Risk of gonococcus gonorrhea infection among women who report sex with women: a prospective study

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American Journal of BioMedicine  Volume 2, Issue 5, pages 598–607, May 2014


Steve R Cudeck;  Matthew Platt; Xiang-Sheng Song; Allan Nielsen; Moritz Walker; Slocum Rothschild; Rueda Bennett; Ezcurra Huggett; Phillips J Drancourt; Bin Lee

Abstract

Infections caused by Neisseria gonorrhoeae (GC) are major public health problems globally. The objective of this study is to assessed risks for GC acquisition in lesbian women in a prospective study. We used comprehensive computer-assisted self-interview (CASI) to assess behavioral risks. Women were followed for 18-months with interval examinations for genital symptoms at any time. PCR for GC-associated bacteria (GCAB) were applied to vaginal fluid obtained at enrollment. Of 467 participants, 134 women (28.7%) had GC at enrollment and were excluded from the longitudinal analysis of risks for GC acquisition, which thus included 333 participants. These 333 women who not have GC at the enrollment visited 277returned for at least one follow-up visit. Median duration of follow-up for these 277 women was 18 months and 95 episodes of GC occurred among these 277 women. Furthermore; analysis the sexual behavioral data which revealed a direct dose-response relationship with increasing numbers of reported episodes of receptive oral-vulvo-vaginal sex. The corresponding estimated relative risk (RR) of 1.02 per act translates to a 31% increase in risk of GC for each additional 10 such acts in the last three months. A similar association with receptive oral-anal sex did not reach statistical significance. Furthermore, the multivariate model of risks for acquisition of GC included a composite variable that was based on detection of any positive PCR assay for the bacteria that were significantly associated with subsequent GC.

Keywords: Neisseria gonorrhoeae; PCR; Oral-vulvo-vaginal sex; Lesbian


References

1.  Fowler T, Edeghere O, Inglis N, et al. Estimating the positive predictive value of opportunistic population testing for gonorrhoea as part of the English Chlamydia Screening Programme. Int J STD AIDS 2013; 24: 185–191. [Abstract/FREE Full Text]

2.  Fleming DT, Wasserheit JN: From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect 1999; 75(1):3-17. [PubMed Abstract]

3. Yokoi S, Deguchi T, Ozawa T, Yasuda M, Ito S, Kubota Y, Tamaki M, Maeda S: Threat to cefixime treatment for gonorrhea. Emerg Infect Dis 2007; 13(8):1275-1277. [PubMed Central Full Text]

4.  Lo JY, Ho KM, Leung AO, Tiu FS, Tsang GK, Lo AC, Tapsall JW: Ceftibuten resistance and treatment failure of Neisseria gonorrhoeae infection. Antimicrob Agents Chemother 2008; 52(10): 3564-3567. [PubMed Abstract]

5.  Lyss SB, Kamb ML, Peterman TA, Moran JS, Newman DR, Bolan G, Douglas JM, Iatesta M, Malotte TA, Zenilman JM, Ehret J, Gaydos C, Newhall WJ, Project RESPECT Study Group: Chlamydia trachomatis among patients infected with and treated for Neisseria gonorrhoeae in sexually transmitted disease clinics in the United States. Ann Intern Med 2003; 139(3):178-85. [PubMed Abstract]

6.  Swanson J, Belland RJ, Hill SA: Neisserial surface variation: how and why? Curr Opin Genet Dev 1992; 2(5):805-811. [PubMed Abstract]

7.  Plummer FA, Chubb H, Simonsen JN, Bosire M, Slaney L, Maclean I, Ndinya-Achola JO, Waiyaki P, Brunham RC: Antibody to Rmp (outer membrane protein 3) increases susceptibility to gonococcal infection. J Clin Invest 1993; 91(1):339-343. [PubMed Abstract]

8.  Shafer WM, Morse SA. Cleavage of the protein III and major iron-regulated protein of Neisseria gonorrhoeae by lysosomal cathepsin G. J Gen Microbiol. 1987;133(1):155-62. [PubMed]

9.  Harvey HA, Post DM, Apicella MA: Immortalization of human urethral epithelial cells: a model for the study of the pathogenesis of and the inflammatory cytokine response to Neisseria gonorrhoeae infection. Infect Immun 2002; 70(10):5808-5815. [PubMed Abstract]

10.  Chung GT, Yoo JS, Oh HB, Lee YS, Cha SH, Kim SJ, Yoo CK: Complete genome sequence of Neisseria gonorrhoeae NCCP11945. J Bacteriol  2008; 190:6035-6036. [PubMed Abstract]

