STI pathogens in the oropharynx: update on screening and treatment.
Journal
Current opinion in infectious diseases
ISSN: 1473-6527
Titre abrégé: Curr Opin Infect Dis
Pays: United States
ID NLM: 8809878
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
medline:
19
12
2023
pubmed:
19
12
2023
entrez:
19
12
2023
Statut:
ppublish
Résumé
The rise in antimicrobial resistance in several STI pathogens such as Neisseria gonorrhoeae has become a public health threat as only one first-line treatment remains. Reducing screening interval for gonorrhoea and chlamydia in high-prevalence populations has been proposed to address antimicrobial stewardship, but this remains controversial. This review aimed to revisit the epidemiology of infections at the oropharynx and review the current screening recommendations and treatment guidelines in different populations. Emerging evidence suggests that the oropharynx is the primary anatomical site for gonorrhoea transmission but maybe not for chlamydia transmission. Most international guidelines recommend 3-monthly oropharyngeal gonorrhoea and chlamydia screening for high-prevalence populations (e.g. men who have sex with men) but not low-prevalence populations (e.g. heterosexuals) given the clinical and public health benefits of screening in low-prevalence populations are still unclear. Doxycycline remains the first-line treatment for oropharyngeal chlamydia in most guidelines. However, some countries have moved from dual therapy (ceftriaxone and azithromycin) to monotherapy (ceftriaxone) for oropharyngeal gonorrhoea treatment to address antimicrobial stewardship. The transmission of gonorrhoea and chlamydia is still not fully understood. Further work will be required to evaluate the benefits and harms of reducing screening in high-prevalence populations.
Identifiants
pubmed: 38112085
doi: 10.1097/QCO.0000000000000997
pii: 00001432-202402000-00006
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-45Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Tran J, Fairley CK, Ong JJ, et al. Combinations of sexual activities during a sex episode with recent casual male partner among men who have sex with men: a cross-sectional study. J Sex Res 2023; doi: 10.1080/00224499.2023.2224310. [Epub ahead of print].
doi: 10.1080/00224499.2023.2224310.
Rosenberger JG, Reece M, Schick V, et al. Sexual behaviors and situational characteristics of most recent male-partnered sexual event among gay and bisexually identified men in the United States. J Sex Med 2011; 8:3040–3050.
Tabesh M, Fairley CK, Hocking JS, et al. Comparison of the patterns of chlamydia and gonorrhoea at the oropharynx, anorectum and urethra among men who have sex with men. Sex Transm Infect 2022; 98:11–16.
Chow EPF, Tabrizi SN, Fairley CK, et al. Prevalence of human papillomavirus in young men who have sex with men after the implementation of gender-neutral HPV vaccination: a repeated cross-sectional study. Lancet Infect Dis 2021; 21:1448–1457.
Colpani V, Soares Falcetta F, Bacelo Bidinotto A, et al. Prevalence of human papillomavirus (HPV) in Brazil: a systematic review and meta-analysis. PLoS One 2020; 15:e0229154.
Zhou X, Wu MZ, Jiang TT, Chen XS. Oral manifestations of early syphilis in adults: a systematic review of case reports and series. Sex Transm Dis 2021; 48:e209–e214.
Towns JM, Leslie DE, Denham I, et al. Treponema pallidum detection in lesion and nonlesion sites in men who have sex with men with early syphilis: a prospective, cross-sectional study. Lancet Infect Dis 2021; 21:1324–1331.
Towns JM, Chow EPF, Wigan R, et al. Anal and oral detection of Treponema pallidum in men who have sex with men with early syphilis infection. Sex Transm Infect 2022; 98:570–574.
Wang C, Hu Z, Zheng X, et al. A new specimen for syphilis diagnosis: evidence by high loads of Treponema pallidum DNA in saliva. Clin Infect Dis 2021; 73:e3250–e3258.
Nieuwenburg SA, Zondag HCA, Bruisten SM, et al. Detection of Treponema pallidum DNA during early syphilis stages in peripheral blood, oropharynx ano-rectum and urine as a proxy for transmissibility. Clin Infect Dis 2022; 75:1054–1062.
