To study the prevalence and clinical features of extragenital forms of sexually transmitted infections (prospective observational clinical and laboratory study)

Background. In preventing the spread of sexually transmitted infections (STIs), timely detection of extragenital localization of the pathogen is important. Modern studies demonstrate a wide prevalence of extragenital forms of STIs not only in men who practice sex with men, but also in heterosexual men and women. However, according to Russian and a number of foreign clinical guidelines, the basis of STI screening includes studies of only urethral, vaginal and cervical samples, which leads to incomplete registration of extragenital infections and contributes to their further spread.

Aims. To study the frequency of prevalence and clinical features of extragenital forms of STIs in heterosexual men and women and men who have sex with men.

Materials and methods. A prospective observational clinical and laboratory study included 57 patients with a history of unprotected orogenital and/or anogenital sexual contacts: group I (n = 20) — women practicing heterosexual sexual contacts, group II (n = 9) — men practicing heterosexual sexual contacts, group III (n = 28) — men who have sex with men (MSM). The identification of STIs was conducted by the polymerase chain reaction method and the ribosomal RNA NASBA detection method was used as an independent additional direct method.

Results. A high level of detection of STIs of extragenital localization has been established: in heterosexual women — in the rectum (10; 76.9%), in the oropharynx (9; 69.2%) and in the conjunctiva (2; 15.4%); in heterosexual men — in the rectum (2; 40%), in the conjunctiva (2; 40%) and in the oropharynx (1; 20%); in MSM — in the rectum (15; 75%), in the oropharynx (11; 55%) and in the conjunctiva (5; 25%); in 14 (36.8%) patients, STI infection of more than 2 localizations was found. In extragenital foci of chlamydia trachomatis infection in group I was most frequently detected (5; 38.5%), in group II — gonococcal infection (2; 40%), in group III — syphilis (9; 45%), gonococcal infection (8; 40%) and chlamydia trachomatis infections (8; 40%). Asymptomatic infections in conjunctiva were detected in 4 (10.5%) patients, in oropharynx — in 15 (39.5%), in rectum — in 22 (57.9%) patients.

Conclusions. The high level of detection of extragenital STIs and their frequent asymptomatic course dictates the need to study clinical samples from the oropharynx, rectum and conjunctiva not only when detecting objective and/or subjective symptoms of diseases, but also when there is a history of unprotected orogenital and/or anogenital sexual contacts, as well as when detected infections of genital localization.