Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

Cornelisse, Vincent J; Walker, Sandra; Phillips, Tiffany R; Hocking, Jane S; Bradshaw, Catriona; Lewis, David A.; Prestage, Garrett; Grulich, Andrew E.; Fairley, Christopher K.; Chow, Eric P F

doi:10.1136/sextrans-2017-053381

Cited by 31 publications

(50 citation statements)

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“…The scarcity of nonpathogenic Neisseria within other bodily niches makes it unlikely that the skin, genital or anorectal site act as an intermediate in this transfer process. As already noted, different types of evidence suggest that pathogenic Neisseria species can be transmitted by kissing [6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Our findings support to the idea that the genus Neisseria can be transmitted by kissing.…”

Section: Discussionsupporting

confidence: 90%

“…Several studies have found that kissing is a risk factor for meningococcal disease [9][10][11] or carriage [12][13][14][15] among students. Likewise, N. gonorrhoeae can be readily cultured from saliva [16][17][18], saliva use as a lubricant is a risk factor for rectal gonorrhea [19], kissing [20][21][22] as well as having a main partner with pharyngeal gonorrhea [23] may be risk factors for pharyngeal gonorrhea and a mathematical transmission model showed that oro-oral transmission is essential to generate the actual prevalence of gonorrhea among MSM [6].…”

Section: Introductionmentioning

confidence: 99%

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Commensal Neisseria Are Shared between Sexual Partners: Implications for Gonococcal and Meningococcal Antimicrobial Resistance

et al. 2020

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Antimicrobial resistance in pathogenic Neisseria parallels reduced antimicrobial susceptibility in commensal Neisseria in certain populations, like men who have sex with men (MSM). Although this reduced susceptibility can be a consequence of frequent antimicrobial exposure at the individual level, we hypothesized that commensal Neisseria are transmitted between sexual partners. We used data from a 2014 microbiome study in which saliva and tongue swabs were taken from 21 couples (42 individuals). Samples were analyzed using 16S rRNA gene sequencing. We compared intimate partners with unrelated individuals and found that the oral Neisseria communities of intimate partners were more similar than those of unrelated individuals (average Morisita-Horn dissimilarity index for saliva samples: 0.54 versus 0.71, respectively (p = 0.005); and for tongue swabs: 0.42 versus 0.63, respectively (p = 0.006)). This similarity presumably results from transmission of oral Neisseria through intimate kissing. This finding suggests that intensive gonorrhea screening in MSM may, via increased antimicrobial exposure, promote, rather than prevent, the emergence and spread of antimicrobial resistance in Neisseria. Non-antibiotic strategies such as vaccines and oral antiseptics could prove more sustainable options to reduce gonococcal prevalence.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Commensal Neisseria Are Shared between Sexual Partners: Implications for Gonococcal and Meningococcal Antimicrobial Resistance

et al. 2020

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“…The second study by Cornelisse et al . was an age‐matched 1:2 case–control study conducted among 531 MSM in Melbourne in 2015 . Similarly, the study found that men who kissed their casual partners in the last three months were 2.2 (95% CI: 1.3 to 3.6) times more likely to have oropharyngeal gonorrhoea than those who did not kiss their casual partners in the univariable analysis.…”

Section: Resultsmentioning

confidence: 95%

“…'s and Cornelisse et al . 's study measured kissing as part of sexual practices and did not investigate kissing without sex as a risk factor. The third study by Chow et al .…”

Section: Resultsmentioning

confidence: 99%

The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission

Chow

Fairley

2019

J Intern AIDS Soc

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Introduction Gonorrhoea and chlamydia cases have been rising among gay, bisexual and other men who have sex with men (MSM) over the last decade. The majority of cases are extragenital and occur at the oropharynx and anorectum. The aim of this narrative review was to review the risk factors and mode of transmission for gonorrhoea and chlamydia at the oropharynx and anorectum among MSM. Results and discussion New evidence suggests that oropharyngeal gonorrhoea can be transmitted by kissing in addition to through the established route of condomless oral sex; and anorectal gonorrhoea can be acquired when saliva is used as a lubricant for anal sex and rimming in addition to the established route of condomless penile‐anal sex in MSM. In contrast, condomless penile‐anal sex remains the major route for chlamydia transmission. Conclusions Substantial transmission of gonorrhoea may occur with practices other than the established routes of condomless oral and/or anal sex and hence condoms may not be effective in preventing gonorrhoea transmission to extragenital sites. In contrast, condoms are effective for chlamydia control because it is mainly transmitted through condomless penile‐anal sex. Novel interventions for gonorrhoea that reduce the risk of transmission at extragenital site are required.

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“…As syphilis transmission gathers pace among men having sex with men (MSM) populations, epidemiologists are increasingly looking to understand the interaction between social and behavioural dynamics, as seen in Schneider et al 5 On the other wide of the world, an Australian case control study of oropharyngeal gonorrhoea in MSM showed an association with higher partner numbers, but none with specific behavioural practices 6…”

mentioning

confidence: 99%

Highlights from this issue

Cassell

2018

Sex Transm Infect

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Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study

Abstract: The finding that oropharyngeal gonorrhoea was associated with a higher number of sexual partners but not specific sexual practices highlights the need for further research in the area of gonorrhoea transmission to define the probability of transmission from specific sex acts.

Cited by 31 publications

References 28 publications

Commensal Neisseria Are Shared between Sexual Partners: Implications for Gonococcal and Meningococcal Antimicrobial Resistance

Commensal Neisseria Are Shared between Sexual Partners: Implications for Gonococcal and Meningococcal Antimicrobial Resistance

The role of saliva in gonorrhoea and chlamydia transmission to extragenital sites among men who have sex with men: new insights into transmission

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