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Kitchen M, Borena WT, Gisinger M, Meindl E, Wanner M, Govrins MA, Sarcletti M. Pharyngeal gonococcal infection and the sensitivity of oral gargle samples in comparison to self-collected throat swabs for the detection of N. gonorrhoeae in persons in Tyrol, Austria. Infection 2024:10.1007/s15010-024-02359-x. [PMID: 39093382 DOI: 10.1007/s15010-024-02359-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE Asymptomatic pharyngeal gonorrhoea could play an important role in transmission and should be screened for in persons at risk. We investigated the sensitivity of oral gargle samples to detect N. gonorrhoea and describe the frequency of infection by anatomical site. METHODS From June 2021 to July 2022 persons diagnosed with gonorrhoea in the STI/HIV department were asked to provide self-collected specimens for single-site testing by NAAT from throat (by gargling and swabbing), anorectum, and first-void urine. RESULTS 104 episodes of gonorrhoea were analysed in 88 individuals. The median age was 33 years, 85 persons (96.5%) were male. The pharynx was the most common site of infection (71 cases, 68.2%); in 26 persons (25.0%) it was the only site of infection. Anorectal infection was detected in 65 cases (62.5%) and urogenital infection in 25 cases (24.0%). In 46 cases (44.2%) infection was detected in more than one anatomical site. Gargling was less sensitive than throat swabbing to detect pharyngeal infection (85.9% versus 97.2%, p = .038), but was preferred by patients. Only 4 of 71 pharyngeal infections (5.6%) were symptomatic; anorectal and urogenital infections were symptomatic in 12.3% and 76.0% of cases, respectively. Culture recovery of N.gonorrhoeae was only possible in 15.8% of throat swabs, but was successful in 61.9% of anorectal and 84.2% of urogenital samples. CONCLUSIONS Asymptomatic pharyngeal gonorrhoea is common. Gargle samples should be used only as alternative specimens with inferior sensitivity compared to throat swab samples.
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Affiliation(s)
- Maria Kitchen
- Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | | | - Martin Gisinger
- Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Eva Meindl
- Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Marina Wanner
- Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Miriam Alisa Govrins
- Institut für Hygiene und Medizinische Mikrobiologie, Medizinische Universität Innsbruck, Innsbruck, Austria
| | - Mario Sarcletti
- Klinik für Dermatologie, Venerologie und Allergologie, Medizinische Universität Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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2
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Thammajaruk N, Ramautarsing RA, Hiransuthikul A, Suriwong S, Tasomboon W, Thapwong P, Phunkron A, Saiwaew S, Sangpasert T, Pankam T, Avery M, Mills S, Phanuphak P, Phanuphak N. Pooled Pharyngeal, Rectal, and Urine Specimens for the Point-of-Care Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by Lay Providers in Key Population-Led Health Services in Thailand. Pathogens 2023; 12:1268. [PMID: 37887784 PMCID: PMC10609829 DOI: 10.3390/pathogens12101268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Routine testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in people with heightened risk is lacking in Thailand. This study aimed to assess the performance of the Cepheid Xpert CT/NG assay, conducted by key population (KP) lay providers, for CT and NG detection on single-site and pooled specimens from the pharynx, rectum, and urine. Between August and October 2019, 188 men who have sex with men and 11 transgender women were enrolled. Participants collected urine specimens while trained KP lay providers obtained pharyngeal and rectal swabs. Compared to single-site testing with the Abbott RealTime CT/NG assay by medical technologists, the Xpert assay missed one pharyngeal NG infection out of 199 single-site specimens, giving a 93.3% sensitivity for pharyngeal NG and one missed pharyngeal NG infection out of fifty pooled specimens, giving an 88.9% sensitivity for pharyngeal NG. There was no discrepancy between the two assays for CT detection. The Cohen's Kappa coefficient of pooled specimen testing by the Xpert was 0.93 for NG and 1 for CT when compared to single-site testing by Abbott. Implementing pooled specimen testing by KP lay providers can be a cost-saving strategy to enhance the uptake of CT/NG services for populations facing increased risk.
