Routine universal testing versus selective or incidental testing for oropharyngeal Neisseria gonorrhoeae in women in the Netherlands: a retrospective cohort study

Liere, Geneviève A F S van; Dukers-Muijrers, Nicole H. T. M.; Kuizenga-Wessel, Sophie; Wolffs, Petra; Hoebe, Christian J. P. A.

doi:10.1016/s1473-3099(20)30594-6

Cited by 9 publications

(8 citation statements)

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“…Our study has shown that 46% of women (115/252) had both oropharyngeal and urogenital gonorrhoea. This is consistent with a large Dutch study of 545 750 women with selective testing for oropharyngeal gonorrhoea, showing 30% of women (349/1150) with urogenital gonorrhoea also had oropharyngeal gonorrhoea [25]. These data are also similar to those of our previous study which showed that oropharyngeal gonorrhoea is common among heterosexual women (49%) and heterosexual men (50%) who reported sexual contact with someone known to have gonorrhoea [16].…”

Section: Discussionsupporting

confidence: 91%

“…All these studies concluded that oropharyngeal gonorrhoea infection is relatively common among women and heterosexual men with urogenital gonorrhoea infection, and the small sample sizes in all these studies are mainly because testing for oropharyngeal gonorrhoea in heterosexual women and heterosexual men is not widely adopted or recommended. Past studies have shown that about 18e40% and 18e89% of oropharyngeal gonorrhoea infections would have been missed by urogenital-only testing among women and heterosexual men, respectively [16,23,25].…”

Section: Discussionmentioning

confidence: 99%

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Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Allen

Fairley

Chen

et al. 2021

Clinical Microbiology and Infection

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Objectives: There is limited evidence about the transmission and prevalence of oropharyngeal gonorrhoea in heterosexuals. From August 2017, Melbourne Sexual Health Centre (MSHC) began testing for oropharyngeal gonorrhoea among heterosexuals with untreated urogenital gonorrhoea. This study aims to determine the positivity of oropharyngeal gonorrhoea among heterosexuals diagnosed with urogenital gonorrhoea at MSHC between August 2017 and May 2020. Methods: We included individuals who had oropharyngeal gonorrhoea testing within 30 days of initial testing. We reported the number and proportion of oropharyngeal gonorrhoea positivity, stratified by gender and contact of gonorrhoea. The c 2 test was performed to compare the oropharyngeal gonorrhoea positivity between groups. Results: Of 617 individuals with untreated urogenital gonorrhoea, 424 (68.7%) were tested for oropharyngeal gonorrhoea. Oropharyngeal gonorrhoea positivity was 38.9% (95%CI 34.2e43.7%, 165/424), and was higher in women than in men (115/252, 45.6% versus 50/172, 29.1%, p ¼ 0.001). Furthermore, oropharyngeal gonorrhoea positivity was higher among individuals who were contacts of gonorrhoea cases compared to those who were not (29/44, 65.9% versus 136/380, 35.8%, p < 0.001). There was also no significant difference between women who were sex workers and those who were not (30/78, 38.5% versus 85/174, 48.9%, p ¼ 0.126). Conclusions: Our data suggest that oropharyngeal gonorrhoea infection is common among heterosexual women and heterosexual men with untreated urogenital gonorrhoea. Testing heterosexual women and heterosexual men for oropharyngeal gonorrhoea will identify a significant proportion with unrecognized oropharyngeal infections whose recommended treatment is different in some countries.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Allen

Fairley

Chen

et al. 2021

Clinical Microbiology and Infection

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show abstract

“…The classification was based on practical experience used in previous research. 19 A clinic calendar year was defined as routine universal testing when more than 85% of the women attending the clinic that year (starting in January) were tested for pharyngeal C trachomatis. A clinic calendar year was defined as selective testing when 5-85% of women were tested pharyngeally and a clinic calendar year was defined as incidental testing when less than 5% was tested.…”

Section: Implications Of All the Available Evidencementioning

confidence: 99%

Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort study

Evers

Liere

Dukers-Muijrers

et al. 2022

The Lancet Infectious Diseases

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“…9 Several settings have implemented selective testing for oropharyngeal gonorrhoea among heterosexuals based on risk profiles. [10][11][12] It is estimated that 18-46% of heterosexuals reporting sexual contact with partners with gonorrhoea had oropharyngeal gonorrhoea, 12 and approximately 40% of heterosexuals diagnosed with urogenital gonorrhoea had oropharyngeal gonorrhoea. 11 These data suggest that oropharyngeal gonorrhoea is relatively common in certain groups.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study of male and female kissing partners among men who have sex with men

et al. 2022

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Background. Kissing may be a risk factor for gonorrhoea. Past studies have focused on male kissing partners among men who have sex with men (MSM). This study aimed to examine the kissing practices of MSM who kiss male and female partners. Methods. We conducted a crosssectional survey at the Melbourne Sexual Health Centre (MSHC) between March and April 2019. Men attending the MSHC, aged ≥16 years who reported any sexual contact with another man in the previous 12 months were invited to participate in the survey. Data about the number of kissing-only (kissing without sex), kissing-with-sex, and sex-only (having sex without kissing) partners in the previous 3 months were collected. Men were asked to report the number of male and female partners separately. Results. There were 357 MSM included in the survey. Most men (97.2%, n = 347) had kissed or had sex with another man, whereas 16.0% (n = 57) had kissed or had sex with a female partner in the previous 3 months. Of the 57 men, 26.3% (n = 15) had only kissed a female partner without having sex. The mean number of male partners for kissing-only was 5.5 (s.d. = 6.6), kissing-with-sex was 5.0 (s.d. = 6.6) and sex-only was 3.9 (s.d. = 4.3). The mean number of female partners for kissing-only was 4.2 (s.d. = 6.9), kissing-with-sex was 3.8 (s.d. = 4.9) and sex-only was 3.2 (s.d. = 3.4). Conclusion. MSM not only kiss men in the absence of sex, but also kiss women in the absence of sex. Gonorrhoea could be transmitted between MSM and women via kissing in the absence of sex.

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Routine universal testing versus selective or incidental testing for oropharyngeal Neisseria gonorrhoeae in women in the Netherlands: a retrospective cohort study

Cited by 9 publications

References 46 publications

Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort study

A cross-sectional study of male and female kissing partners among men who have sex with men

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