Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them? / Alarmante incidencia de reinfecciones tras el tratamiento de Chlamydia trachomatis y gonorrea: ¿podemos predecirlas y prevenirlas?

Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. Methods: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. Results: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9–19.7) and 24.65% (CI95%: 21.9–27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3–2.6), men who have sex with men (OR=1.8; CI95%: 1.3–2.6), number of sexual partners (OR=4.3; CI95%: 2.7–6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08–2.6), not always using a condom (OR=1.4; CI95%: 1.02–1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5–9.5) were associated with reinfection by any STI. Conclusion: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.(AU)

Introducción: Las infecciones por Chlamydia trachomatis (CT) y Neisseria gonorrhoeae (NG) son un problema de salud pública, agravado por frecuentes reinfecciones, cuya incidencia desconocemos en España. Objetivos: Estimar en pacientes diagnosticados de NG, CT o infección mixta (NG y CT): 1) la incidencia de reinfecciones por el mismo germen, 2) la incidencia total de infecciones de transmisión sexual (ITS), tanto por el mismo germen, como por infecciones diferentes a la inicial y 3) identificar características que predicen la reinfección. Métodos: Estudio observacional prospectivo de una serie de casos: 986 pacientes diagnosticados de CT y/o NG en las consultas de ITS de Bizkaia (España) entre septiembre de 2016 a enero de 2019. Resultados: En 6 meses de seguimiento promedio la incidencia de reinfección por el mismo germen fue del 17,24% (IC95%: 14,9-19,7) y la de cualquier ITS (reinfección u otra) del 24,65% (IC95%: 21,9-27,4). Los factores asociados con la reinfección por cualquier ITS fueron: ser inmigrante (OR=1,8; IC95%: 1,3-2,6), hombre que tiene sexo con hombres (OR=1,8; IC95%: 1,3-2,6), número de parejas sexuales (OR=4,3; IC95%: 2,7-6,8 para más de 5 parejas), tener una pareja nueva (OR=1,7; IC95%: 1,08-2,6), no utilizar siempre preservativo (OR=1,4; IC95%: 1,02-1,9) y consumo de alcohol en relación al sexo (OR=3,8; IC95%: 1,5-9,5). Conclusión. Estas características sirven para identificar pacientes de alto riesgo en los que priorizar el rescreening de ITS tras una infección, que debe ser completo, incluyendo otras infecciones diferentes a la inicial.(AU)

Alarming incidence of reinfections after treatment for Chlamydia trachomatis and gonorrhoea: Can we predict and prevent them?

BACKGROUND: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are a public health problem, worsened by frequent reinfections, whose incidence rate is not known in Spain. The objective of this study is to estimate in patients diagnosed with NG, CT or mixed infection (NG and CT): (1) the incidence of reinfections by the same microorganism, (2) the total incidence of Sexually Transmitted Infections (STI), both by the same microorganism and by infections other than the initial one, and (3) to identify predictors of reinfection. METHODS: Observational prospective case series involving 986 patients with CT and/or NG at specialized STI clinics in Biscay (Spain) between 2016 and 2019. RESULTS: The six month cumulative incidence of reinfection by the same microorganism was 17.24% (CI95%: 14.9-19.7) and 24.65% (CI95%: 21.9-27.4) for any STI (reinfection or other). Being an immigrant (OR=1.8; CI95%: 1.3-2.6), men who have sex with men (OR=1.8; CI95%: 1.3-2.6), number of sexual partners (OR=4.3; CI95%: 2.7-6.8 for more than 5 partners), having a new partner (OR=1.7; CI95%: 1.08-2.6), not always using a condom (OR=1.4; CI95%: 1.02-1.9) and consumption of alcohol prior to sex (OR=3.8; CI95%: 1.5-9.5) were associated with reinfection by any STI. CONCLUSION: These characteristics allow doctors to identify patients in whom to prioritize short-term rescreening for repeated infections with any STIs after initial treatment for NG or CT.