11.  Tinsley CR, Nassif X: Analysis of the genetic differences between Neisseria meningitidis and Neisseria gonorrhoeae: two closely related bacteria expressing two different pathogenicities. Proc Natl Acad Sci USA 1996; 93:11109-11114. [PubMed Central Full Text]

12.  Sharp PM, Bailes E, Grocock RJ, Peden JF, Sockett RE: Variation in the strength of selected codon usage bias among bacteria. Nucleic Acids Res 2005; 33:1141-1153. [PubMed Central Full Text]

13.  Fredricks DN, Relman DA. Paraffin removal from tissue sections for digestion and PCR analysis. Biotechniques 1999; 26: 198–200. [PubMed/NCBI]

14.  Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983; 74: 14–22. [PubMed/NCBI]

15.  Kissinger P, Rice J, Farley T, Trim S, Jewitt K, Margavio V, Martin DH. Application of computer-assisted interviews to sexual behavior research. Am J Epidemiology 1999; 149: 950–954. [Abstarct/Full-Text]

16.  Turner CF, Ku L, Rogers M, Lindberg LD, Pleck JH, Sonenstein FL. Adolescent sexual behavior, drug use, and violence: increase reporting with computer survey technology. Science 1998; 280: 867–873. [Abstract/Full-Text]

17.  Webb PM, Zimet G, Fortenberry JD, Blythe MJ. Comparability of a computer-assisted versus written method for collecting health behavior information from adolescent patients. J Adolesc Health 1999; 24: 383–388. [PubMed]

18.  Higuchi R, Fockler C, Dollinger G, Watson R. Kinetic PCR Analysis: Real-time Monitoring of DNA Amplification Reactions. Bio-Technology 1993; 11: 1026–1030. [PubMed]

19.  Sparling PF, Handsfield HH: Neisseria gonorrhoeae. In Principles and Practice of Infectious Diseases Edited by Mandel GL. 2000, 2246. [Abstract/Full-Text]

20.  Alary M, Laga M, Vuylsteke B, Nzila N, Piot P: Signs and symptoms of prevalent and incident cases of gonorrhea and genital chlamydial infection among female prostitutes in Kinshasa, Zaire. Clin Infect Dis 1996; 22:477-484. [PubMed Abstract]

21.  De Jongh M, Dangor Y, Adam A, Hoosen AA: Gonococcal resistance: evolving from penicillin, tetracycline to the quinolones in South Africa – implications for treatment guidelines. Int J STD AIDS 2007; 18:697-699. [PubMed Abstract]

22.  Su X, Jiang F, Qimuge , Dai X, Sun H, Ye S: Surveillance of antimicrobial susceptibilities in Neisseria gonorrhoeae in Nanjing, China, 1999-2006. Sex Transm Dis 2007; 34:995-999. [PubMed Abstract]

23.  Viscidi RP, Demma JC. Genetic diversity of Neisseria gonorrhoeae housekeeping genes. J Clin Microbiol 2003; 41:197-204. [PubMed Central Full Text]

24.  Johansen JD, Smith E. Gonorrhoea in Denmark: high incidence among HIV-infected men who have sex with men. Acta Derm Venereol 2002; 82:365-368. [PubMed Abstract]

25.  Morris SR, Klausner JD, Buchbinder SP, Wheeler SL, Koblin B, Coates T, Chesney M, Colfax GN. 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. [PubMed Abstract]

26.  Rottingen JA, Cameron DW, Garnett GP. A systematic review of the epidemiologic interactions between classic sexually transmitted diseases and HIV: how much really is known? Sex Transm Dis 2001; 28:579-597. [PubMed Abstract]

27.  Berglund T, Asikainen T, Grutzmeier S, Ruden AK, Wretlind B, Sandstrom E. The epidemiology of gonorrhea among men who have sex with men in Stockholm, Sweden,1990–2004. Sex Transm Dis 2007; 34:174-179. [PubMed Abstract]

28.  Hiltunen-Back E, Rostila T, Kautiainen H, Paavonen J, Reunala T. Rapid decrease of endemic gonorrhea in Finland. Sex Transm Dis 1998; 25:181-186. [PubMed Abstract]

29.  Newman LM, Moran JS, Workowski KA. Update on the management of gonorrhea in adults in the United States. Clin Infect Dis 2007; 44(Suppl 3):S84-101. [PubMed Abstract]

30.  Dossett JH, Appelbaum PC, Knapp JS, Totten PA: Proctitis associated with Neisseria cinerea misidentified as Neisseria gonorrhoeae in a child. J Clin Microbiol 1985; 21:575-577. [PubMed Abstract]

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