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Infection with Neisseria gonorrhoeae, the causative agent of gonorrhea, causes significant morbidity worldwide and can have long-term impacts on reproductive health. The greatest global burden of gonorrhea occurs in low- and middle-income settings. Global public health significance is increasing due to rising antimicrobial resistance, which threatens future gonorrhea management. The oropharynx is an important asymptomatic reservoir for gonorrhea transmission and a high-risk site for development of antimicrobial resistance and treatment failure. Controlled human infection model (CHIM) studies using N gonorrhoeae may provide a means to accelerate the development of urgently needed therapeutics, vaccines, and other biomedical prevention strategies. A gonorrhea urethritis CHIM has been used since the 1980s with no reported serious adverse events. Here, we describe the rationale for an oropharyngeal gonorrhea CHIM, including analysis of potential ethical issues that should inform the development of this novel study design.
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http://dx.doi.org/10.1093/infdis/jiaf029 | DOI Listing |
Sex Transm Dis
August 2025
Heersink School of Medicine, Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL.
Background: For people who have anal and/or oral sex, many programs recommend genital and extragenital (defined here as anorectal and oropharyngeal) screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) to identify all potential sites of infection.
Methods: We assessed genital and extragenital CT and NG prevalence among people reporting extragenital sexual exposure.
Results: Among 343 gay and bisexual men who reported sex with men (GBMSM), 42 (12.
BMJ Open
August 2025
Department of Medicine, University of Washington, Seattle, Washington, USA.
Objectives: To assess the prevalence, incidence and factors associated with (CT) and (NG) infection among HIV-negative men who have sex with men (MSM) and transgender women (TGW) in Kenya.
Design: Prospective cohort.
Setting: Kisumu, Nairobi and coastal Kenya.
Lancet Microbe
July 2025
Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia; School of Medicine, University of St Andrews, Fife, Scotland. Electronic address:
Background: Neisseria gonorrhoeae is a human pathogen of major public health importance due to its increasing global prevalence and antimicrobial resistance (AMR). Evidence suggests that oropharyngeal infection plays a key role in N gonorrhoeae transmission and AMR; however, our understanding of oropharyngeal gonorrhoea pathogenesis is poor. A controlled human infection model (CHIM) for oropharyngeal gonorrhoea will improve understanding of infection and accelerate urgently needed novel gonorrhoea prevention and therapeutic strategies.
View Article and Find Full Text PDFJAC Antimicrob Resist
August 2025
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Objectives: Doxycycline post-exposure prophylaxis (doxyPEP) can reduce incident sexually transmitted infections including gonorrhoea for MSM and transgender women. Its effectiveness depends on the level of tetracycline resistance in , which varies by country. Countries implementing doxyPEP should have robust antimicrobial resistance (AMR) surveillance using standardized, quality-assured methods.
View Article and Find Full Text PDFJ Infect
August 2025
Infectious Disease Epidemiology Group, Weill Cornell Medicine - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA; Department of Public Health, College of Health Science
Objectives: The epidemiology of Neisseria gonorrhoeae (NG) infection in South-East Asia remains inadequately understood. This study aimed to systematically review and analyze the available evidence on NG prevalence to provide an understanding of the epidemiology in this region, highlighting prevalence patterns, key populations at risk, and factors influencing transmission.
Methods: A systematic review of the literature up to September 3, 2024, was conducted, with findings reported in accordance with PRISMA guidelines.