Oropharyngeal gonorrhoea among heterosexual men and women at a sexual health centre in Rotterdam, the Netherlands, 2023: reservoir for transmission?

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES Sexually Transmitted Infections Pub Date : 2024-11-28 DOI:10.1136/sextrans-2024-056313

Denise E Twisk, Corné Klaassen, Mireille van Westreenen, Hannelore M Götz

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Abstract

Background: Sexual health centres (SHCs) in the Netherlands report a surge in gonorrhoea, especially among young women (notably oropharyngeal) and men who have sex with women (MSW) since the second half of 2022. MSW are not routinely oropharyngeal tested, and women only when reporting oral sex. This cross-sectional study aimed to assess oropharyngeal gonorrhoea in MSW and women, and potential underdiagnosis.

Methods: From 10 August to 10 November 2023, the SHC in Rotterdam, the Netherlands, extended its gonorrhoea testing protocol, requiring oropharyngeal tests for all MSW and women. Positive cobas nucleic acid amplification test (NAAT) results were followed by culture sampling. Oropharyngeal infections were confirmed with a second NAAT (opa gene-based PCR), and for discrepancies a third NAAT (GeneXpert CT/NG test) was employed. The impact of extended testing on detection rates, along with the corresponding 95% CIs, was analysed.

Results: The overall gonorrhoea detection rate was 6.4% (95% CI 4.7% to 8.8%) among MSW and 6.0% (95% CI 4.8% to 7.6%) among women, compared with 3.6% (95% CI 2.3% to 5.4%) and 6.0% (95% CI 4.8% to 7.6%) without expanded testing. Oropharyngeal rates were 6.4% (95% CI 4.4% to 9.2%) for MSW and 4.3% (95% CI 3.2% to 5.7%) for women. Highest positivity was among individuals notified, <25 years, without migratory background, with lower educational levels and more sex partners. Oropharyngeal cultures confirmed viable gonorrhoea in 39.1% of MSW and 35.5% of women. False positives were 7.4% among MSW and 10.8% among women. Confirmed oropharyngeal gonorrhoea positivity rate was 5.9% (95% CI 4.0% to 8.6%) among MSW and 3.9% (95% CI 2.8% to 5.2%) among women.

Conclusion: Oropharyngeal gonorrhoea is common and currently underdiagnosed among MSW. The impact of this underdiagnosis on transmission dynamics under the current testing policy remains unclear. Further research is needed to inform prevention and control strategies, especially given the recent surge in gonorrhoea.

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2023年荷兰鹿特丹性健康中心异性恋男女口咽淋病：传播库？

背景：荷兰性健康中心（shc）报告称，自2022年下半年以来，淋病病例激增，特别是在年轻女性（特别是口咽）和与女性发生性关系的男性（MSW）中。MSW没有常规的口咽检测，女性只有在报告口交时才进行检测。本横断面研究旨在评估城市妇女和妇女的口咽淋病，以及潜在的漏诊。方法：从2023年8月10日至11月10日，荷兰鹿特丹SHC延长了淋病检测方案，要求对所有城市生活垃圾和妇女进行口咽检测。cobas核酸扩增试验（NAAT）阳性后进行培养取样。口咽感染用第二次NAAT（基于opa基因的PCR）确诊，对于差异采用第三次NAAT （GeneXpert CT/NG测试）。分析了扩展检测对检出率的影响，以及相应的95% ci。结果：总体淋病检出率在MSW中为6.4% (95% CI 4.7%至8.8%)，在女性中为6.0% (95% CI 4.8%至7.6%)，而在没有扩大检测的情况下为3.6% （95% CI 2.3%至5.4%）和6.0% （95% CI 4.8%至7.6%）。女性口咽发病率为4.3% (95% CI 3.2%至5.7%)，女性口咽发病率为6.4% （95% CI 4.4%至9.2%）。结论：口咽淋病在城市生活垃圾中较为常见，但目前诊断不足。在目前的检测政策下，这种诊断不足对传播动态的影响尚不清楚。需要进一步的研究来为预防和控制战略提供信息，特别是考虑到最近淋病的激增。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.