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Takashi Deguchi - One of the best experts on this subject based on the ideXlab platform.
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Male non-Gonococcal Urethritis: From microbiological etiologies to demographic and clinical features.
International Journal of Urology, 2016Co-Authors: Shin Ito, Mitsuru Yasuda, Nozomu Hanaoka, Ken Shimuta, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Makoto Ohnishi, Takashi DeguchiAbstract:Objectives To detect microorganisms responsible for male acute Urethritis and to define the microbiology of non-Gonococcal Urethritis. Methods The present study comprised 424 men with symptoms and signs compatible with acute Urethritis. Their urethral swabs and first-voided urine underwent detection of the microorganisms. Demographic characteristics and clinical features of Mycoplasma genitalium-, Ureaplasma urealyticum-, Haemophilus influenza-, adenovirus- or Herpes simplex virus-positive monomicrobial non-Gonococcal Urethritis, or all-examined microorganism-negative Urethritis in heterosexual men were compared with Urethritis positive only for Chlamydia trachomatis. Results Neisseria gonorrhoeae was detected in 127 men (30.0%). In 297 men with non-Gonococcal Urethritis, C. trachomatis was detected in 143 (48.1%). In 154 men with non-chlamydial non-Gonococcal Urethritis, M. genitalium (22.7%), M. hominis (5.8%), Ureaplasma parvum (9.1%), U. urealyticum (19.5%), H. influenzae (14.3%), Neisseria meningitidis (3.9%), Trichomonas vaginalis (1.3%), human adenovirus (16.2%), and Herpes simplex virus types 1 (7.1%) and 2 (2.6%) were detected. Although some features of monomicrobial non-chlamydial non-Gonococcal Urethritis or all-examined microorganism-negative Urethritis were significantly different from those of monomicrobial chlamydial non-Gonococcal Urethritis, most features were superimposed. Conclusions Predicting causative microorganisms in men with non-Gonococcal Urethritis based on demographic and clinical features is difficult. However, the present study provides useful information to better understand the microbiological diversity in non-Gonococcal Urethritis, and to manage patients with non-Gonococcal Urethritis appropriately.
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antimicrobial chemotherapy of mycoplasma genitalium positive non Gonococcal Urethritis
Expert Review of Anti-infective Therapy, 2012Co-Authors: Takashi Deguchi, Mitsuru Yasuda, Shin Ito, Noriyasu Hagiwara, Shinichi MaedaAbstract:Mycoplasma genitalium is an important pathogen of acute non-Gonococcal Urethritis (NGU) in men and plays a significant role in persistent or recurrent NGU. In the management of patients with M. genitalium-positive NGU, eradication of the mycoplasma from the urethra is necessary to prevent persistent or recurrent NGU. Therefore, M. genitalium should be considered for antimicrobial chemotherapy of NGU. This article reviews the in vitro antimicrobial activities of antibiotics against M. genitalium and the efficacies of various antibiotic regimens against M. genitalium-positive NGU, including the doxycycline and azithromycin regimens recommended as first-line treatments for NGU in the guidelines. Selection of macrolide-resistant M. genitalium by treatment with the single-dose regimen of 1-g azithromycin and mechanisms of macrolide resistance in M. genitalium are discussed. The effectiveness of the moxifloxacin regimen against persistent or recurrent NGU, unsuccessfully treated with azithromycin and/or doxycycline regimens, is emphasized.
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clinical and microbiological outcomes in treatment of men with non Gonococcal Urethritis with a 100 mg twice daily dose regimen of sitafloxacin
Journal of Infection and Chemotherapy, 2012Co-Authors: Shin Ito, Mitsuru Yasuda, Kensaku Seike, Tomohiro Tsuchiya, Shigeaki Yokoi, Masahiro Nakano, Takashi Sugawara, Takashi DeguchiAbstract:Several microorganisms cause non-Gonococcal Urethritis (NGU). Failure to eradicate Mycoplasma genitalium from the urethra could be associated with persistent or recurrent Urethritis; thus, the choice of antibiotics with activities potent enough to eradicate M. genitalium is crucial in the treatment of NGU. In in vitro studies, sitafloxacin has been shown to be highly active against Chlamydia trachomatis and M. genitalium. We treated 89 males with NGU, including 15 patients with persistent or recurrent NGU and 1 patient with post-Gonococcal Urethritis, with a 100-mg twice-daily dose regimen of sitafloxacin to assess its efficacy against NGU. We examined first-void urine samples for the presence of C. trachomatis, M. genitalium, Ureaplasma parvum, and Ureaplasma urealyticum. After treatment, we evaluated 73 patients for clinical outcomes and 44 for microbiological outcomes. Symptoms were alleviated in 62 (84.9%) patients, who were judged clinically cured. Microorganisms detected before treatment were eradicated in 42 (95.5%) patients, who were judged microbiologically cured. Regarding microbiological outcomes of specific microorganisms, eradication rates of C. trachomatis (n = 33), M. genitalium (n = 11), and U. urealyticum (n = 10) were 100%, 100%, and 80.0%, respectively. In all 5 patients with M. genitalium-positive persistent or recurrent NGU who had experienced treatment failures with antibiotics, the mycoplasma was eradicated. These results suggested that the sitafloxacin regimen used, which was effective on both M. genitalium and C. trachomatis infections, could be useful as an appropriate option as first- and second-line treatment of NGU.
