Association of genital mycoplasmas including Mycoplasma genitalium in HIV infected men with nongonococcal urethritis attending STD & HIV clinics.

Background & objectives: Acute nongonococcal urethritis (NGU) is one of the commonest sexually transmitted infections affecting men. The role of genital mycoplasmas including Mycoplasma genitalium in HIV infected men with NGU is still not known. The aim of this study was to determine the isolation pattern/detection of genital mycoplasma including M. genitalium in HIV infected men with NGU and to compare it with non HIV infected individuals. Methods: One hundred male patients with NGU (70 HIV positive, 30 HIV negative) were included in the study. Urethral swabs and urine samples obtained from patients were subjected to semi-quantitative culture for Mycoplasma hominis and Ureaplasama urealyticum, whereas M. genitalium was detected by PCR from urine. The primers MgPa1 and MgPa3 were selected to identify 289 bp product specific for M. genitalium. Chalmydia trachomatis antigen detection was carried out by ELISA. Results: M. genitalium and M. hominis were detected/isolated in 6 per cent of the cases. M. genitalium was more common amongst HIV positive cases (7.1%) as compared to HIV negative cases (3.3%) but difference was not statistically significant. Co-infection of C. trachomatis and U. urealyticum was found in two HIV positive cases whereas, C. trachomatis and M. hominis were found to be coinfecting only one HIV positive individual. M. genitalium was found to be infecting the patients as the sole pathogen. Interpretation & conclusions: Patients with NGU had almost equal risk of being infected with M. genitalium, U. urealyticum or M. hominis irrespective of their HIV status. M.genitalium constitutes one of the important causes of NGU besides other genital mycoplasmas.

clinicopathological study of urethritis in males

To determine the etiology and frequency of different types of urethritis in adult males. A case series. The Dermatology Department of PNS Shifa Hospital, Karachi, from June 2004 to December 2007. One hundred male patients having complaints of urethral discharge and dysuria reporting in the skin OPD were included in the study. Patients who had received systemic treatment for their complaints and those who had other systemic infections were excluded. A detailed history including history of sexual contact was taken. Dermatological examination including examination of external genitalia was also performed. All these patients were subjected to complete physical examination, complete urine examination, urethral pus for gram staining and culture, endo-urethral swab with urethral loop for seeing Chlamydia antigen by fluorescent microscopy, cultures for ureaplasma and Wet mount specimen microscopy for trichomonas along with HIV [serum ELISA] test. Non-gonococcal urethritis was diagnosed on the presence of more than five polymorphonuclear leucocytes per high power field in at least five fields of Gram stained urethral smear, in the absence of Gram negative diplococci. The mean age was 29.2 +/- 5.8 years. Seventy [70%] cases were diagnosed as gonococcal urethritis and 30 [30%] cases as non-gonococcal urethritis [NGU]. History of illicit sexual exposure was available in 25 [25%] patients. The interval period between initiation of symptoms and reporting of patient in gonococcal urethritis was 4 to 30 days [mean 12.8 days] and 4 days to 2 months [mean 20.7 days] in non-gonococcal urethritis. The patients with gonococcal urethritis presented with purulent discharge in 66 [84%] cases, and dysuria in 49 [70%] cases. In the NGU group, 25 [80%] cases had mucoid discharge and 18 [65%] had dysuria. in 70%, Neisseria gonorrhoeae was isolated, Chlamydia trachomatis in 16%, ureaplasma in 8%, and Trichomonas vaginalis in 4%. No organism could be detected in 2% cases. HIV test was negative in all cases. Gonococcal urethritis was the commonest urethritis seen followed by Chlamydia infection in the studied group of adult males

Urethral trichomoniasis in Iraqi females

Trichomonas vaginalis has long been recognized as a cause of infectious vaginitis in women. Different studies have demonstrated a significant burden of the parasite to cause urethritis as well. It has been assumed that the localization of parasite in the urethra may be responsible for the recurrence of vaginal infection. To evaluate the infection rate of urethral trichomoniasis and to evaluate two different laboratory methods used in the diagnosis. The present study consisted of 420 female patients presented with vaginal discharge with or without itching or disorient, investigated for urethral trichomoniasis who were compared to 50 females represented the control group. Each female was asked to collect first 10-20 ml of urine in a sterile screw capped bottle; the deposits were examined microscopically by: 1. Wet mount method for Trichomonas vaginalis. 2. Culture in a specific ready made culture media. At the same time high vaginal swabs were taken and examined by both wet mount and culture methods for vaginal trichomoniasis. Among 420 female patients examined for both urine sediments and vaginal swabs, 80 [19.04%] females were found to be positive for T. vaginalis by vaginal swabs. The parasite was seen either in the vagina alone in 39 [9.28%] or in the vagina and urethra in 41[9.76%], but it was never isolated from urethra alone. Trichomonas vaginalis is a common parasite of female urethra as well as of the vagina, the localization of this flagellate in the urethra may be responsible for the recurrence of vaginal infection, since it may survive in the urethra, possibly in the paraurethral glands [skene's] so when the treatment is limited to the vagina, this will often fail to reach the urethra and the trichomonads may contaminate the vagina following urination or serial intercourse, that is why systemic rather than local treatment is indicated

