{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:53:31Z","timestamp":1791309211844,"version":"4.3.1"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,9,25]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Gonorrhoea<\/jats:italic>\n                      is a common sexually transmitted infection (STI) among men who have sex with men (MSM). Nucleic acid amplification tests (NAATs) are the recommended diagnostic method; however, the interpretation of positive results in asymptomatic individuals remains uncertain. The aim of this study was to identify factors associated with positive culture results in NAAT-confirmed rectal gonorrhoea.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included individuals receiving HIV care, pre-exposure prophylaxis or STI screening at the Infectious Diseases Unit of San Raffaele Hospital, Milan, Italy, between January 2021 and January 2025. Individuals with NAAT-confirmed rectal\n                      <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                      who also underwent culture testing were included. Demographic and clinical data were collected. Group comparisons were performed between individuals with positive or negative cultures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 556 individuals with NAAT-confirmed rectal\n                      <jats:italic>N. gonorrhoeae<\/jats:italic>\n                      (552 MSM and 4\u2009women who have sex with men), 200 (35.3%) had a positive culture. The median age was 35.7 years (IQR=30.7\u201341.9). Individuals with a positive culture were younger (34.9 vs 36.4 years; p=0.013) and more frequently symptomatic (56.5% vs 16.6%; p&lt;0.001), particularly reporting anal burning, gastrointestinal symptoms, tenesmus and anal discharge (all p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gonococcal culture was positive in about one-third of NAAT-confirmed rectal infections. The presence of STI-related symptoms was associated with a positive culture. These findings corroborate the limited sensitivity of gonococcal culture and may help guide resistance surveillance strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056855","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:20:31Z","timestamp":1791307231000},"page":"sextrans-2025-056855","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of positive culture in NAAT-confirmed rectal\n                    <i>N. gonorrhoeae<\/i>\n                    infection among men who have sex with men"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5492-6835","authenticated-orcid":false,"given":"Flavia","family":"Passini","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-6255","authenticated-orcid":false,"given":"Angelo Roberto","family":"Raccagni","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Lolatto","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Capra","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Francesca","family":"Lucente","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Candela","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Muccini","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bruzzesi","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcella","family":"Negri","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Castagna","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2673-2731","authenticated-orcid":false,"given":"Silvia","family":"Nozza","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Vita-Salute San Raffaele University, Milan, Italy"},{"name":"Infectious Diseases Unit, IRCCS Ospedale San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"2026100610202509000_sextrans-2025-056855v1.1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr7005a1"},{"key":"2026100610202509000_sextrans-2025-056855v1.2","doi-asserted-by":"crossref","unstructured":"Miller JM , Binnicker MJ , Campbell S , et al . Guide to utilization of the microbiology laboratory for diagnosis of infectious diseases: 2024 update by the Infectious Diseases Society of America (IDSA) and the American Society for Microbiology (ASM). Clin Infect Dis 2024:ciae104. doi:10.1093\/cid\/ciae104","DOI":"10.1093\/cid\/ciae104"},{"key":"2026100610202509000_sextrans-2025-056855v1.3","unstructured":"European Centre for Disease Prevention and Control . STI cases continue to rise across Europe. Available: https:\/\/www.ecdc.europa.eu\/en\/news-events\/sti-cases-continue-rise-across-europe [Accessed 27 Apr 2026]."},{"key":"2026100610202509000_sextrans-2025-056855v1.4","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03223-12"},{"key":"2026100610202509000_sextrans-2025-056855v1.5","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000000824"},{"key":"2026100610202509000_sextrans-2025-056855v1.6","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.17955.1","article-title":"Screening is not associated with reduced incidence of gonorrhoea or chlamydia in men who have sex with men (MSM); an ecological study of 23 European countries","volume":"8","author":"Kenyon","year":"2019","journal-title":"F1000Res"},{"key":"2026100610202509000_sextrans-2025-056855v1.7","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2021.23487"},{"key":"2026100610202509000_sextrans-2025-056855v1.8","doi-asserted-by":"crossref","first-page":"e233","DOI":"10.1016\/S2352-3018(23)00299-0","article-title":"Effect of screening for Neisseria gonorrhoeae and Chlamydia trachomatis on incidence of these infections in men who have sex with men and transgender women taking HIV pre-exposure prophylaxis (the Gonoscreen study): results from a randomised, multicentre, controlled trial","volume":"11","author":"Vanbaelen","year":"2024","journal-title":"Lancet HIV"},{"key":"2026100610202509000_sextrans-2025-056855v1.9","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12247767","article-title":"Neisseria gonorrhoeae Antimicrobial Resistance: The Future of Antibiotic Therapy","volume":"12","author":"Raccagni","year":"2023","journal-title":"J Clin Med"},{"key":"2026100610202509000_sextrans-2025-056855v1.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0248582","article-title":"Changes in the prevalence of self-reported sexually transmitted bacterial infections from 2010 and 2017 in two large European samples of men having sex with men-is it time to re-evaluate STI-screening as a control strategy?","volume":"16","author":"Marcus","year":"2021","journal-title":"PLoS One"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T17:20:32Z","timestamp":1791307232000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":10,"alternative-id":["10.1136\/sextrans-2025-056855"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056855","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}