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Background: Pharyngeal infection is more difficult to diagnose and treat than genital or rectal infection and can act as a reservoir for gonococcal infection. We determined the prevalence of pharyngeal gonorrhea in Korean men with urethritis and analyzed the molecular characteristics and antimicrobial susceptibility of the isolates. Methods: Seventy-two male patients with symptoms of urethritis who visited a urology clinic in Wonju, Korea, between September 2016 and March 2018 were included. Urethral and pharyngeal gonococcal cultures, antimicrobial susceptibility testing, Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST), and multiplex real-time PCR (mRT-PCR) were performed. Results: Among the 72 patients, 59 tested positive for gonococcus by mRT-PCR. Of these 59 patients, 18 (30.5%) tested positive in both the pharynx and urethra, whereas 41 tested positive only in the urethra. NG-MAST was feasible in 16 out of 18 patients and revealed that 14 patients had the same sequence types in both urethral and pharyngeal specimens, whereas two patients exhibited different sequence types between the urethra and pharynx. Of the 72 patients, 33 tested culture-positive. All patients tested positive only in urethral specimens, except for one patient who tested positive in both. All culture-positive specimens also tested positive by mRT-PCR. All isolates were susceptible to azithromycin and spectinomycin, but resistance rates to ceftriaxone and cefixime were 2.9% and 14.7%, respectively. Conclusions: The prevalence of pharyngeal gonorrhea in Korean men with gonococcal urethritis is as high as 30.5%, highlighting the need for pharyngeal screening in high-risk groups. Ceftriaxone is the recommended treatment for pharyngeal gonorrhea. [ABSTRACT FROM AUTHOR]

Key content: Urethral caruncle is a common post‐menopausal finding.This common benign lesion can be mistaken as a malignancy.Management should be based on the patient's symptoms.Vaginal estrogen should be considered as first‐line management before surgical excision. Learning objectives: To evaluate the symptomatic presentation of urethral caruncle.To establish the differential diagnosis of a mass in the urethra.To review the management options of urethral caruncle including medical and surgical excision.To highlight primary care management of urethral caruncle. Ethical issues: Owing to poor recognition of urethral caruncle, many patients are put through the emotional distress of referral to cancer pathways.Surgery should be considered first line for large urethral caruncle or in symptomatic patients. [ABSTRACT FROM AUTHOR]

Urinary Tract Infections (UTI) include a wide range of symptoms, such as urethritis, cystitis, prostitis and pyelonephritis. The most frequent bacterial infections are UTIs. Lower and upper UTI's are used to categorise UTI's. While pyelonephritis is an upper tract infection, cystitis is a lower tract infection. Significant physiologic changes to the entire urinary system occur during pregnancy and drastically influence the prevalence of UTI's and pyelonephritis. Both symptomatic and asymptomatic forms are possible. Gram-negative bacteria are the most frequent causes of both symptomatic and acute UTI, including Escherichia coli, Klebsiella pneumonia, Pseudomonas areuginosa, Enterobacter and Serratia. The gold standard for the diagnosis of a urinary tract infection is quantitative culture methods. Untreated urinary tract infections have been linked to severe morbidity and mortality in pregnant women and their babies. According to Edward Kass's research, 6% of pregnant women reported asymptomatic bacteriuria, which was linked to higher preterm and perinatal death than those with sterile urine. According to the urine culture and sensitivity results, correct treatment is therefore of utmost importance. An agent with a seven-day dosage schedule that is safe for both the mother and the fetus should be used as the therapy. To prevent a recurrence of UTI, confirmation of the pathogenic organism's full eradication is required. Precautions and good cleanliness can also aid in preventing recurrence. [ABSTRACT FROM AUTHOR]