Aung ET, Fairley CK, Williamson DA, et al. Detection of Treponema pallidum at asymptomatic oral, anal, and vaginal sites in men and women reporting sexual contact with syphilis. Emerg Infect Dis 2023; 29:2083–2092.
Wood GE, Bradshaw CS, Manhart LE. Update in epidemiology and management of Mycoplasma genitalium infections. Infect Dis Clin North Am 2023; 37:311–333.
Calas A, Zemali N, Camuset G, et al. Prevalence of urogenital, anal, and pharyngeal infections with Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium: a cross-sectional study in Reunion island. BMC Infect Dis 2021; 21:95.
Deguchi T, Yasuda M, Horie K, et al. Drug resistance-associated mutations in Mycoplasma genitalium in female sex workers. Japan Emerg Infect Dis 2015; 21:1062–1064.
Latimer RL, Shilling HS, Vodstrcil LA, et al. Prevalence of Mycoplasma genitalium by anatomical site in men who have sex with men: a systematic review and meta-analysis. Sex Transm Infect 2020; 96:563–570.
Latimer RL, Vodstrcil L, De Petra V, et al. Extragenital Mycoplasma genitalium infections among men who have sex with men. Sex Transm Infect 2020; 96:10–18.
Xu X, Bradshaw CS, Chow EPF, et al. Modelling the multiple anatomical site transmission of Mycoplasma genitalium among men who have sex with men in Australia. Sci Rep 2021; 11:11087.
Tuddenham S, Hamill MM, Ghanem KG. Diagnosis and treatment of sexually transmitted infections: a review. JAMA 2022; 327:161–172.
Fairley CK, Hocking JS, Zhang L, Chow EP. Frequent transmission of gonorrhea in men who have sex with men. Emerg Infect Dis 2017; 23:102–104.
Fairley CK, Cornelisse VJ, Hocking JS, Chow EPF. Models of gonorrhoea transmission from the mouth and saliva. Lancet Infect Dis 2019; 19:e360–e366.
Chow EPF, Grulich AE, Fairley CK. Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV. Lancet HIV 2019; 6:e396–e405.
Whelan J, Abbing-Karahagopian V, Serino L, Unemo M. Gonorrhoea: a systematic review of prevalence reporting globally. BMC Infect Dis 2021; 21:1152.
Chan PA, Robinette A, Montgomery M, et al. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect Dis Obstet Gynecol 2016; 2016:5758387.
van Dulm E, Marra E, Kroone MM, Schim van der Loeff MF. Sexually transmissible infections among female sex workers in Amsterdam between 2011 and 2016: does risk vary by work location? Sex Health 2020; 17:368–376.
Chow EP, Williamson DA, Fortune R, et al. Prevalence of genital and oropharyngeal chlamydia and gonorrhoea among female sex workers in Melbourne, Australia, 2015–2017: need for oropharyngeal testing. Sex Transm Infect 2019; 95:398–401.
Cotter J, McManus H, Vickers T, et al. Increasing prevalence of gonorrhoea and chlamydia among female sex workers in northern Sydney. Int J STD AIDS 2005–2019 2023; 34:869–875.
Van Gerwen OT, Jani A, Long DM, et al. Prevalence of sexually transmitted infections and human immunodeficiency virus in transgender persons: a systematic review. Transgend Health 2020; 5:90–103.
Kirkcaldy RD, Weston E, Segurado AC, Hughes G. Epidemiology of gonorrhoea: a global perspective. Sex Health 2019; 16:401–411.
Allan-Blitz LT, Leon SR, Bristow CC, et al. High prevalence of extra-genital chlamydial or gonococcal infections among men who have sex with men and transgender women in Lima. Peru Int J STD AIDS 2017; 28:138–144.
Castillo R, Konda KA, Leon SR, et al. HIV and sexually transmitted infection incidence and associated risk factors among high-risk MSM and male-to-female transgender women in Lima, Peru. J Acquir Immune Defic Syndr 2015; 69:567–575.
