Background: Sexually transmitted rectal infections with Chlamydia (CT) are increasing in the general population and in particular in men who have sex with men (MSM) and women. General guidelines include testing of genital and extragenital sites but national statistics only include results from genital site testing. Few studies have described extragenital infections in MSM and women, in particular pharyngeal infections in MSM and rectal infections in women who engage in anal intercourse. The objective of this study is to determine the rates of pharyngeal CT infections in MSM and rectal CT infections in individuals presenting at the Miami Dade Health Department (MDHD) STD clinic. Methods: Testing for rectal Chlamydia in women who reported anoreceptive intercourse at the Miami Dade Health Department (MDHD) Sexually Transmitted Diseases (STD) clinic that was implemented in May 2007. Routine screening for pharyngeal CT infections in MSM was implemented in the same clinic in October 2011 using APTIMA Combo Assay®. Validation studies were performed in the Florida Department of Health Laboratories prior to implementation of these tests. The study consisted of a retrospective review of medical records of women tested for rectal CT from May 2007 to August 2008 and retrospective review of medical records of individuals tested for pharyngeal CT from October to March 2012. Results from urine and rectal CT testing done at the same time from the same individuals were also reviewed. Results: A total of 475 MSM underwent pharyngeal CT testing and women underwent rectal testing during the study period. Prevalence of pharyngeal CT in MSM was 2.7% and rectal CT in women was 17.5%. Among the MSM with CT pharyngeal infection, 3 (30%) had a positive CT rectal test and 1 (7.7%) a positive urine test. Among the women with CT rectal infection, 16 (94%) had a positive CT urine test. Conclusion: The prevalence of pharyngeal CT infections in MSM and rectal CT infections in women at the MDHD STD clinic is higher than what has been previously reported in other centers. The discrepancy between pharyngeal, rectal and urine tests emphasizes the importance of extragenital testing. Implementing extragenital testing in high risk populations should be a priority for STI and HIV prevention campaigns.
|Original language||English (US)|
|Title of host publication||Chlamydia: Prevalence, Pathogenesis and Prevention|
|Publisher||Nova Science Publishers, Inc.|
|Number of pages||16|
|ISBN (Print)||9781634630375, 9781634630092|
|State||Published - Oct 1 2014|
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