Pathogens associated with symptomatic urethritis detected by polimerase chain reaction (PCR) in immunocompetent men.

Abstract

Background: Urethritis is a multifactorial condition, often sexually transmitted.  Symptomatic urethritis (SU) is diagnosed based on the presence of symptoms such as discharge, dysuria, and/or urethral discomfort associated with the detection of ≥5 polymorphonuclear cells in urethral discharge or first-catch urine. It is advisable to identify the infectious agent by culture or a nucleic acid amplification test (NAAT). Aims: To detect pathogens by polymerase chain reaction (PCR), analyze their association with SU, and identify related risk factors. Patients and Methods: Case-control study. 64 immunocompetent men were included, 32 with SU and 32 asymptomatic. Urine samples were analyzed by direct microscopy, Gram stain, and PCR for Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium. A test of cure was performed at 4 weeks, and risk factors for acquiring the infection were assessed. Results: N. gonorrhoeae was identified in 87.5%, C. trachomatis in 18.8%, and M. genitalium in 37.5%. 43.7% had mixed urethritis. The cure rate was 100% for N. gonorrhoeae and C. trachomatis, and 83% for M. genitalium. Conclusions: N. gonorrhoeae is the most common agent, contrasting with the international literature. The resistance of M. genitalium suggests new antimicrobial regimens.