Extragenital sexually transmitted infections: epidemiology, clinical presentations, diagnosis, and therapy
The paper analyzes the data available in the current literature on the epidemiology, clinical presentations, diagnosis, and therapy of extragenital bacterial sexually transmitted infections (STIs). It systematizes the results of studying the antibiotic resistance of infectious agents and the clinical efficiency of etiotropic antibiotic therapy. An update on the epidemiology of extragenital bacterial STIs is presented; the clinical forms of diseases and methods for their diagnosis and therapy are described. Current studies demonstrate the high prevalence of extragenital bacterial STIs not only in men having sex with men, but also in heterosexuals. The timely diagnosis of extragenital STIs using molecular biological tests and the adequate therapy based on the indicators of antibiotic susceptibility of infectious agents will be able to prevent recurrences and complicated forms of diseases.Rakhmatulina M.R., Bolshenko N.V.
Keywords
References
1. Глобальная стратегия сектора здравоохранения по инфекциям, передаваемым половым путем 2016-2021 гг. ВОЗ; 2016. Available at: http://www.who.int/mediacentre/factsheets/fs110/ru/ [Global healthcare sector strategy on sexually transmitted infections 2016-2021; 2016. Available at: http://www.who.int/mediacentre/factsheets/fs110/ru/ (in Russian)]
2. Chan P.A., Robinette A., Montgomery M., Almonte A., Cu-Uvin S., Lonks J.R. et al. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect. Dis. Obstet. Gynecol. 2016; 2016: 5758387.
3. Park J., Marcus J.L., Pandori M., Snell A., Philip S.S., Bernstein K.T. Sentinel surveillance for pharyngeal chlamydia and gonorrhea among men who have sex with men – San Francisco, 2010. Sex. Transm. Dis. 2012; 39(6): 482-4.
4. Barbee L.A., Dombrowski J.C., Kerani R., Golden M.R. Effect of nucleic acid amplification testing on detection of extragenital gonorrhea and chlamydial infections in men who have sex with men sexually transmitted disease clinic patients. Sex. Transm. Dis. 2014; 41(3): 168-72.
5. van Liere G.A.F.S., Dukers-Muijrers N.H.T.M., Levels L., Hoebe C.J.P.A. High proportion of anorectal Chlamydia trachomatis and Neisseria gonorrhoeae after routine universal urogenital and anorectal screening in women visiting the sexually transmitted infection clinic. Clin. Infect. Dis. 2017; 64(12): 1705-10.
6. Callander D., McManus H., Guy R., Hellard M., O’Connor C.C., Fairley C.K. et al. Rising chlamydia and gonorrhoea incidence and associated risk factors among female sex workers in Australia: A Retrospective Cohort Study. Sex. Transm. Dis. 2018; 45(3): 199-206.
7. Тюленев Ю.А., Махова Т.И., Титов И.С., Гущин А.Е. Экстрагенитальные формы инфекций, передаваемые половым путем (ИППП), как фактор поддержания эпидемического процесса. В кн.: Тезисы XI Международного форума дерматовенерологов и косметологов. Москва 14-16 марта. М.; 2018: 122-3. [Tyulenev Y.A., Makhova T.I., Titov I.S., Guschin A.E. Extragenital forms of infections, sexually transmitted infections (STIs), as a factor in the maintenance of the epidemic process. In: Abstracts of the XI international forum of dermatovenerologists and cosmetologists. Moscow 14-16 March. Moscow; 2018: 122-3. (in Russian)]
8. Макарова Е.В., Соловьев А.М. Распространение и клинические особенности инфекций, передаваемых половым путем, у мужчин, практикующих секс с мужчинами. Клиническая дерматология и венерология. 2015; 5: 125-9. [Makarova E.V. Solovyev A.M. The spread and clinical features of sexually transmitted infections in men, practicing sex with men. Klinicheskaya dermatologiya i venerologiya. 2015; 5: 125-9. (in Russian)]
9. Cabello Úbeda A., Fernández Roblas R., García Delgado R., Martínez García L., Sterlin F., Fernández Guerrero M.L., Górgolas M. Anorectal lymphogranuloma venereum in Madrid: a persistent emerging problem in men who have sex with men. Sex. Transm. Dis. 2016; 43(7): 414-9.
10. Taylor-Robinson D., Jensen J.S. Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin. Microbiol. Rev. 2011; 24(3): 498-514.
