Prevalence of Polymicrobial Infection in Urethritis

Abstract

Objective:Urethritis is the most common sexually-transmitted disease in men and is classified as gonococcal (GU) and non-gonococcal (NGU) according to the pathogens. Increased urethritis prevalence in recent years has brought the presence of polymicrobial infection into question. The objective of this study was to investigate the prevalence of polymicrobial infections in patients diagnosed with urethritis in a urology outpatient clinic, based on real-time multiplex polymerase chain reaction (Rt-MPCR) assay outcomes.Materials and Methods:Data of 171 patients diagnosed with urethritis and undergone Rt-MPCR analysis in a urology outpatient clinic between February 2017 and June 2018 were retrospectively studied. The pathogens that could be detected by the Rt-MPCR were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ueroplasma parvum, Gardnerella vaginalis, Trichomonas vaginalis, Candida albicans and herpes simplex virus type 1-2.Results:The mean age of 171 patients was 33.8 (19-56) years. According to the Rt-MPCR outcomes, polymicrobial infections were found in 16.9% (29/171) of patients. Two-pathogen polymicrobial urethritis was found in 14% (24/171) of the patients, and three-pathogen polymicrobial urethritis in 2.9% (5/171). Among the cases of polymicrobial urethritis, coexistence of both GU and NGU pathogens was found in 17.3% (5/29) and that of only NGU pathogens in 82.7% (24/29). Overall distribution of urethritis pathogens was found to be as follows: Chlamydia trachomatis 22.9%, Neisseria gonorrhoeae 21.7%, Gardnerella vaginalis 16.8%, Ureaplasma urealyticum 14.2%, Mycoplasma genitalium 10.5%, Ueroplasma parvum 4.7%, Mycoplasma hominis 3.7%, Trichomonas vaginalis 3.1%, Candida albicans 1.8% and herpes simplex virus type -2 1.2%.Conclusion:The presence of polymicrobial urethritis should be taken into consideration when planning treatment for urethritis. Particularly, the association of NGU urethritis pathogens should be considered in the cases of polymicrobial urethritis.

Keywords

• Urethritis
• Non-gonogoccal urethritis
• PCR
• Polymicrobial urethritis