Distinct Neisseria gonorrhoeae transmission networks among men who have sex with men in Amsterdam, The Netherlands.
BACKGROUND
Molecular typing was used to elucidate Neisseria gonorrhoeae transmission networks among men who have sex with men (MSM) in Amsterdam, the Netherlands. We determined whether clusters of patients infected with specific N. gonorrhoeae genotypes were related to various epidemiological characteristics.


METHODS
MSM (age ≥18 years) visiting the sexually transmitted infections (STI) clinic between July 2008 and August 2009 were eligible. After STI screening, participants completed a behavioral questionnaire concerning the previous 6 months. N. gonorrhoeae cultures were genotyped using multiple-locus variable-number tandem repeat analysis typing.


RESULTS
We obtained 278 N. gonorrhoeae-positive isolates from 240 MSM. Five large clusters (≥10 isolates), a unique sixth cluster (n = 9), and 8 smaller clusters (5-9 isolates) were identified. Prevalence of human immunodeficiency virus differed between clusters I and VI (P = .003), ranging from 27.8% to 100%. Receptive unprotected anal intercourse was frequently reported by MSM (51.8%) but did not differ significantly among clusters. Significant differences were identified concerning the participant's history of syphilis (P = .030), having met partners at a popular sex venue in Amsterdam (P = .048), and meeting partners outside Amsterdam (P = .036).


CONCLUSIONS
Distinct N. gonorrhoeae transmission networks were present in a mixed high-risk MSM population; concordance between clusters and epidemiological characteristics was present but not marked.
Public Health Service (GGD) of Amsterdam, Cluster of Infectious Diseases, Department of Research, Postbox 2200, 1000 CE Amsterdam, The Netherlands.
Raymond
R
Heymans
Amy
A
A Matser
Sylvia M
SM
Bruisten
Titia
T
Heijman
Ronald B
RB
Geskus
Adrianus G C L
AG
Speksnijder
Udi
U
Davidovich
Henry J C
HJ
de Vries
Roel A
RA
Coutinho
Maarten F
MF
Schim van der Loeff
D000328:Adult; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000235:genetics; D005838:Genotype; D006069:Gonorrhea / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D017720:Molecular Epidemiology; D058889:Molecular Typing; D009344:Neisseria gonorrhoeae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D009426:Netherlands / Q000453:epidemiology; D011795:Surveys and Questionnaires
D004269:DNA, Bacterial