Urinary tract infections (UTIs) are an extremely common pathology among pregnant women and women in labor, the manifestation of which occurs during pregnancy. Physiological changes in a woman’s organism form an optimal background for infection or activation of the aggression of one’s own microbial environments – the microflora that colonizes the periurethral area and mostly belongs to the family of enterobacteria and staphylococci. Clinical manifestations of UTIs during pregnancy are extremely variable and do not always correspond to the usual course of the disease, which necessitates the search for modern approaches to diagnosis and treatment. Also, UTI is one of the leading factors that provoke severe pregnancy complications and can lead to adverse obstetric outcomes. The objective: to evaluate the effectiveness of the modern etiopathogenetic approach to the treatment of UTIs during pregnancy. Materials and methods. In the study, which began in 2022 and is ongoing, 1615 pregnant women at gestational ages 6-37 weeks with clinical manifestations of urinary tract infections (UTIs). This work presents the survey results of 615 pregnant women with UTIs at gestational ages from 20 to 28 weeks, both before and one month after treatment initiation. These women were monitored during their pregnancies in prenatal care clinics of municipal non-commercial enterprises across all regions of Ukraine. At the stage of prescribing treatment the examined women are divided into two groups. The main group included 374 pregnant women with established diagnoses of acute urethritis, acute cystitis, gestational pyelonephritis (GP) and asymptomatic bacteriuria (ABU), who have received antibacterial and uroseptic agents for treatment in accordance with current clinical guidelines in combination with a herbal uroantiseptic containing 120 mg of cranberry berry extract and 36 mg each of extracts of goldenseal, lovage root, rosemary, as well as auxiliary substances. The comparison group included 241 pregnant women with established diagnoses of acute urethritis, acute cystitis, GP and ABU, who were treated exclusively with antibacterial and uroseptic agents for UTIs manifestations. The effectiveness of treatment methods was evaluated on the basis of a developed questionnaire with information on the main symptoms characteristic of diseases of the urinary system, before and one month after the prescribed treatment. Results. On the background of addition to the main antibacterial and uroseptic therapy the herbal uroantiseptic, containing 120 mg of cranberry berry extract and 36 mg each of extracts of yarrow, lovage root, rosemary, as well as auxiliary substances already a month after the start of treatment, the absence of complaints was found in the majority of pregnant women in the main group, related: with frequent urination – 354 (94.6%) (comparison group – 208 (86.3%); p<0.05), the need for urgent urination – 374 (99.1%) (comparison group – 232 (96.3%); p<0.05), the feeling of incomplete emptying of the bladder – 348 (93.3%) (comparison group – 202 (83.9%); p<0.05), with pain: during urination – 369 (98.7%) (comparison group – 231 (95.9%); p<0.05), in the lower abdomen, not associated with urination – 366 (97.9%) (comparison group – 230 (95.9%); p<0.05), in the lower back – 369 (98.7%) (comparison group – 229 (95.1%); p<0.05), with discharge from the urethra not related to urination – 374 (100.0%) (comparison group – 233 (96.7%); p<0.05). Conclusions. On the background of the prescribing of a herbal uroantiseptic containing 120 mg of cranberry extract and 36 mg of extracts of yarrow, lovage root, and rosemary, as well as auxiliary substances, additionally to the main antibacterial and uroseptic therapy in pregnant women of the main group, in a significantly greater number of cases the absence of complaints, which are associated with manifestations of urinary tract infections, was determined. The use of the herbal uroantiseptic, containing 120 mg of cranberry berry extract and 36 mg of extracts of yarrow, lovage root, and rosemary, is safe and creates favorable conditions for the course of pregnancy and further childbirth due to the potentiation of the effects of antibacterial and uroseptic therapy and the effective prevention of recurrences of urinary tract infections. [ABSTRACT FROM AUTHOR]

Introduction: Urinary Tract Infections (UTIs) are caused by microbial invasion of the urinary tract, extending from the renal cortex of the kidney to the urethral meatus. Over the past years, resistance levels to the traditional drugs used for the treatment of UTIs have been gradually increasing. Therefore, a therapy based on the individual culture report and antibiotic sensitivity test is highly encouraged. Aim: To determine the age-wise and sex-wise prevalence of UTI, as well as to determine the bacteriological profile and antimicrobial sensitivity pattern of isolated uropathogens. Materials and Methods: This retrospective record-based study was conducted in the Department of Microbiology at Travancore Medical College in Kollam, Kerala, India. Samples were collected from patients with clinically suspected UTI attending the Outpatient Department (OPD) and Inpatient Department (IPD) of Travancore Medical College, Kollam, Kerela, India over a period of six months from July 2022 to December 2022. Both male and female patients with clinically suspected UTI were included in the study. The clinical diagnostic criteria included dysuria, frequency, urgency, and fever. Data were retrieved from the culture register maintained in the Microbiology laboratory, LIS (ELLIDER), and the WHONET software system. Urine culture was performed using a semiquantative technique. A growth of >105 Colony Forming Units (CFU)/mL was considered indicative of an active UTI with significant bacteriuria. Organisms were identified using Gram stain, motility testing, and biochemical reactions following standard microbiological techniques. Antimicrobial sensitivity testing was conducted using the Kirby-Bauer Disc diffusion method. The data were entered into a Microsoft Excel worksheet, and the results were analysed using simple descriptive statistics involving percentages and proportions using Statistical Package for Social Sciences (SPSS) software version 16.0. Results: Of the total 2,794 samples, 319 (11.4%) samples yielded significant bacteriuria. Among the positive samples, 204 (64%) were from females and 115 (36%) were from males. UTIs were most commonly seen in the age group of 61-80 years. Escherichia coli (E.coli), with 148 isolates (46.4%), was the predominant organism, followed by Klebsiella pneumoniae with 72 isolates (22.6%). E. coli showed the highest susceptibility to meropenem, with 137 isolates (92.6%), and imipenem, with 136 isolates (91.9%), followed by cefoperazone/sulbactam with 129 isolates (87.2%), and piperacillin/tazobactam with 128 isolates (86.5%). Klebsiella pneumoniae was most susceptible to imipenem, with 42 isolates (60%), followed by meropenem, with 29 isolates (41.4%). Most non fermenters were highly susceptible to carbapenems, cefoperazone/sulbactam, and piperacillin/tazobactam. Among the gram-positive organisms, Enterococcus spp. was the most frequently isolated, showing 100% sensitivity to vancomycin and linezolid. Conclusion: In this study, UTI was found to be more prevalent among elderly females. Gram-negative organisms were the most commonly isolated pathogens in UTI, with E. coli being the most frequent agent. Urinary pathogens exhibited resistance to commonly used antibiotics such as ampicillin, cephalosporins, quinolones, and cotrimoxazole. Based on this study, it can be concluded that the resistance to commonly used antibiotics is very high. Due to the changing trends in the sensitivity patterns of various antibiotics, it is important to understand the antibiogram of common isolates in a specific area or hospital to ensure better empirical treatment. [ABSTRACT FROM AUTHOR]

