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. 2022 Dec 13;226(12):2192-2203.
doi: 10.1093/infdis/jiac408.

Neisseria gonorrhoeae Infection in Women Increases With Rising Gonococcal Burdens in Partners: Chlamydia Coinfection in Women Increases Gonococcal Burden

Xiaohong Su  1 , Wenjing Le  1 , Xiaofeng Zhu  1 , Sai Li  1 , Baoxi Wang  1 , Guillermo Madico  2 , Zhaoyan Yang  3 , Christine E Chaisson  3 , Robert E McLaughlin  4 , Sumanth Gandra  5 , Jungwon Yoon  5 , Bo Zheng  5 , Lisa A Lewis  5 , Sunita Gulati  5 , George W Reed  5 , Sanjay Ram  5 , Peter A Rice  5
Affiliations

Neisseria gonorrhoeae Infection in Women Increases With Rising Gonococcal Burdens in Partners: Chlamydia Coinfection in Women Increases Gonococcal Burden

Xiaohong Su et al. J Infect Dis. .

Abstract

Background: Likelihood of Neisseria gonorrhoeae infection in women exposed to male sex partners with increasing N. gonorrhoeae burdens and enhancement by Chlamydia trachomatis is not defined.

Methods: We identified men with urethritis and their regular female sex partners. Exposure to N. gonorrhoeae burdens in men was compared in N. gonorrhoeae-infected versus -uninfected partners. Association of N. gonorrhoeae infection in women with burdens in male partners was estimated using logistic regression. Association of C. trachomatis coinfection and N. gonorrhoeae burdens in women adjusted for burdens in male partners was estimated by linear regression.

Results: In total, 1816 men were enrolled; 202 had ≥2 partners, 91 who confirmed monogamy and were enrolled; 77% were married. Seventy were partners of N. gonorrhoeae-infected men; 58 (83%) were N. gonorrhoeae infected, 26 (45%) C. trachomatis coinfected. Infected women had partners with 9.3-fold higher N. gonorrhoeae burdens than partners of uninfected women (P = .0041). Association of N. gonorrhoeae infection in women with upper quartiles of N. gonorrhoeae burdens in partners increased (odds ratios ≥ 2.97)compared to the first quartile (P = .032). N. gonorrhoeae burdens in C. trachomatis-coinfected women were 2.82-fold higher than in C. trachomatis-uninfected women (P = .036).

Conclusions: N. gonorrhoeae infections increased in women whose partners were infected with higher N. gonorrhoeae burdens. C. trachomatis coinfection was associated with increased N. gonorrhoeae burdens in women.

Keywords: Chlamydia trachomatis infection in women; Neisseria gonorrhoeae.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Men: enrollment (overall) of men with urethritis (having ≥2 sex contacts) and enrolled into this study. Women: identification of regular female sex partners, number contacted and screened, and number eligible and enrolled into this study. Abbreviation: NGU, nongonococcal urethritis.
Figure 2.
Figure 2.
The relative abundance of 11 (of the top 25) bacterial genera measured in Neisseria gonorrhoeae (NG)-infected and/or Chlamydia trachomatis (CT)-infected cervicovaginal lavage specimens that had values significantly different from specimens with neither organism (neg), calculated by t test. Normalized read values of operational taxonomic units (OTUs), quantitated against the SILVA 16s database (https://www.arb-silva.de/) [20] that clustered at 97% OTUs were measured in specimens infected with both N. gonorrhoeae and C. trachomatis (NGCT), C. trachomatis, or N. gonorrhoeae and compared with values in specimens with neither organism (neg). *P < .05, **P < .01, and ***P < .001 denote abundance values that are significantly greater than neither organism (neg). Asterisks denote values significantly greater or less than neg.
Figure 3.
Figure 3.
The load (log10 of colony forming unit equivalents) of Neisseria gonorrhoeae in men and N. gonorrhoeae infection status in 70 exposed monogamous female sex partners. Comparison of the means of N. gonorrhoeae burdens in men whose partners were N. gonorrhoeae-infected versus N. gonorrhoeae-uninfected partners was calculated by t test.
Figure 4.
Figure 4.
The number of coital exposures between Neisseria gonorrhoeae-infected men and their female sex partners and the resultant number of infections in women. The total number of exposures associated with N. gonorrhoeae infection in women was tested using a nonparametric test of trend that examined if the rate of N. gonorrhoeae increased with increasing number of exposures.
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References

    1. Johnson B. OSHA infectious dose white paper. Appl Biosaft 2003; 8:160–5.
    1. Liu Y, Feinen B, Russell MW. New concepts in immunity to Neisseria gonorrhoeae: innate responses and suppression of adaptive immunity favor the pathogen, not the host. Front Microbiol 2011; 2:52. - PMC - PubMed
    1. Hobbs MM, Sparling PF, Cohen MS, Shafer WM, Deal CD, Jerse AE. Experimental gonococcal infection in male volunteers: cumulative experience with Neisseria gonorrhoeae strains FA1090 and MS11mkC. Front Microbiol 2011; 2:123. - PMC - PubMed
    1. Dubbink JH, de Waaij DJ, Bos M, et al. Microbiological characteristics of Chlamydia trachomatis and Neisseria gonorrhoeae infections in South African women. J Clin Microbiol 2016; 54:200–3. - PMC - PubMed
    1. Papadogeorgakis H, Pittaras TE, Papaparaskevas J, Pitiriga V, Katsambas A, Tsakris A. Chlamydia trachomatis serovar distribution and Neisseria gonorrhoeae coinfection in male patients with urethritis in Greece. J Clin Microbiol 2010; 48:2231–4. - PMC - PubMed

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