McNulty A, Bourne C. Transgender HIV and sexually transmissible infections. Sex Health 2017; 14:451–455.
Hiransuthikul A, Janamnuaysook R, Sungsing T, et al. High burden of chlamydia and gonorrhoea in pharyngeal, rectal and urethral sites among Thai transgender women: implications for anatomical site selection for the screening of STI. Sex Transm Infect 2019; 95:534–539.
Stephens SC, Bernstein KT, Philip SS. Male to female and female to male transgender persons have different sexual risk behaviors yet similar rates of STDs and HIV. AIDS Behav 2011; 15:683–686.
Pitasi MA, Kerani RP, Kohn R, et al. Chlamydia gonorrhea and human immunodeficiency virus infection among transgender women and transgender men attending clinics that provide sexually transmitted disease services in six US cities: results from the Sexually Transmitted Disease Surveillance Network. Sex Transm Dis 2019; 46:112–117.
Callander D, Cook T, Read P, et al. Sexually transmissible infections among transgender men and women attending Australian sexual health clinics. Med J Aust 2019; 211:406–411.
Druckler S, Daans C, Hoornenborg E, et al. HIV and STI positivity rates among transgender people attending two large STI clinics in the Netherlands. Sex Transm Infect 2022; 98:188–196.
Fairley CK, Zhang L, Chow EPF. New thinking on gonorrhoea control in MSM: are antiseptic mouthwashes the answer? Curr Opin Infect Dis 2018; 31:45–49.
Chow EPF, Cornelisse VJ, Williamson DA, et al. Kissing may be an important and neglected risk factor for oropharyngeal gonorrhoea: a cross-sectional study in men who have sex with men. Sex Transm Infect 2019; 95:516–521.
Tran J, Ong JJ, Bradshaw CS, et al. Kissing, fellatio, and analingus as risk factors for oropharyngeal gonorrhoea in men who have sex with men: a cross-sectional study. EClinicalMedicine 2022; 51:101557.
Cornelisse VJ, Bradshaw CS, Chow EPF, et al. Oropharyngeal gonorrhea in absence of urogenital gonorrhea in sexual network of male and female participants, Australia, 2018. Emerg Infect Dis 2019; 25:1373–1376.
Cornelisse VJ, Williamson D, Zhang L, et al. Evidence for a new paradigm of gonorrhoea transmission: cross-sectional analysis of Neisseria gonorrhoeae infections by anatomical site in both partners in 60 male couples. Sex Transm Infect 2019; 95:437–442.
Charleson F, Tran J, Kolobaric A, et al. A systematic review of kissing as a risk factor for oropharyngeal gonorrhea or chlamydia. Sex Transm Dis 2023; 50:395–401.
Chow EPF, Vodstrcil LA, Williamson DA, et al. Incidence and duration of incident oropharyngeal gonorrhoea and chlamydia infections among men who have sex with men: prospective cohort study. Sex Transm Infect 2021; 97:452–457.
Cornelisse VJ, Walker S, Phillips T, et al. Risk factors for oropharyngeal gonorrhoea in men who have sex with men: an age-matched case–control study. Sex Transm Infect 2018; 94:359–364.
Templeton DJ, Jin F, McNally LP, et al. Prevalence, incidence and risk factors for pharyngeal gonorrhoea in a community-based HIV-negative cohort of homosexual men in Sydney, Australia. Sex Transm Infect 2010; 86:90–96.
Templeton DJ, Jin F, Imrie J, et al. Prevalence, incidence and risk factors for pharyngeal chlamydia in the community based health in men (HIM) cohort of homosexual men in Sydney, Australia. Sex Transm Infect 2008; 84:361–363.
Chow EPF, Lew C, Tran J, et al. Understanding the duration of tongue kissing among female sex workers for potential oropharyngeal-oropharyngeal gonorrhoea transmission. Sex Transm Infect 2023; 99:75–76.
Lew C, Fairley CK, Tran J, et al. Sexual activities and condom use among heterosexual men and women engaged in mixed-gender group sex events in Melbourne. Australia Sex Health 2023; 20:49–56.