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detection of mycoplasma genitalium mycoplasma hominis ureaplasma parvum biovar 1 and ureaplasma urealyticum biovar 2 in patients with non Gonococcal Urethritis using polymerase chain reaction microtiter plate hybridization
International Journal of Urology, 2004Co-Authors: Shinichi Maeda, Hiroaki Ishiko, Takashi Deguchi, Tetsuro Matsumoto, Seiji Naito, Hiromi Kumon, Taiji Tsukamoto, Shouichi Onodera, Sadao KamidonoAbstract:Abstract Aim: To use polymerase chain reaction (PCR)-microtiter plate hybridization assays to detect Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in first-voided urine specimens from patients with non-Gonococcal Urethritis (NGU). Methods: A total of 153 male patients with NGU, who visited one of 24 clinics in Japan, were recruited for this study. All were examined using PCR-microtiter plate hybridization assays for the presence of M. genitalium, M. hominis, U. parvum (biovar 1) and U. urealyticum (biovar 2) in first-voided urine specimens. They were also examined for the presence of Chlamydia trachomatis. Results: Of these 153 patients, 73 (47.7%) were positive for C. trachomatis. Overall, the prevalence was 17.0% for M. genitalium, 16.3% for U. urealyticum (biovar 2), 7.8% for U. parvum (biovar 1) and 2.6% for M. hominis. In the 80 patients with non-chlamydial NGU, the prevalence of M. genitalium, U. urealyticum (biovar 2), U. parvum (biovar 1) and M. hominis was 23.8%, 18.8%, 8.8% and 2.6%, respectively. Conclusions: This study shows the prevalence of mycoplasmas and ureaplasmas in NGU in Japan. M. genitalium and U. urealyticum (biovar 2) might be pathogens of NGU and could be associated with persistent and recurrent Urethritis. When patients with NGU are treated, such pathogens should be taken into account. This PCR-microtiter plate hybridization assay provides a useful method for diagnosing NGU caused by M. genitalium and U. urealyticum (biovar 2).
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treatment of uncomplicated Gonococcal Urethritis by double dosing of 200 mg cefixime at a 6 h interval
Journal of Infection and Chemotherapy, 2003Co-Authors: Takashi Deguchi, Mitsuru Yasuda, Shigeaki Yokoi, Kenichiro Ishida, Masayasu Ito, Satoshi Ishihara, Ken Minamidate, Y Harada, Kanhin Tei, Kentaro KojimaAbstract:The efficacy of antimicrobial regimens for the treatment of uncomplicated Gonococcal Urethritis depends partially upon the period of time (therapeutic time) during which the drug concentration in the blood after the concentration peak is greater than four times the minimum inhibitory concentration for 90% of clinical isolates of Neisseria gonorrhoeae (MIC90). A therapeutic time of at least 10 h is suggested as an important determinant for elimination of 95% or more of the infection. In this study, therapeutic times for a single 400-mg dose of cefixime at various MIC90s were calculated, and pharmacokinetic profiles of double-dosing of 200 mg cefixime at various intervals were simulated. Subsequently, a dosing interval of 6 h was tested in 6 healthy Japanese men, and then 93 Japanese men with Gonococcal Urethritis were treated with a regimen of two 200-mg doses of cefixime given at a 6-h interval. For a single dose of 400 mg cefixime, therapeutic times were calculated to be 12.8, 9.1, 5.4, and 1.7 h for MIC90s of 0.06, 0.125, 0.25, and 0.5 μg/ml, respectively. In the simulation study of double-dosing of 200 mg cefixime at a 6-h interval, the therapeutic times for the MIC90s of ≤0.125 μg/ml were longer than 10 h. Of the 93 patients, 68 were evaluated for microbiological outcome, and N. gonorrhoeae was eradicated in 60 (88.2%). The MIC90 of cefixime for the 61 isolates tested was 0.125 μg/ml. All strains with MICs of ≤0.06 μg/ml were eradicated, whereas 8 of 16 strains with MICs of ≥0.125 μg/ml persisted after treatment. This regimen would not be effective against infection by strains exhibiting cefixime MIC90s of ≥0.125 μg/ml. For such strains, a different regimen with a higher dose of cefixime would be required.
