Enrique Rayo, Giulia Malingamba, Hanna Marti, Delia Onorini, Cory Ann Leonard, Nicola Low, Benjamin Hampel, Nicole Borel
{"title":"<i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> bacterial loads in men who have sex with men on pre-exposure prophylaxis: a cross-sectional study.","authors":"Enrique Rayo, Giulia Malingamba, Hanna Marti, Delia Onorini, Cory Ann Leonard, Nicola Low, Benjamin Hampel, Nicole Borel","doi":"10.1136/sextrans-2025-056579","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong><i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG) are the most commonly reported sexually transmitted infections globally. Anorectal CT/NG detection among men who have sex with men (MSM) and coinfections is common. Epidemiological studies suggest that CT/NG coinfections might result in greater bacterial load and transmissibility than single infection. The purpose of this study was to compare bacterial load and symptoms between CT/NG single and coinfections in MSM.</p><p><strong>Methods: </strong>MSM positive for CT or NG on a triple swab (throat, urethra and rectal locations combined) were enrolled. Before treatment, they self-collected anorectal swabs. Bacterial loads for CT/NG were calculated using real-time PCR and compared between single or coinfected individuals, with or without rectal symptoms.</p><p><strong>Results: </strong>We enrolled 382 MSM from December 2021 to December 2024. Among all samples: total CT (n=114), total NG (n=125), CT/NG coinfection 29/382 (7.6%). The bacterial loads in single and coinfected samples were comparable. The mean difference between CT alone and CT/NG was 0.40 target copies/mL (95% CI (-0.09 to 0.89), p value=0.107). The mean difference for NG alone and CT/NG was 0.24 copies/mL (95% CI (-0.49 to 0.99), p value=0.498). Among 382 MSM, 15.4% (n=59/382) experienced anorectal symptoms. There was no statistical difference in bacterial burdens between symptomatic and asymptomatic (CT difference of the means 0.52 copies/mL, 95% CI (-0.51 to 1.55); p value=0.313) (NG difference of the means 0.63, CI (0.01 to 1.28); p value=0.05).</p><p><strong>Conclusions: </strong>In contrast to prior research, we found similar bacterial burdens in anorectal MSM samples with single CT/NG versus coinfection. Further research is needed to understand the clinical implications of CT/NG coinfections. Future studies should investigate factors influencing anorectal CT/NG bacterial burden, transmissibility and susceptibility, including the function of pre-exposure prophylaxis and the rectal microbiota.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sexually Transmitted Infections","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/sextrans-2025-056579","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most commonly reported sexually transmitted infections globally. Anorectal CT/NG detection among men who have sex with men (MSM) and coinfections is common. Epidemiological studies suggest that CT/NG coinfections might result in greater bacterial load and transmissibility than single infection. The purpose of this study was to compare bacterial load and symptoms between CT/NG single and coinfections in MSM.
Methods: MSM positive for CT or NG on a triple swab (throat, urethra and rectal locations combined) were enrolled. Before treatment, they self-collected anorectal swabs. Bacterial loads for CT/NG were calculated using real-time PCR and compared between single or coinfected individuals, with or without rectal symptoms.
Results: We enrolled 382 MSM from December 2021 to December 2024. Among all samples: total CT (n=114), total NG (n=125), CT/NG coinfection 29/382 (7.6%). The bacterial loads in single and coinfected samples were comparable. The mean difference between CT alone and CT/NG was 0.40 target copies/mL (95% CI (-0.09 to 0.89), p value=0.107). The mean difference for NG alone and CT/NG was 0.24 copies/mL (95% CI (-0.49 to 0.99), p value=0.498). Among 382 MSM, 15.4% (n=59/382) experienced anorectal symptoms. There was no statistical difference in bacterial burdens between symptomatic and asymptomatic (CT difference of the means 0.52 copies/mL, 95% CI (-0.51 to 1.55); p value=0.313) (NG difference of the means 0.63, CI (0.01 to 1.28); p value=0.05).
Conclusions: In contrast to prior research, we found similar bacterial burdens in anorectal MSM samples with single CT/NG versus coinfection. Further research is needed to understand the clinical implications of CT/NG coinfections. Future studies should investigate factors influencing anorectal CT/NG bacterial burden, transmissibility and susceptibility, including the function of pre-exposure prophylaxis and the rectal microbiota.
期刊介绍：
Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
