Journal Article

The Role of <i>Mycoplasma genitalium</i> and <i>Ureaplasma urealyticum</i> Biovar 2 in Postgonococcal Urethritis

Shigeaki Yokoi, Shin-ichi Maeda, Yasuaki Kubota, Masayoshi Tamaki, Kohsuke Mizutani, Mitsuru Yasuda, Shin-ichi Ito, Masahiro Nakano, Hidetoshi Ehara and Takashi Deguchi

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 45, issue 7, pages 866-871
Published in print October 2007 | ISSN: 1058-4838
Published online October 2007 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/521266
The Role of Mycoplasma genitalium and Ureaplasma urealyticum Biovar 2 in Postgonococcal Urethritis

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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. urealytiucm 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. trachoamtis. Men with GU should be treated presumptively with antibiotics that are active against C. trachomatis, M. genitalium, and U. urealyticum biovar 2.

Journal Article.  4113 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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