Microbiological and serological study of non-gonococcal urethritis with special reference to Mycoplasma genitalium.

Abstract

SUMMARY Twenty two men with non-goncoccal urethritis (NGU), 19 with gonorrhoea, and 22 without urethritis were examined for various micro-organisms. Chlamydia trachomatis was isolated from the urethra of 45% of men with NGU, 21%o of those with gonorrhoea, but from none without urethritis. Ureaplasma urealyticum but not Mycoplasma hominis was recovered from a larger proportion of men with NGU than from those in the other groups. Mgenitalium was isolated presumptively from 32% of men with NGU, 12% of those with gonorrhoea, from 10% of men without urethritis, and from 42% of the men with NGU from whom chlamydiae were not isolated. U urealyticum, M hominis, and M genitalium were sought also in the rectum of men in the three groups. The first two micro-organisms were confined almost exclusively to homosexual men, whereas Mgenitalium was apparently not restricted in this way and was found particularly in this site in men with NGU. The latter mycoplasma may be a resident primarily of the intestinal tract.A fourfold or greater rise in the titre of antibody to C trachomatis was detected in about 20070 of the patients with NGU, but not in other men. A similar rise in the titre of antibody to Mgenitalium was seen in 29% of the patients with NGU and in 12% of those without urethritis. A concomitant antibody response to Mpneumoniae, which is antigenically related to M genitalium, was seen in one patient only. The responses to Mgenitalium suggest infection by this mycoplasma and indicate the need for further serological studies.Introduction Glucose fermenting mycoplasmas, as distinct from Mycoplasma fermentans, were isolated first from men with non-gonococcal urethritis (NGU). 1 2 These micro-organisms were also found to be different serologically from all other mycoplasmas and later were termed M genitalium.3 One of the original isolates (strain G37) was shown to cause disease of the lower genital tract and serological responses in common marmosets after intravaginal inoculation4 and

Mycoplasma genitalium Infection Is Associated with Microscopic Signs of Cervical Inflammation in Liquid Cytology Specimens

“…Despite solid evidence for this organism as a cause of male nongonococcal urethritis (NGU), additional studies are needed to unequivocally implicate M. genitalium as a cause of cervicitis and other female re-productive tract syndromes. M. genitalium has a remarkable ability to establish chronic infections of the lower genital tract (13)(14)(15)(16) in lieu of strong antibody responses to at least two outer membrane antigens (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). The data regarding M. genitalium as a cause of cervicitis have been conflicting, with approximately half of published studies showing significant associations (28).…”

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

“…3), with the mycoplasma being found in more than one-third of men with such disease, indicating that M. genitalium and C. trachomatis act as separate causes of the condition. There have been few attempts to measure M. genitalium antibody responses; these have met with some but limited success (98,189,201,205 question of whether M. genitalium is truly a cause; it argues against the notion that the mycoplasma is significantly associated with acute NGU due to it merely being an invader of tissue damaged by some other agent that is the real cause of NGU. Furthermore, the changes seen after the experimental inoculation of the urogenital tract of subhuman primates (204) were in keeping with those seen for acute NGU.…”

“…During the "fallow" period, attempts to repeat the original observation were made by many researchers, for example, Samra et al (174), but without success. In the laboratory of D.T.-R., specimens from other patients with NGU, as well as men with gonorrhea and those without urethritis when they were seen at the STD clinic, were examined by using SP4 medium (201). The latter, however, was not the same batch as that used earlier.…”

Use of TaqMan 5′ Nuclease Real-Time PCR for Quantitative Detection of Mycoplasma genitalium DNA in Males with and without Urethritis Who Were Attendees at a Sexually Transmitted Disease Clinic

“…Despite repeated attempts by conventional culture techniques (21,23), other urogenital isolates have been extremely rare and have been difficult to obtain (10,17). Isolation of M. genitalium in cultures of throat and synovial fluid specimens has also been recorded, although these isolates were mixed with Mycoplasma pneumoniae (1,25).…”