Main etiological agents identified in 170 men with urethritis attended at the Fundação Alfredo da Matta, Manaus, Amazonas, Brazil<sup>,</sup>

de Souza, Lucilene Sales; Sardinha, José Carlos; Talhari, Sinésio; Heibel, Marcel; Santos, Mônica Nunes dos; Talhari, Carolina

doi:10.1016/j.abd.2020.07.007

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Original Article • An. Bras. Dermatol. 96 (2) • Mar-Apr 2021 • https://doi.org/10.1016/j.abd.2020.07.007 copy

Main etiological agents identified in 170 men with urethritis attended at the Fundação Alfredo da Matta, Manaus, Amazonas, Brazil^☆ ☆ How to cite this article: Souza LS, Sardinha JC, Talhari S, Heibel M, Santos MN, Talhari C. Main etiological agents identified in 170 men with urethritis attended at the Fundação Alfredo da Matta, Manaus, Amazonas, Brazil. An Bras Dermatol. 2021;96:176-83. ^,^☆☆ ☆☆ Study conducted at the Fundação Alfredo da Matta and Universidade do Estado do Amazonas, Manaus, AM, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

Sexually transmitted infections (STI) are a global public health problem. Urethritis are among the most common STIs, and can cause several complications and facilitate the transmission of the HIV virus.

Objectives:

To investigate the main etiologic agents of urethritis in 170 men treated at Fundação Alfredo da Matta.

Methods:

To identify the agents, urethral exudate and urine were collected. Gram and culture tests were performed in Thayer-Martin medium for Neisseria gonorrhoeae and polymerase chain reaction for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Mycoplasma genitalium, and herpes simplex types 1 and 2.

Results:

N. gonorrhoeae were identified in 102 (60.0%) patients, C. trachomatis in 50 (29.4%), U. urealyticum in 29 (17.0%), M. genitalium in 11 (6.5 %), U. parvum in ten (5.9%), and M. hominis in seven (4.1%). Herpes simplex type 2 was diagnosed in 24 (21.6%) of the 111 patients who underwent PCR for this pathogen. In 69 cases there was co-infection; the most frequent were: N. gonorrhoeae and C. trachomatis in 21 (14.7%) patients; N. gonorrhoeae and C. trachomatis in 21 (12.4%) patients; N. gonorrhoeae and herpes simplex type 2 in 11 (6.5%), and N. gonorrhoeae and U. urealyticum in nine (5.3%).

Study limitations:

Not relevant.

Conclusion:

N. gonorrhoeae, C. trachomatis, U. urealyticum, and herpes simplex type 2 were the pathogens most frequently identified in the present study. The main coinfection found was N. gonorrhoeae and C. trachomatis. T. vaginalis and herpes simplex type 1 were not identified in any of the patients.

KEYWORDS
Chlamydia trachomatis; Mycoplasma genitalium; Mycoplasma hominis; Neisseria gonorrhoeae; Sexually transmitted infections; Ureaplasma urealyticum; Urethritis

Characteristics	n*	%
Age range
< 20	31	18.2
20 to 29	80	47.1
30 to 39	38	22.4
40 to 49	17	10.0
> 49	4	2.4
Age at 1st intercourse	(n = 167)
< 15	66	39.5
15 to 19	96	57.5
20 to 23	5	3.0
		Not reported = 3
Sexual partners in the last 3 months
None	18	10.6
1	60	35.3
2 to 4	56	32.9
≥ 5	36	21.2
Condom use	(n = 167)
In all intercourses	7	4.2
Sometimes	128	76.6
Does not use	32	19.2
		Not informed = 3
Sexual orientation	(n = 167)
Active MSM	1	0.6
Passive MSM	2	1.2
Active/passive MSM	6	3.6
Bisexual	7	4.2
Heterosexual	151	90.4
		Not informed = 3
Venereal history
Yes	94	55.3
No	76	44.7
		*n = 170

Exams	n	Results
Exams	n	Positive	%	Negative	%
Gram test	152	94	61.8	58	38.2
Culture for Gonococcus	153	82	53.6	71	46.4
Rapid syphilis test	158	17	10.8	141	89.2
VDRL	23	12	52.2	11	47.8
Rapid HIV test	164	8	4.9	156	95.1
Hepatitis B	142	0	0.0	142	100.0
Hepatitis C	157	1	0.6	156	99.4

Etiological agents	n*	%
N. gonorrhoeae	46	27.1
N. gonorrhoeae and C. trachomatis	21	12.4
C. trachomatis	13	7.6
N. gonorrhoeae and HSV-2	11	6.5
N. gonorrhoeae and U. urealyticum	9	5.3
U. urealyticum	7	4.1
M. genitalium	5	2.9
U. parvum	5	2.9
N. gonorrhoeae, C. trachomatis, and HSV-2	4	2.4
C. trachomatis and U. urealyticum	3	1.8
HSV-2	2	1.2
M. genitalium and U. urealyticum	2	1.2
N. gonorrhoeae, U. parvum, and HSV-2	2	1.2
N. gonorrhoeae, C. trachomatis, and U. urealyticum	2	1.2
U. urealyticum and M. hominis	3	1.8
C. trachomatis and HSV-2	1	0.6
C. trachomatis, M. hominis, and M. urealyticum	1	0.6
C. trachomatis, M. genitalium	1	0.6
C. trachomatis, M. genitalium, and HSV-2	1	0.6
N. gonorrhoeae, M. hominis, U. parvum, and HSV-2	1	0.6
N. gonorrhoeae and M. genitalium	1	0.6
N. gonorrhoeae, U. parvum, and M. hominis	1	0.6
N. gonorrhoeae, U. urealyticum, and HSV-2	1	0.6
N. gonorrhoeae, C. trachomatis, and M. genitalium	1	0.6
N. gonorrhoeae, C. trachomatis, and M. hominis	1	0.6
N. gonorrhoeae, C. trachomatis, and U. parvum	1	0.6
U. urealyticum and HSV-2	1	0.6
No agent	23	13.5
		*n = 170

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[1] * Corresponding author. E-mail: carolinatalhari@gmail.com (C. Talhari).