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Affiliation(s)
| | | | - Akarin Hiransuthikul
- Institute of HIV Research and Innovation (IHRI), Bangkok 10330, Thailand
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Sujittra Suriwong
- Institute of HIV Research and Innovation (IHRI), Bangkok 10330, Thailand
| | - Waranya Tasomboon
- Institute of HIV Research and Innovation (IHRI), Bangkok 10330, Thailand
| | - Prasopsuk Thapwong
- The Service Workers In Group Foundation (SWING), Bangkok 10500, Thailand
| | - Atachai Phunkron
- The Service Workers In Group Foundation (SWING), Bangkok 10500, Thailand
| | - Somporn Saiwaew
- Rainbow Sky Association of Thailand (RSAT), Bangkok 10240, Thailand
| | | | - Tippawan Pankam
- Thai Red Cross Anonymous Clinic, Thai Red Cross AIDS Research Centre (TRCARC), Bangkok 10330, Thailand
| | - Matthew Avery
- USAID/EpiC Thailand project, FHI 360, Bangkok 10330, Thailand
| | - Stephen Mills
- USAID/EpiC Thailand project, FHI 360, Bangkok 10330, Thailand
| | - Praphan Phanuphak
- Institute of HIV Research and Innovation (IHRI), Bangkok 10330, Thailand
| | - Nittaya Phanuphak
- Institute of HIV Research and Innovation (IHRI), Bangkok 10330, Thailand
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Mizushima D, Shintani Y, Takano M, Shiojiri D, Ando N, Aoki T, Watanabe K, Nakamoto T, Gatanaga H, Oka S. Prevalence of Asymptomatic Mpox among Men Who Have Sex with Men, Japan, January-March 2023. Emerg Infect Dis 2023; 29:1872-1876. [PMID: 37506678 PMCID: PMC10461655 DOI: 10.3201/eid2909.230541] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
We prospectively assessed asymptomatic monkeypox virus infections among men who have sex with men in Tokyo, Japan, during the initial phase of the mpox epidemic. Our findings suggest that asymptomatic infections were likely underestimated and were comparable in magnitude to symptomatic infections, highlighting the need to improve testing accessibility among high-risk populations.
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Affiliation(s)
| | | | - Misao Takano
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Daisuke Shiojiri
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Naokatsu Ando
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Takahiro Aoki
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Koji Watanabe
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Takato Nakamoto
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Hiroyuki Gatanaga
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
| | - Shinichi Oka
- National Center for Global Health and Medicine, Tokyo, Japan (D. Mizushima, Y. Shintani, M. Takano, D. Shiojiri, N. Ando, T. Aoki, K. Watanabe, T. Nakamoto, H. Gatanaga, S. Oka)
- Personal Health Clinic, Tokyo (D. Shiojiri); Kumamoto University, Kumamoto, Japan (H. Gatanaga, S. Oka)
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4
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Jiang TT, Cao NX, Shi MQ, Jia TJ, Zhou Q, Liu JW, Zhang J, Zhang Y, Yin YP, Chen XS. Using pooled urogenital, anorectal and oropharyngeal specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae among men who have sex with men in China: a multisite diagnostic accuracy study. BMJ Open 2023; 13:e069876. [PMID: 36878660 PMCID: PMC9990619 DOI: 10.1136/bmjopen-2022-069876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at both urogenital and extragenital sites has been recommended in many countries. Testing of the infections using pooled specimens from urogenital and extragenital sites offer the opportunity to shorten the testing time and reduce the testing cost. Ex-ante pooling is placing the original single-site specimens in a tube with transport media, while ex-post pooling is making a pool of the transport media from both anorectal and oropharyngeal specimens and the urine. This study aimed to conduct a multisite performance evaluation of two pool-specimen approaches (ex-ante and ex-post) in detection of CT and NG using the Cobas 4800 platform among men who have sex with men (MSM) in China. DESIGN Diagnostic accuracy study. SETTING, PARTICIPANTS AND OUTCOME MEASURES Participants were recruited from MSM communities at six cities in China. Two oropharyngeal and anorectal swabs collected by clinical staff and 20 mL first-void urine collected by the participant himself were used for evaluating sensitivity and specificity. RESULTS A total of 1311 specimens were collected from 437 participants in six cities. The sensitivities of ex-ante pooling approach as compared with single-specimen approach (reference standard) were 98.7% (95% CI, 92.7% to 100.0%) for detection of CT and 89.7% (95% CI, 75.8% to 97.1%) for NG, and the specificities were 99.5% (95% CI, 98.0% to 99.9%) and 98.7% (95% CI, 97.1% to 99.6%), respectively. The sensitivities of ex-post pooling approach were 98.7% (95% CI, 92.7% to 100.0%) for CT and 100.0% (95% CI, 91.0% to 100.0%) for NG, and the specificities were 100.0% (95% CI, 99.0% to 100.0%) and 100.0% (95% CI, 99.1% to 100.0%), respectively. CONCLUSIONS The ex-ante and ex-post pooling approaches show good sensitivity and specificity in detecting urogenital and extragenital CT and/or NG, indicating that these approaches can be used in epidemiological surveillance and clinical management of CT and NG infections, particularly among MSM population.