IVD Weller - One of the best experts on this subject based on the ideXlab platform.
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The effects of Urethritis on seminal plasma HIV-1 RNA loads in homosexual men not receiving antiretroviral therapy
Sexually Transmitted Infections, 2005Co-Authors: S T Sadiq, Steve Kaye, Susan M. Drake, Stephen Taylor, Andrew Copas, J. Bennett, Deenan Pillay, S Kirk, IVD WellerAbstract:Objectives: To examine the effects of Urethritis and its treatment on semen plasma HIV-1 RNA load in HIV-1 infected men not receiving antiretroviral therapy (ART), in a developed world setting. Methods: Prospective case-control study. HIV-1 infected homosexual men, not receiving ART for at least 3 months, with (cases) and without (controls) symptomatic Urethritis, were recruited. Blood and semen were collected for HIV-1 RNA quantification at presentation, before antibiotic therapy, and at 1 and 2 weeks. Results: 20 cases (13 Gonococcal Urethritis and/or chlamydial Urethritis (GU/CU) and seven non-specific Urethritis (NSU)) and 35 controls were recruited. Baseline characteristics and blood plasma viral load were similar in cases and controls. Mean log semen plasma viral loads were higher among those with GU/CU compared with controls (4.27 log versus 3.55 log respectively; p = 0.01) but not in those with NSU (3.48 log; p = 0.82). Following antibiotics, semen plasma viral loads fell by a mean of 0.25 log (95% CI: 0.03 to 0.47) in those with GU/CU. Semen plasma viral loads did not fall in those with NSU. Conclusions: In this study of 55 homosexual men not on ART, semen plasma viral loads were approximately fivefold higher in those with GU/CU, but not NSU, compared with controls. Treatment of GU/CU resulted in reduction in semen plasma viral loads. Although absolute effects were considerably lower when compared to patients from a similar study from sub-Saharan Africa, our data demonstrate the potential for sexually transmitted infections to enhance HIV infectivity of men not receiving ART in the developed world. Abbreviations: ART, antiretroviral therapy; BPVL, blood plasma viral loads; CU, chlamydial Urethritis; GEE, generalised estimating equations; GU, Gonococcal Urethritis; NGU, non-Gonococcal Urethritis; NSU, non-specific Urethritis; PCR, polymerase chain reaction; p/hpf, polymorphs per high power field; SPVL, seminal plasma viral loads.
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The effects of antiretroviral therapy on HIV-1 RNA loads in seminal plasma in HIV-positive patients with and without Urethritis.
AIDS, 2002Co-Authors: S T Sadiq, Steve Kaye, Susan M. Drake, Stephen Taylor, R. Johnstone, P O'byrne, Andrew Copas, J. Bennett, Deenan Pillay, IVD WellerAbstract:Background: High seminal plasma HIV-1 RNA loads (SVL) have been reported during Gonococcal, non-Gonococcal and chlamydial Urethritis in patients not taking antiretroviral therapy.Objective: To examine if Urethritis leads to increased SVLin HIV-positive patients taking antiretroviral therapy. Methods: Men who had been taking therapy for at least 3 months were recruited: 24 had urethitis (PWU) and 16 were without Urethritis (controls). At three visits, 1 week apart, blood plasma viral load (BVL) and SVL were assayed by quantitative polymerase chain reaction or the NASBA assay.Results: Most subjects had undetectable SVL (18 PWU, 13 controls). Among those with undetectable BVL prior to first study visit, virus was undetectable in semen in 5/5 episodes of chlamydial Urethritis, 6/7 episodes of non-Gonococcal Urethritis and 4/5 cases of Gonococcal Urethritis. Two PWU with undetectable BVL just prior to the first study visit had low to moderate SVL, which became undetectable by visit 2 following treatment. Of nine subjects with detectable SVL, eight had detectable BVL (3/3 controls and 5/6 PWU). Of these, 1/3 controls and 4/5 PWU (all with Gonococcal Urethritis) had poorly controlled BVL just prior to the first study visit. These four PWU had high SVL and one had higher levels in semen than in blood. This patient's SVL was reduced more than 20-fold following treatment for Gonococcal Urethritis.Conclusions: Effective antiretroviral therapy appeared to limit the effect of Urethritis on SVL. When BVL was poorly controlled by antiretroviral therapy, high SVL occurred during Gonococcal Urethritis, increasing the potential risk of transmitting both wild type and drug resistant strains of HIV-1. (C) 2002 Lippincott Williams Wilkins.
