Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection

Ito, Shin; Horie, Kengo; Seike, Kensaku; Yasuda, Mitsuru; Tsuchiya, Tomohiro; Yokoi, Shigeaki; Nakano, Masahiro; Deguchi, Takashi

doi:10.1016/j.jiac.2014.08.002

Cited by 7 publications

(9 citation statements)

References 17 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was higher than the 5% we found when testing all samples submitted for STI testing, 7 and similar to the 10% prevalence in males with non-gonococcal urethritis presenting to local sexual health clinics. 16 We also found that 80% of patients included in our pilot had symptoms of an STI, suggesting that sterile pyuria has good predictive value for urethritis, 11,12 and that testing for MG in samples with sterile pyuria may be an efficient screening tool where limited resources are available.…”

Section: Discussionmentioning

confidence: 68%

“…A challenge in community laboratories, where large numbers of samples are submitted for STI testing, often from low-risk patients, and where requests rarely include clinical details, is to determine groups of patients who may be at risk of disease, and where testing may be directed most efficiently. 7 Previous studies have indicated that sterile pyuria may be useful as a proxy for urethritis, 11,12 a potentially useful marker for directing resources in our patient population.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Barriers to testing and management of Mycoplasma genitalium infections in primary care

McAuliffe

Bissessor²,

Basu

et al. 2019

Int J STD AIDS

View full text Add to dashboard Cite

Testing and treatment for Mycoplasma genitalium (MG) infections has recently been facilitated by the increasing availability of molecular tests, but the role of testing in community-based populations is not established. Between 15 May 2017 and 22 November 2017, we tested 561 samples from 547 individuals presenting to primary care in Auckland, New Zealand, requesting investigation for sexually transmitted infections, with concurrent sterile pyuria, using the Aptima MG assay (Hologic, San Diego, CA, USA) in order to establish the prevalence of MG in this group, rates of macrolide resistance and audit primary care’s capacity to manage infections in line with international guidelines. MG was detected in 55 (10%) samples, and co-pathogens were detected in 24 (44%) MG-positive samples. Macrolide resistance mutations were detected in 22/36 (61%) samples subsequently tested using PlexPCR M. genitalium ResistancePlus (Speedx Pvt Ltd., Sydney, Australia). Empiric azithromycin treatment was given to 18 (33%) patients, and test of cure was performed in 15 (27%) patients. Our pilot study demonstrates that sterile pyuria can be a useful marker to direct testing resources in community settings, but highlights important barriers to management of MG in primary care, including clinician knowledge, high prevalence of macrolide resistance and poor completion rates for test of cure.

show abstract

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Barriers to testing and management of Mycoplasma genitalium infections in primary care

McAuliffe

Bissessor²,

Basu

et al. 2019

Int J STD AIDS

View full text Add to dashboard Cite

show abstract

“…In a study by Grosso et al a urethral smear mixed with transport medium was used that is not comparable with our method [18]. In a study by Ito et al a cut-off point of leukocyte counts of 12.5 WBCs/ml resulted in a sensitivity of 86.9% and specificity of 88.6% for predicting chlamydial infection in asymptomatic men [7]. Men positive for C. trachomatis (n = 84) had the range 1.8-1666.9 WBCs/μl (median, 43.3 WBCs/μl) in their FVU, which is lower compared with our results (median 222.3 WBCs/μl and range 0.9-2400.2 WBCs/μl).…”

Section: Plos Onementioning

confidence: 95%

“…Compared with urethral swabbing, this technique is simple to perform, automated, fast (results within a few minutes), offers high sample throughput and is not invasive. However, the majority of studies have controlled the performance of flow cytometry for urinary tract infections using midstream urine [6], and there is only limited information about the performance and cut-off values for flow cytometry in diagnosis of STIs associated with urethritis [7]. In a previous study we highlighted the symptomatology of STIs associated with urethritis and could not provide a detailed description of inflammatory reaction for each particular pathogen due to the shortcomings associated with urine dipstick analysis [8].…”

Section: Introductionmentioning

confidence: 99%

Profile of sexually transmitted infections causing urethritis and a related inflammatory reaction in urine among heterosexual males: A flow-cytometry study

2020

View full text Add to dashboard Cite

Background Information about the use of flow cytometry in the diagnosis of male urethritis is scarce. The current study aims to evaluate the performance of flow cytometry on first-voided urine in males with infectious urethritis (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis). Methods Male patients of the Andrology Centre (Tartu University Hospital, Estonia) were recruited during the period March 2015 –January 2018. Cases included 306 patients with infectious urethritis caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and/or Trichomonas vaginalis. The control group consisted of 192 patients without uro-genital complaints, negative tests for C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis from first-voided urine and no inflammation in first-voided urine, mid-stream urine and urine after prostate massage. C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis were detected from first-voided urine using polymerase chain reaction (PCR) method. First-voided urine was analysed using urine particle analyzer Sysmex UF-500i. Results The most prevalent infection was chlamydia (64.1%), followed by Mycoplasma genitalium (20.9%), gonorrhoea (7.8%) and trichomoniasis (1.6%). Gonorrhoea caused the highest flow-cytometric leucocyte/bacteria count, followed by chlamydia and Mycoplasma genitalium. Trichomonas vaginalis showed nearly absent inflammation in first-voided urine. Using an empiric flow-cytometry diagnostic threshold for urethritis in first-voided urine (leucocytes ≥ 15/μl and bacteria ≥ 20/μl) the total calculated sensitivity was over 90%. However, when applying such criteria for deciding whether to perform first-voided urine PCR for C. trachomatis, N. gonorrhoeae, M. genitalium and T. vaginalis or not, we could miss 23 cases with infectious urethritis that makes up 7,5% of all proven cases. Conclusions Flow cytometry of first-voided urine can be considered as a rapid and objective screening method in case of suspected male infectious urethritis.

show abstract

“…Also, about 50% of patients are considered asymptomatic despite detection of C. trachomatis [21e23] (III, B). Particularly, caution is necessary for male partners of patients with chlamydial cervicitis as they may be asymptomatic [23,24] (III, B).…”

Section: Commentsmentioning

confidence: 99%

The JAID/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders

Hamasuna

Yasuda

Takahashi

et al. 2021

Journal of Infection and Chemotherapy

Self Cite

View full text Add to dashboard Cite

Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection

Cited by 7 publications

References 17 publications

Barriers to testing and management of Mycoplasma genitalium infections in primary care

Barriers to testing and management of Mycoplasma genitalium infections in primary care

Profile of sexually transmitted infections causing urethritis and a related inflammatory reaction in urine among heterosexual males: A flow-cytometry study

The JAID/JSC guidelines to Clinical Management of Infectious Disease 2017 concerning male urethritis and related disorders

Contact Info

Product

Resources

About