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Affiliation(s)
- Ting-Ting Jiang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ning-Xiao Cao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Mei-Qin Shi
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Tian-Jian Jia
- Department of Outpatient, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Qian Zhou
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Jing-Wei Liu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Jin Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yan Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Yue-Ping Yin
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xiang-Sheng Chen
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
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5
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Prazuck T, Lanotte P, Le Moal G, Hocqueloux L, Sunder S, Catroux M, Garcia M, Perfezou P, Gras G, Plouzeau C, Lévêque N, Beby-Defaux A. Pooling Rectal, Pharyngeal, and Urine Samples to Detect Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium Using Multiplex Polymerase Chain Reaction Is as Effective as Single-Site Testing for Men Who Have Sex With Men. Open Forum Infect Dis 2022; 9:ofac496. [PMID: 36324326 PMCID: PMC9620425 DOI: 10.1093/ofid/ofac496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background Screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) at pharyngeal, urogenital, and anorectal sites is recommended for men who have sex with men (MSM). Pooling samples is a promising technique, but no data are available when pooled screening also includes Mycoplasma genitalium (MG). The main objective of this study was to examine the sensitivity of pooled samples for detecting CT, NG, and MG in MSM using nucleic acid amplification versus single-site testing. Methods In this multicenter study, MSM with a positive result for CT, NG, or MG were recalled to the clinic for treatment and were asked to participate in this study. Separate samples were sent to a central virological department that proceeded to form the pooled samples. Testing was performed using the multiplex real-time polymerase chain reaction Allplex STI Essential Assay (Seegene, Seoul, Korea), which can simultaneously detect 7 pathogens. Results A total of 130 MSM with at least 1 positive test for CT, NG, or MG were included. A total of 25.4% had a coinfection. The sensitivities of pooled-sample testing were 94.8% for CT, 97.0% for NG, and 92.3% for MG. Pooling failed to detect 8 infections, but pooled-sample analysis missed detecting only samples with a low bacterial load (cycle threshold >35). Conclusions Pooling samples from MSM to detect CT, NG, and MG is as sensitive as individual-site testing for these 3 pathogens using the Allplex assay. Missed infections with a very low bacterial load could have a low impact on further transmission. Clinical Trials Registration. NCT03568695.
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Affiliation(s)
- Thierry Prazuck
- Service des maladies infectieuses et tropicales, CHR Orléans, Orleans, France
| | - Philippe Lanotte
- Service de bacteriologie-virologie, Centre Hospitalier Universitaire Tours, Tours, France
| | - Gwénaël Le Moal
- Service des maladies infectieuses, Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Laurent Hocqueloux
- Service des maladies infectieuses et tropicales, CHR Orléans, Orleans, France
| | - Simon Sunder
- Service des maladies infectieuses, CH Niort, Niort, France
| | - Mélanie Catroux
- Service des maladies infectieuses, Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Magali Garcia
- Laboratoire inflammation tissus épitheliaux et cytokines EA 4331, Université de Poitiers, Poitiers, France
| | | | - Guillaume Gras
- Service des maladies infectieuses, Centre Hospitalier Universitaire Tours, Tours, France
| | - Chloé Plouzeau
- Laboratoire de bactériologie, Centre Hospitalier Universitaire Poitiers, Poitiers, France
| | - Nicolas Lévêque
- Laboratoire inflammation tissus épitheliaux et cytokines EA 4331, Université de Poitiers, Poitiers, France
| | - Agnès Beby-Defaux
- Laboratoire de virologie et mycobactériologie, Centre Hospitalier Universitaire Poitiers, Poitiers, France
