Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature

Chan, Philip A.; Robinette, Ashley; Montgomery, Madeline; Almonte, Alexi; Cu-Uvin, Susan; Lonks, John R.; Chapin, Kimberle C.; Kojic, Erna M.; Hardy, Erica J.

doi:10.1155/2016/5758387

Cited by 330Reproductive tract infections researchCervical Cancer and HPV ResearchHIV/AIDS Research and Interventions

Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature

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Chan, Philip A., Robinette, Ashley, Montgomery, Madeline, Almonte, Alexi, Cu-Uvin, Susan, Lonks, John R., Chapin, Kimberle C., Kojic, Erna M. +1 more·2016·Infectious Diseases in Obstetrics and Gynecology

DOI 10.1155/2016/5758387PMC PMC4913006

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Abstract

In the United States, sexually transmitted diseases due to Chlamydia trachomatis and Neisseria gonorrhoeae continue to be a major public health burden. Screening of extragenital sites including the oropharynx and rectum is an emerging practice based on recent studies highlighting the prevalence of infection at these sites. We reviewed studies reporting the prevalence of extragenital infections in women, men who have sex with men (MSM), and men who have sex only with women (MSW), including distribution by anatomical site. Among women, prevalence was found to be 0.6-35.8% for rectal gonorrhea (median reported prevalence 1.9%), 0-29.6% for pharyngeal gonorrhea (median 2.1%), 2.0-77.3% for rectal chlamydia (median 8.7%), and 0.2-3.2% for pharyngeal chlamydia (median 1.7%). Among MSM, prevalence was found to be 0.2-24.0% for rectal gonorrhea (median 5.9%), 0.5-16.5% for pharyngeal gonorrhea (median 4.6%), 2.1-23.0% for rectal chlamydia (median 8.9%), and 0-3.6% for pharyngeal chlamydia (median 1.7%). Among MSW, the prevalence was found to be 0-5.7% for rectal gonorrhea (median 3.4%), 0.4-15.5% for pharyngeal gonorrhea (median 2.2%), 0-11.8% for rectal chlamydia (median 7.7%), and 0-22.0% for pharyngeal chlamydia (median 1.6%). Extragenital infections are often asymptomatic and found in the absence of reported risk behaviors, such as receptive anal and oral intercourse. We discuss current clinical recommendations and future directions for research.

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Basing screening practices solely on history might be suboptimal because providers might feel uncomfortable taking a detailed sexual history, men might also feel uncomfortable sharing personal sexual information with their provider, and rectal and pharyngeal infections can be identified even in the absence of reported risk behaviors.
“Basing screening practices solely on history might be suboptimal because providers might feel uncomfortable taking a detailed sexual history (229), men might also feel uncomfortable sharing personal sexual information with their provider, and rectal and pharyngeal infections can be identified even in the absence of reported risk behaviors (171).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [171]
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Among MSM, prevalence of rectal gonorrhea and chlamydia ranges from 0.2% to 24% and 2.1% to 23%, respectively, and prevalence of pharyngeal gonorrhea and chlamydia ranges from 0.5% to 16.5% and 0% to 3.6%, respectively.
“Studies have demonstrated that among MSM, prevalence of rectal gonorrhea and chlamydia ranges from 0.2% to 24% and 2.1% to 23%, respectively, and prevalence of pharyngeal gonorrhea and chlamydia ranges from 0.5% to 16.5% and 0% to 3.6%, respectively (171).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [171]

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Authors: Chan, P. A., Robinette, A., Montgomery, M., Almonte, A., Cu-Uvin, S., Lonks, J. R., Chapin, K. C., Kojic, E. M., & Hardy, E. J.
Affiliations: Brown University (US)
Division of Infectious Diseases, Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI 02903, USA
Rhode Island Hospital (US)
Corresponding author: Chan, Philip A.
ORCID: Chan, Philip A.
Robinette, Ashley
Montgomery, Madeline
Almonte, Alexi
Cu-Uvin, Susan
Lonks, John R.
Chapin, Kimberle C.
Hardy, Erica J.
Venue: Infectious Diseases in Obstetrics and Gynecology
Publisher: Wiley
Published: 2016
Volume: 2016
Pages: 1-17
ISSN: 1064-7449 (ISSN-L)
1098-0997
DOI: 10.1155/2016/5758387
PMC: PMC4913006
OpenAlex: W2413108535
Cited by: 330
References: 171
Citations by year: 2026: 19 · 2025: 17 · 2024: 44 · 2023: 35 · 2022: 39 · 2021: 58 · 2020: 42 · 2019: 33 · 2018: 27 · 2017: 15
FWCI: 2.76
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0/ (unspecified)
Locations: Infectious Diseases in Obstetrics and Gynecology (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: National Institutes of Health (K23AI096923, P30AI042853)
National Institute of Allergy and Infectious Diseases (K23AI096923, P30AI042853)
Topics: Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: Chlamydia trachomatis, Neisseria gonorrhoeae, extragenital infection, rectal gonorrhea, pharyngeal gonorrhea, rectal chlamydia, sexually transmitted infections, prevalence, men who have sex with men, women, asymptomatic infection, screening
MeSH terms: Chlamydia Infections, Chlamydia trachomatis, Female, Gonorrhea, Humans, Male, Neisseria gonorrhoeae, Sexual Behavior

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Extragenital Infections Caused by Chlamydia trachomatis and Neisseria gonorrhoeae: A Review of the Literature

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