Detection of Neisseria gonorrhea, chlamydia trachomatis and mycoplasma genitalium in acute male urethritis using multiplex PCR

ABSTRACT

Acute urethritis is one of the most common STD Syndromes diagnosed in men. This study was to identify Neisseria Gonorrhea, Chlamydia trachomatis and Mycoplasma genitalium in acute male urethritis using Multiplex PCR technique and to compare urethral discharge versus urine as samples for diagnosis of urethritis. Evaluation of different microbiological techniques used for the diagnosis of gonococcal urethritis was also studied. Thirty adult males attending in the Venereal Disease Clinics, Ain Shams University Hospitals complaining of symptoms suggestive of acute urethritis were included in the study. Urethral discharge and first voided urine samples were subjected to wet and Gram stained smears, Gonococcal culture and Multiplex PCR for detection of Neisseria gonorrhea, Chlamydia trachomatis and Mycoplasma genitalium. Causative organisms of urethritis were identified in 22 out of the 30 studied patients [73.3%]. Gonococcal urethritis was diagnosed in 7 cases [23.3%], while non gonococcal urethritis due to Chlamydia trachomatis and Mycoplasma genitalium was detected in 10 [33.3%] cases. Simultaneous gonococcal and non gonococcal urethritis was identified in 5 cases [16.7%]. While the sensitivity of Gram stain for diagnosis of Gonococci was 75% while specificity was 100%. Culture, sensitivity and specificity were 58.2% and 100%, respectively, in comparison to the standard PCR test. Urethral discharge samples showed higher sensitivity compared to urine samples for detection of causative organisms of urethritis using PCR technique [78.9% Vs 45.4%, P urethritis caused by Neisseria gonorrhea is the most common type of infection identified in study, mixed simultaneous gonococcal and non gonococcal infection was also identified. Testing for more than one organism in a single PCR assay could be a useful approach to laboratory diagnosis of urethritis in men. PCR technique should be the diagnostic tool for screening of urethritis for its high specificity and sensitivity