Anaerobes in men with urethritis

Area of Science:

• Microbiology
• Urology
• Infectious Diseases

Background:

• Non-gonococcal urethritis (NGU) and gonococcal urethritis (GU) are common infections in men.
• The etiology of NGU is often polymicrobial, with Chlamydia trachomatis and Ureaplasma urealyticum being common culprits.
• The role of anaerobic bacteria in urethritis remains less understood.

Purpose of the Study:

• To investigate the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, and anaerobic bacteria in men with NGU, GU, and in asymptomatic controls.
• To determine the association of specific anaerobic bacteria, particularly Gram-negative anaerobic bacilli, with NGU.
• To explore the potential etiological significance of Gram-negative anaerobic bacilli in chlamydia- and ureaplasma-negative NGU cases.

Main Methods:

• Urethral specimens were collected from 64 men with NGU, 7 with GU, and 30 asymptomatic controls.
• Microbiological cultures were performed to isolate Chlamydia trachomatis, Ureaplasma urealyticum, aerobes, and anaerobes.
• Gram staining and biochemical tests were used for bacterial identification.

Main Results:

• Chlamydia trachomatis was isolated from 22% of NGU and 18% of GU cases.
• Ureaplasma urealyticum was found in 42% of NGU, 43% of GU, and 27% of controls.
• A Gram-negative anaerobic bacillus was isolated from 50% of NGU patients, significantly higher than in GU (14%) or control (13%) groups.
• This bacillus was prevalent in chlamydia-negative (56%) and chlamydia- and ureaplasma-negative (61%) NGU cases.

Conclusions:

• While Chlamydia trachomatis and Ureaplasma urealyticum are common in urethritis, a significant proportion of NGU cases remain unexplained.
• Gram-negative anaerobic bacilli, particularly in chlamydia- and ureaplasma-negative NGU, warrant further investigation as potential causative agents.
• Prospective therapeutic trials are needed to evaluate the clinical significance and treatment efficacy against these anaerobic bacteria in NGU.