Abstract: objective: to determine the prevalence of lymph swelling (LGV)and non-
LGV-related serum of chlamydia urethra and rectum (CT)
Male infection in sexual relations with men (MSM).
Design: multi-center crossover
Segment survey.
Location: four urological medical clinics in the UK from 2006.
Study subjects: 4825 urethra and 6778 rectal samples of consecutive male gay men who participated in sexual health screening.
Methods: A standard nucleic acid amplification test was used to perform a CT test on the urethra swab or urine and rectal swab. Chlamydia-
Positive specimens were sent to the reference laboratory for serovar determination.
Main results: Positive for LGV and non-LGV
CT serum related to LGV;
Proportion of cases with symptoms.
Results: enthusiasm (
95% confidence intervals)
6 in rectal specimens. 06% (5. 51% to 6. 66%)for non-LGV CT and 0. 90% (0. 69% to 1. 16%)for LGV;
Urethra sample 3. 21% (2. 74% to 3. 76%)for non-LGV CT and 0. 04% (0. 01% to 0. 16%)for LGV.
Most of LGV has symptoms (
Rectal 95%, one of 2 cases of urethra); non-
Chlamydia LGV is mostly manifested as urinary tract symptoms (68%)
But not in the rectum. 16%).
Conclusion: among men who have sex with men who participate in sexual health screening, algae infection is common, most of which are non-
LGV related serum.
We did not find a large number of asymptomatic LGV in the rectum or urethra.
Men who have sex with men who require sexual health screening should include tests for rectal and urinary chlamydia, but serovar-
Typing is not displayed when there are no symptoms.
We have not yet identified the source of most LGV cases in the UK.
Lymph swelling of sexually transmitted diseases (LGV)has re-
Is an important sexually transmitted infection (STI)
In men who have sex with men (MSM)
In Britain and Europe.
Following the initial outbreaks and case clusters in the Netherlands, Germany, the UK and France, several other places in Europe, North America and Australia were also reported.
1 there were sporadic LGV cases in the West before these outbreaks, although it may not have
Diagnosed due to limited diagnostic methods and facilities.
LGV is an established cause of straight inflammation in men who have sex with men, but the prevalence and clinical profile of infection are unknown.
2 previously the outbreak of LGV appeared to have a relatively short life span, but there is growing evidence that LGV has now become a popular disease for men who have sex with men in the UK.
From October 2004 to December 2008, the National Reference Center identified LGV in 854 isolates (
(Unpublished data).
The clinical features of recent LGV cases have been documented, but there are many outstanding issues regarding the spread and persistence of infection in the population.
The vast majority of cases are rectal, with fewer cases diagnosed from the urinary and reproductive system.
The risk factors for obtaining the report included HIV infection, other sexually transmitted infections, anal enema use, unprotected receptive anal sex, attending sex parties, reporting punches and using sex toys.
These findings suggest that transmission may be primarily rectal-to-
Stimulate the rectum through intermediate transportation on the hand or toys or enema equipment.
However, this does not explain the spread of men who only report that anal origin may be an infection of the urinary and reproductive system.
In the UK, if there is a significant asymptomatic LGV, this will not be detected through conventional pathways, as the LGV typing is performed only for those patients whose clinical symptoms suggest infection.
Although the urinary tract examination of chlamydia is now usually performed in the clinic, rectal screening is not routinely performed in all clinics.
7 therefore, we conducted a case-finding activity in which four clinics standardized routine testing of chlamydia to estimate the prevalence of LGV and non-LGV
Chlamydia LGV (CT)
Among men who have sex with men in the UK, determine whether there is a large number of asymptomatic urinary system or rectal LGV infections that may be a reservoir of undiagnosed and untreated infections.
Methods men who have sex with men in four kinds of urinary and reproductive medicine (GUM)
The UK's sexual health screening clinic has performed a urinary and rectal CT test, regardless of the symptoms.
Data collection takes place between 2006 and 2007, with limited time per clinic, usually three months.
The basis for choosing these clinics is that they have reported a large number of LGV cases and have served a large number of men who have sex with men.
They have tested chlamydia in men and lesbians, but rectal examination is often limited to people with symptoms.
Before the start of this initiative, CT-
Positive specimens are forwarded to the reference laboratory for LGV typing only if the patient meets the inclusion criteria --
That is to say, there are symptoms that prompt LGV, or there is a connection with LGV.
In the process of finding a case, all men who have sex with men in each clinic have a rectal swab and a sample of urine or urethra for chlamydia testing, regardless of symptoms, based on sexual risk assessment.
A sample of rectal and urinary tract/urine was tested in a local diagnostic laboratory using the Probetec chain replacement test (
Sparks Picton Dickinson SDA, Maryland, USA)
Or combined loudspeaker (
Roche diagnostic system, Fort Blanc, New Jersey, USA)
For the identification of CT.
All samples with positive CT detection were sent to the reference laboratory of sexually transmitted bacteria (STBRL)
LGV-for LGV testingspecific real-
Time PCR (PCR)assay.
