Analysis of UU,CT, NG and MG in Infertile Women and Comparison of Different Detection Methods / 现代检验医学杂志

Objective To analyze the distribution of pathogens in the genital tract of infertile female,and comparing traditional methods with simultaneous amplification and testing (SAT) in the detection of UU,CT,NG and MG.Methods 467 female infertility patients were selected from the reproductive center of Suzhou Hospital Affiliated to Nanjing Medical University between June and September 2016 to analyze the distribution of UU,CT,MG and NG.The age was between 20 to 48 years old (mean 31.52±6.83 years old).352 cases of female patients with assisted reproductive technology were selected,aged from 21 to 46 years old (mean 30.67±6.67 years old).The swabs were tested by traditional methods or SAT.The sensitivity and specificity of the methods in detecting the pathogens were evaluated according to the experimental results.Results Among the 467 infertile women,the number of UU positive cases was the highest,the positive rate was 62.53％ (292/467),the positive rate of CT was 1.93％ (9/467) and the positive rate of NG was 0.21％ (1/467),and the positive rate of MG was 1.71％ (8/467).UU infection rate was higher in infertile women than normal control group 23.81％ (25/105) (x2 =52.01,P＜0.01).352 cases of female patients with assisted reproductive technology were selected for further analysis.For UU detection,the positive rate of swab samples detected by liquid culture was 48.9％,while the positive rate detected by SAT was 63.9％.Obviously the positive rate of SAT was higher than that of liquid culture.Swab culture and SAT results were analyzed by paired x2 test (x2 =41.93,P＜0.01).The positive rate of CT SAT was 1.71％,and the positive rate of CT-latex method was 0.28 ％.There was significant difference between CT latex method and SAT (Fisher exact probabilistic method statistical analysis,P＜0.005),which indicated that SAT method had a higher sensitivity.The positive rate (1.7 ％) and sensitivity (100％) of SAT were also higher than that of traditional method.Conclusion UU was the most common pathogen in female reproductive tract pathogens,followed by CT and MG.The SAT method has higher sensitivity than the conventional method in detecting of UU and CT.

Prevalence of Co-infection with Gonorrhoea and Non-Gonococcal Urethritis in Males with Urethral Discharge Genitourinary Clinic, Hospital Kuala Lumpur: A 5-year study between 2011 – 2015

Introduction:Dual infection with Neisseria gonorrhoeae and Chlamydia sp has been reported in several studies worldwidein men presenting with urethral discharge. The rate of co-infection has been reported to be between 1.5 to 51%.This study aims to determine the demographic characteristics and sexual behaviour of men diagnosed to haveurethritis.Methods:This is a retrospective study on all men who presented with urethral discharge and diagnosed to havegonococcal (GU) and non-gonococcal urethritis (NGU) for the year 2011 to 2015 in Genito-UrinaryMedicine Clinic (GUM), Hospital Kuala Lumpur. The case notes were retrieved and reviewed.Results:There were a total of 307 men who attended the GUM clinic with urethral discharge. The mean ageof patients was 26.4 years (range 16-57 years). Majority (64.5%) were in the age group between 20-29 years. Around 95% were Malaysians and of these about 80% were Malays. Thirty-seven patients(12%) completed their tertiary education. There were 24 patients (8%) documented to have substanceabuse. Majority (78%) were heterosexual. About 36% of patients had 2 or more partners (range 2-10)6 months before the symptoms developed. The most common cause of urethritis was gonococcalurethritis (66.4%), followed by NGU (24.4%). Among the NGU, nine were detected to have Chlamydiasp infection (12%). Co-infection with Neisseria gonorrhoea and Chlamydia sp were detected in 28men (9.1%). Seven (2.3%) were HIV seropositive.Conclusion:Majority of males diagnosed with gonorrhoea were heterosexuals acquired mainly via casual partners.About 10% had co-infection with Neisseria gonorrhoeae and Chlamydia sp.

120 cases of non gonococcal urethritis mycoplasma and chlamydia infection and drug resistance status / 中国基层医药

Objective To investigate non gonococcal urethritis mycoplasma and chlamydia infection and drug sensitivity status.Methods From June 2014 to December 2014,120 cases of non gonococcal urethritis patients in our hospital were given chlamydia trachomatis,ureaplasma,mycoplasma detection and mycoplasma culture and drug sensitivity test of mycoplasma.Mycoplasma and chlamydia test results were compared between male and female patients.Positive drug sensitivity test results of ureaplasma urealyticum (Uu) and mycoplasma hominis (Mh) were observed.Results Among the 120 patients with positive detection,the proportion of Uu was the highest,up to 41.67％ (50/120);the second was Mh,accounting for 31.67％ (38/120).The detection rate of Uu in women (57.14％)was significantly higher than that in males (28.13％),and the difference was statistically significant (x2 =10.35,P ＜ 0.05).The susceptibility of mycoplasma to pristinamycin susceptible rate highest,Uu and type mycoplasma reached 100.00％;followed by doxycycline,the susceptibility of Uu reached 98.00％ and the susceptibility of Mh to 100.00％;sensitive rates of Uu and Mh to josamycin were 96.00％ and 90.48％.The sensitive rates of Uu and Mh to tetracycline were 92.00％ and 90.48％ respectively.Conclusion The mycoplasma infection was mainly caused by Uu.Clinical treatment of mycoplasma infection can be based on the drug sensitivity test results to reasonably choose antibiotics,and sensitive rates of pristinamycin,doxycycline were higher.

