https://doi.org/10.4081/aiua.2021.4.468

Epidemiological, clinical and laboratory differences between male urethral infections due to Haemophilus spp. and those due to Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum: A descriptive study

Vol. 93 No. 4 (2021)
Submitted: August 15, 2021
Accepted: October 7, 2021
Published: December 21, 2021
Haemophilus spp, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, Urethral infections, Males, Sexually transmitted infections
Abstract Views: 1247
PDF: 757
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Alvaro Vives
Sexually Transmitted Infection Department, Andrology Service, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
Marco Cosentino
doccosentino@gmail.com
Sexually Transmitted Infection Department, Andrology Service, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Italy.
Lluis Bassas
Sexually Transmitted Infection Department, Andrology Service, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
Carles Alonso
Sexually Transmitted Infection Department, Andrology Service, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
Felix Millan
Sexually Transmitted Infection Department, Andrology Service, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.

Objective: To describe the epidemiological, clinical and laboratory characteristics of male patients diagnosed with Haemophilus spp. urethral infection and to compare them with the characteristics of male patients diagnosed with N. gonorrhoeae, C. trachomatis, M. genitalium and U. urealyticum urethral infection. Over the past 2 years, an increase in urethral infections due to Haemophilus spp. was observed.
Materials and methods: All male patients who attended our Department of Sexually Transmitted Infections between January 2018 and February 2019 were retrospectively studied; they underwent conventional bacteriological and multiplex PCR studies in the urethra at the same time.
Results: Of the 86 patients studied, a unique microorganism was detected in 76 cases, N. gonorrhoeae in 24, Haemophilus spp. in 21 (16 H. parainfluenzae and 5 H. influenzae), C. trachomatis in 19, M. genitalium in 8 and U. urealyticum in 4; 10 cases presented more than one microorganism. In case of multiple aetiological agents, sexual partnership was multiple. In the Haemophilus group, 81% reported only unprotected oral insertive sex; symptoms lasted for more than one week in 62% of the patients.
Conclusions: Haemophilus is an aetiological agent of non-gonococcal urethritis whose incidence is clearly increasing; the main route of transmission is oral sex. The most common reason for consultation is dysuria and testicular pain, while urethral discharge was predominant for the other causes of urethral infection. Due to the high frequency of antibiotic resistance in the Haemophilus group, it is necessary to confirm eradication by performing a test of cure.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
Ito S, Hanaoka N, Shimuta K, et al. Male non-gonococcal urethritis: from microbiological etiologies to demographic and clinical features. Int J Urol. 2016; 23: 325-331. DOI: https://doi.org/10.1111/iju.13044
Janier M, Lassau F, Casin I, et al. Male urethritis with and without discharge: a clinical and microbiological study. Sex Transm Dis. 1995; 22:244-52. DOI: https://doi.org/10.1097/00007435-199507000-00008
Bradshaw CS, Tabrizi SN, Read TRH, et al. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis. 2006; 193: 336-345.
Deza G, Martin-Ezquerra G, Gómez J, et al. Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in urethralexudates from men with acute urethritis: a descriptive study of 52 cases. Sex Transm Infect. 2015; 92: 29-31. DOI: https://doi.org/10.1136/sextrans-2015-052135
Hsu MS, Wu MY, Lin TH, et al. Haemophilus parainfluenzae urethritis among homosexual men. J Microbiol Immunol Infect. 2012;48: 450-452. DOI: https://doi.org/10.1016/j.jmii.2012.11.007
Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-fifth Informational Supplement. CLSI document M100-S25 (ISBN 1-56238-990-4). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087. USA, 2015.
Horner PJ, Blee K, Falk L, et al. European guideline on the management of non-gonococcal urethritis. Int J STD AIDS. 2016;27:928-37. DOI: https://doi.org/10.1177/0956462416648585