Lew C, Fairley CK, Tran J, et al. Sexual activities and changes in condom use in group sex events among female sex workers in Melbourne, Australia. Front Public Health 2022; 10:834901.
Tran J, Fairley CK, Ong JJ, et al. The duration and body position during tongue-kissing among heterosexual men and women. Front Public Health 2022; 10:934962.
Phillips TR, Fairley CK, Bradshaw CS, et al. Associations between oral sex practices and frequent mouthwash use in heterosexuals: a cross-sectional survey in Melbourne, Australia. BMJ Open 2021; 11:e041782.
Phillips TR, Constantinou H, Fairley CK, et al. Oral, vaginal and anal sexual practices among heterosexual males and females attending a sexual health clinic: a cross-sectional survey in Melbourne, Australia. Int J Environ Res Public Health 2021; 18:12668.
Zappulla A, Fairley CK, Donovan B, et al. Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017–18. Sex Health 2020; 17:53–60.
Charleson FJ, Fairley CK, Hocking JS, et al. Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne. Australia Sex Health 2020; 17:279–287.
Read PJ, Wand H, Guy R, et al. Unprotected fellatio between female sex workers and their clients in Sydney. Australia Sex Transm Infect 2012; 88:581–584.
Zhang L, Regan DG, Chow EPF, et al. Neisseria gonorrhoeae transmission among men who have sex with men: an anatomical site-specific mathematical model evaluating the potential preventive impact of mouthwash. Sex Transm Dis 2017; 44:586–592.
Xu X, Chow EPF, Ong JJ, et al. Modelling the potential role of saliva use during masturbation in the transmission of Neisseria gonorrhoeae at multiple anatomical sites. Sex Health 2022; 18:466–474.
Xu X, Chow EPF, Ong JJ, et al. Modelling the contribution that different sexual practices involving the oropharynx and saliva have on Neisseria gonorrhoeae infections at multiple anatomical sites in men who have sex with men. Sex Transm Infect 2021; 97:183–189.
Phillips TR, Fairley CK, Maddaford K, et al. Bacterial load of chlamydia trachomatis in the posterior oropharynx, tonsillar fossae, and saliva among men who have sex with men with untreated oropharyngeal chlamydia. J Clin Microbiol 2019; 58:e01375–19.
Wijers J, Dukers-Muijrers N, van Liere G, et al. Men and women have an equal oropharyngeal and anorectal Chlamydia trachomatis bacterial load: a comparison of 3 anatomic sites. J Infect Dis 2021; 223:1582–1589.
Xu X, Chow EPF, Ong JJ, et al. Chlamydia trachomatis transmission between the oropharynx, urethra and anorectum in men who have sex with men: a mathematical model. BMC Med 2020; 18:326.
Wallin J, Siegel MS. Pharyngeal neisseria gonorrhoeae: coloniser or pathogen? Br Med J 1979; 1:1462–1463.
Kinghorn G. Pharyngeal gonorrhoea: a silent cause for concern. Sex Transm Infect 2010; 86:413–414.
Mimiaga MJ, Mayer KH, Reisner SL, et al. Asymptomatic gonorrhea and chlamydial infections detected by nucleic acid amplification tests among Boston area men who have sex with men. Sex Transm Dis 2008; 35:495–498.
Chow EP, Camilleri S, Ward C, et al. Duration of gonorrhoea and chlamydia infection at the pharynx and rectum among men who have sex with men: a systematic review. Sex Health 2016; 13:199–204.
van Liere G, Hoebe C, Dirks JA, et al. Spontaneous clearance of urogenital, anorectal and oropharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae in women, MSM and heterosexual men visiting the STI clinic: a prospective cohort study. Sex Transm Infect 2019; 95:505–510.
Mensforth S, Ayinde OC, Ross J. Spontaneous clearance of genital and extragenital Neisseria gonorrhoeae: data from GToG. Sex Transm Infect 2020; 96:556–561.
