Recalibrating the Gram Stain Diagnosis of Male Urethritis in the Era of Nucleic Acid Amplification Testing

Rietmeijer, Cornelis A.; Mettenbrink, Christie

doi:10.1097/olq.0b013e3182354da3

Cited by 31 publications

(15 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the classical evaluation, NGU diagnosis is made when intracellular diplococci are not seen on microscopic evaluation of a urethral gram stained smear. Recent studies recommended lowering the diagnostic criteria of the diagnosis to ≥2 PMNL/HPF due to false negative results obtained especially in NGU cases with mild inflammation (9,10). In a recent study conducted by Sarier et al (11), the authors showed that gram staining had 92.9% sensitivity in GU diagnosis and only 55.6% sensitivity in NGU when the threshold was ≥5 PMNL/HPF, while sensitivity in GU diagnosis increased to 100% and to 92.6% in NGU diagnosis when the cutoff value was lowered to ≥2 PMNL/HPF.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Polymicrobial Infection in Urethritis

Sarıer¹

2019

jus

View full text Add to dashboard Cite

Üretrit erkeklerde en sık görülen cinsel yolla bulaşan hastalıktır ve patojenlerine göre gonokoksik (GU) ve non-gonokoksik üretrit (NGU) olarak sınıflandırılmaktadır. Son yıllarda artan üretrit olguları polimikrobial enfeksiyon varlığını da gündeme getirmiştir. Bu çalışmanın amacı üroloji polikliniğinde üretrit tanısı alan hastalarda gerçek zamanlı multiplex polimeraz zincir reaksiyonu (Rt-MPCR) sonuçlarına göre polimikrobial enfeksiyon prevelansının araştırılmasıdır.

show abstract

Section: Discussionmentioning

confidence: 99%

Prevalence of Polymicrobial Infection in Urethritis

Sarıer¹

2019

jus

View full text Add to dashboard Cite

show abstract

“…31 Current clinical criteria for urethritis were based on the pathogenesis of gonorrhea and may be less useful as we explore the role of the microbiome in disease. As this field of study progresses, continuous measures of inflammation may provide better distinction between normal and pathogenic microflora.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Vaginosis–Associated Bacteria in Men

Manhart

Khosropour

Liu

et al. 2013

Sexually Transmitted Diseases

View full text Add to dashboard Cite

Background Approximately 45% of nongonococcal urethritis cases have no identified etiology. Novel bacteria recently associated with bacterial vaginosis (BV) in women may be involved. We evaluated the association of idiopathic nongonococcal urethritis and 5 newly described BV-associated bacteria (BVAB). Methods Heterosexual men 16 years or older attending a sexually transmitted disease clinic in Seattle, Washington, from May 2007 to July 2011 and negative for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium, and Ureaplasma urealyticum–biovar2 were eligible. Cases had urethral discharge or 5 or more polymorphonuclear leukocytes per high-power field in urethral exudates. Controls had no urethral discharge and less than 5 polymorphonuclear leukocytes per high-power field. Urine was tested for Atopobium spp., BVAB-2, BVAB-3, Megasphaera spp., and Leptotrichia/Sneathia spp. using quantitative taxon-directed polymerase chain reaction. Results Cases (n = 157) and controls (n = 102) were of similar age, education, and income, and most were white. Leptotrichia/Sneathia spp. was significantly associated with urethritis (24/157 [15.3%] vs. 6/102 [5.9%], P = 0.03). BVAB-2 was more common in cases than in controls (7/157 [4.5%] vs. 1/102 [1.0%], P = 0.15), and BVAB-3 (n = 2) and Megasphaera spp. (n = 1) were only detected in men with urethritis, but these bacteria were found only in men who also had Leptotrichia/Sneathia spp. Atopobium spp. was not associated with urethritis. The quantity of bacteria did not differ between cases and controls. Among treated cases, doxycycline was more effective than azithromycin for clinical cure of men with Leptotrichia/Sneathia spp. (9/10 vs. 7/12, P = 0.16) and BVAB-2 (3/3 vs. 0/3, P = 0.10). Conclusions Leptotrichia/Sneathia spp. may be urethral pathogens or contribute to a pathogenic microbiota that can also include BVAB-2, BVAB-3, and Megasphaera spp. Doxycycline may be more effective than azithromycin against these newly identified bacteria.

show abstract

“…GSS still protects its validity in the diagnosis of acute urethritis because it is inexpensive and easy to perform. However, the sensitivity of five PMNL/ HPF (polymorphonuclear leucocytes per high-power field) as a "classical" cut-off in GSS is quite controversial for the diagnosis of lowinflammation nongonococcal urethritis (Rietmeijer & Mettenbrink, 2012;Sarier et al, 2018). Therefore, the Centres for Disease Control and Prevention (CDC) dropped the cut-off value to ≥2 PMNL/HPF in its 2015 Sexually Transmitted Disease (STD) Treatment Guidelines (Workowski & Bolan, 2015).…”

Section: Polymerase Chain Reaction Assay In Acute Urethritismentioning

confidence: 99%

Polymerase chain reaction assay in acute urethritis

Sarıer

2019

Andrologia

View full text Add to dashboard Cite

Recalibrating the Gram Stain Diagnosis of Male Urethritis in the Era of Nucleic Acid Amplification Testing

Cited by 31 publications

References 5 publications

Prevalence of Polymicrobial Infection in Urethritis

Prevalence of Polymicrobial Infection in Urethritis

Bacterial Vaginosis–Associated Bacteria in Men

Polymerase chain reaction assay in acute urethritis

Contact Info

Product

Resources

About