Vázquez F, Andrés MT, Palacio V. Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in genitourinary infections: a 4-year review. Enferm Infec Microbiol Clin. 1996; 14:181-185.
Wetmore CMP, Manhart LEP, Lowens MSP, et al. Demographic, behavioral, and clinical characteristics of men with nongonococcal urethritis differ by etiology: a case comparison study. Sex Transm Dis. 2011; 38:180-6. DOI: https://doi.org/10.1097/OLQ.0b013e3182040de9
Gaydos C, Maldeis NE, Hardick A, et al. Mycoplasma genitalium compared to chlamydia, gonorrhoea and trichomonas as an aetiological agent of urethritis in men attending STD clinics. Sex Transm Infect. 2009; 85:438-40. DOI: https://doi.org/10.1136/sti.2008.035477
Füzi M. Haemophili in sexually transmitted diseases. Lancet. 1980; 2:476. DOI: https://doi.org/10.1016/S0140-6736(80)91910-8
Manhart LE, Holmes KK, Hughes JP, et al. Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection. Am J Public Health. 2007; 97:1118-25. DOI: https://doi.org/10.2105/AJPH.2005.074062
Orellana MA, Gómez ML, Teresa Sánchez M, Fernández-Chacón T. Microbiological diagnosis of urethritis in men. 3 years Review. Rev Esp Quimioter. 2009; 22:83.
Sturm AW. Haemophilus influenzae and Haemophilus parainfluenzae in nongonococcal urethritis. J Infect Dis. 1986; 153:165-7. DOI: https://doi.org/10.1093/infdis/153.1.165
Rane VS, Fairley CK, Weerakoon A, et al. Characteristics of acute nongonococcal urethritis in men differ by sexual preference. J Clin Microbiol. 2014; 52:2971-2976. DOI: https://doi.org/10.1128/JCM.00899-14
Bradshaw CS, Tabrizi SN, Read TRH, et al. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis. 2006; 193:336-45. DOI: https://doi.org/10.1086/499434
Gonzalez MD, Ledeboer NA Haemophilus. Chapter 38. Manual of Clinical Microbiology, 12th Edition.
Smith R, Copas AJ, Prince M, et al. Poor sensitivity and consistency of microscopy in the diagnosis of low grade non-gonococcal urethritis. Sex Transm Infect. 2003; 79:487-90. DOI: https://doi.org/10.1136/sti.79.6.487
CDC Sexually Transmitted Diseases Treatment Guidelines. 2021.
Deguchi T, Ito S, Hatazaki K, et al. Antimicrobial susceptibility of Haemophilus influenza strains isolated from the urthra of men with acute urethritis and/or epididymitis. J Infect Chemother. 2017;23:804-7. DOI: https://doi.org/10.1016/j.jiac.2017.05.009
Horner P, Blee K, O'Mahony C, et al. Clinical Effectiveness Group of the British Association for Sexual Health and HIV. 2015 UK National Guideline on the management of non-gonococcal urethritis. Int J STD AIDS. 2016; 27:85-96. DOI: https://doi.org/10.1177/0956462415586675
Zhang N, Wang R, Li X, Liu X, Tang Z, Liu Y. Are Ureaplasma spp. a cause of nongonococcal urethritis? A systematic review and meta-analysis. PLoS One. 2014; 9: e113771. DOI: https://doi.org/10.1371/journal.pone.0113771
Magri V, Boltri M, Cai T, et al. Multidisciplinary approach to prostatitis. Arch Ital Urol Androl. 2019; 90:227-248. DOI: https://doi.org/10.4081/aiua.2018.4.227
Stamatiou K, Magri V, Perletti G, et al. Chronic prostatic infection: Microbiological findings in two Mediterranean populations. Arch Ital Urol Androl. 2019; 91:177-181. DOI: https://doi.org/10.4081/aiua.2019.3.177
Ford DK,Henderson E. Non-gonococcal urethritis due to Tmycoplasma (Ureaplasma urealyticum) serotype 2 in a conjugal sexual partnership. Br J Venereal Dis. 1976; 52:341-342. DOI: https://doi.org/10.1136/sti.52.5.341
Lee JS, Kim KT, Lee HS, et al. Concordance of Ureaplasma urealyticum and Mycoplasma hominis in infertile couples: impact on semen parameters. Urology. 2013; 81:1219-24. DOI: https://doi.org/10.1016/j.urology.2013.02.044
Ma XP, Gao XQ. The effect of Ureaplasma urealyticum on the level of P34H expression, the activity of hyaluronidase, and DNA fragmentation in human spermatozoa. Am J Reprod Immunol. 2017;77. doi:10.1111/aji.12600. DOI: https://doi.org/10.1111/aji.12600

How to Cite

Vives, A., Cosentino, M., Bassas, L., Alonso, C., & Millan, F. (2021). Epidemiological, clinical and laboratory differences between male urethral infections due to Haemophilus spp. and those due to Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum: A descriptive study. Archivio Italiano Di Urologia E Andrologia, 93(4), 468–474. https://doi.org/10.4081/aiua.2021.4.468

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.