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Dukers-Muijrers NHTM, Evers YJ, Hoebe CJPA, Wolffs PFG, de Vries HJC, Hoenderboom B, van der Sande MAB, Heijne J, Klausner JD, Hocking JS, van Bergen J. Controversies and evidence on Chlamydia testing and treatment in asymptomatic women and men who have sex with men: a narrative review. BMC Infect Dis 2022; 22:255. [PMID: 35287617 PMCID: PMC8922931 DOI: 10.1186/s12879-022-07171-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection (STI) worldwide. CT is mainly asymptomatic. Test-and-treat strategies are widely implemented to prevent transmission and complications. Strategies are not without controversy in asymptomatic women and men who have sex with men (MSM). Concerns are emerging to test and treat asymptomatic persons for urogenital CT (‘Controversy 1’) and pharyngeal or rectal CT (‘Controversy 2’), whereby testing symptomatic persons is not under debate. Opposed views in CT treatment involve using azithromycin versus doxycycline (‘Controversy 3’). The objective of this review is to provide coverage of these public health and clinical controversies by reviewing the current scientific evidence. Methods A literature search was performed using PubMed for relevant publications between 2018 and September 2021, and iterative retrieval of additional relevant publications. Results Controversy 1. In women, the majority of asymptomatic CT are at the urogenital site, and detections mostly include viable CT. CT easily transmits to a partner and potentially also between the vaginal and rectal areas; the clinical impact of urogenital CT is established, although risks for adverse outcomes are uncertain. Wide-scale testing in asymptomatic women has not resulted in reduced prevalence. In MSM, evidence for the clinical impact of asymptomatic urogenital CT is lacking. Controversy 2. Rectal CT is common in women diagnosed with urogenital CT, but the clinical impact of asymptomatic rectal CT is uncertain. In MSM, rectal CT is common, and most CT infections are at the rectal site, yet the risk of longer term complications is unknown. In both sexes, pharyngeal CT is uncommon and has no documented clinical impact. Controversy 3. In the treatment of rectal CT, doxycycline has superior effectiveness to azithromycin. Evidence has also accumulated on the harms of test-and-treat strategies. Conclusions Current practices vary widely, from widescale test-and-treat approaches to more individual patient- and partner-level case management. Choosing which asymptomatic people to test at what anatomic site, and whether to test or not, requires an urgent (re-)definition of the goals of testing and treating asymptomatic persons. Treatment guidelines are shifting toward universal doxycycline use, and clinical practice now faces the challenge of implementation. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07171-2. Test-and-treat is a key strategy in the control of Chlamydia trachomatis (CT). We discuss recent controversies and present scientific evidence regarding urogenital, rectal, and pharyngeal CT test-and-treat strategies in women and in men who have sex with men (MSM). This should inform best practices for the prevention and management of the most common bacterial sexually transmitted infection (STI) worldwide.
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Affiliation(s)
- Nicole H T M Dukers-Muijrers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands. .,Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.
| | - Ymke J Evers
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Christian J P A Hoebe
- Department of Sexual Health, Infectious Diseases, and Environmental Health, South Limburg Public Health Service, PO Box 33, 6400 AA, Heerlen, The Netherlands.,Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands.,Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Petra F G Wolffs
- Department of Medical Microbiology, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Henry J C de Vries
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of Infectious Diseases, Public Health Service of Amsterdam (GGD Amsterdam), Amsterdam, The Netherlands.,Department of Dermatology, Amsterdam Infection & Immunity Institute (AII), Amsterdam University Medical Center (UMC), Amsterdam, The Netherlands
| | - Bernice Hoenderboom
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Institute for Public Health Genomics, Genetics & Cell Biology, Maastricht University, Faculty of Health and Medicine and Life Sciences, Maastricht, The Netherlands
| | - Marianne A B van der Sande
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.,Global Health, Julius Centre for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Janneke Heijne
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Jeffrey D Klausner
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jan van Bergen
- Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,STI AIDS Netherlands, Amsterdam, The Netherlands
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7
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Laumen JGE, Van Dijck C, Abdellati S, De Baetselier I, Serrano G, Manoharan-Basil SS, Bottieau E, Martiny D, Kenyon C. Antimicrobial susceptibility of commensal Neisseria in a general population and men who have sex with men in Belgium. Sci Rep 2022; 12:9. [PMID: 34997050 PMCID: PMC8741786 DOI: 10.1038/s41598-021-03995-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/08/2021] [Indexed: 12/03/2022] Open
Abstract
