Neisseria gonorrhoeae infection in women increases with rising numbers of gonococci in partners: Chlamydia coinfection in women increases gonococcal burden.

<bold>Background: </bold>Likelihood of Neisseria gonorrhoeae (Ng) infection in women exposed to male sex partners with increasing Ng burdens and enhancement by Chlamydia trachomatis (Ct) is not defined.<bold>Methods: </bold>We identified men with urethritis and their regular female sex partners. Exposure to Ng burdens present in men was compared in Ng-infected versus -uninfected partners. Association of Ng infection in women with burdens in male partners was estimated using logistic regression. Association of Ct coinfection and Ng burdens in women adjusted for burdens in male partners was estimated by linear regression.<bold>Results: </bold>1816 men were enrolled; 202 had ≥ 2 partners, 91 who confirmed monogamy and were enrolled; 77% were married. Seventy were partners of Ng-infected men; 58 (83%) were Ng-infected, 26 (45%) Ct-coinfected. Infected women had partners with 9.3-fold higher Ng burdens than partners of uninfected women (p = 0.0041). Association of Ng infection in women with upper quartiles of Ng burdens in partners increased (Odds Ratios ≥ 2.97) compared to the first quartile (p = 0.032). Ng burdens in Ct-coinfected women were 2.82 fold higher than in Ct-uninfected women (p = 0.036).<bold>Conclusion: </bold>Ng infections increased in women whose partners were infected with higher Ng burdens. Ct coinfection was associated with increased Ng burdens in women. [ABSTRACT FROM AUTHOR]