Abstract
Pharyngeal chlamydial and gonococcal infections can occur as a consequence of oral sex, and they also can be transmitted from the pharynx to the genital tract of sex partners. There have been many reports on the prevalence of pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in men who have sex with men; however, there have been few reports on the prevalence of these pathogens in the pharynges of heterosexual men. In this study, we determined the prevalence of pharyngeal C. trachomatis and N. gonorrhoeae in 42 heterosexual men diagnosed with urethritis. Pharyngeal swabs and first-voided urine specimens were tested using the Gen-Probe APTIMA Combo 2 transcription-mediated amplification assay. The prevalence of pharyngeal C. trachomatis and N. gonorrhoeae in patients with urethritis was 2.4 % (1/42) and 11.9 % (5/42), respectively. Among patients with either chlamydial or gonococcal urethritis, 9.1 % (1/11) and 25.0 % (5/20) had pharyngeal C. trachomatis or N. gonorrhoeae, respectively. Our results suggest that screening for pharyngeal colonization by N. gonorrhoeae and C. trachomatis using validated nucleic acid amplification tests should be performed in heterosexual men diagnosed with urethritis.
Similar content being viewed by others
References
Johnson AM, Mercer CH, Erens B, Copas AJ, McManus S, Wellings K, et al. Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet. 2001;358:1835–42.
Bradshaw CS, Tabrizi SN, Read TR, Garland SM, Hopkins CA, Moss LM, et al. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with urogenital exposure. J Infect Dis. 2006;193:336–45.
Edwards S, Came C. Oral sex and transmission of non-viral STIs. Sex Transm Infect. 1998;74:95–100.
Lafferty WE, Hughes JP, Handsfield HH. Sexually transmitted diseases in men who have sex with men. Acquisition of gonorrhea and nongonococcal urethritis by fellatio and implications for STD/HIV prevention. Sex Transm Dis. 1997;24:272–8.
Hamasuna R, Hoshina S, Imai H, Jensen JS, Osada Y. Usefulness of oral wash specimens for detecting Chlamydia trachomatis from high-risk groups in Japan. Int J Urol. 2007;14:473–5.
Dan M, Poch F, Amitai Z, Gefen D, Shohat T. Pharyngeal gonorrhea in female sex workers: response to a single 2-g dose of azithromycin. Sex Transm Dis. 2006;33:512–5.
Kent CK, Chaw JK, Wong W, Liska S, Gibson S, Hubbard G, et al. Prevalence of rectal, urethral, and pharyngeal chlamydia and gonorrhea detected in 2 clinical settings among men who have sex with men: San Francisco, California, 2003. Clin Infect Dis. 2005;41:67–74.
Gunn RA, O’Brien CJ, Lee MA, Gilchick RA. Gonorrhea screening among men who have sex with men: value of multiple anatomic site testing, San Diego, California, 1997–2003. Sex Transm Dis. 2008;35:845–8.
Mimiaga MJ, Helms DJ, Reisner SL, Grasso C, Bertrand T, Mosure DJ, et al. Gonococcal, chlamydial, and syphilis infection positivity among MSM attending a large primary care clinic, Boston, 2003 to 2004. Sex Transm Dis. 2009;36:507–11.
Schachter J, Moncagda J, Liska S, Shayevich C, Klasusner JD. Nucleic acid amplification tests in the diagnosis of chlamydial and gonococcal infections of the oropharynx and rectum in men who have sex with men. Sex Transm Dis. 2008;35:637–42.
Bachmann LH, Johnson RE, Cheng H, Markowitz LE, Papp JR, Hook EW 3rd. Nucleic acid amplification tests for diagnosis of Neisseria gonorrhoeae oropharyngeal infections. J Clin Microbiol. 2009;47:902–7.
Schachter J, Chemesky MA, Willis DE, Fine PM, Martin DH, Fuller D, et al. Vaginal swabs are the specimens of choice when screening for Chlamydia trachomatis and Neisseria gonorrhoeae: results from a multicenter evaluation of the APTIMA assays for both infections. Sex Transm Dis. 2005;32:725–8.
Farrell DJ. Evaluation of AMPLICOR Neisseria gonorrhoeae PCR using cppB nested PCR and 16S rRNA PCR. J Clin Microbiol. 1999;37:386–90.
Van Der Pol B, Martin DH, Schachter J, Quinn TC, Gaydos CA, Jones RB, et al. Enhancing the specificity of the COBAS AMPLICOR CT/NG test for Neisseria gonorrhoeae by retesting specimens with equivocal results. J Clin Microbiol. 2001;39:3092–8.
Imai H, Shinohara H, Nakao H, Tsukino H, Hamasuna R, Katoh T. Prevalence and risk factors of asymptomatic chlamydial infection among students in Japan. Int J STD AIDS. 2004;15:408–14.
Soendjojo A. Gonococcal urethritis due to fellatio. Sex Transm Dis. 1983;10:41–2.
Takahashi S, Kurimura Y, Hashimoto J, Takeyama K, Koroku M, Tsukamoto T, et al. Pharyngeal Neisseria gonorrhoeae detection in oral-throat wash specimens of male patients with urethritis. J Infect Chemother. 2008;14:442–4.
Hamasuna R, Takahashi S, Uehara S, Matsumoto T. Should urologists care for the pharyngeal infection of Neisseria gonorrhoeae or Chlamydia trachomatis when we treat male urethritis? J Infect Chemother. 2012 [Epub ahead of print].
Papp JR, Ahrens K, Phillips C, Kent CK, Philip S, Klausner JD. The use and performance of oral-throat rinses to detect pharyngeal Neisseria gonorrhoeae and Chlamydia trachomatis infections. Diagn Microbiol Infect Dis. 2007;59:259–64.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Wada, K., Uehara, S., Mitsuhata, R. et al. Prevalence of pharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae among heterosexual men in Japan. J Infect Chemother 18, 729–733 (2012). https://doi.org/10.1007/s10156-012-0410-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10156-012-0410-y