Mycoplasma genitalium: An emerging sexually transmitted pathogen.

Mycoplasma genitalium is a member of genital mycoplasmas, which is emerging as an important causative agent of sexually transmitted infections both in males and females. The advent of polymerase chain reaction and other molecular methods have made studies on M. genitalium more feasible, which is otherwise a difficult organism to isolate. Besides Chlamydia trachomatis, M. genitalium is now an important and established cause of non gonococcal urethritis (NGU) in men, more so in persistent and recurrent NGU. Multiple studies have also shown a positive association of M. genitalium with mucopurulent cervicitis and vaginal discharge in females as well. The evidences for M. genitalium pelvic inflammatory diseases and infertility are quite convincing and indicate that this organism has potential to cause ascending infection. Lack of clear association with M. genitalium has been reported for bacterial vaginosis and adverse pregnancy outcomes. Diagnosis of M. genitalium infections is performed exclusively using nucleic acid amplification tests (NAATs), owing to poor or slow growth of bacterium in culture. Although there are no guidelines available regarding treatment, macrolide group of antimicrobials appear to be more effective than tetracyclines. The present review provides an overview of the epidemiology, pathogenesis, clinical presentation and management of sexually transmitted infections due to M. genitalium.

Agentes etiológicos de uretritis infecciosa masculina en pacientes que concurren a laboratorios de Asunción / Etiological aspects o male infectious urethritis in patients attending laboratories of Asuncion

Esta investigación se efectuó para ampliar el conocimiento sobre los agentes etiológicos de la uretritis masculina en Asunción; se basó en una revisión retrospectiva de las fichas clínicas de 619 pacientes que acudieron con propósitos diagnósticos a tres laboratorios privados y a un laboratorio público de Asunción. La edad promedio ± DE fue de37,6±15,2 años (rango 0-91 años), 373 pacientes concurrieron a Meyer Lab, 166 al laboratorio San Roque, 68 al laboratorio de Santa Clara y 12 al laboratorio de Microbiología del IICS. En total se procesaron muestras de orina de 289 pacientes, secreción uretral de 326 y en 4 pacientes tanto orina como secreción uretral. Las indicaciones médicas fueron búsqueda de Neisseria gonorrhoeae en 295 pacientes, Chlamydia trachomatis en 256, Ureaplasma urealyticum en 264, Mycoplasma hominis en199. Se demostró la presencia de N. gonorrhoeae en el 6,4% de los casos, C. trachomatisen el 3,5%, U. urealyticum 11,5% y M. hominis 2,5%. A pesar de que se halló un franco predominio de la forma no gonocóccica, considerando las limitaciones que tiene el estudio por su carácter retrospectivo, es necesario realizar estudios prospectivos con mayor número de muestras para establecer con certeza la prevalencia de los agentes etiológicosde las uretritis infecciosas en el varón, incluyendo búsqueda de otros agentes infecciosos. Es necesario disponer de datos sobre uretritis en otros grupos socio económicos e investigar aspectos como la frecuencia en nuestro medio del síndrome de uretritis postgonocóccica (UPG) y de cepas de N. gonorrhoeae productoras de β lactamasa.

This study was carried out in order to contribute to the knowledge of the etiological agents of male urethritis in Asunción. It is based on a retrospective review of clinical records of 619 patients from one public and three private laboratories in Asunción. Theage mean ± SD was 37.6 ± 15.2 years (range 0-91 years); 373 patients were from Meyer Lab, 166 from San Roque Laboratory, 68 from Santa Clara Laboratory and twelve from the Laboratory of Microbiology of the IICS. Urine samples from 289 patients, urethra secretion from 326 and both types of samples from 4 patients were studied. Diagnosis of Neisseria gonorrhoeae was requested for 295 patients, Chlamydia trachomatis for 256,Ureaplasma urealyticum for 264, Mycoplasma hominis for 199. Presence of N. gonorrhoeae was demonstrated in 6.4% of the cases, C. trachomatis in 3.5%, U. urealyticum in 11.5% and M. hominis in 2.5%. Even though there was a clear predominance of non-gonococcal urethritis, considering the limitation of this study due to its retrospective nature, prospective studies with larger samples are necessary toestablish with certainty the prevalence of the etiological agents of male infectious urethritis, including the search of other infectious agents. It is also necessary to have data about urethritis in other socioeconomic groups and investigate aspects such as thefrequency of post-gonococcal urethritis syndrome (PGU) and beta-lactamase producing N. Gonorrhoeae strains in our area.

