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Duman I. Chlamydia Infection from Androgical Perspective. Infect Dis (Lond) 2023. [DOI: 10.5772/intechopen.110045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
Chlamydia trachomatis is a microorganism known for years to cause ocular, urogenital, and neonatal infections in humans. It usually causes urogenital system infections. The pathogen, which is the most common cause of urethritis in males, is one of the sexually transmitted microorganisms. As most males are asymptomatic, they do not realize they are infected and act as reservoirs. This causes the incidence of urethritis due to chlamydia to increase day by day. Chlamydia urethritis, which poses a risk to sexual partners, can cause serious complications if left untreated. In this section, we assess the approach to male urethritis due to chlamydia, which is very common in urology practice and can cause serious problems if left untreated.
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Nguyen BH, Pham QM, Hoang L, Sansone A, Jannini EA, Tran CM. Investigating the microbial pathogens of sexually transmitted infections among heterosexual Vietnamese men with symptomatic urethritis. Aging Male 2022; 25:125-133. [PMID: 35416126 DOI: 10.1080/13685538.2022.2063272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
OBJECTIVE To explore the microbial etiology of urethritis in Vietnamese men and the association with patients' characteristics, especially their sexual behaviors. METHODS This study was conducted on 349 men who presented with symptomatic urethritis and evidence of STIs (determined by multiplex PCR tests) at the Department of Andrology and Sexual Medicine-Hanoi Medical University Hospital. All information regarding medical history, sexual activities, and symptoms of urethritis was documented. RESULTS C. trachomatis and N. gonorrhoea remained the two most common causative pathogens, followed by an unexpectedly high prevalence of Mycoplasma and Ureaplasma species. Coinfection was significant with a rate of 40.7%. Men who had sex with female sex workers (FSWs) were more likely to be positive with N. gonorrhoea but less likely to be positive with C. trachomatis and M. genitalium than those having sex with only one romantic partner. CONCLUSIONS Our findings suggested the important role of other microorganisms, especially M. genitalium, in the etiology of urethritis in men besides the previously well-known causes of STIs. Since the coinfection rate is quite high, targeted treatment with clear microbial evidence should be considered rather than empiric antimicrobial therapy.
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Affiliation(s)
- Bac Hoai Nguyen
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Quan Minh Pham
- Department of Andrology and Sexual Medicine, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Long Hoang
- Department of Urology, Hanoi Medical University's Hospital, Hanoi, Vietnam
| | - Andrea Sansone
- Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Endocrinology and Sexual Medicine (ENDOSEX), University of Rome Tor Vergata, Rome, Italy
| | - Chau Minh Tran
- Department of Microbiology and Parasitology, Hanoi Medical University's Hospital, Hanoi, Vietnam
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Meštrović T, Neuberg M, Sviben M, Ribić R, Drenjančević D, Škrlec I, Talapko J, Kozina G, Profozić Z. Corynebacterium glucuronolyticum in men with and without urethritis syndrome: An underrecognized pathogen or a bona fide commensal? Infect Dis Now 2022; 52:441-446. [PMID: 36030041 DOI: 10.1016/j.idnow.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/27/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND By analysing the largest collection of Corynebacterium glucuronolyticum (C. glucuronolyticum) isolates from a single centre thus far, we aimed to appraise a potential causal link between an infrequently isolated species and the urethritis syndrome in men. METHODS A total of 1055 Caucasian male individuals with or without urethritis syndrome were included in this single-centre case-control study. Group-wise comparisons were pursued by analysing sociodemographic, behavioural and microbiological specificities between the two groups. C. glucuronolyticum isolates from urethral specimens were identified using the analytical profile index biotyping system (API Coryne) and additionally confirmed by MALDI-TOF mass-spectrometry, with subsequent determination of their antimicrobial sensitivity profiles. Statistical significance was set at p < 0.05 (two-tailed). RESULTS C. glucuronolyticum was isolated in 5.08% of study participants with urethritis syndrome and 3.60% of those without it (p = 0.303). In the urethritis group, the species was more frequently found as a sole isolate (p = 0.041) and after prior infection with Chlamydia trachomatis (p = 0.025). The most frequent presentation of urethritis included a clear discharge in small or moderate amounts, without any pathognomonic findings. The resistance rates were 62.22% for clindamycin, 42.22% for tetracycline and 26.67% for ciprofloxacin. CONCLUSIONS Our study provides major insights on the relevance of urethral C. glucuronolyticum in non-gonococcal urethritis, with significant implications for further aetiological research and management approaches.
