{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:05:39Z","timestamp":1790665539448,"version":"4.1.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T00:00:00Z","timestamp":1616112000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1147735"],"award-info":[{"award-number":["GNT1147735"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study aimed to identify enteric and sexually acquired rectal pathogens, other than chlamydia and gonorrhea, associated with symptomatic proctitis in men who have sex with men (MSM).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Anorectal swab samples were obtained from MSM presenting with rectal symptoms and a clinical diagnosis of proctitis at the Melbourne Sexual Health Centre between January 2017 and March 2019. Samples that tested positive for Neisseria gonorrhoeae and Chlamydia trachomatis were excluded. As a comparison group, anorectal samples were also obtained from MSM not reporting symptoms of proctitis between November 2018 and February 2019. Samples from both groups were tested for 15 viral, bacterial, and protozoal enteric pathogens using polymerase chain reaction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Anorectal samples from 499 men with symptomatic proctitis and 506 asymptomatic men were analyzed. Age, HIV status, and pre-exposure prophylaxis (PrEP) use did not differ between men with proctitis and asymptomatic men. Treponema pallidum was more common in men with proctitis (risk difference [RD], 3.6%; 95% CI, 2.0%\u20135.2%). Most men with anorectal T. pallidum presented with painful anal primary infections. Shigella spp. was more common among men with proctitis compared with asymptomatic men (RD, 1.8%; 95% CI, 0.1%\u20133.5%). Most men with Shigella did not report diarrhea. Mycoplasma genitalium was more common in men with proctitis (RD, 4.3%; 95% CI, 1.1%\u20137.5%). Herpes simplex virus (HSV)\u20131 (RD, 10.1%; 95% CI, 6.8%\u201313.3%) and HSV-2 (RD, 7.2%; 95% CI, 4.5%\u201310.0%) were more common with proctitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Testing for T. pallidum, Shigella, and HSV should be considered in MSM presenting with symptomatic proctitis. These data provide support for M. genitalium as a significant cause of proctitis. A comprehensive diagnostic evaluation is required for MSM with proctitis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab137","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T17:43:30Z","timestamp":1616175810000},"source":"Crossref","is-referenced-by-count":31,"title":["Nonclassical Pathogens as Causative Agents of Proctitis in Men who Have Sex With Men"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1766-0657","authenticated-orcid":false,"given":"Eric P F","family":"Chow","sequence":"first","affiliation":[{"name":"Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Lee","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Bond","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Maddaford","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Wigan","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenda","family":"Fehler","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigrid A","family":"Lange","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"De Petra","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bissessor","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catriona S","family":"Bradshaw","sequence":"additional","affiliation":[{"name":"Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"},{"name":"Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P","family":"Howden","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane S","family":"Hocking","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah A","family":"Williamson","sequence":"additional","affiliation":[{"name":"Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity at The University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Department of Microbiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Central Clinical School, Monash University, Melbourne, Victoria, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,19]]},"reference":[{"key":"2021102115331772400_CIT0001","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1097\/OLQ.0000000000000614","article-title":"New human immunodeficiency virus diagnosis independently associated with rectal gonorrhea and chlamydia in men who have sex with men","volume":"44","author":"Barbee","year":"2017","journal-title":"Sex Transm 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Are microscopy and proctoscopy worthwhile?","volume":"96","author":"Mwasakifwa","year":"2020","journal-title":"Sex Transm Infect"},{"key":"2021102115331772400_CIT0008","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1056\/NEJM198309083091002","article-title":"The polymicrobial origin of intestinal infections in homosexual men","volume":"309","author":"Quinn","year":"1983","journal-title":"N Engl J Med"},{"key":"2021102115331772400_CIT0009","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/0016-5085(88)90557-4","article-title":"Prevalence of enteric pathogens in homosexual men with and without acquired immunodeficiency syndrome","volume":"94","author":"Laughon","year":"1988","journal-title":"Gastroenterology"},{"key":"2021102115331772400_CIT0010","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1086\/380838","article-title":"Etiology of clinical proctitis among men who have sex with men","volume":"38","author":"Klausner","year":"2004","journal-title":"Clin Infect Dis"},{"key":"2021102115331772400_CIT0011","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.cmi.2015.11.016","article-title":"The contribution of Mycoplasma genitalium to the aetiology of sexually acquired infectious proctitis in men who have sex with men","volume":"22","author":"Bissessor","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"2021102115331772400_CIT0012","doi-asserted-by":"crossref","first-page":"2023","DOI":"10.1056\/NEJMra1907194","article-title":"Emerging and reemerging sexually transmitted infections","volume":"382","author":"Williamson","year":"2020","journal-title":"N Engl J Med"},{"key":"2021102115331772400_CIT0013","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1093\/cid\/ciz005","article-title":"Co-circulation of multidrug-resistant shigella among men who have sex with men in Australia","volume":"69","author":"Ingle","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2021102115331772400_CIT0014","doi-asserted-by":"crossref","first-page":"e396","DOI":"10.1016\/S2352-3018(19)30043-8","article-title":"Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV","volume":"6","author":"Chow","year":"2019","journal-title":"Lancet HIV"},{"key":"2021102115331772400_CIT0015","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciab052","article-title":"Clinical presentation of incident syphilis among men who have sex with men taking HIV pre-exposure prophylaxis in Melbourne, Australia","author":"Peel","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2021102115331772400_CIT0016","doi-asserted-by":"crossref","first-page":"e1917134","DOI":"10.1001\/jamanetworkopen.2019.17134","article-title":"Global epidemiologic characteristics of sexually transmitted infections among individuals using preexposure prophylaxis for the prevention of HIV infection: a systematic review and meta-analysis","volume":"2","author":"Ong","year":"2019","journal-title":"JAMA Netw Open"},{"key":"2021102115331772400_CIT0017","doi-asserted-by":"crossref","first-page":"115221","DOI":"10.1016\/j.diagmicrobio.2020.115221","article-title":"Performance characteristics of the SpeeDx PlexPCR VHS assay for the molecular detection of herpes simplex virus, varicella zoster virus, and Treponema pallidum in lesion swabs","volume":"99","author":"Goldstein","year":"2021","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2021102115331772400_CIT0018","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1056\/NEJM198304143081503","article-title":"Herpes simplex virus proctitis in homosexual men. 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