Background: The urinary biomarker response precedes the appearance of any renal structural or functional derangement. Transforming growth factor-Pi (TGF-P1), neutrophil gelatinase associated lipocalin (NGAL), and Cystatin C (CysC) can act as the early prognostic markers in posterior urethral valve (PUV) patients. Aim: To compare the urinary levels of TGF-β1, NGAL, and CysC between PUV cases and age matched controls and to correlate these with renal structural and functional parameters. Materials and Methods: This prospective study included children with PUV diagnosed using the standard investigations and an equal number of age-matched controls with nonurological problems. For the study subjects, the urinary samples were collected at three different time points (pre- and postoperatively at 3 and 6 months), whereas for controls, only single-voided samples were studied. The urinary levels of TGF-β1, NGAL, and CysC were estimated by the standardized techniques using the ELISA kits. Statistical methods were used to drive the comparisons between cases and controls. Results: Fifteen children with a median age of 10 (5-48) months were enrolled in each of the two groups. The mean uTGF-β1 in the case group was significantly higher at all three time points (43.20 ± 6.13 pg/ml, 43.33 ± 11.89 pg/ml and 40.71 ± 9.01 pg/ml) as compared to the control group (29.12 ± 8.31 pg/ml) (P ≤ 0.001). The median uNGAL in the case group was also higher (17.78 ng/ml, 2.35 ng/ml and 2.536 ng/ml) as compared to the control group (1.31 ng/ml). However, the difference was significant only preoperatively (P = 0.02). The median uCysC in case group was similarly higher (0.347 µ.g/ml, 0.439 µ.g/ml, and 0.382 µ.g/ml) than the control group (0.243 µ.g/ml) (P > 0.05). Serum creatinine in the case group (0.49 mg/dl) showed no significant rise above that of control (0.24 mg/dl). A cutoff value of uTGF-β1 = 36.55 pg/ml (P < 0.001), uNGAL = 0.879 ng/ml (P = 0.02), and uCysC = 0.25 µg/ml (P = 0.22) was found to be associated with renal damage in PUV. A significant correlation was found between uNGAL and S. creatinine at 3 months (r = 0.43, P = 0.017) and 6 months (r = 0.47, P = 0.08). Conclusion: The elevated uTGF-β1, a decline in uNGAL and an increase in uCysC suggests ongoing inflammation, improvement in hydronephrosis and a prolonged proximal tubular dysfunction in PUV patients, respectively. [ABSTRACT FROM AUTHOR]

The 2014 shutdown localization of prostitution in Surabaya City, East Java Province, Indonesia, has given rise to an illegal prostitution industry, resulting in the spread of uncontrolled sexually transmitted infections (STIs). Mapping needs to be done to track the spread of the disease. This study used secondary data on STIs in 2020 from the Surabaya City Health Office. By using biplot analysis, this study sought to offer a detailed understanding of the distribution and dynamics of STI cases in different parts of Surabaya. The early-stage syphilis was found in Tegalsari and Krembangan Subdistricts; then, gonorrheal urethritis was found in Tandes, Karang Pilang, and Pabean Cantian Subdistricts. Meanwhile, gonorrhea was typically found in Tandes, Gunung Anyar, Sawahan, and Karang Pilang Subdistricts. On the other hand, Tegalsari, Krembangan, and Pabean Cantian Subdistricts also had cases of advanced syphilis. This study enables relevant parties, specifically the Surabaya City Health Office, to monitor the method's rapid spread and respond to each case according to the predominant type of STI. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) are a major public health, frequently seen by general practitioners central to healthcare. This study evaluated the knowledge and practices of general practitioners in Fez regarding STIs. Materials and Methods: A cross-sectional study involving 73 general practitioners used a questionnaire to assess their STI knowledge and practices. Results: Most practitioners (63%) had received specific STI training, and 95.9% had treated STI cases. Urethritis was the most common condition (87.14%), with 88.57% of the practitioners treating patients after clinical assessment. A majority (83.6%) were familiar with the syndromic approach for genital ulceration and urethral discharge. Conclusion: Fez's general practitioners and emphasizing the need for ongoing medical education. Their role is crucial in addressing STIs, especially in underprivileged communities. [ABSTRACT FROM AUTHOR]

