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Isolation of Chlamydia trachomatis from the male urethra
Abstract:
Chlamydia trachomatis was isolated from 26% of urethral swabs taken from 509 men with urethritis. The highest yield of 68% was obtained from a selected group of men with nonspecific urethritis (NSU) who had a frank urethral discharge. This is a higher than in previous reports, and is significantly higher than the isolation of C. trachomatis from men with less severe urethritis. The higher yield was similar to C. trachomatis isolation rates reported among patients with severe trachoma in hyperendemic areas. Men with a previous history of NSU had low isolation rates. Overall, 30% of 385 men with NSU had positive chlamydial culture results, 7% of 59 men with gonococcal urethritis alone were Chlamydia-positive, 15% of 59 men with gonorrhoea followed by NSU (post-gonococcal urethritis) were Chlamydia-positive, and only 3% of 61 men without urethritis harboured Chlamydia. Swabs taken from the cervical os of 28 of 108 female contacts of men with NSU had a positive result for C. trachomatis. Significantly more pairs of sexual partners had the same chlamydial culture result than had different results. The chlamydial isolation rate was higher among men admitting a casual sexual contact than in men claiming only regular partnerships. The findings provide further evidence for the sexual transmission of C. trachomatis and for its aetiological role in NSU.
Insights
Chlamydia trachomatis is a common cause of nonspecific urethritis (NSU) in men, particularly those with significant discharge. This study confirms its sexual transmission and role in NSU.
Area of Science:
- Urology
- Infectious Diseases
- Microbiology
Background:
- Nonspecific urethritis (NSU) is a common condition in men.
- The etiological role of Chlamydia trachomatis in NSU requires further investigation.
Purpose of the Study:
- To determine the prevalence of Chlamydia trachomatis in men with urethritis.
- To investigate the association between Chlamydia trachomatis and NSU.
- To explore the sexual transmission patterns of Chlamydia trachomatis.
Main Methods:
- Urethral swabs were collected from 509 men with urethritis.
- Chlamydia trachomatis was isolated using culture methods.
- Contact tracing was performed on female partners of men with NSU.
Main Results:
- Chlamydia trachomatis was isolated from 26% of men with urethritis.
- Isolation rates were highest (68%) in men with NSU and frank urethral discharge.
- 30% of men with NSU tested positive for Chlamydia trachomatis.
- Chlamydia trachomatis was detected in 15% of women who were sexual contacts of men with NSU.
- Sexual transmission was supported by higher concordance rates in sexual partners and higher isolation rates in men with casual sexual contacts.
Conclusions:
- Chlamydia trachomatis is a significant etiological agent in NSU.
- The findings support the sexual transmission of Chlamydia trachomatis.
- Public health strategies should address Chlamydia trachomatis in the context of NSU.