Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis.
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Abstract:
A polymerase chain reaction (PCR) was developed for Chlamydia trachomatis in which a 380 base pair DNA fragment was amplified. Amplification occurred with the DNA from the 15 serovars but not with that from other Chlamydia spp or with DNA from a variety of other organisms. Chlamydial DNA (10(-16) g) could be detected and the PCR seemed to be able to detect single organisms. Urethral swabs were obtained from 37 men with acute non-gonococcal urethritis (NGU), 18 (49%) of whom were positive for C trachomatis by MicroTrak. As a result of clinical re-examinations 65 urethral swabs were available for analysis by the PCR. In comparison with MicroTrak, PCR had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 86% and a negative predictive value of 98%. The PCR was apparently less sensitive (82%) in tests on urine samples. Overall, however, values of sensitivity and specificity of the PCR compared favourably with those of MicroTrak. The PCR for C trachomatis is likely to be a valuable technique for research, but problems of DNA contamination suggest that it should not be recommended for routine diagnosis.Keywords:
Non-gonococcal urethritis
Neisseria gonorrhoeae
The Chlamydiales order is composed of obligate intracellular bacteria and includes the Chlamydiaceae family and several family-level lineages called Chlamydia-related bacteria. In this review we will highlight the conserved and distinct biological features between these two groups. We will show how a better characterization of Chlamydia-related bacteria may increase our understanding on the Chlamydiales order evolution, and may help identifying new therapeutic targets to treat chlamydial infections.
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Chlamydophila pneumoniae
Chlamydophila
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Non-gonococcal urethritis
Gonococcal infection
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The criteria that need to be fulfilled before regarding a mycoplasma as a cause of non-gonococcal urethritis (NGU) are outlined. Of the seven mycoplasmas that have been isolated from the human genitourinary tract, most cannot be considered as contenders for causing NGU. Although there is no evidence to support an etiological role for Mycoplasma hominis, it may be unwise to ignore this mycoplasma in view of its known pathogenicity in other situations. The cumulative weight of evidence indicates that strains of Ureaplasma urealyticum (ureaplasmas) cause NGU in some patients. The reason for their occurrence in the urethra of some men without disease needs to be established. Ureaplasmas do not seem to cause post-gonococcal urethritis. The role in NGU of M. genitalium, newly discovered in the male urethra, is unknown, but its biological features, morphological appearance, and ability to cause genital disease in marmosets suggest that it may be pathogenic for man.
Ureaplasma urealyticum
Mycoplasma genitalium
Non-gonococcal urethritis
Mycoplasma hominis
Etiology
Ureaplasma
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for a long time after the cure of the gonorrhzea.It seems that this secondary infection, as like as not with sulphonamide resistant organisms, is well nigh inevitable, but it is debatable whether the condition will clear up properly without adequate local treatment.My own experience leads me to think that usually it will not do so, and in many of my own cases the initial week of chemotherapy is followed by two, three or four weeks of local treatment before the cervix and its secretion approach the normal.The subject of non-gonococcal vaginal discharges to be discussed at a future meeting of this society, has a direct bearing on the problem of non-gonococcal urethritis in men.VII NON-GONOCOCCAL URETHRITIS * By I. N. ORPW'OOD-PRICE, M.R
Non-gonococcal urethritis
Gonococcal infection
Neisseria gonorrhoeae
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The association between urinary abnormalities detected by the two-glass urine test and objective urethritis was investigated in a study of 221 male patients with non-gonococcal urethritis. A strong correlation existed between urinary threads and urethritis, but use of the test for diagnosis and in the assessment of cure is limited by its poor predictive value in both treated and untreated patients.
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Ninety-six men with non-gonococcal urethritis (NGU) were studied to determine the microbiology of NGU in Singapore. Chlamydia trachomatis emerged as the most common aetiologic agent, being isolated in 29 (30.2%) of 96 patients. The recovery rate of other potential pathogens and their significance locally are discussed.
Non-gonococcal urethritis
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Introduction
Neisseria gonorrhoeae is one of the most important pathogens causing sexually transmitted infection. Resistant N. gonorrhoeae trains against several antimicrobials are increasing worldwide. In this study, the trends of antimicrobial susceptibilities among N. gonorrhoeae strains isolated from male patients with urethritis were investigated as the second Japanese national surveillance, which was conducted by a Japanese surveillance committee.Methods
The targets were male patients older than 16 years with urethral discharge and symptoms of urethritis. Urethral discharge was collected from patients at 26 medical facilities from March 2012 to January 2013 and the antimicrobial susceptibility of strains were tested.Results
From 151 patients (median age 32 years), 103 N. gonorrhoeae strains were tested for susceptibility to 20 antimicrobial agents. None was susceptible to penicillin G (MIC: ≤0.06 μg/mL). The prevalence of penicillinase producing N. gonorrhoeae or chromosomally mediated resistant N. gonorrhoeae was 1.9% or 20.8%, respectively. The susceptible rate for fluoroquinolone such as ciprofloxacin or levofloxacin was 20.3%. The susceptible rate for cefixime was 89.3%, that decreased from 98.8% at 2009. No ceftriaxone-resistant strains founded. The prevalence of less susceptible strain to ceftriaxone (MIC: 0.125 μg/mL) was 10.7%. No azithromycin high-resistant strain found and 5 strains (4.9%) had MIC ≥0.5 μg/mL. Among all strains, 83 strains (80.6%) were resistant to more than 2 kinds of antimicrobials and 42 strains (40.1%) was included to the criteria as multi-drug resistant N. gonorrhoeae.Conclusion
The antimicrobial susceptibility of N. gonorrhoeae was not different between 2009 and 2012–2013, in Japan.Disclosure of interest statement
Nothing to declare.Neisseria gonorrhoeae
Gonococcal infection
Neisseriaceae
Neisseria
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Mycoplasma genitalium: a cause of non-gonococcal urethritis?
Mycoplasma genitalium
Non-gonococcal urethritis
Neisseria gonorrhoeae
Gonococcal infection
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Non-gonococcal urethritis
Gonococcal infection
Neisseria gonorrhoeae
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Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though it is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.
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Neisseriaceae
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