11. Abbott C.E., Greene R.E., Kapadia F., Halkitis P.N. A case of rectal ureaplasma infection and implications for testing in young men who have sex with men: The P18 Cohort Study. LGBT Health. 2017; 4(2): 161-3.
12. Sethi S., Zaman K., Jain N. Mycoplasma genitalium infections: current treatment options and resistance issues. Infect. Drug Resist. 2017; 10: 283-92.
13. Mimiaga M.J., Mayer K.H., Reisner S.L., Gonzalez A., Dumas B., Vanderwarker R. 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(5): 495-8.
14. Linhart Y., Shohat T., Amitai Z., Gefen D., Srugo I., Blumstein G., Dan M. Sexually transmitted infections among brothel-based sex workers in Tel-Aviv area, Israel: high prevalence of pharyngeal gonorrhoea. Int. J. STD AIDS. 2008; 19(10): 656-9.
15. Федеральные клинические рекомендации. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем. 5-е изд. М.: Деловой экспресс; 2016. 768с. [Federal clinical guidelines. Dermatovenereology 2015: Diseases of the skin. Sexually transmitted infections. 5th ed. Moscow: Business Express; 2016. 768p. (in Russian)]
16. Sultan S. Sexually transmissible infections of the anus and the rectum. Rev. Prat. 2008; 58(16): 1793-801.
17. Bignell C., Fitzgerald M.; BASHH Guideline Development Group. UK national guideline for the management of gonorrhoea in adults, 2011. Int. J. STD AIDS. 2011; 22(10): 541-7.
18. Rank R.G., Yeruva L. “Hidden in plain sight:” Chlamydial gastrointestinal infection and its relevance to “persistence” in human genital infections. Infect. Immun. 2014; 82(4): 1362-71.
19. Yeruva L., Melnyk S., Spencer N., Bowlin A., Rank R.G. Differential susceptibilities to azithromycin treatment of chlamydial infection in the gastrointestinal tract and cervix. Antimicrob. Agents Chemother. 2013; 57(12):6290-4.
20. Бибков М.М., Мальханов В.Б., Бабушкин А.Э. Конъюнктивиты: дифференциальная диагностика и лечение. М.; 2015. 107с. [Bibkov M.M., Malkhanov V.B., Babushkin A.E. Conjunctivitis: differential diagnosis and treatment. Moscow; 2015. 107p. (in Russian)]
21. Patton M.E., Kidd S., Llata E., Stenger M., Braxton J., Asbel L. et al. Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men- STD Surveillance Network, United States, 2010-2012. Clin. Infect. Dis. 2014; 58(11): 1564-70.
22. Trebach J.D., Chaulk C.P., Page K.R., Tuddenham S., Ghanem K.G. Neisseria gonorrhoeae and Clamydia trachomatis among women reporting extragenital exposures. Sex. Transm. Dis. 2015; 42(5): 233-9.
23. Hunte T., Alcaide M., Castro J. Rectal infections with Chlamydia and gonorrhea in women attending a multiethnic sexually transmitted diseases urban clinic. Int. J. STD AIDS. 2010; 21(12): 819-22.
24. Rodriguez-Hart C., Chitale R.A., Rigg R., Goldstein B.Y., Kerndt P.R., Tavrow P. Sexually transmitted infection testing of adult film performers: is disease being missed? Sex. Transm. Dis. 2012; 39(12): 989-94.
25. Garner A.L., Schembri G., Cullen T., Lee V. Should we screen heterosexuals for extra-genital chlamydial and gonococcal infections? Int. J. STD AIDS. 2015; 26(7): 462-6.
26. Koedijk F.D., van Bergen J.E., Dukers-Muijrers N.H., van Leeuwen A.P., Hoebe C.J., van der Sande M.A.; Dutch STI centres. The value of testing multiple anatomic sites for gonorrhoea and chlamydia in sexually transmitted infection centres in the Netherlands, 2006-2010. Int. J. STD AIDS. 2012; 23(9): 626-31.
27. Javanbakht M., Gorbach P., Stirland A., Chien M., Kerndt P., Guerry S. Prevalence and correlates of rectal Chlamydia and gonorrhea among female clients at sexually transmitted disease clinics. Sex. Transm. Dis. 2012; 39(12): 917-22.
