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Gastroenteritis in Men Who Have Sex With Men in Seattle, Washington, 2017-2018.

Authors
  • Newman, Kira L1
  • Newman, Gretchen Snoeyenbos1
  • Cybulski, Robert J2
  • Fang, Ferric C1, 3, 4
  • 1 Department of Medicine, University of Washington School of Medicine, Seattle, USA.
  • 2 Department of Pathology and Area Laboratory Services, Brooke Army Medical Center, San Antonio, Texas, USA.
  • 3 Department of Laboratory Medicine, University of Washington School of Medicine, Seattle, USA.
  • 4 Department of Microbiology, University of Washington School of Medicine, Seattle, USA.
Type
Published Article
Journal
Clinical Infectious Diseases
Publisher
Oxford University Press
Publication Date
Jun 24, 2020
Volume
71
Issue
1
Pages
109–115
Identifiers
DOI: 10.1093/cid/ciz783
PMID: 31621824
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Men who have sex with men (MSM) are at risk for sexual transmission of enteric pathogens. The microbiology of gastroenteritis in MSM has not been examined since the advent of antiretroviral therapy and molecular diagnostics. Our objective was to assess the causes of gastroenteritis among MSM living with and without human immunodeficiency virus (HIV) coinfection in Seattle, Washington. We conducted a retrospective cohort study of 235 MSM who underwent multiplex stool polymerase chain reaction (PCR) testing between 1 January 2017 and 1 June 2018. We abstracted clinical and laboratory data from electronic medical records. Parallel or reflexive culture and susceptibility testing were performed when PCR detected cultivable pathogens. Among 235 MSM tested (268 episodes), 131 had 151 episodes with positive test results. 148 (63.0%) individuals were living with HIV. Among positive tests, 88.7% detected a bacterial pathogen, 26% a virus, and 40% a parasite. Diarrheagenic Escherichia coli (enteroaggretative, enteropathogenic), Shigella, and Campylobacter were the most commonly detected bacteria (33.1%, 30.5%, and 17.2% of positive samples, respectively). Forty-three percent of positive specimens had ≥2 pathogens. Etiologies and clinical presentations were similar between men living with and without HIV. Cultured Shigella and Campylobacter isolates were frequently resistant to multiple antibiotics. MSM present with gastroenteritis from varied pathogens, including some not detected by conventional stool culture. High levels of antibiotic resistance are consistent with frequent antibiotic exposure in this population and the transmission of multiresistant strains. New approaches are needed to detect, treat, and prevent enteric infections in MSM. © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected]

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