Coinfection of genital mycoplasmas among men with gonococcal urethritis and their roles in post-gonococcal urethritis
Abstract number: 1733_830
Deguchi T., Yasuda M., Maeda S., Tamaki M., Ito S., Nakano M., Yokoi S.
Objectives: F We determined the prevalence of coinfection with genital mycoplasmas, including Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum, among men with gonococcal urethritis (GU) and analysed roles of the genital mycoplasmas in post-gonococcal urethritis (PGU).
Methods: We examined first-voided urine samples from 390 men with gonococcal urethritis (GU) for the presence of C. trachomatis, M. genitalium, M. hominis, U. parvum and U. urealyticum, by polymerase chain reaction-based assays. The patients were treated with cefixime, ceftriaxne, or spectinomycin. PGU was judged to occur if, in spite of the eradication of Neisseria gonorrhoeae, the urethral smear showed significant numbers of polymorphonuclear leucocytes from 7 days to 14 days after treatment.
Results:C. trachomatis and/or the genital mycoplasmas were coinfected in 132 (33.8) of 390 men with culture-confirmed N. gonorrhoeae. In 85 (21.8%), C. trachomatis was detected with or without the genital mycoplasmas. One or two species of the genital mycoplasmas were detected in 15 men coinfected with C. trachomatis (3.8%) and in 47 men without chlamydia cofinfection (12.1%). Of these 47 men, M. genitalium and U. urealyticum were detected in 12 and 23, respectively. In 291 men, the eradication of N. gonorrhoeae was confirmed by culture after treatment. Of these 291 men, 103 men (35.4%) were judged to have PGU. PGU occurred in 51 (77.3%) of 66 men with chlamydia-positive GU and in 14 (46.7%) of 30 men with chlamydia-negative but mycoplasma- and/or ureaplasma-positive GU, whereas it was observed in 38 (19.5%) of 195 men with GU negative for all of C. trachomatis and the genital mycoplasmas. C. trachomatis, M. genitalium and U. urealyticum were significantly associated with PGU, but M. hominis or U. parvum was not.
Conclusion: The prevalence of coinfection with C. trachomatis among men with GU was 21.8%, whereas that with the genital mycoplasmas was 15.9%. M. genitalium and U. urealyticum were associated with PGU as well as C. trachomatis. In clinical settings, the detection of genital mycoplasmas is frequently difficult so that men with NGU should be treated presumptively with antimicrobial agents active against C. trachomatis and genital mycoplasmas.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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