28. Рахматулина М.Р. Гонококковая инфекция: тактика диагностики и терапии согласно российским и зарубежным клиническим рекомендациям. Вестник дерматологии и венерологии. 2015; 2: 41-8. [Rakhmatulina M.R. Gonococcal infection: tactics of diagnosis and therapy in accordance with Russian and foreign clinical recommendations. Vestnik dermatologii i venerologii. 2015; 2: 41-8. (in Russian)]
29. Bignell C., Unemo M. 2012 European guideline on the diagnosis and treatment of gonorrhoea in adults. Int. J. STD AIDS. 2013; 24(2): 85-92. Available at: http://www.iusti.org/regions/Europe/pdf/2012/ Gonorrhoea_2012.pdf
30. Workowski K.A., Bolan G.A.; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm. Rep. 2015; 64(RR-03): 1-137.
31. Holmes K.K., Sparling P.F., Stamm W.E., Piot P., Wasserheit J.N., Corey L. et al., eds. Sexually transmitted diseases. 4th ed. McGraw-Hill; 2008.
32. Geisler W.M., Koltun W.D., Abdelsayed N., Burigo J., Mena L., Taylor S.N. et al. Safety and efficacy of WC2031 versus vibramycin for the treatment of uncomplicated urogenital Chlamydia trachomatis infection: a randomized, double-blind, double-dummy, active-controlled, multicenter trial. Clin. Infect. Dis. 2012; 55(1): 82-8.
33. Hathorn E., Opie C., Goold P. What is the appropriate treatment for the management of rectal Chlamydia trachomatis in men and women? Sex. Transm. Infect. 2012; 88(5): 352-4.
34. Kong F.Y.S., Tabrizi S.N., Fairley C.K., Vodstrcil L.A., Huston W.M. et al. The efficacy of azithromycin and doxycycline for the treatment of rectal chlamydia infection – a systematic review and meta-analysis. J. Antimicrob. Chemother. 2015; 70(5): 1290-7.
35. Mena L.A., Mroczkowski T.F., Nsuami M., Martin D.H. A randomized comparison of azithromycin and doxycycline for the treatment of Mycoplasma genitalium-positive urethritis in men. Clin. Infect. Dis. 2009; 48(12): 1649-54.
36. Guschin A., Ryzhikh P., Rumyantseva T., Gomberg M., Unemo M. Treatment efficacy, treatment failures and selection of macrolide resistance in patients with high load of Mycoplasma genitalium during treatment of male urethritis with josamycin. BMC Infect. Dis. 2015; 15: 40.
37. Андреева И.В., Козлов С.Н., Королев С.В., Беликов А.Н., Гринев А.В., Евстафьев В.В., Кирпичева Н.Н., Сердюцкая М.В., Стецюк О.У., Фокин А.А., Хрянин А.А. Тактика ведения пациентов с негонококковым уретритом: результаты многоцентрового описательного исследования. Антибиотики и химиотерапия. 2012; 57(5-6): 32-40. [Andreeva I.V., Kozlov S.N., Korolev S.V., Belikov A.N., Grinev A.V., Evstafyev V.V., Kirpicheva N.N., Serdyutskaya M.V., O. Stetsyuk, A.A. Fokin, A.A. Khryanin Management tactics for patients with non-gonococcal urethritis: a multicenter, descriptive study. Antibiotiki i khimioterapiya. 2012; 57 (5-6): 32-40. (in Russian)]
Received 11.09.2018
Accepted 22.09.2018
About the Authors
Rakhmatulina, Margarita R., MD, Professor of the Department of Dermatovenereology and Cosmetology with a course of clinical laboratory diagnosis, State Research Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Biomedical Agency of Russia.123098, Russia, Moscow, Zhivopisnaya str. 46. Tel.: +79162031003. E-mail: ra.marg@yandex.ru
Bolshenko, Natalia V., PhD, Senior Researcher, Scientific Advisory Clinical and Diagnostic Center, Central Research Institute of Epidemiology, Russian Federal Service
for Supervision of Consumer Rights Protection and Human Well-Being. 111123, Russia, Moscow, Novogireevskaya str. 3a. Tel.: +79164224280. E-mail: sanabol@mail.ru
For citations: Rakhmatulina M.R., Bolshenko N.V. Extragenital sexually transmitted infections: epidemiology, clinical presentations, diagnosis, and therapy. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (10): 41-6. (in Russian)
https://dx.doi.org/10.18565/aig.2018.10.41-46