Certain attributes of the sexual ecosystem of high-risk MSM have resulted in an altered microbiome with an enhanced propensity to generate and transmit antibiotic resistance

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Abstract

Surveillance data from a number of countries have indicated that antibiotic resistance in Neisseriagonorrhoea is strongly associated with men who have sex with men (MSM). This manuscript advances the hypothesis that certain features of the MSM sexual ecosystem may be responsible for this association. It is argued that in comparison with heterosexuals, high-risk MSM (hrMSM) have a higher prevalence of oro-penile, oro-rectal and anal sex which facilitates an enhanced mixing of the pharyngeal, rectal and penile microbiomes. In addition, hrMSM have an increased number of sexual partners per unit time and an increased prevalence of sexual relationships overlapping in time. The increased flux of microbiomes between different body habitats between sexual partners, in combination with the increased connectivity of the sexual network, serve to create a novel high-risk MSM sexual ecosystem with important consequences for the genesis and spread of antibiotic resistance.

Original languageEnglish
JournalMedical Hypotheses
Volume83
Issue number2
Pages (from-to)196-202
Number of pages7
ISSN0306-9877
DOIs
Publication statusPublished - 2014

Keywords

  • Australia
  • Drug Resistance, Bacterial
  • Great Britain
  • Homosexuality, Male
  • Humans
  • Male
  • Microbiota
  • Neisseria gonorrhoeae
  • Prevalence
  • Risk Factors
  • Sexual Behavior
  • Sexual Partners
  • Sexually Transmitted Diseases
  • United States

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