Teker B, de Vries H, Heijman T, et al. Spontaneous clearance of asymptomatic anogenital and pharyngeal Neisseria gonorrhoeae: a secondary analysis from the NABOGO trial. Sex Transm Infect 2023; 99:219–225.
van Rooijen MS, van der Loeff MF, Morre SA, et al. Spontaneous pharyngeal Chlamydia trachomatis RNA clearance. A cross-sectional study followed by a cohort study of untreated STI clinic patients in Amsterdam, The Netherlands. Sex Transm Infect 2015; 91:157–164.
Apewokin SK, Geisler WM, Bachmann LH. Spontaneous resolution of extragenital chlamydial and gonococcal infections prior to therapy. Sex Transm Dis 2010; 37:343–344.
Barbee LA, Soge OO, Khosropour CM, et al. The duration of pharyngeal gonorrhea: a natural history study. Clin Infect Dis 2021; 73:575–582.
Khosropour CM, Soge OO, Golden MR, et al. Incidence and duration of pharyngeal chlamydia among a cohort of men who have sex with men. Clin Infect Dis 2022; 75:875–881.
Dukers-Muijrers N, Evers YJ, Hoebe C, et al. Controversies and evidence on Chlamydia testing and treatment in asymptomatic women and men who have sex with men: a narrative review. BMC Infect Dis 2022; 22:255.
Williams E, Williamson DA, Hocking JS. Frequent screening for asymptomatic chlamydia and gonorrhoea infections in men who have sex with men: time to re-evaluate? Lancet Infect Dis 2023; 23:e558–e566.
Kenyon C. How actively should we screen for chlamydia and gonorrhoea in MSM and other high-ST-prevalence populations as we enter the era of increasingly untreatable infections? A viewpoint. J Med Microbiol 2019; 68:132–135.
Kenyon C, Laumen J, Van Dijck C. Could intensive screening for gonorrhea/chlamydia in preexposure prophylaxis cohorts select for resistance? historical lessons from a mass treatment campaign in greenland. Sex Transm Dis 2020; 47:24–27.
Fifer H, Hughes G. Oropharyngeal Neisseria gonorrhoeae infections: should women be routinely tested? Lancet Infect Dis 2021; 21:754–756.
Coleman H, Samuel I, Soni S, et al. BASHH summary guidance on testing for sexually transmitted infections. Macclesfield, United Kingdom: British Association for Sexual Health & HIV; 2023. https://www.bashhguidelines.org/media/1334/bashh-summary-guidance-on-testing-for-stis-2023.pdf. [Accessed 5 December 2023]
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep 2021; 70:1–187.
Ong JJ, Bourne C, Dean JA, et al. Australian sexually transmitted infection (STI) management guidelines for use in primary care 2022 update. Sex Health 2023; 20:1–8.
Lanjouw E, Ouburg S, de Vries HJ, et al. 2015 European guideline on the management of Chlamydia trachomatis infections. Int J STD AIDS 2016; 27:333–348.
Tsoumanis A, Hens N, Kenyon CR. Is screening for chlamydia and gonorrhea in men who have sex with men associated with reduction of the prevalence of these infections? A systematic review of observational studies. Sex Transm Dis 2018; 45:615–622.
Traeger MW, Guy R, Asselin J, et al. Real-world trends in incidence of bacterial sexually transmissible infections among gay and bisexual men using HIV preexposure prophylaxis (PrEP) in Australia following nationwide PrEP implementation: an analysis of sentinel surveillance data. Lancet Infect Dis 2022; 22:1231–1241.
Vanbaelen T, Tsoumanis A, Florence E, et al. Does screening for Neisseria gonorrhoeae and Chlamydia trachomatis affect the incidence of these infections in men who have sex with men taking HIV pre-exposure prophylaxis (PrEP)Results from a randomized, multicentre controlled trial (the Gonoscreen study). medRxiv [Preprint] 2023:2023.08.14.23294056.
Machalek DA, Tao Y, Shilling H, et al. Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis 2020; 20:1302–1314.
Radovanovic M, Kekic D, Jovicevic M, et al. Current susceptibility surveillance and distribution of antimicrobial resistance in N. gonorrheae within WHO regions. Pathogens 2022; 11:1230.