S T Sadiq - One of the best experts on this subject based on the ideXlab platform.
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Performance evaluation of automated urine microscopy as a rapid, non-invasive approach for the diagnosis of non-Gonococcal Urethritis.
'BMJ', 2015Co-Authors: Mj Pond, Av Nori, Patel S, Laing K, Ajayi M, Aj Copas, Pd Butcher, Hay P, S T SadiqAbstract:OBJECTIVES: Gram-stained urethral smear (GSUS), the standard point-of-care test for non-Gonococcal Urethritis (NGU) is operator dependent and poorly specific. The performance of rapid automated urine flow cytometry (AUFC) of first void urine (FVU) white cell counts (UWCC) for predicting Mycoplasma genitalium and Chlamydia trachomatis urethral infections was assessed and its application to asymptomatic infection was evaluated. METHODS: Receiver operating characteristic curve analysis, determining FVU-UWCC threshold for predicting M. genitalium or C. trachomatis infection was performed on 208 'training' samples from symptomatic patients and subsequently validated using 228 additional FVUs obtained from prospective unselected patients. RESULTS: An optimal diagnostic threshold of >29 UWC/µL gave sensitivities and specificities for either infection of 81.5% (95% CI 65.1% to 91.6%) and 85.8% (79.5% to 90.4%), respectively, compared with 86.8% (71.1% to 95%) and 64.7% (56.9% to 71.7%), respectively, for GSUS, using the training set samples. FVU-UWCC demonstrated sensitivities and specificities of 69.2% (95% CI 48.1% to 84.9%) and 92% (87.2% to 95.2%), respectively, when using validation samples. In asymptomatic patients where GSUS was not used, AUFC would have enabled more infections to be detected compared with clinical considerations only (71.4% vs 28.6%; p=0.03). The correlation between UWCC and bacterial load was stronger for M. genitalium compared with C. trachomatis (τ=0.426, p≤0.001 vs τ=0.295, p=0.022, respectively). CONCLUSIONS: AUFC offers improved specificity over microscopy for predicting C. trachomatis or M. genitalium infection. Universal AUFC may enable non-invasive diagnosis of asymptomatic NGU at the PoC. The degree of urethral inflammation exhibits a stronger association with pathogen load for M. genitalium compared with C. trachomatis
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The effects of Urethritis on seminal plasma HIV-1 RNA loads in homosexual men not receiving antiretroviral therapy
Sexually Transmitted Infections, 2005Co-Authors: S T Sadiq, Steve Kaye, Susan M. Drake, Stephen Taylor, Andrew Copas, J. Bennett, Deenan Pillay, S Kirk, IVD WellerAbstract:Objectives: To examine the effects of Urethritis and its treatment on semen plasma HIV-1 RNA load in HIV-1 infected men not receiving antiretroviral therapy (ART), in a developed world setting. Methods: Prospective case-control study. HIV-1 infected homosexual men, not receiving ART for at least 3 months, with (cases) and without (controls) symptomatic Urethritis, were recruited. Blood and semen were collected for HIV-1 RNA quantification at presentation, before antibiotic therapy, and at 1 and 2 weeks. Results: 20 cases (13 Gonococcal Urethritis and/or chlamydial Urethritis (GU/CU) and seven non-specific Urethritis (NSU)) and 35 controls were recruited. Baseline characteristics and blood plasma viral load were similar in cases and controls. Mean log semen plasma viral loads were higher among those with GU/CU compared with controls (4.27 log versus 3.55 log respectively; p = 0.01) but not in those with NSU (3.48 log; p = 0.82). Following antibiotics, semen plasma viral loads fell by a mean of 0.25 log (95% CI: 0.03 to 0.47) in those with GU/CU. Semen plasma viral loads did not fall in those with NSU. Conclusions: In this study of 55 homosexual men not on ART, semen plasma viral loads were approximately fivefold higher in those with GU/CU, but not NSU, compared with controls. Treatment of GU/CU resulted in reduction in semen plasma viral loads. Although absolute effects were considerably lower when compared to patients from a similar study from sub-Saharan Africa, our data demonstrate the potential for sexually transmitted infections to enhance HIV infectivity of men not receiving ART in the developed world. Abbreviations: ART, antiretroviral therapy; BPVL, blood plasma viral loads; CU, chlamydial Urethritis; GEE, generalised estimating equations; GU, Gonococcal Urethritis; NGU, non-Gonococcal Urethritis; NSU, non-specific Urethritis; PCR, polymerase chain reaction; p/hpf, polymorphs per high power field; SPVL, seminal plasma viral loads.
