The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis.
BACKGROUND
There are few studies on coinfection with genital mycoplasmas and ureaplasmas in men with gonococcal urethritis (GU). The role of these species in postgonococcal urethritis (PGU) is poorly understood. Thus, we conducted a study to determine the prevalence of coinfection with genital mycoplasmas and ureaplasmas among men with GU and to assess the role of these pathogens in PGU.


METHODS
Three hundred ninety men infected with culture-confirmed Neisseria gonorrhoeae participated in the study. Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum biovar 1, and Ureaplasma urealyticum biovar 2 in first-voided urine samples were detected by polymerase chain reaction-based assay at the patients' initial visits. PGU was judged to be present if the urethral smear was positive for polymorphonuclear leucocytes 7-14 days after treatment for gonorrhea. The association between each microorganism and PGU, measured by the odds ratio, was estimated by multivariate logistic regression analysis.


RESULTS
C. trachomatis, M. genitalium, M. hominis, U. parvum biovar 1, and U. urealyticum biovar 2 were detected in 85 (21.8%), 16 (4.1%), 8 (2.1%), and 33 men (8.5%), respectively. In patients with chlamydia-negative GU, coinfection with M. genitalium was associated with a 14.54-fold greater risk of PGU (95% confidence interval, 2.91-72.74), and coinfection with U. urealyticum biovar 2 was associated with a 3.64-fold greater risk of PGU (95% confidence interval, 1.24-10.63).


CONCLUSIONS
Coinfection with M. genitalium or U. ureaplasma biovar 2 in men with GU was significantly associated with PGU, independent of C. trachomatis. Men with GU should be treated presumptively with antibiotics that are active against C. trachomatis, M. genitalium, and U. urealyticum biovar 2.
Yokoi
Shigeaki
S
Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan.
Maeda
Shin-ichi
S
Kubota
Yasuaki
Y
Tamaki
Masayoshi
M
Mizutani
Kohsuke
K
Yasuda
Mitsuru
M
Ito
Shin-ichi
S
Nakano
Masahiro
M
Ehara
Hidetoshi
H
Deguchi
Takashi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D002690:Chlamydia Infections / Q000150:complications* / Q000188:drug therapy; D002692:Chlamydia trachomatis / Q000472:pathogenicity; D015331:Cohort Studies; D006069:Gonorrhea / Q000150:complications*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009175:Mycoplasma Infections / Q000150:complications* / Q000188:drug therapy; D045704:Mycoplasma genitalium / Q000472:pathogenicity; D016869:Ureaplasma Infections / Q000150:complications* / Q000188:drug therapy; D016990:Ureaplasma urealyticum / Q000472:pathogenicity; D014526:Urethritis / Q000188:drug therapy / Q000382:microbiology*