Asymptomatic urethral infection in male sexually transmitted disease clinic attendees

Abstract

The purpose of this study is to determine the prevalence of asymptomatic male patients with urethral infections attending a government sexually transmitted infection clinic in Hong Kong and their microbiological profile. A total of 274 consecutive male patients without any symptoms for urethral infections were recruited. A questionnaire was used to record the symptoms, sexual history and demographics. Further assessment, including urethral smear for Gram stain, gonococcal culture and polymerase chain reaction (PCR) for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG) and Ureaplasma urealyticum (UU) were performed. In 274 asymptomatic patients, 36 patients had non-gonococcal urethritis (NGU) and two patients had positive gonococcal culture. Among the asymptomatic patients with NGU, there were 6 (16.6%), 10 (22.8%) and five (13.9%) patients with positive PCR for CT, UU and MG, respectively. In addition, there were 14 asymptomatic patients with positive PCR for CT but without evidence of NGU. In conclusion, urethral infections were identified in a significant number of asymptomatic male patients and therefore, routine screening for this group is warranted.

Sensitivity of Gram stain in the diagnosis of urethritis in men

“…This statement is also applicable to asymptomatic patients, when the study of urethritis is indicated, by previous studies demonstrating the presence of urethritis-producing microorganisms in the patient 21. It is, however, necessary to conduct further research to clarify the significance of the isolation of microorganisms whose role in the production of urethritis remains unclear.…”

“…In Hong Kong, Yu et al ,21 in a study of prevalence of urethral infection in 274 asymptomatic male patients, found 36 patients with NGU and two positive gonococcal cultures. Among the cases of NGU, 17%, 23% and 14% were positive PCR for Chlamydia trachomatis , Mycoplasma genitalium and Ureaplasma urealyticum , respectively, and, further, 14 of the patients positive for Chlamydia trachomatis by PCR had no signs or symptoms of NGU, demonstrating that urethral infection can be present in a significant number of asymptomatic patients.…”

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

“…In numerous studies (2,9,14,19 232,234,235) in which microscopy has been the dominant feature in making the diagnosis, M. genitalium has been strongly and almost uniformly associated with acute NGU (Fig. 2).…”

“Express testing” in STI clinics: extant literature and preliminary implementation data

“…Researchers in the US have similarly identified that such risk assessments do not accurately identify asymptomatic STI/HIV infections, and should not be the sole basis of STI/HIV care (Duffus et al, 2009;Markos et al, 2007;Yu et al, 2008). This situation may contribute to the vicious cycle of transmission [see Figure 1] (Mercer et al, 2007;White et al, 2005).…”