BACKGROUND: The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened annually for gonorrhea (GC) infection at the urethral, pharyngeal, or rectal site based on recent sexual exposure. This evaluation estimated the proportion of GC infections in MSM that would be missed if only urethral or urine specimens were tested. METHODS: Culture of specimens from all sites and urethral (or urine) nucleic acid amplification test (NAAT) results for gonorrhea were reviewed for all identified MSM attending the San Diego County STD Clinic during 1997-2003. RESULTS: During the 7-year period, 7333 MSM were tested for GC and 1157 (15.8\%) had a positive test result at \textgreater or =1 sites. Overall, 10.8\% of urethral, 9.8\% of rectal, and 4.0\% of pharyngeal tests were positive. Among 5812 patients who had a urethral and a rectal or pharyngeal specimen tested, 970 were positive and among those, 369 (38\%) had a negative test result in their urethral or urine specimen. Among 163 patients who had only a rectal and/or pharyngeal specimen tested for GC, 16 (9.8\%) were positive. If the clinic had tested only urethral or urine specimens, 33\% of total gonorrhea cases among MSM 385 (369 + 16) of 1157 would have been missed. CONCLUSION: GC screening strategies for MSM should include testing of rectal and pharyngeal specimens based on exposure. Given the decline of culture availability, efforts are needed to encourage laboratories to validate NAATs for rectal/pharyngeal specimens, which will likely increase exposure-based screening of MSM.
%0 Journal Article
%1 gunn_gonorrhea_2008
%A Gunn, Robert A
%A O'Brien, Catherine J
%A Lee, Marjorie A
%A Gilchick, Robert A
%D 2008
%J Sexually Transmitted Diseases
%K Acid Adult, Amplification Bacterial, Behavior, California, Culture Diseases, Gonorrhea, Homosexuality, Humans, Male, Mass Media, Neisseria Nucleic Pharyngeal Pharynx, Rectal Rectum, Screening, Sexual Sexually Techniques, Transmitted Urethra, Urethritis gonorrhoeae,
%N 10
%P 845--848
%R 10.1097/OLQ.0b013e318177ec70
%T Gonorrhea screening among men who have sex with men: value of multiple anatomic site testing, San Diego, California, 1997-2003
%U http://www.ncbi.nlm.nih.gov/pubmed/18607315
%V 35
%X BACKGROUND: The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened annually for gonorrhea (GC) infection at the urethral, pharyngeal, or rectal site based on recent sexual exposure. This evaluation estimated the proportion of GC infections in MSM that would be missed if only urethral or urine specimens were tested. METHODS: Culture of specimens from all sites and urethral (or urine) nucleic acid amplification test (NAAT) results for gonorrhea were reviewed for all identified MSM attending the San Diego County STD Clinic during 1997-2003. RESULTS: During the 7-year period, 7333 MSM were tested for GC and 1157 (15.8\%) had a positive test result at \textgreater or =1 sites. Overall, 10.8\% of urethral, 9.8\% of rectal, and 4.0\% of pharyngeal tests were positive. Among 5812 patients who had a urethral and a rectal or pharyngeal specimen tested, 970 were positive and among those, 369 (38\%) had a negative test result in their urethral or urine specimen. Among 163 patients who had only a rectal and/or pharyngeal specimen tested for GC, 16 (9.8\%) were positive. If the clinic had tested only urethral or urine specimens, 33\% of total gonorrhea cases among MSM 385 (369 + 16) of 1157 would have been missed. CONCLUSION: GC screening strategies for MSM should include testing of rectal and pharyngeal specimens based on exposure. Given the decline of culture availability, efforts are needed to encourage laboratories to validate NAATs for rectal/pharyngeal specimens, which will likely increase exposure-based screening of MSM.
@article{gunn_gonorrhea_2008,
abstract = {{BACKGROUND:} The Centers for Disease Control and Prevention recommends that men who have sex with men {(MSM)} be screened annually for gonorrhea {(GC)} infection at the urethral, pharyngeal, or rectal site based on recent sexual exposure. This evaluation estimated the proportion of {GC} infections in {MSM} that would be missed if only urethral or urine specimens were tested. {METHODS:} Culture of specimens from all sites and urethral (or urine) nucleic acid amplification test {(NAAT)} results for gonorrhea were reviewed for all identified {MSM} attending the San Diego County {STD} Clinic during 1997-2003. {RESULTS:} During the 7-year period, 7333 {MSM} were tested for {GC} and 1157 (15.8\%) had a positive test result at {\textgreater} or =1 sites. Overall, 10.8\% of urethral, 9.8\% of rectal, and 4.0\% of pharyngeal tests were positive. Among 5812 patients who had a urethral and a rectal or pharyngeal specimen tested, 970 were positive and among those, 369 (38\%) had a negative test result in their urethral or urine specimen. Among 163 patients who had only a rectal and/or pharyngeal specimen tested for {GC,} 16 (9.8\%) were positive. If the clinic had tested only urethral or urine specimens, 33\% of total gonorrhea cases among {MSM} [385 (369 + 16) of 1157] would have been missed. {CONCLUSION:} {GC} screening strategies for {MSM} should include testing of rectal and pharyngeal specimens based on exposure. Given the decline of culture availability, efforts are needed to encourage laboratories to validate {NAATs} for rectal/pharyngeal specimens, which will likely increase exposure-based screening of {MSM.}},
added-at = {2011-03-11T10:05:34.000+0100},
author = {Gunn, Robert A and {O'Brien}, Catherine J and Lee, Marjorie A and Gilchick, Robert A},
biburl = {https://www.bibsonomy.org/bibtex/20e09fe69944129f2d5f464112d8e8da3/jelias},
doi = {10.1097/OLQ.0b013e318177ec70},
interhash = {f94c53c9c017c3291c9a97c22f256f07},
intrahash = {0e09fe69944129f2d5f464112d8e8da3},
issn = {1537-4521},
journal = {Sexually Transmitted Diseases},
keywords = {Acid Adult, Amplification Bacterial, Behavior, California, Culture Diseases, Gonorrhea, Homosexuality, Humans, Male, Mass Media, Neisseria Nucleic Pharyngeal Pharynx, Rectal Rectum, Screening, Sexual Sexually Techniques, Transmitted Urethra, Urethritis gonorrhoeae,},
month = oct,
note = {{PMID:} 18607315},
number = 10,
pages = {845--848},
shorttitle = {Gonorrhea screening among men who have sex with men},
timestamp = {2011-03-11T10:06:51.000+0100},
title = {Gonorrhea screening among men who have sex with men: value of multiple anatomic site testing, San Diego, California, 1997-2003},
url = {http://www.ncbi.nlm.nih.gov/pubmed/18607315},
volume = 35,
year = 2008
}