Prevalence and characteristics of gastrointestinal infections in men who have sex with men diagnosed with rectal chlamydia infection in the UK: an ‘unlinked anonymous’ cross-sectional study.
Abstract
Introduction Gastrointestinal infections (GII) can cause serious ill health and morbidity. Although primarily transmitted through faecal contamination of food or water, transmission through sexual activity is well described, especially among men who have sex with men (MSM). Methods We investigated the prevalence of GIIs among a convenience sample of MSM who were consecutively diagnosed with rectal Chlamydia trachomatis (CT) at 12 UK genitourinary medicine clinics during 10 weeks in 2012. Residual rectal swabs were coded, anonymised and tested for Shigella, Campylobacter, Salmonella, shiga toxin-producing Escherichia coli and enteroaggregative E. coli (EAEC) using a real-time PCR. Results were linked to respective coded and anonymised clinical and demographic data. Associations were investigated using Fisher's exact tests. Results Of 444 specimens tested, overall GII prevalence was 8.6% (95% CI 6.3% to 11.6%): 1.8% (0.9% to 3.6%) tested positive for Shigella, 1.8% (0.9% to 3.6%) for Campylobacter and 5.2% (3.5% to 7.7%) for EAEC. No specimens tested positive for Salmonella or other diarrhoeagenic E. coli pathotypes. Among those with any GII, 14/30 were asymptomatic (2/7 with Shigella, 3/6 with Campylobacter and 9/17 with EAEC). Shigella prevalence was higher in MSM who were HIV-positive (4.7% (2.1% to 10.2%) vs 0.5%(0.1% to 3.2%) in HIV-negative MSM; p=0.01). Conclusions In this small feasibility study, MSM with rectal CT appeared to be at appreciable risk of GII. Asymptomatic carriage may play a role in sexual transmission of GII.
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Global increases in the incidence of shigellosis among adult MSM have been more recently observed.
“Global increases in the incidence of shigellosis among adult MSM have been more recently observed (252–256).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [256]
The Introduction reports a sharp rise in diagnoses of non-travel-associated Shigella flexneri in England and describes sexual transmission among MSM. It does not establish a global increase in shigellosis incidence among adult MSM; the study’s own results measure prevalence in a selected UK group, not incidence trends. (LLM, conf=0.85)
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Cites
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- Authors
- Hughes, G., Silalang, P., Were, J., Patel, H., Childs, T., Alexander, S., Duffell, S., Saxon, C., Ison, C., Mitchell, H., Field, N., & Jenkins, C.
- Affiliations
- Public Health England (GB)
- Corresponding author
- Hughes, Gwenda
- Venue
- Sexually Transmitted Infections
- Publisher
- BMJ
- Published
- 2017-03-30
- Volume
- 94
- Issue
- 7
- Pages
- 518-521
- ISSN
- 0007-134X (ISSN-L)
- 1368-4973
- 1472-3263
- OpenAlex
- W2601177436
- Cited by
- 27
- References
- 15
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 3
- FWCI
- 2.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sexually Transmitted Infections (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- gastrointestinal infections, men who have sex with men, Shigella, Campylobacter, enteroaggregative Escherichia coli, asymptomatic carriage, sexual transmission, HIV, prevalence, rectal swabs
- MeSH terms
- Adult, Chlamydia Infections, Chlamydia trachomatis, Cross-Sectional Studies, Escherichia coli, Escherichia coli Infections, Feasibility Studies, Gastrointestinal Diseases, Gonorrhea, United Kingdom, Humans, Male, Mass Screening, Neisseria gonorrhoeae, Rectal Diseases, Rectum, Risk Factors, Sexual Behavior, Sexually Transmitted Diseases, Bacterial, Prevalence, Polymerase Chain Reaction, Homosexuality, Male, Asymptomatic Infections
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