le Roux Marie Cecilia, Hoosen Anwar Ahmed
From the *Department of Microbiological Pathology, Sefako Makgatho Health Sciences University, Pretoria; and †Department of Medical Microbiology, University of the Free State, Bloemfontein, South Africa.
Sex Transm Dis. 2017 Jan;44(1):17-20. doi: 10.1097/OLQ.0000000000000540.
This study was done to diagnose Mycoplasma genitalium infection based on bacterial load in urine specimens from symptomatic and asymptomatic men.
Urine specimens from 94 men with visible urethral discharge, 206 with burning on micturition and 75 without symptoms presenting to a family practitioner were tested for M. genitalium as well as Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis by transcription-mediated amplification assays. A quantitative polymerase chain reaction assay was used to determine the bacterial load for all specimens in which M. genitalium was the only organism detected.
Among the 375 specimens collected, M. genitalium was detected in 59 (15.7%) men (both symptomatic and asymptomatic) using the transcription-mediated amplification assay, and in 45 (12.0%) of the total population, it was the only pathogen detected. One or more pathogens were detected in 129 (43%) of the symptomatic men, with N. gonorrhoeae in 50 (16.7%); C. trachomatis in 37 (12.3%) and T. vaginalis present in 24 (8.0%) patients. Among the 17 patients where mixed infections were detected, M. genitalium with N. gonorrhoeae was the most common (11/17; 64.7%). Patients with visible urethral discharge had significantly higher M. genitalium concentrations than those with burning on micturition. The median M. genitalium load in symptomatic men was significantly higher than that in asymptomatic men.
This study confirms the high prevalence of M. genitalium among men with urethritis in South Africa and demonstrates that there is a strong association with M. genitalium bacterial load and clinical urethritis. As the number of organisms increased, the severity of the symptoms increased, an indication of the role that the organism plays in disease progression.
本研究旨在根据有症状和无症状男性尿液标本中的细菌载量来诊断生殖支原体感染。
对94名有尿道口可见分泌物、206名有排尿烧灼感以及75名无症状的男性患者向家庭医生就诊时所采集的尿液标本进行检测，通过转录介导扩增试验检测生殖支原体以及淋病奈瑟菌、沙眼衣原体、阴道毛滴虫。采用定量聚合酶链反应试验来确定所有仅检测到生殖支原体的标本中的细菌载量。
在收集的375份标本中，使用转录介导扩增试验在59名（15.7%）男性（有症状和无症状）中检测到生殖支原体，在45名（12.0%）总人口中，它是唯一检测到的病原体。在129名（43%）有症状男性中检测到一种或多种病原体，其中淋病奈瑟菌50名（16.7%）；沙眼衣原体37名（12.3%），阴道毛滴虫24名（8.0%）。在检测到混合感染的17名患者中，生殖支原体与淋病奈瑟菌混合感染最为常见（11/17；64.7%）。有尿道口可见分泌物的患者生殖支原体浓度显著高于有排尿烧灼感的患者。有症状男性的生殖支原体载量中位数显著高于无症状男性。
本研究证实南非尿道炎男性中生殖支原体感染率很高，并表明生殖支原体细菌载量与临床尿道炎之间存在密切关联。随着病原体数量增加，症状严重程度增加，这表明该病原体在疾病进展中所起的作用。
