Lefevre J C, Lepargneur J P, Bauriaud R, Bertrand M A, Blanc C
Group for the Study and Prevention of Sexually Transmitted Diseases, Faculty of Medicine Purpan, Toulouse, France.
Sex Transm Dis. 1991 Apr-Jun;18(2):76-9. doi: 10.1097/00007435-199118020-00004.
On hundred twenty-six men who attended a hospital microbiology laboratory and 99 men who attended a private laboratory in Toulouse, France, for symptoms of urethritis were examined during 1988, for evidence of urethral pathogens. The following incidences were found: Neisseria gonorrhoeae: 24 (10.7%); Chlamydia trachomatis: 58 (25.8%); Ureaplasma urealyticum: 46 (20.4%); Gardnerella vaginalis: 21 (9.3%); Haemophilus parainfluenzae: 21 (9.3%); Streptococcus agalactiae: 15 (6.7%); Candida albicans: 10 (4.4%); and Trichomonas vaginalis: 4 (1.8%). The prevalence of these microorganisms was similar in the two groups of patients. No pathogen was isolated from 71 patients (31.6%). Mixed infections with at least two pathogens were found in 49 men (21.8%). Another goal of this study was to determine the relative prevalence of urethral pathogens in relation to clinical findings. N. gonorrhoeae was isolated significantly more often in patients who had a urethral discharge (P less than .05) that contained five or more polymorphonuclear cells per high-power field (PMN/HPF) (P less than .001). G. vaginalis was isolated significantly more often in patients who did not have an urethral discharge (P less than .05) and in men with less than five PMN/HPF (P less than .05). Isolation of C. albicans was significantly associated with pruritus (P less than .05) and balanitis (P less than .001). Like the clinical features, the gram-stained urethral smear was of limited value in diagnosis and therapeutic decision-making regarding non-gonococcal urethritis. In contrast, this study underlines the importance of full identification of urethral isolates in the management of urethritis in men.
1988年，对126名因尿道炎症状前往医院微生物实验室的男性和99名前往法国图卢兹一家私人实验室的男性进行了检查，以寻找尿道病原体的证据。发现了以下发病率：淋病奈瑟菌：24例（10.7%）；沙眼衣原体：58例（25.8%）；解脲脲原体：46例（20.4%）；阴道加德纳菌：21例（9.3%）；副流感嗜血杆菌：21例（9.3%）；无乳链球菌：15例（6.7%）；白色念珠菌：10例（4.4%）；阴道毛滴虫：4例（1.8%）。这两组患者中这些微生物的患病率相似。71名患者（31.6%）未分离出病原体。49名男性（21.8%）发现至少两种病原体的混合感染。本研究的另一个目的是确定尿道病原体相对于临床发现的相对患病率。在每高倍视野有五个或更多多形核细胞（PMN/HPF）的尿道分泌物患者中，淋病奈瑟菌的分离率显著更高（P<0.05）（P<0.001）。在没有尿道分泌物的患者中（P<0.05）以及PMN/HPF少于五个的男性中（P<0.05），阴道加德纳菌的分离率显著更高。白色念珠菌的分离与瘙痒（P<0.05）和龟头炎（P<0.001）显著相关。与临床特征一样，革兰氏染色尿道涂片在非淋菌性尿道炎的诊断和治疗决策中价值有限。相比之下，本研究强调了在男性尿道炎管理中全面鉴定尿道分离株的重要性。