Detección de Mycoplasma genitalium y correlación con manifestaciones clínicas en una población del estado Zulia, Venezuela / Mycoplasma genitalium detection and correlation with clinical manifestations in population of the Zulia State, Venezuela

Diverse studies demonstrate an association between Mycoplasma genitalium and urogenital pathologies. The aim of this study was to investigate the prevalence of M. genitalium in patients attending gynecological evaluation in private clinics (n = 172). DNA amplification assays of the genes 16S rRNA and MgPa were utilized. The prevalence of M. genitalium in the study population was 7.5 percent. M. genitalium was detected in 12.1 percent and 4.1 percent of the symptomatic and asymptomatic patients, respectively (p = 0.047). The infection was diagnosed in patients with cervicitis (17.2 percent) and mucopurulent secretion (16.6 percent) and the highest prevalence of infections was registered in the 31-40 years age group. No significant association between the presence of M.genitalium and individual clinical manifestations or the patients age was showed (p > 0.05). The high prevalence of M. genitalium infections, mostly in patients with clinical manifestations showed in this study, warrants the application of diagnostic strategies in the population to investigate the clinical meaning of these microorganisms and to reevaluate therapeutic schemes against non-gonococcal and non-chlamydial infections.

Diversos estudios demuestran una asociación entre Mycoplasma genitalium y patologías urogenitales. El objetivo de este trabajo fue investigar la prevalencia de infecciones por M. genitalium en pacientes atendidas en clínicas privadas (n = 172). Se utilizaron ensayos de amplificación de genes 16S rARN y MgPa. La prevalencia de M. genitalium en esta población fue 7,5 por ciento. Mycoplasma genitalium fue detectado en 12,1 y 4,1 por ciento) de las pacientes sintomáticas y asintomáticas, respectivamente (p = 0,047). La infección se diagnosticó en pacientes con cervicitis (17,2 por ciento) y con secreción mucopurulenta (16,6 por ciento) y la mayor prevalencia de infecciones se registró en el grupo etario de 31 a 40 años. No se encontró asociación significativa entre la presencia de M. genitalium y manifestaciones clínicas individuales o edad de las pacientes (p > 0,05). La alta prevalencia de infecciones por M. genitalium, principalmente en pacientes con manifestaciones clínicas demostrada en este estudio, demanda la aplicación de estrategias diagnósticas en la población para investigar el significado clínico de estos microorganismos y reevaluar esquemas terapéuticos contra infecciones no gonocóccicas y no clamidiales.

Clinical study of non-gonococcal bacterial septic arthritis in Siriraj Hospital, Thailand.

Sixty-eight cases of non-gonococcal bacterial septic arthritis (SA) who admitted to Siriraj Hospital in 2003-2004 were retrospectively reviewed. Acute monoarthritis, oligoarthritis and polyarthritis were presented in 60.3%, 35.3% and 4.4% of the cases, respectively. Fever was presented in 51.5% of cases. The knee was the most commonly affected joint (40.2%). The organisms were identified from synovial fluid either by gram stained smears or cultures in 85.9% of cases. The microorganisms isolated were gram-positive cocci in 72.7%, gram-negative bacilli in 25.0% and mixed-organisms in 2.3%. The three most common causative organisms were Streptococcus spp. (40.1%), Staphylococcus aureus (33.4%) and Salmonella spp. (8.9%). Complications occurred in 39.7% of cases and the mortality rate was 11.8%. In conclusion, during the past two years, gram-positive cocci were the major isolated pathogen responsible for non-gonococcal bacterial SA in adult Thai-patients from Siriraj Hospital. Despite adequate treatment, bacterial SA continues to be associated with a considerable degree of morbidity and mortality.

Drug Sensitivity Test for Mycoplasma Urethritis: An Analysis of 263 Cases / 中华医院感染学杂志

OBJECTIVE To collect the document about drug sensitivity in mycoplasma-infected cases in Beijing area and to instruct drug-selecting in clinic treatment. METHODS Drug sensitivity test on 263 Mycoplasma-positive non-gonococcal urethritis(NGU)(mucopurulent cervicitis,MPC)cases was conducted. RESULTS Tetracyclines and minocycline performed the highest sensitivity(94.68%),followed by josamycin(94.30%) and doxycycline(91.63%).Lomefloxacin had the lowest sensitivity(15.59%). CONCLUSIONS Tetracyclines and macrolides can be employed as the first-choice drugs in NGU(MPC)treatment.

