Results of Multiplex Polymerase Chain Reaction Assay to Identify Urethritis Pathogens

Abstract

Objective: The purpose of this study was to evaluate the results of multiplex polymerase chain reaction (PCR) test applied to identify the pathogens in male patients who attended our urology clinic with a pre-diagnosis of urethritis related with sexual intercourse. Materials and Methods: In this study, we included a total of 91 male patients, who sought medical advice in our clinic between August 2015 and October 2016 due to complaints of urethral discharge, dysuria and urethral itching, having a visible urethral discharge during the physical examination or a positive leukocyte esterase test (Combur-Test®-Roche) in the first urine sample. In the urethral swab samples of these patients, urethritis pathogens were searched with a multiplex PCR test. The multiplex PCR kit, which is able to identify nine pathogens and produced by PathoFinder® (Holland), was used in the process. The pathogens that could be detected by the kit were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Gardnerella vaginalis, Trichomonas vaginalis, Treponema pallidum, and Candida albicans. Results: The average age of the subjects was 35.1 (19-57) years. Sixty one out of 91 patients (67%) were found to have a pathogen in the urethral swab sample. In 45 patients (49.4%), only one pathogen, in 12 (13.1%) - two different pathogens and in 4 (4.3%) patients, 3 different pathogens were detected. The pathogens found were as follows: Ureaplasma urealyticum in 22 patients (27.1%), Gardnerella vaginalis in 15 (18.6%), Neisseria gonorrhoeae in 13 (16.1%), Mycoplasma genitalium (10 patients; 12.3%), Mycoplasma hominis (8 patients; 9.9%), Chlamydia trachomatis (8 patients; 9.9%), Trichomonas vaginalis (3 patients; 3.8%), and Candida albicans (2 patients; 2.4%). None of the patients were identified with Treponema pallidum. None of the pathogens were identified in 30 patients (32.9%) whose samples were examined by PCR method. Conclusion: Sexually transmitted pathogens that are quite difficult to identify and that cause urethritis are possibly defined with only one swab sample in a short time using multiplex PCR method providing new possibilities and scopes for the diagnosis.

Keywords

• Polymerase chain reaction
• urethritis
• mycoplasma
• ureaplasma
• Gardnerella vaginalis
• sexual transmitted disease