Sexually transmitted coinfections in patients with a new episode of syphilis.

Abstract

Objective: Sexually transmitted infections (STI) are a major public health problem with an increasing trend worldwide. Syphilis is often associated with other STI. We measured the STI coinfection rate in a sample of patients presenting with syphilis.

Methods: In a prospective interventional study patients attending the STI clinic in Brescia, Italy with a new diagnosis of syphilis were systematically tested for Chlamydia trachomatis, Mycoplasma genitalium and Neisseria gonorrhoeae at genital, anal, and oral sites using molecular methods. Serological markers for HIV, HBV, and HAV were also searched. Statistical methods were used to measure the association between STI coinfections and demographic, behavioural and clinical variables.

Results: Among 101 patients with syphilis a concomitant STI was identified in 31 (30,7%) for a total of 38 STIs infections: C.trachomatis (17 - 16.8%), M.genitalium (10 - 9.9%) and N.gonorrhoeae (9 - 8.9%). Two additional patients with positive HBsAg were detected. Age was the only independent variable statistically inversely associated to a higher chance of STIs coinfection.

Conclusions: In the study setting screening patients with syphilis for other STIs allowed to detect an STI coinfection in almost a third of the cases. Most associated coinfections were asymptomatic providing further public health benefit.