Copyright of Die Urologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In South Africa, Neisseria gonorrhoeae , which is the predominant cause of male urethritis, is treated syndromically using dual ceftriaxone and azithromycin therapy. We determined antimicrobial susceptibilities of N. gonorrhoeae isolates from urethral discharge specimens, and genetically characterised those with elevated minimum inhibitory concentrations (MICs) for first-line antimicrobials. Methods: Routine antimicrobial susceptibility testing (AST) of N. gonorrhoeae isolates included E-test for ceftriaxone, cefixime and gentamicin and agar dilution for azithromycin and spectinomycin. Neisseria gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) was performed for isolates with elevated MICs to identify antimicrobial resistance (AMR) determinants, and Neisseria gonorrhoeae Multi-Antigen Sequence Typing (NG-MAST) was used to determine strain relatedness. Results: N. gonorrhoeae was cultured from urethral discharge swab specimens obtained from 196 of 238 (82.4%) men presenting to a primary healthcare facility in Johannesburg in 2021. All viable isolates were susceptible to extended-spectrum cephalosporins. Four isolates had high azithromycin MICs ranging from 32 mg/L to >256 mg/L and grouped into two novel NG-MAST and NG-STAR groups. Two isolates from Group 1 (NG-MAST ST20366, NG-STAR ST4322) contained mutated mtrR (G45D) and 23S rRNA (A2059G) alleles, while the two isolates from Group 2 (NG-MAST ST20367, NG-STAR ST4323) had different mutations in mtrR (A39T) and 23S rRNA (C2611T). Conclusions: We report the first cases of high-level azithromycin resistance in N. gonorrhoeae from South Africa. Continued AMR surveillance is critical to detect increasing azithromycin resistance prevalence in N. gonorrhoeae , which may justify future modifications to the STI syndromic management guidelines. We report the first cases of high-level azithromycin resistant N. gonorrhoeae emerging from South Africa. All viable isolates obtained during 2021 were susceptible to extended-spectrum cephalosporins; however, four isolates had high azithromycin MICs ranging from 32 mg/L to >256 mg/L and grouped into two distinct novel NG-MAST and NG-STAR groups. Continued antimicrobial resistance surveillance is critical to detect increasing azithromycin resistance prevalence in N. gonorrhoeae , which may justify future modifications to the STI syndromic management guidelines. [ABSTRACT FROM AUTHOR]

Circinate balanitis, although a common cutaneous manifestation of reactive arthritis (ReA), is usually an associated finding present along with the triad of arthritis, conjunctivitis, and urethritis. It is rarely seen as the only or the preceding manifestation of ReA. Here, we report three cases of circinate balanitis as stand-alone and initial presentation of probable ReA without any other symptoms of arthritis and conjunctivitis at the time of presentation. [ABSTRACT FROM AUTHOR]

The urinary system, primarily responsible for the filtration of blood and waste, is affected by several infectious and inflammatory conditions. Focusing on the lower tract, this review outlines the physiological and immune landscape of the urethra and bladder, addressing key immunological and microbiological aspects of important infectious/inflammatory conditions. The conditions addressed include urethritis, interstitial cystitis/bladder pain syndrome, urinary tract infections, and urosepsis. Key aspects of each condition are addressed, including epidemiology, pathophysiology, and clinical considerations. Finally, therapeutic options are outlined, highlighting gaps in the knowledge and novel therapeutic approaches. [ABSTRACT FROM AUTHOR]

Human papillomavirus (HPV) infection can lead to HPV‐related cancer in men, including the anus, penile, and oropharyngeal cancers and precancerous lesions. This study retrospectively investigated HPV prevalence and genotype distribution in Liaocheng men between 2016 and 2022. The total HPV positive rate was 64.87% (2388/3681, 95% confidence interval [CI]: 63.32%–66.40%), where high risk (HR)‐HPV and low risk (LR)‐HPV accounted for 42.49% (1564/3681, 95% CI: 40.90%–44.09%) and 69.71% (2566/3681, 95% CI: 68.20%–71.17%), respectively. The mixed HPV infection rate of two and more genotypes was 35.72%. The infection rate of HR‐HPV increased with the number of positive cases annually from 2016 (16.91%) to 2022 (46.59%). The most common HR‐HPV genotypes were HPV16 (11.60%), HPV52 (6.95%), and HPV59 (6.28%), whereas the least common HR‐HPV was HPV26. The most common LR‐HPV genotypes were HPV6 (56.99%), HPV11 (23.79%), and HPV43 (6.37%). The 9 v HPV vaccine preventable for LR‐HPV and HR‐HPV accounted for 80.78% and 30.40%, respectively, in this study. Most HPV‐positive patients aged 1–86 were in the 30–39 age group. This study confirmed that HPV prevalence in Liaocheng men was common and diverse. HPV16, HPV52, and HPV59 are widely distributed in Liaocheng men, and the male HR‐HPV infection rate remained high in this region. Regarding public health and cancer prevention, it is recommended and effective to include the HPV vaccination in the national vaccination program for men. [ABSTRACT FROM AUTHOR]