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Affiliation(s)
- T Meštrović
- Department of Health Metrics Sciences, University of Washington School of Medicine, Seattle, Washington, USA; University Centre Varaždin, University North, Varaždin, Croatia; Clinical Microbiology and Parasitology Unit, Dr. Zora Profozić Polyclinic, Zagreb, Croatia.
| | - M Neuberg
- University Centre Varaždin, University North, Varaždin, Croatia
| | - M Sviben
- Microbiology Service, Croatian National Institute of Public Health, Zagreb, Croatia; Medical Microbiology Department, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - R Ribić
- University Centre Varaždin, University North, Varaždin, Croatia
| | - D Drenjančević
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; University Hospital Centre Osijek, Osijek, Croatia
| | - I Škrlec
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - J Talapko
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - G Kozina
- University Centre Varaždin, University North, Varaždin, Croatia
| | - Z Profozić
- Clinical Microbiology and Parasitology Unit, Dr. Zora Profozić Polyclinic, Zagreb, Croatia
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Mostafa MM, Mahdy A, Ghoniem G. Updates on Sexually Transmitted Urethro-cystitis. Curr Bladder Dysfunct Rep 2022. [DOI: 10.1007/s11884-022-00659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Purpose of Review
We performed recent literature review with the aim to address the updates in diagnosis and management of sexually transmitted urethro-cystitis.
Recent Findings
There are multiple, recently published studies that collectively lead to an organized stepwise plan for diagnosis and management of sexually transmitted urethro-cystitis.
Summary
Sexually transmitted urethro-cystitis is a common health condition that can be managed efficiently if the appropriate steps are taken in diagnosis and management.
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Braam JF, van Dam AP, Bruisten SM, van Rooijen MS, de Vries HJ, Schim van der Loeff MF, Vergunst CE. Macrolide-Resistant Mycoplasma genitalium Impairs Clinical Improvement of Male Urethritis After Empirical Treatment. Sex Transm Dis 2022; 49:360-367. [PMID: 34962241 PMCID: PMC8994036 DOI: 10.1097/olq.0000000000001591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/05/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mycoplasma genitalium (MG) is associated with urethritis in men and could play a role in clinical outcome. We examined clinical improvement of symptoms in men receiving empirical treatment for urethritis and correlated the outcome with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), MG, and MG macrolide resistance-associated mutations (MRAM) status. METHODS At the sexually transmitted infection clinic in Amsterdam, the Netherlands, empirical treatment for gonococcal urethritis is 1 g ceftriaxone and for nongonococcal urethritis 1 g azithromycin. In 2018 to 2019, we tested urine samples of men with urethritis for CT, NG, and MG using transcription-mediated amplification assays. Mycoplasma genitalium-positive samples were tested for MRAM using quantitative polymerase chain reaction. Two weeks after receiving therapy, men were sent a text message inquiring after clinical improvement. RESULTS We evaluated 2505 cases of urethritis. The positivity rates of NG, CT, and MG were 26% (648 of 2489), 29% (726 of 2489), and 23% (522 of 2288), respectively. In 768 of 2288 of the cases (34%), no causative agent was detected. Most cases were infected with a single pathogen: NG, 417 of 2288 (18%); CT, 486 of 2288 (21%); and MG, 320 of 2288 (14%). The prevalence of MRAM among MG-positives was 74% (327 of 439). For 642 (25.6%) cases, we could evaluate clinical improvement after treatment of whom 127 (20%) indicated no improvement; 9% (15 of 174) in NG cases, 18% (35 of 195) in CT cases, 14% (4 of 28) in MG wild-type cases, and 40% (38 of 94) in MG-MRAM cases. Clinical improvement in MG-MRAM cases was significantly lower compared with all other groups (P < 0.001). CONCLUSIONS Presence of MG-MRAM is associated with lack of clinical improvement in azithromycin-treated nongonococcal urethritis.