Non-pathogenic Neisseria are a reservoir of antimicrobial resistance genes for pathogenic Neisseria meningitidis and Neisseria gonorrhoeae. Men who have sex with men (MSM) are at risk of co-colonization with resistant non-pathogenic and pathogenic Neisseria. We assessed if the antimicrobial susceptibility of non-pathogenic Neisseria among MSM differs from a general population and if antimicrobial exposure impacts susceptibility. We recruited 96 participants at our center in Belgium: 32 employees, 32 MSM who did not use antibiotics in the previous 6 months, and 32 MSM who did. Oropharyngeal Neisseria were cultured and identified with MALDI-TOF–MS. Minimum inhibitory concentrations for azithromycin, ceftriaxone and ciprofloxacin were determined using E-tests® and compared between groups with non-parametric tests. Non-pathogenic Neisseria from employees as well as MSM were remarkably resistant. Those from MSM were significantly less susceptible than employees to azithromycin and ciprofloxacin (p < 0.0001, p < 0.001), but not ceftriaxone (p = 0.3). Susceptibility did not differ significantly according to recent antimicrobial exposure in MSM. Surveilling antimicrobial susceptibility of non-pathogenic Neisseria may be a sensitive way to assess impact of antimicrobial exposure in a population. The high levels of antimicrobial resistance in this survey indicate that novel resistance determinants may be readily available for future transfer from non-pathogenic to pathogenic Neisseria.
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Affiliation(s)
- Jolein Gyonne Elise Laumen
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium.,Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
| | - Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium.,Laboratory of Medical Microbiology, University of Antwerp, Wilrijk, Belgium
| | - Saïd Abdellati
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Gabriela Serrano
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles, Pôle Hospitalier Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Emmanuel Bottieau
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Delphine Martiny
- Department of Microbiology, Laboratoire Hospitalier Universitaire de Bruxelles, Pôle Hospitalier Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium.,Faculté de Médecine et Pharmacie, Université de Mons, Mons, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine Antwerp, Nationalestraat 155, 2000, Antwerp, Belgium. .,Department of Medicine, University of Cape Town, Cape Town, South Africa.
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8
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Almeria J, Pham J, Paris KS, Heskett KM, Romyco I, Bristow CC. Pooled 3-Anatomic-Site Testing for Chlamydia trachomatis and Neisseria gonorrhoeae: A Systematic Review and Meta-Analysis. Sex Transm Dis 2021; 48:e215-e222. [PMID: 34535614 PMCID: PMC8756562 DOI: 10.1097/olq.0000000000001558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pooled testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) may be a cost-saving solution to increase screening by simplifying testing procedures and reducing resource burdens. We conducted a systematic review and meta-analysis to examine the performance of pooled 3-anatomic-site testing (pharyngeal, rectal, and urogenital sites) for CT and NG in comparison with single-anatomic-site testing. METHODS We conducted a systematic literature search in PubMed, Embase, and Web of Science to identify original evaluation studies of the performance of pooled testing for CT and NG infections and identified 14 studies for inclusion. Each study was systematically evaluated for bias. We conducted bivariate fixed-effects and random-effects meta-analyses using a full Bayesian method of the positive percent agreement and negative percent agreement. RESULTS The combined positive percent agreement for CT was 93.11% (95% confidence interval [CI], 91.51%-94.55%), and the negative percent agreement was 99.44% (95% CI, 99.18%-99.65%). For NG, the combined positive percent agreement was 93.80% (95% CI, 90.26%-96.61%), and the negative percent agreement was 99.73% (95% CI, 99.30%-99.97%). CONCLUSIONS We found that pooled 3-anatomic-site tests performed similarly to single-anatomic-site tests for the detection of CT and NG. The pooled 3-anatomic-site tests have the added potential benefit of reduced cost and resource requirement, which could lead to improved testing access and screening uptake.
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Affiliation(s)
- Jasmine Almeria
- Department of Family Medicine and Public Health, University of California, San Diego
| | - Joshua Pham
- Department of Family Medicine and Public Health, University of California, San Diego
| | - Keely S. Paris
- Department of Family Medicine and Public Health, University of California, San Diego
| | | | | | - Claire C. Bristow
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego
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