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The effects of antiretroviral therapy on HIV-1 RNA loads in seminal plasma in HIV-positive patients with and without Urethritis.
AIDS, 2002Co-Authors: S T Sadiq, Steve Kaye, Susan M. Drake, Stephen Taylor, R. Johnstone, P O'byrne, Andrew Copas, J. Bennett, Deenan Pillay, IVD WellerAbstract:Background: High seminal plasma HIV-1 RNA loads (SVL) have been reported during Gonococcal, non-Gonococcal and chlamydial Urethritis in patients not taking antiretroviral therapy.Objective: To examine if Urethritis leads to increased SVLin HIV-positive patients taking antiretroviral therapy. Methods: Men who had been taking therapy for at least 3 months were recruited: 24 had urethitis (PWU) and 16 were without Urethritis (controls). At three visits, 1 week apart, blood plasma viral load (BVL) and SVL were assayed by quantitative polymerase chain reaction or the NASBA assay.Results: Most subjects had undetectable SVL (18 PWU, 13 controls). Among those with undetectable BVL prior to first study visit, virus was undetectable in semen in 5/5 episodes of chlamydial Urethritis, 6/7 episodes of non-Gonococcal Urethritis and 4/5 cases of Gonococcal Urethritis. Two PWU with undetectable BVL just prior to the first study visit had low to moderate SVL, which became undetectable by visit 2 following treatment. Of nine subjects with detectable SVL, eight had detectable BVL (3/3 controls and 5/6 PWU). Of these, 1/3 controls and 4/5 PWU (all with Gonococcal Urethritis) had poorly controlled BVL just prior to the first study visit. These four PWU had high SVL and one had higher levels in semen than in blood. This patient's SVL was reduced more than 20-fold following treatment for Gonococcal Urethritis.Conclusions: Effective antiretroviral therapy appeared to limit the effect of Urethritis on SVL. When BVL was poorly controlled by antiretroviral therapy, high SVL occurred during Gonococcal Urethritis, increasing the potential risk of transmitting both wild type and drug resistant strains of HIV-1. (C) 2002 Lippincott Williams Wilkins.
Patrick J Horner - One of the best experts on this subject based on the ideXlab platform.
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REVIEW Open Access Management of non-Gonococcal Urethritis
2016Co-Authors: Harald Moi, Karla Blee, Patrick J HornerAbstract:Non-Gonococcal Urethritis (NGU), or inflammation of the urethra, is the most common treatable sexually transmitted syndrome in men, with approximately 20-50 % of cases being due to infection with Chlamydia trachomatis and 10-30 % Mycoplasma genitalium. Other causes are Ureaplasma urealyticum, Trichomonas vaginalis, anaerobes, Herpes simplex virus (HSV) and adenovirus. Up to half of the cases are non-specific. Urethritis is characterized by discharge, dysuria and/or urethral discomfort but may be asymptomatic. The diagnosis of Urethritis is confirmed by demonstrating an excess of polymorpho-nuclear leucocytes (PMNLs) in a stained smear. An excess of mononuclear leucocytes in the smear indicates a viral etiology. In patients presenting with symptoms of Urethritis, the diagnosis should be confirmed by microscopy of a stained smear, ruling out gonorrhea. Nucleid acid amplifications tests (NAAT) for Neisseria gonorrhoeae, C. trachomatis and for M. genitalium. If viral or protozoan aetiology is suspected, NAAT for HSV, adenovirus and T. vaginalis, if available. If marked symptoms and Urethritis is confirmed, syndromic treatment should be given at the first appointment without waiting for the laboratory results. Treatment options are doxycycline 100 mg x 2 for one week or azithromycin 1 gram single dose or 1,5 gram distributed in five days. However, azithromycin as first line treatment without test of cure for M. genitalium and subsequent Moxifloxacin treatment of macrolide resistant strains will select and increase the macrolide resistan
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2016 European guideline on the management of non-Gonococcal Urethritis.