Detection of Chlamydia trachomatis and Ureaplasma urealyticum by Fluorescence Quantitative PCR / 中华医院感染学杂志

OBJECTIVE To discuss the infection rate of Chlamydia trachomatis(Ct) and Ureaplasma urealyticum(Uu) in patients with non-gonococcal infection.METHODS Fluorescence quantitative PCR method was used on 1025 cases and 30 cases of NGU patients for Ct and Uu detection.RESULTS Of 1025 NGU patients,positive Ct alone accounted for 156 cases,the positive rate was 15.22%.505 cases were separate Uu,the positive rate was 49.27%.Ct,Uu mixed in 217 cases,the positive rate was 21.17%.The detection rate was 85.66%.Uu infection rate in women was more than that in men(?2 = 104.56 P0.05).of control group,the Ct Uu Results negative.CONCLUSIONS In NGH patients,Uu is most common pathgen in man and woman.To diagnosis of NGU,Uu and Ct should be followed by Ct infection rate but no gender tested at the same time to avoid missed diagnosis.

Doxycycline in the Treatment of Non-Gonococcal Urethritis / 대한비뇨기과학회지

A retrospective study of 152 heterosexual male patients with non-gonococcal urethritis (NGU) was carried out to find out the efficacious treatment of NGU. We obtained urethral swabs for analysis by Chlamydiazyme (Abbott, North Chicago, IL) and Gram's stain from all patients. We classified the patients into two groups: 72 patients with no history of treatment (group I), and 80 patients with recurrent or persistent NGU (group II). Doxycycline was initially administered to 130 patients about two weeks. Ciprofloxacin, erythromycin, or doxycycline as second-line antibiotics were used in the patients with recurrent or persistent NGU after treatment with doxycycline. C. trachomatis was detected in 50 (32.9%) of the 152 patients: a larger proportion (40.3%) of the group I than the group II (26.3%) was chlamydia-positive, but the difference between two groups was not significant (p>0.05). After treatment with doxycycline, a higher cure rate was observed in the chlamydia-positive men (72.5% ; 29 of 40 patients) than in the chlamydia- negative men (50.0% ; 45 of 90 patients): in 90 chlamydia-negative men, 27 (75.0%) of 36 patients of the group I and 18 (33.3%) of 64 patients of the group II was cured (p<0.05). Doxycycline was efficacious for the chlamydia-positive men. But the patients with recurrent or persistent chlamydia-negative NGU were tend to be resistant to doxycycline therapy.

Detection of Chlamydia Trachomatis in Non-gonococcal Urethritis and Chronic Prostatitis by Enzyme Immunoassay Technique / 대한비뇨기과학회지

Possible role of chlamydia trachomatis (C. trachomatis) in non-gonococcal Urethritis and chronic prostatitis was investigated by enzyme immunoassay technique in a study of 85 cases of non-gonococcal urethritis and 23 chronic prostatitis cases. 1. C. trachomatis was detected from 21 (24.7%) of 85 non-gonococcal urethritis patients and third decade represented the highest positive rate. 2. C. trachomatis was detected from 5 cases (21.7%) of 23 chronic prostatitis patients. 3. A significantly higher positive C. trachomatis detection rate of 60. 7% was obtained from those with a profuse urethral discharge compared with those with a scanty discharge. 4. A significantly higher positive C. trachomatis detection rate of 52.3% was obtained from cases with no previous history of urethritis compared with those who had previous history of urethritis in 85 cases of non-gonococcal urethritis.

Investigation of Hemophilus vaginalis in patients with Non-gonococcal Urethritis / 대한비뇨기과학회지

The urethral discharge was cultured on 87 patients who were suspected as non-gonococcal urethritis by clinical symptoms and Gram's stain. Among them, H. vaginalis could be cultured and isolated from 9 patients. The results obtained in this investigation were summarized as follows. 1. The distribution of age showed the highest incidence in 20 to 39 years. The ratio of gonococcal to non-gonococcal urethritis was 1:2.2. The isolated organisms were S. aureus (15 cases), H. vaginalis (9 cases), Streptococcus (8 cases), Diphtheroid (7 cases), S. epidermidis (4 cases), Enterobacter (1 case), Pseudomonas (1 case), Acinetobacter (1 case), and Corynebacterium species (1 case) in order Of their frequency. 2. In group of the patients with H. vaginalis, incubation period was 10 to 20 days in the majority of patients, and there were no clinical symptoms except scanty urethral discharge, and there was no extra-marital sexual relations in 3 patients. 3. Gram (-) bacilli and coccobacilli were found in Gram's stain. And WBC was found in the counts of less than 10/HPF in 78%. 4. All the H. vaginalis were sensitive to ampicillin and cephlosporin in sensitivity test. 5. The incidence of H. vaginalis urethritis in man corresponded to 7% of all urethritis, and 10% of non-gonococcal urethritis.