Chlamydial proctitis?

Munday, P E; Carder, J M; Taylor‐Robinson, David

doi:10.1136/sti.61.6.376

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…1 2 These behaviours may lead to sexually transmitted infections resulting from Chlamydia trachomatis or Neisseria gonorrhoeae, which continue to be common among some populations of MSM. [1][2][3][4][5][6][7][8][9][10][11] If not detected and treated, these infections may result in painful clinical syndromes such as urethritis, epididymitis, or proctitis, 12 and they also appear to increase the risk of HIV transmission. [13][14][15][16] Because chlamydial and gonorrhoea infections are often asymptomatic, it has been suggested that routine screening for these infections should be performed among at-risk MSM in order to prevent disease complications and to reduce the risk of HIV transmission.…”

mentioning

confidence: 99%

Prevalence of chlamydia and gonorrhoea among a population of men who have sex with men

Cook

George²,

Silvestre³

et al. 2002

Sexually Transmitted Infections

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Objectives: Few data are available on the prevalence of sexually transmitted diseases (STDs) in men who have sex with men (MSM), making it difficult to develop STD screening guidelines for this population. The objective of the study was to determine the prevalence of urethral infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae within a large, community based population of MSM, and to assess the feasibility of rectal screening in this population. Methods: This was a cross sectional study of 566 MSM, who were predominantly middle aged, white, asymptomatic, and engaged in sex with multiple partners. All provided a urine sample to screen for chlamydial and gonorrhoea infections using a PCR assay; rectal screening was performed on 48 participants.Results: Urethral C trachomatis infections were detected in 1/566 participants (prevalence 0.2%, 95% CI 0.004% to 1.0%), and rectal C trachomatis infections were detected in 2/48 men (prevalence 4.2%, 95% CI 0.5% to 14.2%). No gonorrhoea infections were detected, and none of the 117 HIV positive men had either infection. Conclusions: Chlamydial and gonorrhoea infections were uncommon in this sample of MSM, even among those with multiple sexual partners or HIV infection. These data call into question recommendations to screen all MSM based on their individual sexual behaviours or HIV. Additional data are needed on the prevalence of these infections in MSM from different settings.M any men who have sex with men (MSM) continue to practise risky sexual behaviours, despite the ongoing risk of HIV infection. 1 2 These behaviours may lead to sexually transmitted infections resulting from Chlamydia trachomatis or Neisseria gonorrhoeae, which continue to be common among some populations of MSM. [1][2][3][4][5][6][7][8][9][10][11] If not detected and treated, these infections may result in painful clinical syndromes such as urethritis, epididymitis, or proctitis, 12 and they also appear to increase the risk of HIV transmission. [13][14][15][16] Because chlamydial and gonorrhoea infections are often asymptomatic, it has been suggested that routine screening for these infections should be performed among at-risk MSM in order to prevent disease complications and to reduce the risk of HIV transmission. 16 17 To date, nearly all data on the prevalence of chlamydial and gonorrhoea infections among MSM have come from men attending sexually transmitted disease (STD) clinics, which may not be representative of other MSM in the community. The most recent recommendations from the US Preventive Services Task Force conclude that there is insufficient information available to recommend for or against screening for chlamydial or gonorrhoea infections among MSM. 18 Until better data are available, the US Centers for Disease Control and Prevention recommends annual STD screening for at-risk MSM, defined as those who are young, who have more than one sex partner per year, or who have HIV infection. 17 Data from MSM outside of STD clinics are urgently needed to confirm current recomme...

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mentioning

confidence: 99%

Prevalence of chlamydia and gonorrhoea among a population of men who have sex with men

Cook

George²,

Silvestre³

et al. 2002

Sexually Transmitted Infections

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“…Acute inflammation of the epididymides could lead to decreased fertility even in the absence of occlusion (6,11,13,31). Furthermore, the role that C. trachomatis may have in Reiter's syndrome, sexually acquired reactive arthritis, proctitis, prostatitis, and granulomatous bowel disease requires further investigation (6,24,33,36,39).…”

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confidence: 99%

New Murine Model for the Study of Chlamydia trachomatis Genitourinary Tract Infections in Males

2004

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The lack of an experimental model has significantly limited the understanding of the pathogenesis of Chlamydia trachomatis infections in males. In an attempt to establish a model using the natural route of infection, we inoculated male mice in the meatus urethra. To establish the 50% infectious dose (ID 50 ), C3H/HeN (H-2 k ) male mice were inoculated in the meatus urethra with doses ranging from 10 1 to 10 7 inclusion-forming units (IFU) of C. trachomatis mouse pneumonitis biovar (MoPn) and were euthanized at 10 days postinfection (p.i.). Approximately 50% of the animals inoculated with 5 ؋ 10 4 IFU had positive cultures of the urethra, urinary bladder, epididymides, and/or testes. Subsequently, to characterize the course of the infection, a group of animals was inoculated with 10 6 IFU/mouse (20 times the ID 50 ). Positive cultures from the urethra, urinary bladder, epididymides, and testes were obtained from the animals. The infection peaked in the first 2 weeks p.i. and subsequently declined over the 7 weeks of observation. C. trachomatis-specific antibodies were first detected in serum by 2 weeks p.i. and rose over the period of observation. The titers of immunoglobulin G2a (IgG2a) were 16-fold higher than those of IgG1. A lymphoproliferative assay using splenocytes and local lymph nodes showed a strong cell-mediated immune response. Levels of gamma interferon were significantly higher than those of interleukin-4 in the supernatants from stimulated lymphocytes. An acute inflammatory infiltrate consisting of polymorphonuclear leukocytes was detected in the urethra at 1 week p.i. At 3 weeks p.i., a mixed acute and chronic inflammatory infiltrate was observed in the urethra that by 5 to 6 weeks was mainly composed of mononuclear cells. Similar findings were also observed in the urinary bladder, although the inflammatory infiltrate was delayed by approximately a week relative to that in the urethra. Sections of the epididymides showed a focal acute inflammatory infiltrate at 2 weeks p.i. Immunohistochemical staining demonstrated multiple chlamydial inclusions in the epithelium of the urethra and urinary bladder. No chlamydial inclusions were observed in the epididymides or testes. In conclusion, inoculation of male mice in the meatus urethra with C. trachomatis MoPn results in an infection of the genitourinary tract that closely parallels that described in humans. This model should help to characterize the pathogenesis of chlamydial infections in males and to test therapeutic and preventive measures.

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“…Zur Manifestationshäufigkeit im Anorektum liegen keine Zahlen vor; es muss jedoch aufgrund der vorliegenden Literatur davon ausgegangen werden, dass anale Sexualpraktiken -besonders bei häufig wechselnden und homosexuellen Sexualpartnern -ein deutlich erhöhtes Infektions risiko bergen [7,11,47,61].…”

Section: Häufigkeitunclassified

“…Betroffen ist die anorektale Übergangszone unter Einschluss des Plexus hämorrhoidalis [47]. [48,49,61].…”

Section: Lokalisationunclassified

Leitlinie: Anorektale Manifestationen sexuell �bertragbarer Erkrankungen (Entwicklungsstufe S1, IDA -)

Lenhard

2005

Coloproctol

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Chlamydial proctitis?

Cited by 8 publications

References 8 publications

Prevalence of chlamydia and gonorrhoea among a population of men who have sex with men

Prevalence of chlamydia and gonorrhoea among a population of men who have sex with men

New Murine Model for the Study of Chlamydia trachomatis Genitourinary Tract Infections in Males

Leitlinie: Anorektale Manifestationen sexuell �bertragbarer Erkrankungen (Entwicklungsstufe S1, IDA -)

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