Ingle DJ, Easton M, Valcanis M, et al. Co-circulation of multidrug-resistant Shigella among men who have sex with men in Australia. Clin Infect Dis 2019; 69:1535–1544.
Yang C, Xiang Y, Qiu S. Resistance in enteric Shigella and nontyphoidal Salmonella: emerging concepts. Curr Opin Infect Dis 2023; 36:360–365.
O’Flanagan H, Siddiq M, Llewellyn C, Richardson D. Antimicrobial resistance in sexually transmitted Shigella in men who have sex with men: A systematic review. Int J STD AIDS 2023; 34:374–384.
Laumen JGE, Van Dijck C, Abdellati S, et al. Antimicrobial susceptibility of commensal Neisseria in a general population and men who have sex with men in Belgium. Sci Rep 2022; 12:9.
Dong HV, Pham LQ, Nguyen HT, et al. Decreased cephalosporin susceptibility of oropharyngeal Neisseria species in antibiotic-using men who have sex with men in Hanoi, Vietnam. Clin Infect Dis 2020; 70:1169–1175.
Vanbaelen T, Van Dijck C, Laumen J, et al. Global epidemiology of antimicrobial resistance in commensal Neisseria species: a systematic review. Int J Med Microbiol 2022; 312:151551.
Kumari R, Yadav Y, Misra R, et al. Emerging frontiers of antibiotics use and their impacts on the human gut microbiome. Microbiol Res 2022; 263:127127.
Elvers KT, Wilson VJ, Hammond A, et al. Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: a systematic review. BMJ Open 2020; 10:e035677.
Tsoumanis A, Van Dijck C, Hens N, Kenyon C. Rethinking screening intensity in terms of reducing prevalence or increasing selection pressure for the emergence of resistant gonorrhea: a modeling study of men who have sex with men in Belgium. Open Forum Infect Dis 2023; 10:ofad165.
Wardley AM, Williams H, Coombe J, et al. Would men who have sex with men support less frequent screening for asymptomatic chlamydia and gonorrhoea to improve antibiotic stewardship? A qualitative study. Sex Health 2023; 20:148–157.
Unemo M, Ross J, Serwin AB, et al. 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults. Int J STD AIDS 2020; doi: 10.1177/0956462420949126. [Epub ahead of print].
doi: 10.1177/0956462420949126.
Bittleston H, Hocking JS, Coombe J, et al. Young Australians’ receptiveness to discussing sexual health with a general practitioner. Aust J Prim Health 2023; doi: 10.1071/PY23083. [Epub ahead of print].
doi: 10.1071/PY23083.
Allen C, Fairley CK, Chen MY, et al. Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia. Clin Microbiol Infect 2021; 27:1799–1804.
Chow EPF, Chen MY, Williamson DA, et al. Oropharyngeal and genital gonorrhea infections among women and heterosexual men reporting sexual contact with partners with gonorrhea: implication for oropharyngeal testing of heterosexual gonorrhea contacts. Sex Transm Dis 2019; 46:743–747.
McLaughlin SE, Golden MR, Soge OO, et al. Pharyngeal gonorrhea in heterosexual male and female sex partners of persons with gonorrhea. Sex Transm Dis 2023; 50:203–208.
Dresser M, Hussey J. Testing for pharyngeal gonorrhoea in heterosexual men: should we revisit national guidelines? Int J STD AIDS 2020; 31:593–595.
Evers YJ, van Liere G, Dukers-Muijrers N, et al. Routine universal testing versus selective or incidental testing for oropharyngeal Chlamydia trachomatis in women in the Netherlands: a retrospective cohort study. Lancet Infect Dis 2022; 22:552–561.
van Liere G, Dukers-Muijrers N, Kuizenga-Wessel S, et al. Routine universal testing versus selective or incidental testing for oropharyngeal Neisseria gonorrhoeae in women in the Netherlands: a retrospective cohort study. Lancet Infect Dis 2021; 21:858–867.
Rank RG, Yeruva L. Hidden in plain sight: chlamydial gastrointestinal infection and its relevance to persistence in human genital infection. Infect Immun 2014; 82:1362–1371.
