Orogenital Contact and the Isolation of Neisseria gonorrhoeae, Mycoplasma hominis, and Ureaplasma urealyticum from the Pharynx

Prevalence, incidence and risk factors for pharyngeal gonorrhoea in a community-based HIV-negative cohort of homosexual men in Sydney, Australia

“…This may partly reflect the lack of association of symptoms with pharyngeal gonorrhoea compared with anogenital infections which more commonly lead to clinical presentation 21. This lack of association of sore throat with infection among HIM participants supports findings from other community-based3 4 and clinic-based9 21 22 MSM populations. The relatively lower prevalence of unprotected anal as compared with unprotected oral sex that has been described in homosexual men13 is likely to be another reason why pharyngeal infection is more common than infection at other sites.…”

“…Several studies1 4 9 21 have reported an independent association of receptive penile-oral sex with pharyngeal gonorrhoea infection among MSM. Although the relative risks associated with this behaviour in the HIM cohort were in the order of 3, it was not statistically significant.…”

“…The high prevalence of gonorrhoea among MSM is not surprising, given that the gonococcus is more efficiently transmitted via fellatio than cunnilingus,9 oral sexual behaviours are substantially more common among homosexual than heterosexual men,11 12 and behaviour change since the mid-1980s has led to reduced rates of unprotected anal, but not oral, intercourse 13. We have previously described an association of urethral and anal gonorrhoea with a range of oro-genital and oro-anal sexual behaviours14 in the Health in Men (HIM) cohort.…”

Failure to detect Mycoplasma genitalium in the pharynges of female sex workers in Japan

“…9 Isolation from the pharynges of both men and women seeking treatment at several clinics in the United States yielded respective prevalence rates of M. hominis and U. urealyticum, including U. parvum (biovar 1) and U. urealyticum (biovar 2), which were not distinguishable from each other at the time of isolation, of 14.3% and 14.8%. 3 A history of having performed fellatio was signifi cantly associated with M. hominis and U. urealyticum pharyngeal infection. M. genitalium, which is detected in both urethral and cervical specimens, was isolated from throat specimens from military recruits participating in an inactivated M. pneumoniae vaccine fi eld trial and from patients hospitalized with pneumonia.…”

“…2 A history of having performed fellatio has been signifi cantly associated with M. hominis and U. urealyticum pharyngeal infection. 3 Conversely, some respiratory tract organisms, including Neisseria meningitidis, Moraxella catarrhalis, Haemophilus infl uenzae, and Mycoplasma pneumoniae, are isolated from the genitals of men and women. 2 In cases of male urethritis, the transmission of N. gonorrhoeae, N. meningitidis, and M. catarrhalis from the throat to the urethra by fellatio has been reported.…”