International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026
Sexually transmitted enteric infections among men who have sex with men in southern Taiwan: A molecular surveillance study.
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Chu Pin-Cheng, Wang Jiun-Ling, Lee Nan-Yao, Chen Po-Lin, Huang Sung-Hsi, Chen Szu-Ying, Tang Yu-Wen, Tsai Huey-Pin, Lin Ying-Jun, Tsai Pei-Fang, Mao Lin-Wen, Ko Wen-Chien, Tsai Chin-Shiang
Аннотация
BACKGROUND: Sexually transmitted enteric infections (STEIs) are increasingly recognized among men who have sex with men (MSM), yet contemporary surveillance data from Asia remain limited. We conducted a molecular surveillance study to characterize the burden, clinical features, and associated factors of STEIs among MSM in southern Taiwan.
METHODS: Between March 2019 and March 2024, MSM participants were enrolled from several sources, including human immunodeficiency virus outpatient clinics, pre-exposure prophylaxis services, hospitals (for diarrheal illness), and venue-based community outreach programs, regardless of gastrointestinal (GI) symptoms. Stool specimens were tested using multiplex polymerase chain reaction panels targeting enteric pathogens (GI panel) and sexually transmitted pathogens (sexually transmitted infection [STI] panel). Clinical, behavioral, and microbiological data were analyzed to identify factors associated with pathogen detection.
RESULTS: Among 565 participants, 107 (19%) reported GI symptoms at the time of testing. Overall, at least one pathogen detected by the GI or STI panel was noted in 107 participants (19%). Regarding STI pathogens, Chlamydia trachomatis and Neisseria gonorrhoeae were detected in 7% and 3% of participants, respectively. Notably, among the C. trachomatis-positive samples, 11 of 38 (29%) were identified as lymphogranuloma venereum (LGV) strains. Among enteric pathogens, Shigella (4%) was most common, followed by Giardia duodenalis (4%) and Entamoeba histolytica (3%). Multivariable analysis showed that detection of rectal LGV (adjusted odds ratio [aOR] 10.8), proton pump inhibitor use (aOR 7.3), rectal N. gonorrhoeae (aOR 6.8), and insertive anal sex (aOR 3.2) were independently associated with GI panel positivity. Shigella was associated with prior syphilis and concurrent Campylobacter detection. Co-detection of enteric and sexually transmitted pathogens was observed in 21% of 107 pathogen-positive participants.
CONCLUSION: This study provides comprehensive, molecular surveillance of STEIs among MSM in Asia and reveals a significant burden of frequent co-detection with conventional STIs. Rectal LGV had different co-infection patterns compared with non-LGV genotypes. Our findings highlight the need for integrating enteric pathogen surveillance into comprehensive sexual health frameworks for MSM.
METHODS: Between March 2019 and March 2024, MSM participants were enrolled from several sources, including human immunodeficiency virus outpatient clinics, pre-exposure prophylaxis services, hospitals (for diarrheal illness), and venue-based community outreach programs, regardless of gastrointestinal (GI) symptoms. Stool specimens were tested using multiplex polymerase chain reaction panels targeting enteric pathogens (GI panel) and sexually transmitted pathogens (sexually transmitted infection [STI] panel). Clinical, behavioral, and microbiological data were analyzed to identify factors associated with pathogen detection.
RESULTS: Among 565 participants, 107 (19%) reported GI symptoms at the time of testing. Overall, at least one pathogen detected by the GI or STI panel was noted in 107 participants (19%). Regarding STI pathogens, Chlamydia trachomatis and Neisseria gonorrhoeae were detected in 7% and 3% of participants, respectively. Notably, among the C. trachomatis-positive samples, 11 of 38 (29%) were identified as lymphogranuloma venereum (LGV) strains. Among enteric pathogens, Shigella (4%) was most common, followed by Giardia duodenalis (4%) and Entamoeba histolytica (3%). Multivariable analysis showed that detection of rectal LGV (adjusted odds ratio [aOR] 10.8), proton pump inhibitor use (aOR 7.3), rectal N. gonorrhoeae (aOR 6.8), and insertive anal sex (aOR 3.2) were independently associated with GI panel positivity. Shigella was associated with prior syphilis and concurrent Campylobacter detection. Co-detection of enteric and sexually transmitted pathogens was observed in 21% of 107 pathogen-positive participants.
CONCLUSION: This study provides comprehensive, molecular surveillance of STEIs among MSM in Asia and reveals a significant burden of frequent co-detection with conventional STIs. Rectal LGV had different co-infection patterns compared with non-LGV genotypes. Our findings highlight the need for integrating enteric pathogen surveillance into comprehensive sexual health frameworks for MSM.