Heijne JCM, van Liere G, Hoebe C, et al. What explains anorectal chlamydia infection in women? Implications of a mathematical model for test and treatment strategies. Sex Transm Infect 2017; 93:270–275.
Jones RB, Rabinovitch RA, Katz BP, et al. Chlamydia trachomatis in the pharynx and rectum of heterosexual patients at risk for genital infection. Ann Intern Med 1985; 102:757–762.
Cantor A, Dana T, Griffin JC, et al. Screening for chlamydial and gonococcal infections: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2021; 326:957–966.
Bell K, McCaffery KJ, Irwig L. Screening tests for gonorrhoea should first do no harm. Med J Aust 2015; 202:281–282.
Chow EP, Fehler G, Read TR, et al. Gonorrhoea notifications and nucleic acid amplification testing in a very low-prevalence Australian female population. Med J Aust 2015; 202:321–323.
Fifer H, Ison CA. Nucleic acid amplification tests for the diagnosis of Neisseria gonorrhoeae in low-prevalence settings: a review of the evidence. Sex Transm Infect 2014; 90:577–579.
Hocking JS, Geisler WM, Kong FYS. Update on the epidemiology, screening, and management of chlamydia trachomatis infection. Infect Dis Clin N Am 2023; 37:267–288.
Dragovic B, Nwokolo N: Update on the treatment of Chlamydia trachomatis (CT) infection, vol. 2023. Macclesfield, United Kingdom: British Association for Sexual Health & HIV; 2018. https://www.bashhguidelines.org/media/1191/update-on-the-treatment-of-chlamydia-trachomatis-infection-final-16-9-18.pdf. [Accessed 5 December 2023]
Australasian Society for HIV Viral Hepatitis and Sexual Health Medicine (ASHM). Australian STI management guidelines for use in primary care – Chlamydia. 2021. https://sti.guidelines.org.au/sexually-transmissible-infections/chlamydia/. [Accessed 5 December 2023]
Moran JS. Treating uncomplicated Neisseria gonorrhoeae infections: is the anatomic site of infection important? Sex Transm Dis 1995; 22:39–47.
Merrick R, Cole M, Pitt R, et al. Antimicrobial-resistant gonorrhoea: the national public health response England 2013 to 2020. Euro Surveill 2022; 27:2200057.
Unemo M, Shafer WM. Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future. Clin Microbiol Rev 2014; 27:587–613.
Mensforth S, Ross JDC. Should we still use azithromycin for gonorrhoea treatment? Sex Health 2019; 16:442–448.
Australasian Society for HIV Viral Hepatitis and Sexual Health Medicine (ASHM). Australian STI management guidelines for use in primary care – Gonorrhoea. 2021. https://sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea/. [Accessed 5 December 2023]
Fifer H, Saunders J, Soni S, et al. 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. Int J STD AIDS 2020; 31:4–15.
St Cyr S, Barbee L, Workowski KA, Thorpe P. Update to CDC's treatment guidelines for gonococcal infection 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1911–1916.
European STI Guidelines Project Editorial Board. European sexually transmitted infection (STI) guidelines: protocol for production and revision, vol. 2023. February 2023. The International Union against Sexually Transmitted Infections (IUSTI); 2023. https://iusti.org/wp-content/uploads/2023/02/Protocol-for-production-2023.pdf. [Accessed 5 December 2023]
Van Dijck C, Kenyon C. No evidence of reduced cephalosporin susceptibility of circulating strains of Neisseria gonorrhoeae in the Netherlands despite nearly a decade of recommending ceftriaxone monotherapy. Sex Transm Infect 2023; 99:213–214.
Taylor SN, Marrazzo J, Batteiger BE, et al. Single-dose zoliflodacin (ETX0914) for treatment of urogenital gonorrhea. N Engl J Med 2018; 379:1835–1845.
Taylor SN, Morris DH, Avery AK, et al. Gepotidacin for the treatment of uncomplicated urogenital gonorrhea: a phase 2, randomized, dose-ranging, single-oral dose evaluation. Clin Infect Dis 2018; 67:504–512.
