Transmissão de gonorreia da cavidade oral para o trato retal: uma revisão sistemática

Abstract

The antimicrobial resistance of Neisseria gonorrhoeae and the high prevalence of asymptomatic extragenital infections are a worldwide concern. Evidence of high viable gonococcal loads in positive samples from the oral cavity supported the hypothesis that this organ could infect the anorectal tract. This research aims to answer: “Among men who have sex with men, can gonorrhea be transmitted from the oral cavity to the anorectal tract”? A systematic review was conducted in the main databases, with Mesh terms, synonyms and most frequent key words in the literature. Quality was analyzed with STROBE and NOS instruments. Out of 1011 publications, the final sample was consisted of 6 studies. According to the NOS, two studies (33.3%) presented “very good” quality, two (33.3%) “good” and two (33.3%) “satisfactory”. According to STROBE, most described a complete methodology (83.3%) and only one (16.7%) partially. Four studies (66.7%) presented most results and discussion criteria. One study (16.7%) found an association with the use of saliva in penoanal sex and another (16.7%) with ororectal sex. Three showed that in the absence of urethral infections, men with rectal gonorrhea had partners with oropharyngeal gonorrhea. Two of these three studies (33.3%) found high phylogenetic concordance between positive couples for oropharynx and rectum. However, there were limitations regarding the differences in diagnostic methods, methodologies and variables used. The results do not allow us to affirm, but they may suggest the existence of transmissibility of gonorrhea from the mouth to the anorectal tract. There is a need for more research on this subject.