Infección por Chlamydia trachomatis en varones y su asociación con las alteraciones ginecológicas de su compañera sexual / Chlamydia trachomatis infection in men and its association to gynecologic alterations of his sexual mate

Objective.To determinate the frequency of Chlamydia trachomatis infection in male partners of infertile couples who attend to the infertility clinic at Instituto Nacional de Perinatologia, as well as to compare the clinical data and lifestyle between C. trachomatis-inifected and uninfected men to establish a possible association with gynecological damage in their sexual female partners. Methods. An open prospective study was performed in infertile couples, whose follow up was carried out at Instituto Nacional de Perinatologia between June 2000 and April 2001. Urethral and cervical swabs were obtained from each couple and the specimens were subjected to a C. trachomatis-specific liquid-phase hibridization test (PACE-2) and routine microbiological analysis. Semen analysis were also included. A relative risk (RR) test was done to analyze variables and square chi test was used to analize clinical and gynecological data from female partners and data from semen examination. Statistical differences were considered as significant when the p value was below 0.05. Results. C. trachomatis active infection was found in 14 out of 384 urethral swabs (3.6%). No significant alterations were observed in semen samples of C. trachomatis-infected men, as compared to non-infected individuals. Microbiological analyses of semen showed a significant isolation o/Mycoplasma sp (RR = 5.87, IC95% 1.4-24.7). Eight out of fourteen female partners of C. trachomatis-infected men were also infected with C. trachomatis (RR= 10.57, IC95% 5.67-19.7), Candida albicans was other pathogen isolated from 8/14 of those women (RR = 1.89, IC95% 1.17-3.05). Gynecological and obstetrical associations found among female partners of C. trachomatis-infected men were as follows: tubal adhesions in 10/14 (RR = 1.54, IC95% 1.08-2.18), salpingitis in 2/14 (RR = 2.2), history of ectopic pregnancies in 11/14 (RR =2.94, IC95% 1.01-8.53) and abnormal pregnancy loss in 9/14 (RR = 1.5). Conclusion. A low prevalence of C. trachomatis infection was observed among male partners of infertile couples as compared with other reports, but this discrepancy could be attributable to the specimen collection and diagnostic assay used. Otherwise, this data suggests that a chronic pathogen's antigenic stimulation may result in an increased formation of tubal adhesions and/or in ectopic pregnancies among female partners of C. trachomatis-infected individuals. Thus, preventive and control measures must be introduced into men's healthcare services, through laboratory and clinical examination, since these subjects are the main reservoirs of C trachomatis.

Objetivo. Determinar la frecuencia de infección por Chlamydia trachomatis y comparar la información clínica y el estilo de vida de varones con y sin infección por este patógeno, así como su asociación con las alteraciones ginecológicas que presenta su compañera sexual en un grupo de parejas que asisten a la Clínica de Infertilidad del Instituto Nacional de Perinatologia de la Ciudad de México. Métodos. Se realizó un estudio abierto, longitudinal y prospectivo en un grupo de parejas con diagnóstico de infertilidad, que fueron tratadas en el Instituto Nacional de Perinatologia durante el periodo de junio del 2000 a abril del 2001. Se recolectaron muestras uretrales y cervicales de cada pareja para el diagnóstico de C. trachomatis mediante la prueba de hibridación en fase líquida (PACE-2). También se recolectaron muestras de semen para el análisis de espermatobioscopia y se hicieron cultivos microbiológicos de rutina a las muestras cervicales y de semen. Los datos microbiológicos, clínicos y ginecológicos de los participantes fueron comparados por %z, el análisis de tendencia para proporciones fue usado para establecer el nivel de riesgo en las variables (RR). Las diferencias fueron consideradas estadísticamente significativas si p < 0.05. Resultados. Se analizaron un total de 384 muestras uretrales de varones, 14 presentaron infección activa por C. trachomatis (3.6%), Los datos de espermatobioscopia de los individuos positivos a C. trachomatis no mostraron alteraciones significativas con respecto al de varones no infectados con esta bacteria. El análisis microbiológico del semen mostró un número de aislamientos significativos de infección por Mycoplasma sp. (RR = 5.87, IC95% 1.40-24.70). En cuanto a las muestras cervicovaginales de mujeres con compañero sexual infectado por C. trachomatis, los patógenos aislados con mayor frecuencia fueron: Candida albicans en ocho de 14 (RR = 1.89, IC95% 1.17-3.05) y C. trachomatis en ocho de 14 (RR = 10.57, IC95% 5.67-19.7). Las asociaciones ginecológicas y obstétricas de la compañera sexual de varones positivos a C. trachomatis fueron adherencias tubáricas en 10 de 14 (RR = 1.54, IC95% 1.08-2.18), salpingitis en dos de 14 (RR = 2.2), antecedentes de embarazos ectópicos en 11 de 14 casos (RR = 2.94, IC95% 1.01-8.53) y abortos previos en nueve de 14 (RR = 1.5). Conclusión. Se observó una baja prevalencia de infección por C. trachomatis en los varones de mujeres infértiles en comparación con lo reportado por otros autores, esta diferencia puede estar dada por el método de diagnóstico y la toma del producto. Estos resultados sugieren que el estímulo constante del patógeno produce un aumento de adherencias tubáricas y embarazos ectópicos en las compañeras sexuales de los varones infectados con C. trachomatis. Por lo que una evaluación diagnóstica y de laboratorio deberá ser llevada a cabo en el varón como una medida de prevención y control para la infección por este patógeno, ya que estos individuos actúan como reservónos importantes de infección.