Kong FYS, Hatzis CL, Lau A, et al. Treatment efficacy for pharyngeal Neisseria gonorrhoeae: a systematic review and meta-analysis of randomized controlled trials. J Antimicrob Chemother 2020; 75:3109–3119.
de Vries HJC, de Laat M, Jongen VW, et al. Efficacy of ertapenem, gentamicin, fosfomycin, and ceftriaxone for the treatment of anogenital gonorrhoea (NABOGO): a randomised, noninferiority trial. Lancet Infect Dis 2022; 22:706–717.
Kong FYS, Hocking JS. Treating pharyngeal gonorrhoea continues to remain a challenge. Lancet Infect Dis 2022; 22:573–574.
Kong FYS, Unemo M, Lim SH, et al. Optimisation of treatments for oral Neisseria gonorrhoeae infection: Pharmacokinetics Study (STI-PK project) – study protocol for nonrandomised clinical trial. BMJ Open 2022; 12:e064782.
Celentano A, Matthyssen T, Paolini R, et al. Development of a novel human oral tissue model of gonorrhoea. In 2022 Joint Australasian HIV&AIDS + Sexual Health Conferences, edn 2022/10/14, vol. 19. Sunshine Coast, Australia: Sexual Health; 2022:xxvii.
Informa Pharma Intelligence. Clinical development success rates and contributing factors 2011–2020. 2021.
Grant JS, Stafylis C, Celum C, et al. Doxycycline prophylaxis for bacterial sexually transmitted infections. Clin Infect Dis 2020; 70:1247–1253.
Kong FYS, Kenyon C, Unemo M. Important considerations regarding the widespread use of doxycycline chemoprophylaxis against sexually transmitted infections. J Antimicrob Chemother 2023; 78:1561–1568.
Hui BB, Padeniya TN, Rebuli N, et al. A gonococcal vaccine has the potential to rapidly reduce the incidence of Neisseria gonorrhoeae infection among urban men who have sex with men. J Infect Dis 2022; 225:983–993.
Luetkemeyer AF, Donnell D, Dombrowski JC, et al. Postexposure doxycycline to prevent bacterial sexually transmitted infections. N Engl J Med 2023; 388:1296–1306.
Mortimer TD, Grad YH. A genomic perspective on the near-term impact of doxycycline postexposure prophylaxis on Neisseria gonorrhoeae antimicrobial resistance. Clin Infect Dis 2023; 77:788–791.
Vanbaelen T, Manoharan-Basil SS, Kenyon C. Doxycycline postexposure prophylaxis could induce cross-resistance to other classes of antimicrobials in Neisseria gonorrhoeae: an in silico analysis. Sex Transm Dis 2023; 50:490–493.
Bruxvoort KJ, Lewnard JA, Chen LH, et al. Prevention of Neisseria gonorrhoeae with meningococcal B vaccine: a matched cohort study in southern California. Clin Infect Dis 2023; 76:e1341–e1349.
Gestels Z, Manoharan-Basil SS, Kenyon C. Doxycycline post exposure prophylaxis could select for cross-resistance to other antimicrobials in various pathogens: an in silico analysis. Int J STD AIDS 2023; 34:962–968.
Reichert E, Grad YH. Resistance and prevalence implications of doxycycline postexposure prophylaxis for gonorrhea prevention in men who have sex with men: a modeling study. medRxiv [Preprint] 2023; 2023.04.24.23289033.
Tran J, Fairley CK, Bowesman H, et al. Nonconventional interventions to prevent gonorrhea or syphilis among men who have sex with men: a scoping review. Front Med (Lausanne) 2022; 9:952476.
Morris SR, Klausner JD, Buchbinder SP, et al. Prevalence and incidence of pharyngeal gonorrhea in a longitudinal sample of men who have sex with men: the EXPLORE study. Clin Infect Dis 2006; 43:1284–1289.
Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM). Australian STI Management Guidelines for use in primary care. 2021. https://sti.guidelines.org.au/ [Accessed 5 December 2023]