Article Text

PDF

Clinical sciences poster session 7: vaginal infections
P3-S7.14 The association of Ureaplasma urealyticum with male non-gonococcal urethritis
  1. M Frølund1,
  2. P Lidbrink2,
  3. M Cullberg2,
  4. A Wikström2,
  5. P Ahrens1,
  6. J S Jensen1
  1. 1Statens Serum Institute, Copenhagen, Denmark
  2. 2Karolinska University Hospital, Sweden

Abstract

Background The aetiology of non-gonococcal urethritis (NGU) is unexplained in 30–50% of cases. The role of ureaplasmas is not clear. We detected Ureaplasma urealyticum (Uu) and U parvum (Up) by quantitative PCR in the urine of men with and without NGU to show a possible association with urethritis.

Methods Urine samples from 158 male STD-clinic attendees with symptomatic NGU (>5 PMNL/hpf) and 77 asymptomatic men without NGU (<5 PMNL/hpf) were collected. The patient's age and number of partners within the previous 6 months were recorded. All samples were tested for Neisseria gonorrhoeae (Ng), Chlamydia trachomatis (Ct), Mycoplasma genitalium (Mg), Uu, Up, Trichomonas vaginalis (Tv), herpes simplex virus (HSV) 1 and 2, and adenovirus by real-time PCR.

Results Ct and Mg were found in 22 and 30% of NGU, respectively, and were associated with NGU (p<0.0001 both). Three had dual Ct and Mg infection. Uu was detected in 13% of NGU cases and 12% of controls (p>0.99). The median Uu bacterial DNA load was higher in men with NGU than in men without (223 genome equivalents (geq) and 10 geq, respectively; p=0.002). Using ROC-curve analysis to determine the optimal cut-off, patients with >53 geq were more likely to have urethritis (p=0.02). In men with NGU of unknown aetiology, there was no difference in the rate of Uu detection when compared to controls (p=0.26). The corresponding median Uu bacterial DNA load were significantly higher in this group than in controls (p=0.01), and using a cut-off of >53 geq, men with NGU of unknown aetiology were more likely to harbour Uu (14%) than were men from the control group (1%), (p=0.005). Up was detected in 14% of NGU cases and 19% of controls (p=0.34). There was no difference in the detection rate of Up or in the median Up bacterial load in any of the groups. HSV-1 was detected in 3% of cases and 1% of controls. HSV-2 was found in 2% of NGU cases. All urine samples were negative for adenovirus. Cases and controls had similar median number of partners within 6 months (2 partners) and age (28 and 29 years, respectively).

Conclusion The bacterial load of U urealyticum in men with NGU and in men with NGU of unknown aetiology was higher than in men without NGU, and the presence of >53 geq of Uu was associated with urethritis in both groups. In accordance with other studies, U parvum was not associated with urethritis. (Preliminary results were presented at the ASM general meeting, San Diego 2010).

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.