International Journal of Std & Aids, 2016Co-Authors: Patrick J Horner, Willem I. Van Der Meijden, Karla Blee, Lars Falk, Harald MoiAbstract:We present the updated International Union against Sexually Transmitted Infections (IUSTI) guideline for the management of non-Gonococcal Urethritis in men. This guideline recommends confirmation o...
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management of non Gonococcal Urethritis
BMC Infectious Diseases, 2015Co-Authors: Harald Moi, Karla Blee, Patrick J HornerAbstract:Non-Gonococcal Urethritis (NGU), or inflammation of the urethra, is the most common treatable sexually transmitted syndrome in men, with approximately 20-50 % of cases being due to infection with Chlamydia trachomatis and 10-30 % Mycoplasma genitalium. Other causes are Ureaplasma urealyticum, Trichomonas vaginalis, anaerobes, Herpes simplex virus (HSV) and adenovirus. Up to half of the cases are non-specific. Urethritis is characterized by discharge, dysuria and/or urethral discomfort but may be asymptomatic. The diagnosis of Urethritis is confirmed by demonstrating an excess of polymorpho-nuclear leucocytes (PMNLs) in a stained smear. An excess of mononuclear leucocytes in the smear indicates a viral etiology. In patients presenting with symptoms of Urethritis, the diagnosis should be confirmed by microscopy of a stained smear, ruling out gonorrhea. Nucleid acid amplifications tests (NAAT) for Neisseria gonorrhoeae, C. trachomatis and for M. genitalium. If viral or protozoan aetiology is suspected, NAAT for HSV, adenovirus and T. vaginalis, if available. If marked symptoms and Urethritis is confirmed, syndromic treatment should be given at the first appointment without waiting for the laboratory results. Treatment options are doxycycline 100 mg x 2 for one week or azithromycin 1 gram single dose or 1,5 gram distributed in five days. However, azithromycin as first line treatment without test of cure for M. genitalium and subsequent Moxifloxacin treatment of macrolide resistant strains will select and increase the macrolide resistant strains in the population. If positive for M. genitalium, test of cure samples should be collected no earlier than three weeks after start of treatment. If positive in test of cure, moxifloxacin 400 mg 7–14 days is indicated. Current partner(s) should be tested and treated with the same regimen. They should abstain from intercourse until both have completed treatment. Persistent or recurrent NGU must be confirmed with microscopy. Reinfection and compliance must be considered. Evidence for the following recommendations is limited, and is based on clinical experience and guidelines. If doxycycline was given as first therapy, azithromycin five days plus metronidazole 4–500 mg twice daily for 5–7 days should be given. If azithromycin was prescribed as first therapy, doxycycline 100 mg x 2 for one week plus metronidazole, or moxifloxacin 400 mg orally once daily for 7–14 days should be given.
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2015 UK National Guideline on the management of non-Gonococcal Urethritis
International Journal of Std & Aids, 2015Co-Authors: Patrick J Horner, C O'mahony, Karla Blee, Peter Muir, Ceri Evans, Keith Radcliffe, HivAbstract:We present the updated British Association for Sexual Health and HIV guideline for the management of non-Gonococcal Urethritis in men. This document includes a review of the current literature on i...
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association of mycoplasma genitalium with balanoposthitis in men with non Gonococcal Urethritis
Sexually Transmitted Infections, 2011Co-Authors: Patrick J Horner, D TaylorrobinsonAbstract:Objective To determine whether Mycoplasma genitalium is associated with balanitis and/or posthitis in a previous study of the role of M genitalium in men with acute non-Gonococcal Urethritis (NGU). Methods In a previous study of men with acute NGU, the existence of balanitis and/or posthitis was recorded. Chlamydia trachomatis , M genitalium and ureaplasmas were sought in urethral swabs and urine using a direct fluorescent antibody test and in-house PCR, an in-house PCR and a culture method, respectively. Men were treated with doxycycline or erythromycin. Results M genitalium was associated significantly (p=0.01) with balanitis and/or posthitis in 114 men with acute NGU. This association persisted when there was control for C trachoma tis and urethral discharge (p=0.021, OR 4.1, 95% CI 1.2 to 13.5). C trachomatis and ureaplasmas were not associated with balanitis and/or posthitis. Conclusion Detection of M genitalium in men with acute NGU was associated significantly with balanitis and/or posthitis. The association is biologically plausible and may have a role in HIV-1 transmission and susceptibility.