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Affiliation(s)
- Joyce F. Braam
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
| | - Alje P. van Dam
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Department of Medical Microbiology, Amsterdam Institute for Infection and Immunity (AII)
| | - Sylvia M. Bruisten
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Department of Medical Microbiology, Amsterdam Institute for Infection and Immunity (AII)
| | | | - Henry J.C. de Vries
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Department of Dermatology
| | - Maarten F. Schim van der Loeff
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity (AII), Amsterdam University Medical Center (UMC), Amsterdam
| | - Clarissa E. Vergunst
- From the Department of Infectious Diseases, Public Health Service of Amsterdam
- Department of Dermatology, NWZ, Den Helder, the Netherlands
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Sarier M, Sepin N, Emek M, Germen AT, Hoscan MB, Konuk E, Turgut H. Evaluating the utility of the A.F. Genital System test for pathogen diagnosis in acute male urethritis. Andrologia 2022; 54:e14377. [DOI: 10.1111/and.14377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Mehmet Sarier
- Department of Urology Istinye University Istanbul Turkey
- Department of Urology Medical Park Hospital Antalya Turkey
| | - Nevgun Sepin
- Department of Clinical Microbiology and Infectious Disease Training and Research Hospital Antalya Turkey
| | - Mestan Emek
- Department of Public Health Akdeniz University Antalya Turkey
| | | | - Mustafa Burak Hoscan
- Department of Dialysis Vocational School of Health Services Bilim University Antalya Turkey
| | - Elcin Konuk
- Public Health Laboratory Provincial Directorate of Health Antalya Turkey
| | - Hasan Turgut
- Faculty of Health Science Avrasya University Trabzon Turkey
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Abstract
BACKGROUND Infectious urethritis are classified in N. gonorrhoeae (NG) urethritis and non-gonococcal urethritis, caused commonly by C. trachomatis (CT) or M. genitalium (MG) in Western Europe. The primary objective of the study is to evaluate the association between the clinical profile and the pathogens. Secondly, to assess the prevalence of co-infections. METHODS The clinical profile of urethritis in men caused by NG, CT and MG confirmed by nucleic acid amplification test (NAAT) on first void urine has been retrospectively collected. The clinical profiles comprised the assessment of dysuria and/or discharge and the clinical-dermoscopic examination of the genitalia. Serological tests for syphilis and HIV were also performed. RESULTS A total of 101 episodes of NAAT confirmed NG, CT or MG urethritis were identified. The prevalence for each pathogen was 50.60%, 33.73% and 15.66%, respectively. Co-infections were observed in few cases (four MG+CT, one NG+CT, one NG+MG), with M. hominis, U. urealitycum and U. parvum positivity found concomitantly in 7-8% cases. The median age of patients was 33 years. Dysuria was reported in 88% cases (95% NG, 79% CT, 78% MG urethritis). Urethral discharge was found in 86% of cases, including purulent discharge in 61% (98% NG, 70% MG) and transparent in 25% (64% CT). Dysuria and purulent discharge were observed in 95% NG, 54% MG and 29% CT cases, whereas dysuria and transparent discharge were observed in 50% CT, 23% MG and in none of NG cases (P<0.01). Balanitis/meatitis was observed in 24% of cases, genital warts in 12% and proctalgia in 4%. CONCLUSIONS NAAT is crucial for defining urethritis etiology. Dysuria is the most common symptom. Gonococcal urethritis present with purulent discharge, whereas transparent discharge is associated with non-gonococcal pathogens. Co-infections are rare. Clinical exam may detect other infectious diseases, in particular genital warts.
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Affiliation(s)
- Francesco Bellinato
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy -
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Maria Lleo Fernandez
- Section of Microbiology, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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Toh E, Williams JA, Qadadri B, Ermel A, Nelson DE. Development of a SimpleProbe real-Time PCR Assay for rapid detection and identification of the US novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC). PLoS One 2020; 15:e0228467. [PMID: 32040516 DOI: 10.1371/journal.pone.0228467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/15/2020] [Indexed: 11/25/2022] Open
Abstract
Urethritis, or inflammation of the urethra, is one of the most common reasons men seek clinical care. Sexually transmitted pathogens including Neisseria gonorrhoeae are responsible for over half of the symptomatic urethritis cases in U.S. men. Recently, clinics in Indianapolis, Columbus, Atlanta, and other U.S. cities began to note increasing numbers of men presenting with urethritis and Gram-negative intracellular diplococci in their urethral smears who test negative for N. gonorrhoeae. Many of these discordant cases, which have periodically reached highs of more than 25% of presumed gonococcal cases in some sexually transmitted infection clinics in the U.S. Midwest, are infected with strains in a novel urethrotropic clade of Neisseria meningitidis ST-11 (US_NmUC). However, no cultivation-independent tests are available for the US_NmUC strains, and prior studies relied on microbial culture and genome sequencing to identify them. Here, we describe a PCR test that can identify the US_NmUC strains and distinguish them from commensal and invasive N. meningitidis strains as well as N. gonorrhoeae. Our SimpleProbe®-based real-time PCR assay targets a conserved nucleotide substitution in a horizontally acquired region of US_NmUC strain genomes. We applied the assay to 241 urine specimens whose microbial compositions had previously been determined by deep shotgun metagenomic sequencing. The assay detected the single US_NmUC positive case in this cohort, with no false positives. Overall, our simple and readily adaptable assay could facilitate investigation of the pathogenesis and epidemiology of the US_NmUC clade.
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Sarier M. Polymerase chain reaction assay in acute urethritis. Andrologia 2019; 51:e13366. [PMID: 31273814 DOI: 10.1111/and.13366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mehmet Sarier
- Department of Urology, Faculty of Medicine, Istinye University, İstanbul, Turkey
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Bovbjerg ML, Pillai S. Current Resources for Evidence-Based Practice, September 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:568-582. [PMID: 31442383 DOI: 10.1016/j.jogn.2019.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Sarier M, Kukul E. Classification of non-gonococcal urethritis: a review. Int Urol Nephrol 2019; 51:901-907. [DOI: 10.1007/s11255-019-02140-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/01/2019] [Indexed: 12/22/2022]
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