title: Should we screen heterosexuals for extra-genital chlamydial and gonococcal infections?
abstract: Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are two of the most prevalent bacterial sexually transmitted infections in the UK. Although the high burden of extra-genital infections with GC and CT in men who have sex with men has been well established, a significant number of extra-genital site infections with CT and GC could similarly be present in heterosexual women. For this reason we started to routinely offer extra-genital site testing for GC and CT in all patients attending our sexual health clinic who reported having had receptive anal sex and/or giving oral sex. This followed a review of current evidence by the clinical team and a change in local testing policy. This study not only confirmed a large reservoir of extra-genital infection amongst men who have sex with men, but also demonstrates that a comparable reservoir of extra-genital infection is present amongst heterosexual women. Our study adds to the mounting evidence that extra-genital site testing in heterosexual women should occur when oral or anal sexual activity is reported.
authors.affiliation: Manchester Centre for Sexual Health, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK anna.garner@rothgen.nhs.uk.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Garner
authors.affiliation: Manchester Centre for Sexual Health, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Schembri
authors.affiliation: Manchester Centre for Sexual Health, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cullen
authors.affiliation: Manchester Centre for Sexual Health, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
authors.forename: Vincent
authors.initials: V
authors.lastname: Lee
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D015331:Cohort Studies; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D020010:Heterosexuality; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D009344:Neisseria gonorrhoeae / Q000302:isolation & purification; D021141:Nucleic Acid Amplification Techniques; D010614:Pharynx / Q000382:microbiology*; D015995:Prevalence; D012007:Rectum / Q000382:microbiology*; D006113:United Kingdom / Q000453:epidemiology; D014505:Urban Population
keywords: Heterosexual; chlamydia; extra-genital infection; gonorrhoea; pharyngeal; rectal; screening; sexually transmitted infection; throat; women