Tetsuro Matsumoto - One of the best experts on this subject based on the ideXlab platform.
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single dose treatment of male patients with Gonococcal Urethritis using 2 g spectinomycin microbiological and clinical evaluations
International Journal of Antimicrobial Agents, 2008Co-Authors: Munekado Kojima, Kento Masuda, Yasufumi Yada, Yoshimasa Hayase, Tetsuro Muratani, Tetsuro MatsumotoAbstract:The microbiological and clinical efficacies of a single-dose treatment of 2 g spectinomycin administered by intramuscular injection were studied in 365 male patients with Gonococcal Urethritis. A total of 210 patients (57.5%) could be evaluated, in 28 (13.3%) of whom Chlamydia trachomatis was detected in addition to Neisseria gonorrhoeae. A single dose of spectinomycin eradicated N. gonorrhoeae in 203 (96.7%) of the 210 patients. Among patients in whom N. gonorrhoeae was eradicated, pyuria and clinical symptoms, respectively, disappeared in 92.6% (162/175) and 98.9% (173/175) of patients without concomitant C. trachomatis and in 78.6% (22/28) and 71.4% (20/28) with C. trachomatis. Minimal inhibitory concentrations (MICs) were determined for four of seven N. gonorrhoeae strains isolated after spectinomycin treatment. MICs to spectinomycin for three of the four isolates were 16 μg/mL (defined as susceptible) and the MIC of the other isolate was 128 μg/mL, indicating resistance. The resistant isolate was a multidrug-resistant strain with resistance to ciprofloxacin, tetracycline, penicillin and cephalosporins, except for ceftriaxone. The results of this study indicate that a single-dose treatment using 2 g spectinomycin is effective in treating patients with Urethritis caused by N. gonorrhoeae, even in the era of multidrug-resistant N. gonorrhoeae.
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detection of mycoplasma genitalium mycoplasma hominis ureaplasma parvum biovar 1 and ureaplasma urealyticum biovar 2 in patients with non Gonococcal Urethritis using polymerase chain reaction microtiter plate hybridization
International Journal of Urology, 2004Co-Authors: Shinichi Maeda, Hiroaki Ishiko, Takashi Deguchi, Tetsuro Matsumoto, Seiji Naito, Hiromi Kumon, Taiji Tsukamoto, Shouichi Onodera, Sadao KamidonoAbstract:Abstract Aim: To use polymerase chain reaction (PCR)-microtiter plate hybridization assays to detect Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in first-voided urine specimens from patients with non-Gonococcal Urethritis (NGU). Methods: A total of 153 male patients with NGU, who visited one of 24 clinics in Japan, were recruited for this study. All were examined using PCR-microtiter plate hybridization assays for the presence of M. genitalium, M. hominis, U. parvum (biovar 1) and U. urealyticum (biovar 2) in first-voided urine specimens. They were also examined for the presence of Chlamydia trachomatis. Results: Of these 153 patients, 73 (47.7%) were positive for C. trachomatis. Overall, the prevalence was 17.0% for M. genitalium, 16.3% for U. urealyticum (biovar 2), 7.8% for U. parvum (biovar 1) and 2.6% for M. hominis. In the 80 patients with non-chlamydial NGU, the prevalence of M. genitalium, U. urealyticum (biovar 2), U. parvum (biovar 1) and M. hominis was 23.8%, 18.8%, 8.8% and 2.6%, respectively. Conclusions: This study shows the prevalence of mycoplasmas and ureaplasmas in NGU in Japan. M. genitalium and U. urealyticum (biovar 2) might be pathogens of NGU and could be associated with persistent and recurrent Urethritis. When patients with NGU are treated, such pathogens should be taken into account. This PCR-microtiter plate hybridization assay provides a useful method for diagnosing NGU caused by M. genitalium and U. urealyticum (biovar 2).