Objective To observe the clinical efficacy and safety of Shuangshi Tonglin capsules combined with doxycycline hydrochloride in treating male non-gonococcal urethritis (Damp-Heat Pouring Downward type). Methods From March 2022 to March 2023, 104 patients with non-gonococcal urethritis (Damp-Heat Pouring Downward type) were randomly divided into two groups based on block randomization, including the treatment group (n =52) and the control group ( n = 52) . The patients in the control group were orally administrated with doxycycline hydrochloride for 7 days, and the treatment group with Shuangshi Tonglin capsules in combination with doxycycline hydrochloride for 7 days. Both groups of patients were re-examined at the 7th day after stopping the medication. The clinical efficacy of the two groups was observed and compared, as well as the traditional Chinese medicine symptom scores, the time of clinical symptom regression, laboratory test results for the pathogen, and the incidence of adverse reactions. Results The total efficacy rate for the treatment group and the control group was 96. 15% and 84. 62%, respectively, with a significant difference (P <0. 05) . Symptom regression times of the treatment group for frequent urination, urgency, pain, redness and swelling of the urethral opening, itching, and urethral discharge[ (3.12 ±0.38), (3.34 +0.44), (4.12 ±0.68), (4.03 ±0.59), (3.36 ±0.32), and (3.56 ±0.52) days] were all better than those of the control group[ (4.26 ± 0.76), (4.76 ±0.83), (4.89 ±0.89), (5.12 ±0.92), (4.56 ± 0.82), and (4.64 ±0.78) days], with statistical significance (P <0. 05) . Symptom scores of both groups after treatment showed an obvious decrease (P <0.05), and the scores for the treatment group for each symptom [(0.86 ±0.18), (0.94 ± 0.23), (0.79 ±0. 6), (1.01 ±0.27), (0.83 ± 0.20), and (0.97 ±0.25)] were all notably lower than those of the control group[ (1.38 ±0.46), (1.54 ± 0.52), (1.46 ±0.49), (1.50 ± 0.51), (1.44 ± 0.43), and (1.32 ± 0.36)], with a significant difference (P <0. 05) . The pathogen clearance rate of the treatment group was 96. 15%, which was higher than that of in the control group (82. 69%, P <0.05) . The cases with gastrointestinal reactions, headaches, maculopapular rash, and dry mouth in the treatment group were 1, 1, 0, and 1 and the cases in the control group were 1, 2, 2, and 0 cases. The incidence of adverse reactions in the treatment group was 5.77%, which was lower than that in the control group. However, the difference was not statistically significant (P >0.05). Conclusions The combined treatment of Shuangshi Tonglin capsules and doxycycline hydrochloride for male non-gonocoecal urethritis of the Damp-Heat Pouring Downward type can significantly enhance the clinical pathogen clearance rate, effectively improve clinical symptoms and the life quality of patients. [ABSTRACT FROM AUTHOR]

Copyright of Gazi Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: Sexually Transmitted Infections (STIs) in men are a significant public health problem due to the consequences they can have, such as chronic diseases, infertility, cancer, and even death. This study aimed to determine the frequency of microorganisms associated with STIs in men with urethritis attending urology consultations, and to explore their clinical correlations. (2) Methods: A population that attended the urology consultation of the University Hospital "Dr. José E. González" was studied. Written consent was obtained, and interviews and clinical history were conducted about specific risk factors identifying signs and symptoms associated with any genitourinary condition; after that, urine samples were collected. Identification of C. trachomatis, N. gonorrhoeae, U. urealyticum, and M. genitalium was based on amplifying species-specific DNA fragments. (3) Results: A total of 200 patients were included. The mean age was 55 years (20–95). According to the interviews, only 32.5% (n = 65) had received prior sex education. Additionally, 75% (n = 150) do not usually use any protection during sexual intercourse. Regarding clinical factors, 69.4% (n = 138) presented burning or pain when urinating. Molecular analysis revealed the presence of C. trachomatis to be 9.5% (n = 19), with U. urealyticum at 13% (n = 26), and M. genitalium at 2% (n = 4). (4) Conclusions: This is the most extensive molecular epidemiological study of the frequency of STIs in men in Mexico in third-level care and its association with different risk factors. As reported globally, a similar frequency of C. trachomatis, U. urealyticum, and M. genitalium was detected. [ABSTRACT FROM AUTHOR]

Neisseria meningitidis causes invasive meningococcal diseases and has also been identified as a causative agent of sexually transmitted infections, including urethritis. Unencapsulated sequence type 11 meningococci containing the gonococcal aniA-norB locus and belonging to the United States N. meningitidis urethritis clade (US_NmUC) are causative agents of urethral infections in the United States, predominantly among men who have sex with men. We identified 2 subtypes of unencapsulated sequence type 11 meningococci in Japan that were phylogenetically close to US_NmUC, designated as the Japan N. meningitidis urethritis clade (J_NmUC). The subtypes were characterized by PCR, serologic testing, and whole-genome sequencing. Our study suggests that an ancestor of US_NmUC and J_ NmUS urethritis-associated meningococci is disseminated worldwide. Global monitoring of urethritis-associated N. meningitidis isolates should be performed to further characterize microbiologic and epidemiologic characteristics of urethritis clade meningococci. [ABSTRACT FROM AUTHOR]

We report on an outbreak of nongroupable Neisseria meningitidis–associated urethritis, primarily among men who have sex with men in southern Vietnam. Nearly 50% of N. meningitidis isolates were resistant to ciprofloxacin. This emerging pathogen should be considered in the differential diagnosis and management of urethritis. [ABSTRACT FROM AUTHOR]

