Pharyngeal Flora in a Sexually Active Population

Abstract

During a 7-week period 1141 patients attending the Genitourinary Clinic at Charing Cross Hospital completed a brief questionnaire and had pharyngeal swabs cultured for Neisseria spp, β-haemolytic streptococci, corynebacterium and yeasts. The study included 397 heterosexual men, 492 heterosexual women, 189 homosexuals, 41 lesbians and 22 bisexual men and women. Four hundred and sixty patients (40%) admitted oro-genital contact in the preceding 2 weeks. The meningococcal carriage rate was 11.6%. Homosexuals had the highest carriage 23.8% and heterosexual females the lowest 5.9%. Significant differences in carriage rates were found between homosexual and heterosexual men ( P<0.0001), heterosexual men and women ( P<0.005) and between lesbian and heterosexual women ( P< 0.025). Recent oro-anal contact significantly increased meningococcal isolation ( P<0.001). A significant association between β-haemolytic streptococci and concomitant meningococcal carriage was also found ( P<0.01). Sexual orientation and oro-genital contact influences both meningococcal and pharyngeal yeast isolation and should be considered when interpreting pharyngeal culture results.