital infection. These serve as a hidden reservoir for ongoing transmission and may cause complications. Additionally, they drive the transmission of other sexually transmitted infections (STIs) including HIV and may contribute to the development of antimicrobial resistance. The current study was undertaken to study the anatomic site distribution of gonococcal infection in MSM as limited data are available from India.
A total of 127 MSM patients attending the STI clinic Dermatology Outpatient Department of AIIMS were included in the study. A duplex polymerase chain reaction (PCR) targeting and psuedogene targets using in-house primers was standardized and used for testing. In addition, all samples were processed by conventional methods, i.e., microscopy and culture.
A total of 26 patients were found to be positive for NG by PCR with a prevalence rate of 20%. The prevalence rate for urethral, rectal, and pharyngeal gonorrhea was 8.7%, 9.4%, and 4.7% respectively. Out of the 26 positives, 15 patients, i.e., 57.7%, had only extragenital infections and none were positive at all three sites. On the other hand, only three patients were culture positive at the urethral site.
We would have missed approximately 60% of the infections if the testing was restricted to genital sites only.
An expanded testing including extragenital sites for screening of gonococcal infection in MSM will have clinical and public health benefits.
淋病奈瑟菌（NG）引起的肛肠和咽部感染在男男性行为者（MSM）中很常见。然而，这些感染通常无症状，且在没有报告的风险行为和并发生殖器感染的情况下被发现。它们是持续传播的隐藏源头，可能导致并发症。此外，它们还会促使包括艾滋病毒在内的其他性传播感染（STI）的传播，并可能导致抗菌药物耐药性的产生。由于印度的相关数据有限，本研究旨在探讨MSM中淋球菌感染的解剖部位分布情况。
本研究纳入了127名就诊于全印度医学科学研究所皮肤科门诊性传播感染诊所的MSM患者。使用内部引物靶向NG和假基因靶点的双重聚合酶链反应（PCR）方法被标准化并用于检测。此外，所有样本均采用传统方法进行处理，即显微镜检查和培养。
通过PCR检测，共有26名患者NG呈阳性，患病率为20%。尿道、直肠和咽部淋病的患病率分别为8.7%、9.4%和4.7%。在这26名阳性患者中，有15名患者（即57.7%）仅有生殖器外感染，且没有一名患者在所有三个部位均呈阳性。另一方面，只有三名患者尿道部位培养呈阳性。
如果检测仅局限于生殖器部位，我们将遗漏大约60%的感染病例。
对MSM进行淋球菌感染筛查时，扩大检测范围至生殖器外部位将具有临床和公共卫生益处。