Objectives. Illustration of a case of systemic mastocytosis mimicking reactive arthritis in the absence of an infectious etiology. Methods. Review of the patient's medical records. Results. We report a case of systemic mastocytosis relapse, presenting with pancytopenia accompanied by knee monoarthritis, cystitis, and bilateral conjunctivitis occurring simultaneously at the same time interval within 2–4 days, mimicking reactive arthritis in the absence of an infectious etiology. Conclusion. Our case demonstrated reactive arthritis features (triad of urethritis, conjunctivitis, and arthritis) without an infectious trigger but rather a relapse of mastocytosis. We should think outside the box when faced with such a clinical scenario in the absence of an infectious etiology. Paraneoplastic reactive arthritis is to be considered after excluding an underlying infection. [ABSTRACT FROM AUTHOR]

Introduction: Gonococcal infection of the penile raphe is rarely encountered in the clinical setting. The study aimed to understand the incidence, sites, clinical manifestations, and treatment of gonococcal infection of the penile raphe. Methods: We enrolled men with gonococcal infection of the penile raphe and men with urethral gonorrhea from January 2010 to December 2021. All patients' demographic data and clinical characteristics were recorded. All patients were treated with ceftriaxone. Incision and drainage were performed in patients with non-ruptured abscesses. Nodules and sinus tract-like lesions that did not resolve after 1 month of treatment were excised. Results: Among 2,736 men who presented with urethral gonorrhea from January 2010 to December 2021, 5 (0.18%) had accompanying gonococcal infection of the penile raphe. An additional two men presented with gonococcal infection of the penile raphe without urethritis. Thus, 7 (0.26%; confidence interval, 0.11–0.56%) of 2,738 men had urethral gonorrhea or gonococcal infection of the penile raphe confirmed both clinically and by laboratory testing. Lesions were present in the frenulum of the prepuce and at the median aspect, proximal end, distal end, and both the proximal and distal ends of the penile raphe. The lesions manifested as abscesses, ulcers, a nodule, and a nodule with a sinus-like lesion. All lesions exhibited tenderness. All seven patients were cured after treatment. Conclusion: Gonococcal infection of the penile raphe is a rare, atypical type of involvement of the male urogenital tract by Neisseria gonorrhoeae. It may be a local complication of urethral gonorrhea or an independent primary infection. The proximal end, distal end, and median aspect of the penile raphe can be infected by N. gonorrhoeae. Cutaneous lesions present as abscesses, ulcers, nodules, and sinus-like lesions. Ceftriaxone is effective, but sinus-like lesions require surgery. [ABSTRACT FROM AUTHOR]

We found that the odds of return clinic visits for persistent non-gonococcal urethritis (NGU) were significantly lower (odds ratio:.4; 95% confidence interval:.3–.6; P <.0001) after implementing (1) testing for Mycoplasma genitalium during initial evaluations for NGU and (2) switching from azithromycin to doxycycline as first-line NGU treatment. [ABSTRACT FROM AUTHOR]

Background: Male urethritis is primarily sexually transmitted in India and has also shown a high rate. Urethritis or inflammation of the urethra is a multifactorial condition. It is called gonococcal urethritis (GU) when Neisseria gonorrhoeae is detected in a urethral smear of the patient and non-gonococcal urethritis (NGU) when this organism cannot be visualized. Aims and Objectives: To study the demographic profile and management pattern of NGU retrospectively in male patients. Materials and Methods: Urethritis cases were identified from the dermatology outpatient record. A retrospective study of data of patients diagnosed with NGU was done for 5 years from August 2015 to July 2020. We included only male patients more than 10 years of age. Results: Chlamydia trachomatis (CT, 48%) was the most common causative organism found. The diagnosis was confirmed by demonstrating ≥5 polymorphonuclear lymphocytes (PMNLs) from the anterior urethra using a Gram-stained urethral smear followed by the polymerase chain reaction (PCR.) of urine. The most common age group affected was 21–30, (30, 46%) years with a mean ± standard deviation (SD) of 30.32 ± 10.80. Most patients were from low socioeconomic status, labourers (36, 55%). A history of heterosexual behaviour, (57, 88%) was the most common and it had been seen that sexual exposure was more common in unmarried patients (38, 59%). Associated features were seen in 18 patients. Among recommended initial therapies for NGU, doxycycline and azithromycin might be improved by the addition of antimicrobial coverage for Trichomonas vaginalis (T. vaginalis). Further, it was seen that response to doxycycline therapy was better than azithromycin. Conclusions: Though there is an increased incidence of Herpes infections, we found Chlamydia infection to be the most common cause of NGU. Doxycycline showed better results in NGU due to Chlamydia infection. [ABSTRACT FROM AUTHOR]

Mycoplasma penetrans is an emerging pathogen with a reduced genome. This bacterium has only previously been cultured from individuals with chronic immunodeficiencies. Here we report the characteristics of 4 M. penetrans isolates from the urine of immunocompetent males with nongonococcal urethritis, in comparison with strain HF-2 from an immunocompromised patient. Several features exhibited distinct differences between these isolates and HF-2. Unlike HF-2, all 4 were resistant to azithromycin. They exhibited greater sialic acid-dependent binding to erythrocytes, gliding motility speed, and H2O2 production than HF-2. All new isolates produced thinner capsules than HF-2. Invasiveness varied, with some isolates being more invasive than HF-2 and some less invasive. Cytotoxicity to HeLa cells was similar to HF-2, and all strains could clear extracellular traps produced by innate immune cells. We conclude that subtle differences among M. penetrans strains may be critical for this organism to establish an infection in an otherwise healthy individual. [ABSTRACT FROM AUTHOR]