Prevalence of Ureaplasma urealyticum and Mycoplasma genitalium in men with non-gonococcal urethritis

This study in Teheran, Islamic Republic of Iran, investigated the prevalence of Ureaplasma urealyticum and Mycoplasma species in men with non-gonococcal urethritis. Urethral swab samples were collected from 125 cases and 125 healthy men as a control group. The samples were then investigated by culture methods. The rates of detected bacteria in case and control groups were 19.2% and 7.2% for U. urealyticum, 7.2% and 0.8% for M. genitalium, and 2.4% and 1.6% for M. hominis respectively. Statistical analysis showed a significant difference between case and control groups in the prevalence of U. urealyticum and M. genitalium but not M. hominis. It is concluded that in men, U. urealyticum and M. genitalium may have an etiologic role in non-gonococcal urethritis

Prevalence of Chlamydia trachomatis & herpes simplex virus in males with urethritis & females with cervicitis attending STD clinic.

BACKGROUND & OBJECTIVES: Cervicitis and urethritis due to Chlamydia trachomatis are common sexually transmitted diseases. However, there is a paucity of information on urethritis and mucopurulent cervicitis due to herpes simplex virus (HSV) from India. We used polymerase chain reaction (PCR) to find out the prevalence of C. trachomatis and HSV associated urethritis in males and mucopurulent cervicitis in females attending a sexually transmitted diseases (STD) clinic. METHODS: Twenty five endocervical swabs from 25 women with mucopurulent cervicitis and 75 urethral swabs from 72 males with urethritis were processed for the detection of C. trachomatis and HSV by antigen detection by fluorescent antibody test (FAT), culture and PCR. RESULTS: Among the 25 women, one (4.0%) was positive for C. trachomatis and 3 (12.0%) were positive for HSV by PCR. FAT and culture were negative. Nine (12.0%) of the 75 urethral swabs were positive for C. trachomatis and 5 (6.6%) were positive for HSV by PCR. Among the 9 positive by PCR for C. trachomatis, 3 (4.0%) were positive by FAT. Cultures for both organisms were negative. INTERPRETATION & CONCLUSION: Endocervicitis and male urethritis due to C. trachomatis and HSV are not uncommon among high-risk individuals. The diagnosis could be established mainly by PCR.

Etiología, tratamiento y conducta epidemiológica en pacientes con uretritis / Etiolgy, treatment and epidemiologic approach in patients with urethritis

Trabajo retrospectivo de revisión de 40 Historias Clínicas con diagnóstico de Uretritis, cuyo exámen bacteriológico identificó Neisseria Gonorrhoae en 76,3, otras bacterias como Estafilococos Albus, Estreptococo en 23,7. En 55,3 fueron tratados con PenicilinaProcáinica en dósis de 4,8 U.I. con resultados óptimops, el segundo antibiótico utilizado en 10,5, también con buenos resultados fué la tetraciclina en dósis de 2 gr/d. por siete días, en 10,5 se utilizaron otros antibióticos como ser Eritromicina, Gentamicina. El Estudio de contactos, y localización de los mismos no se efectuo en ninguno de los casos.

Etiologia de la uretritis masculina: estudio en el Centro de Salud No. 25 de la Ciudad de Medellin / Etiology of male urethritis: study in Centro de Salud No. 25 of Medellin City

En 64 hombres con uretritis estudiados en un Centro de Salud de Medellin, se hallo un franco predominio de la gonorrea (UG) sobre la uretritis no gonococcica (UNG); la primera constituyo el 85% de los casos; este dato contrasta con el abierto predominio de la UNG en estudios previos de la misma ciudad; la discrepancia puede deberse a diferencias socioeconomicas, que requeririan estudio ulterior, o al hecho de que los pacientes de esta serie no tenian historia de antibioterapia; esta ultima hipotesis plantea la posibilidad de que muchos pacientes con UNG en las seis anteriores hayan sido en realidad uretritis postgonococcicas (UPG).

Incidence of urethritis in Bangladesh.

Urethritis is either gonococcal or non-gonococcal. This paper describes the investigation of 286 cases of urethral or vaginal discharges, dysuria or urethral irritation. Non-gonococcal urethritis (NGU) was found to be the commonest form of urethritis accounting for 65.05 per cent of cases. Gonococcal urethritis (GU) and abacterial urethritis were accounted for 24.47 per cent and 10.48 per cent of cases respectively. No history of sexual exposure was found in 21.27 per cent of cases with NGU, whereas this was invariably present in cases of GU. This may indicate that in at least some of the patients with NGU, the disease may not be sexually transmitted. This point needs further study.