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Prevalence and risk factors of bacterial enteric pathogens in men who have sex with men: a cross-sectional study at the UK's largest sexual health service

Mitchell, Holly D; Whitlock, Gary; Zdravkov, Jey; Olsson, Jenny; Silalang, Panida; Bardsley, Megan; Blomquist, Paula B; ... Hughes, Gwenda; + view all (2023) Prevalence and risk factors of bacterial enteric pathogens in men who have sex with men: a cross-sectional study at the UK's largest sexual health service. Journal of Infection , 86 (1) pp. 33-40. 10.1016/j.jinf.2022.10.033. Green open access

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Abstract

OBJECTIVES: Outbreaks of bacterial enteric pathogens (BEPs) in men who have sex with men (MSM) associated with antimicrobial resistance are a public health concern. We investigated the prevalence and risk factors of BEPs in MSM to inform infection control. METHODS: We conducted a cross-sectional study at a London sexual health clinic between 20/12/2017 and 06/02/2018. Residual rectal swabs from MSM attending for sexually transmitted infection (STI) testing were anonymously tested for a range of BEPs using real-time PCR. A sub-set of samples were tested for the mphA gene (a marker of azithromycin resistance). Results were linked to electronic health records. RESULTS: BEPs were detected in 207 of 2,116 participants, giving an overall prevalence of 9·8% (95% CI 8·5%-11·1%) ranging from 0·8% (0·4%-1·2%) for Shigella to 4.9% (4·0%-5·9%) for Enteroaggregative E. coli. MSM with BEPs were more likely to have a history of bacterial STIs (p=0·010), to report more sexual partners (p<0·001), and among HIV-negative MSM, to report current HIV pre-exposure prophylaxis use (p<0·001). Gastrointestinal symptoms were rare (1·7%) and not associated with BEPs. 41·3% of MSM with BEPs and 14·1% of those without BEPs carried mphA (p<0·001). Among the former, this was associated with a history of bacterial STIs (51·5% vs 31·1%, p=0·003). CONCLUSIONS: One in ten MSM had a BEP detected and most did not report symptoms. MphA carriage was common, particularly among those with BEPs. Bacterial STI treatment might contribute to selection of resistant gut organisms, emphasising the need for better antimicrobial stewardship.

Type: Article
Title: Prevalence and risk factors of bacterial enteric pathogens in men who have sex with men: a cross-sectional study at the UK's largest sexual health service
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.jinf.2022.10.033
Publisher version: https://doi.org/10.1016/j.jinf.2022.10.033
Language: English
Additional information: Crown Copyright © 2022. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Asymptomatic Infections, Bacterial, Bacterial Infections, Cross-Sectional Studies, Drug Resistance, Bacterial, Prevalence, Sexually Transmitted Diseases, Sexual Behavior
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10159625
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