Objectives: Sexually transmitted infections are a prevalent global health care problem. Treatment guidelines have recently been updated as a result of antimicrobial resistance and public health trends. The aim of the study was to assess the appropriateness of empirical antibiotic therapy prescribed for cervicitis and urethritis in the emergency department. Methods: We designed a retrospective observational cohort study. We included adult patients with suspected cervicitis or urethritis who attended the emergency department of a tertiary hospital in 2020. We excluded patients with suspected pelvic inflammatory disease, pregnancy or prostatitis and those requiring admission to hospital. Appropriateness of empirical antibiotic therapy was evaluated taking into account 4 aspects: indication, dosing, duration of therapy, and route of administration. Data were obtained from the electronic medical record, the electronic prescription program, and the discharge summary. Results: The study population comprised 176 patients; mean age was 28.9 years (SD = 7.7), and 90.9% were men. The most prescribed treatment was the combination of ceftriaxone and azithromycin (83.0%). Treatment was inappropriate in 71.6% of patients. A total of 159 drug errors were recorded. The most frequent cause was undertreatment (36.4%) related to underdosing (46.5%), particularly with regard to ceftriaxone. The percentage of errors was 11.9% for indication, 84.9% for dosing, 3.1% for duration, and 0% for route of administration. Conclusions: A high percentage of patients who attended the emergency department for suspected cervicitis or urethritis received an inappropriate empirical antibiotic regimen. The main reason was undertreatment due to underdosing. [ABSTRACT FROM AUTHOR]

Despite developing surgical techniques in urethral surgery, the outcome and complications are still unsatisfactory. Alternative treatment modality has been coming up, particularly in patients with longer stricture, under revision surgery, and penile stricture. Tissue engineering grafts are a promising approach for substituting urethral reconstruction. Over the decades, numerous preclinical studies have been published to show the efficacy and safety of different origins of materials, the presence of autologous cells (acellular matrices or autologous cell-seeded matrices), and the construction of engineered tissue (patch or tubularized constructs) on animal models. However, the results of these studies have not yet reached the intended level for daily clinical practice. A PubMed database search was performed for articles, using specific keywords, published between 1998 and 2022, with a selection on using tissue-engineered grafts for urethroplasty. Many materials have been used as a graft, such as acellular bladder matrix, small intestinal submucosa, acellular dermal matrix, and polyglycolic acid with or without cells, and were evaluated according to the functional and anatomical outcomes comprising complications. According to current literature, tubularized scaffolds constructed from co-cultured cells have promising results for the future. However, high-quality evidence through randomized controlled studies with larger sample sizes, with a long-term follow-up is required to determine accurate outcomes. [ABSTRACT FROM AUTHOR]

Background: Accessing care for sexual health has always been a challenge in our Indian context. The primary reason is a lack of awareness of modes of transmission of sexually transmitted diseases (STD), appropriate testing, and treatment options. The second is taboo associated with the morality of the individual. The third is the accessibility and availability of Quality STD care by allopathic specialists in comparison to the demand. This has paved way for lots of myths and misconceptions among the general public regarding STDs and HIV disease. Compounding it is the mushrooming of nonqualified practitioners and healers who claim to cure all STDs and HIV has led to poor treatment outcomes. Several methods of partnership with qualified allopathic practitioners have been tried for the provision of quality STD care by various donor-funded, HIV and STD prevention programs in the country. The key reasons for the nonsustainability of these clinics were the lack of technical capability to handle the sexual health and STD clinical cases and the huge cost involved in the advertisement and maintenance of the clinics. Methodology: Seven clinicians from different geographical locations in Tamil Nadu, who were exclusively qualified in Venereology, conceived the idea of provision of comprehensive clinical care cum counseling and testing services through a networking model from December 01, 2020. The model comprised the following: (1) Dedicated YouTube channel (Nakshatra Health) to provide scientific information on STD and HIV, modes of transmission, clinical symptoms, lab testing, interpretation of results, clinical treatment options, and counseling on prevention, (2) Dedicated telephone helpline was established with WhatsApp to answer the queries of clients by the network venereologists, (3) Dedicated website (www.nakshatra.health) was developed to provide information on STD and HIV and options to clarify doubts and fix appointments online, (4) Clinical consultations were done in a hybrid mode with an option for direct clinic and online consultation. Prescriptions were provided using dedicated software instantly, (5) Networking was done with NABL-accredited labs and collection centers for performing STD and HIV tests with e-test request forms, (6) Networking was done with pharma companies to provide pre- and postexposure prophylaxis (PEP) services to clients through e-prescriptions. Cross referrals were made across the network members to facilitate easy access to clinical services by clients from different parts of Tamil Nadu. The entire concept was branded as "Nakshatra health" with a tagline - "Your sparkling solution for safe sexual health care." Quality STD care and ethical practice were the underlying motos of this concept. Results: During the 20 months (December 2020 to July 2022), 6442 phone calls and 9328 WhatsApp messages were received. 82.3% of the calls and messages were queries from clients related to their sexual exposures, and 16.4% were general information seekers. During this period, the Nakshatra Health YouTube channel had 1590 subscribers and nearly 2.4 lakh views of all its 24 videos. Among the viewers, 92.4% were male. 52.29% of viewers were between the ages of 25 and 34 years, 28.25% were between the ages of 18 and 24 years, and 17.25% viewers were between the ages of 35 and 44 years. 86% of the viewers were from India and 13% were Tamil-speaking viewers from Middle East, Southeast Asian countries and 1% were from European, African, and American countries. The most commonly watched videos were related to HIV symptoms and lab tests for STD and HIV. 16% of the viewers repeatedly watched the various videos in the series. The network laboratories provided testing services for 1082 clients with 2423 various STD/HIV tests. Totally 3328 clients availed of online consultation and 924 clients accessed clinic-based services across the network members. Among these cases, 18 cases of Syphilis (primary and secondary) and 12 cases of acute gonococcal urethritis, and 10 cases of genital warts were diagnosed and treated. 12 cases of phimosis and 4 cases of anal warts were surgically treated in collaboration with a surgeon. Through this initiative, PEP and PreP services were provided to 228 and 8 individuals. Conclusion: Designing a comprehensive sexual health service package is crucial to ensure the availability and ease of access to services to the general public. Provision of correct scientific information, networking and cross-referral of cases with like-minded dermatovenereologists/clinicians interested in venereology sexually transmitted infections, easily accessible clinical, laboratory, and treatment services including PreP and PEP medications, and ethical practice are the key factors for scaling this concept. [ABSTRACT FROM AUTHOR]

