Estimated prevalence and associations of sexually transmissible bacterial enteric pathogens in asymptomatic men who have sex with men: a systematic review and meta-analysis.

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES Sexually Transmitted Infections Pub Date : 2024-11-18 DOI:10.1136/sextrans-2024-056183

Daniel Richardson, Amber Savary-Trathen, Colin Fitzpatrick, Deborah Williams

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Abstract

Objective: The reservoir of sexually transmissible bacterial enteric pathogens in asymptomatic men who have sex with men (MSM) may impact future outbreaks, and the evolution of antimicrobial resistance. We aimed to estimate the pooled prevalence and explore any factors associated with Shigella spp, Campylobacter spp, diarrhoeagenic Escherichia coli and Salmonella spp in asymptomatic MSM using the random effects model.

Methods: We searched Embase, MEDLINE, CINAHL and Web of Science Core Collections for manuscripts published up to February 2024. One author screened citations and abstracts; two authors independently conducted a full-text review. We included manuscripts which measured the prevalence of Shigella spp, Campylobacter spp, diarrhoeagenic E. coli and Salmonella spp in asymptomatic MSM. Quality and risk of bias was assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We calculated pooled prevalence and CIs using the random effects model.

Results: Six manuscripts were included in the final review. The manuscripts were from Australia (n=2), the UK (n=2), the Netherlands (n=1) and the USA (n=1) and included data from 3766 asymptomatic MSM tested for bacterial enteric pathogens. The prevalence of Shigella spp was 1.1% (95% CI 0.7% to 1.7%), Campylobacter spp 1.9% (95% CI 1.5% to 2.5%), diarrhoeagenic E. coli 3.8% (95% CI 2.1% to 6.7%) and Salmonella spp 0.3% (95% CI 0.1% to 0.6%). Two manuscripts demonstrated that the detection of bacterial enteric pathogen was more frequent in asymptomatic MSM using HIV-pre-exposure prophylaxis (PrEP), living with HIV, reporting <5 new sexual partners in the past 3 months, reporting insertive oral-anal sex and group sex compared with MSM testing negative.

Conclusion: Despite a small number of manuscripts, this review has estimated the pooled prevalence, and highlighted some possible associations with sexually transmissible bacterial enteric pathogens in asymptomatic MSM, which can inform future clinical guidelines, public health control strategies and research to increase our understanding of transmission and the evolution of antimicrobial resistance.

Prospero registration number: CRD42024518700.

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无症状男男性行为者中性传播细菌性肠道病原体的估计流行率和关联：系统回顾和荟萃分析。

目的：无症状男男性行为者（MSM）中的性传播细菌肠道病原体库可能会影响未来的疫情爆发和抗菌药耐药性的演变。我们的目的是利用随机效应模型估算无症状男男性行为者中志贺氏杆菌属、弯曲杆菌属、致泻性大肠杆菌和沙门氏菌属的总体流行率，并探讨与之相关的任何因素：我们检索了 Embase、MEDLINE、CINAHL 和 Web of Science 核心库中截至 2024 年 2 月发表的手稿。一位作者筛选了引文和摘要；两位作者独立进行了全文审阅。我们纳入了测量无症状 MSM 中志贺氏菌、弯曲杆菌、致泻性大肠杆菌和沙门氏菌感染率的稿件。由两位作者使用乔安娜-布里格斯研究所（Joanna Briggs Institute）的批判性评估工具对论文的质量和偏倚风险进行独立评估。我们使用随机效应模型计算了汇总的流行率和CIs：六篇手稿被纳入最终评审。这些手稿分别来自澳大利亚（2 篇）、英国（2 篇）、荷兰（1 篇）和美国（1 篇），包含了 3766 名无症状 MSM 的细菌性肠道病原体检测数据。志贺氏菌的发病率为 1.1%（95% CI 为 0.7% 至 1.7%），弯曲杆菌为 1.9%（95% CI 为 1.5% 至 2.5%），致腹泻大肠杆菌为 3.8%（95% CI 为 2.1% 至 6.7%），沙门氏菌为 0.3%（95% CI 为 0.1% 至 0.6%）。两篇手稿显示，在使用艾滋病暴露前预防疗法（PrEP）的无症状男男性行为者、艾滋病病毒感染者和报告结论者中，细菌性肠道病原体的检出率更高：尽管手稿数量较少，但本综述估算了汇总流行率，并强调了无症状男男性行为者中可通过性传播的细菌性肠道病原体可能存在的一些关联，可为未来的临床指南、公共卫生控制策略和研究提供参考，从而加深我们对传播和抗菌药耐药性演变的了解：CRD42024518700。

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来源期刊

Sexually Transmitted Infections 医学-传染病学

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.