Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Connor Allen; Christopher K Fairley; Marcus Y Chen; Kate Maddaford; Jason J Ong; Deborah A Williamson; Eric P F Chow

doi:10.1016/j.cmi.2021.03.033

Oropharyngeal gonorrhoea infections among heterosexual women and heterosexual men with urogenital gonorrhoea attending a sexual health clinic in Melbourne, Australia

Clin Microbiol Infect. 2021 Dec;27(12):1799-1804. doi: 10.1016/j.cmi.2021.03.033. Epub 2021 May 6.

Authors

Connor Allen¹, Christopher K Fairley¹, Marcus Y Chen¹, Kate Maddaford², Jason J Ong¹, Deborah A Williamson³, Eric P F Chow⁴

Affiliations

¹ Central Clinical School, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
² Central Clinical School, Monash University, Melbourne, Victoria, Australia.
³ Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; Department of Microbiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
⁴ Central Clinical School, Monash University, Melbourne, Victoria, Australia; Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia. Electronic address: eric.chow@monash.edu.

PMID: 33845205
DOI: 10.1016/j.cmi.2021.03.033

Abstract

Objectives: There is limited evidence about the transmission and prevalence of oropharyngeal gonorrhoea in heterosexuals. From August 2017, Melbourne Sexual Health Centre (MSHC) began testing for oropharyngeal gonorrhoea among heterosexuals with untreated urogenital gonorrhoea. This study aims to determine the positivity of oropharyngeal gonorrhoea among heterosexuals diagnosed with urogenital gonorrhoea at MSHC between August 2017 and May 2020.

Methods: We included individuals who had oropharyngeal gonorrhoea testing within 30 days of initial testing. We reported the number and proportion of oropharyngeal gonorrhoea positivity, stratified by gender and contact of gonorrhoea. The χ² test was performed to compare the oropharyngeal gonorrhoea positivity between groups.

Results: Of 617 individuals with untreated urogenital gonorrhoea, 424 (68.7%) were tested for oropharyngeal gonorrhoea. Oropharyngeal gonorrhoea positivity was 38.9% (95%CI 34.2-43.7%, 165/424), and was higher in women than in men (115/252, 45.6% versus 50/172, 29.1%, p = 0.001). Furthermore, oropharyngeal gonorrhoea positivity was higher among individuals who were contacts of gonorrhoea cases compared to those who were not (29/44, 65.9% versus 136/380, 35.8%, p < 0.001). There was also no significant difference between women who were sex workers and those who were not (30/78, 38.5% versus 85/174, 48.9%, p = 0.126).

Conclusions: Our data suggest that oropharyngeal gonorrhoea infection is common among heterosexual women and heterosexual men with untreated urogenital gonorrhoea. Testing heterosexual women and heterosexual men for oropharyngeal gonorrhoea will identify a significant proportion with unrecognized oropharyngeal infections whose recommended treatment is different in some countries.

Keywords: Extragenital; Heterosexual; Neisseria gonorrhoeae; Pharyngeal; Sexual behaviour; Sexual practice; Testing; Throat.

MeSH terms

Ambulatory Care Facilities
Australia / epidemiology
Female
Gonorrhea* / epidemiology
Heterosexuality
Humans
Male
Neisseria gonorrhoeae
Oropharynx / microbiology*
Sexual Health*