Gonorrhoea diagnoses in a network of STI clinics in Spain during the period 2006–2010: differences by sex and transmission route

Abstract

BackgroundGonorrhoea infection is one of the most common bacterial sexually transmitted infections and an important cause of morbidity and serious complications. The objectives of this paper are: a) to describe gonorrhoea cases diagnosed in a network of 15 (out of 16) STI clinics in Spain during 2006–2010; b) to analyse differences among men who have sex with men (MSM), men who have sex exclusively with women (MSW) and women; and c) to evaluate factors associated to with HIV co-infection.MethodsAll gonorrhoea cases diagnosed in the network were included (25.7% of total cases notified in Spain). Data were collected by clinical staff. Descriptive/bivariate analyses were carried out stratifying by sex and transmission category; association and trends were evaluated using the chi-square test. Factors associated with HIV co-infection were estimated using a logistic regression model.Results2385 cases were included: 55.3% among MSM, 31.3% among MSW and 13.3% among females; cases among MSM increased from 55.8% in 2006 to 62.9% in 2010 while no trends were found among the other two groups.Most MSM cases were Spaniards (72%), aged 25–34 years (46%), 49% reported previous STI and 25% concurrent STI (excluding HIV); casual partners were the commonest source of infection, and 21% of cases had rectal gonorrhoea. MSW cases did not differ from MSM by age, origin or source of infection, but frequencies of prior or concurrent STI were lower. Female cases were younger than male, were mostly foreigners (58%), and 41% were sex workers; concurrent STI (other than HIV) were diagnosed in 30%; 20.4% had symptoms (72.5% and 89.2% in MSM and MSW), and pharyngeal location was present in 30%.HIV co-infection was highest in MSM (20.9%). Co-infection was associated with age > 35 years, low educational level, being Western European or Latin-American, being MSM, having previous or concurrent STI and reporting contact with an HIV-infected partner; it was inversely associated with female sex.ConclusionDifferences by sex, transmission route and origin should be considered when implementing care and preventive programmes for gonorrhoea, and MSM are a priority group for intervention, in particular HIV-infected MSM.

Extragenital Infections Caused byChlamydia trachomatisandNeisseria gonorrhoeae: A Review of the Literature

“…A total of nine studies evaluated the prevalence of extragenital infections due to N. gonorrhoeae or C. trachomatis in MSW [ 19 , 26 , 27 , 33 , 36 , 38 , 44 , 45 , 100 ] ( Table 3 ). Overall, there are limited prevalence data of extragenital infections among MSW.…”

Impacto de los movimientos migratorios en la resistencia bacteriana a los antibióticos

“…Mientras que en Estados Unidos, el 77% de los casos ocurrieron en población inmigrante 28 , los datos en España son dispares, lo que pone de manifiesto la ausencia de redes de vigilancia a nivel nacional y la escasez de estudios comparativos entre la población autóctona e inmigrantes. En los escasos estudios compa-rativos que existen, el 28% de los casos de gonococia son descritos en población inmigrante 29 , siendo los grupos mas prevalentes los inmigrantes de América Latina (17%) y Europa Central (10%).…”

Comparison of an in-house real-time duplex PCR assay with commercial HOLOGIC® APTIMA assays for the detection of Neisseria gonorrhoeae and Chlamydia trachomatis in urine and extra-genital specimens

“…In addition to MSM, some of whom reside within high-risk core groups or who may act as a bridge for bacterial STI transmission to the wider community [28], there is a large heterosexual population at risk of infection at extra-genital sites [16, 29]. Treatment failures in patients with N. gonorrhoeae infection due to antimicrobial resistance or reduced antimicrobial susceptibility are well documented [23, 30–32].…”