Only positive rectal samples were forwarded for LGV typing in one clinic.
The clinic recorded the number of urinary and rectal tests performed on men who had sex with men during the data collection, which were collated with the results of the chlamydia test and LGV typing.
For all LGV cases, the clinic is required to confirm whether the patient has symptoms;
As a case,
The three clinics of lgv ct are also able to provide symptom data.
Both patients reported whether the patient had symptoms (
Discharge from hospital, post-emergency weight, rectal bleeding, rectal pain, change of defecation habits, urinary tract symptoms)
Or according to clinical findings (
Straight officer inflammation, mucus discharge, direct officer mirror examination and contact bleeding seen during sampling).
Colonoscopy was performed in all patients.
No approval from the ethics committee and consent from the individual patient as this is considered to be the standard case investigation work in the context of the outbreak investigation;
The tests performed comply with the existing clinical guidelines;
Routine detection of chlamydia rectal has been standard care in many clinics and recommended by the BASHH guidelines of 2006.
Seven or Nine patients were informed of the ongoing test.
As part of case monitoring, data from LGV patients were collected retroactively.
Regardless of the symptoms, all CT
During this period, the positive specimens obtained at these centers were transferred to LGV typing, which makes sense, as the symptoms LGV rate in London/Brighton has not yet been determined in this epidemic.
Confirmed LGV-
Positive specimens communicate these results to them and manage them as appropriate in their respective clinics.
Results there were 4825 cases of urinary/urinary tract and 6778 rectal samples of men who had sex with men in 4 clinics.
In these samples, the overall prevalence of CT was 3.
25% within the urethra (
157 positive test)and 6.
Rectal 96% (
472 positive test).
Table 1 shows both LGV and non-
Lgv ct positive overall and clinical of urethra and rectal specimens.
Most CT of the two anatomical sites is attributed to non-LGV strains (99.
4% within the urethra, 87.
1% in the rectum).
The findings of the clinic are consistent.
View this table: View the inline View pop-up table 1 chlamydia (CT)
Swollen lymph ball (LGV)and non-
Clinical data show that LGV chlamydia positive in the urethra and rectal specimens of men who have sex with men can be used in all LGV cases and all urinary tract non-
Lgv ct infection;
Lack of clinical data for 110/411 (26. 8%)
Non-induced rectal infectionLGV CT.
LGV is mainly characterized by symptoms: 58 of 61 rectal cases (95%)
One of two cases of urethra
In center A, 2 of 38 cases of rectal LGV were infected with gonorrhoea;
One was asymptomatic and the other had secretions and straight officer inflammation. Details on co-
There were no cases of infection in other centers. Non-
Chlamydia LGV is mostly manifested as urinary tract symptoms (
105 cases of 155, 67. 7%)
But not in the rectum. 49/301, 16. 3%).
Discussion of this large study conducted in unselected men who had sex with men at London and Brighton GUM clinics showed an estimated prevalence of 0 for LGV.
Rectal 90%, 0.
Urinary tract 04%, changes are small in the four centers included in this study.
We did not find a large reservoir of the urethra LGV or the asymptomatic rectal LGV.
We found only two cases of the urethra LGV, so it is not possible to further summarize this performance.
The majority of cases of rectal LGV are male with symptoms. Co-
For example, in a center with records, a small number of cases were infected with gonoseria. Non-
LGV chlamydia is more common in the rectum, most of which are asymptomatic and have symptoms in the urethra.
This is the largest study to date to estimate the prevalence of LGV among men who have sex with men, and it has the advantage of having men participate in clinics serving different local populations.
This study is limited due to the lack of detailed data on all screened persons, so we are unable to provide a real prevalence estimate as individuals may have been screened more than once, for all screened persons, or some patients with chlamydia, we have no details of the symptoms.
The lack of these and related data, such as HIV status, reflects the nature of the study: It was established as part of an outbreak survey with the aim of identifying undiagnosed cases that may help control the work.
The proportion of cases is relatively small (6%)
It is asymptomatic and it does not seem likely that this situation is the main factor of continuous transmission.
A related study from another large Clinic in London screened 3076 men who had not been selected for male sex and found that the overall prevalence of LGV was similar to 36 cases (1. 17%)
Among them, there are 35 rectum and 1 urethra.
They reported a higher proportion of asymptomatic rectal cases (
Compared with 17% in the present study, 5% did not achieve statistical significance p = u200a 0. 069).
To sum up, these results do not provide sufficient evidence to suggest routine screening of rectal LGV for all men who have sex with men.
Current recommendation for LGV-CT diagnostic teststyping of CT-
Positive specimens of straight-inflammation male or LGV male contacts should be kept in place.
These findings are in contrast to reports in the Netherlands, where most of the reported LGV cases are asymptomatic.
6 11 our findings came from a sample of men who participated in the gum clinic rather than an unselected population, but this is unlikely to explain the difference as they are similar to the study environment in the Netherlands.
Key news: the swelling of the lymph ball that continues to erupt (LGV)
In men who have sex with men (MSM)in the UK.
LGV was identified at 1% and