The objective: to optimize the treatment of acute inflammatory diseases of the female genital organs with the symptoms of urethritis and vaginitis using the modern treatment – the antibiotic fosfomycin and complex suppositories containing metronidazole and miconazole nitrate. Materials and methods. I group (main group) included 52 women 20–32 years old with a clinical complex of acute vaginitis in combination with symptoms of acute urethritis and cystitis. Patients of this group received suppositories containing metronidazole and miconazole nitrate 1 time per day for 7 days, fosfomycin sachet 3 g orally once. II group (comparison group) included 30 women with clinical signs of vaginitis and urethritis who received several types of multidirectional suppositories without additional prescription of uroantiseptics (antibiotics). The data of women in the II group were collected retrospectively. Clinical, cultural, instrumental research methods were used, the assessment of complaints and clinical manifestations of the disease was carried out in points. Results. In the I group the elimination of pathogens and the disappearance of symptoms were observed in 96.2 % of patients. In the II group clinical signs of the disease, complaints persisted in a third of patients. After treatment, the assessment of pain syndrome in the I group was 0.5±0.25 points, in the II group – 2.5±0.25 points, dysuric manifestations – 0.25±0.5 and 4.0±0.25 points, respectively, discharge from the genital tract – 1±0.25 and 2.0±0.25 points, feeling of burning – 0.2±0.2 and 0.75±0.25 points, dyspareunia – 0.25±0.2 and 4.5±0.5 points. According to sonography, the disappearance of excess blood flow, signs of inflammatory changes in organs in patients of the I group were observed. Conclusions. The combination of the use of suppositories containing metronidazole and miconazole nitrate for 7 days and a sachet of fosfomycin 3 g leads to the elimination of pathogenic flora and the elimination of symptoms of acute inflammatory diseases of the female genital area with symptoms of urethritis and vaginitis in 96.2 % of cases. This treatment regimen reduces the volume of drugs, prevents the development of generalized forms of the disease. [ABSTRACT FROM AUTHOR]

The US Neisseria meningitidis urethritis clade (US_NmUC) harbors gonococcal deoxyribonucleic acid alleles and causes gonorrhea-like urogenital tract disease. A large convenience sample of US_NmUC isolates (N = 122) collected between January 2015 and December 2019 in Columbus, Ohio demonstrated uniform susceptibility to antibiotics recommended for gonorrhea treatment and meningococcal chemoprophylaxis. [ABSTRACT FROM AUTHOR]

Mycoplasma genitalium (M. genitalium) has emerged as a sexually transmitted infection (STI) all over the world in the last three decades. It has been identified as a cause of male urethritis, and there is now evidence that it also causes cervicitis and pelvic inflammatory disease in women. However, the precise role of M. genitalium in diseases such as pelvic inflammatory disease, and infertility is unknown, and more research is required. It is a slow-growing organism, and with the advent of the nucleic acid amplification test (NAAT), more studies are being conducted and knowledge about the pathogenicity of this organism is being elucidated. The accumulation of data has improved our understanding of the pathogen and its role in disease transmission. Despite the widespread use of single-dose azithromycin in the sexual health field, M. genitalium is known to rapidly develop antibiotic resistance. As a result, the media frequently refer to this pathogen as the "new STI superbug." Despite their rarity, antibiotics available today have serious side effects. As the cure rates for first-line antimicrobials have decreased, it is now a challenge to determine the effective antimicrobial therapy. In this review, we summarise recent M. genitalium research and investigate potential therapeutic targets for combating this pathogen. [ABSTRACT FROM AUTHOR]

To explore the microbial etiology of urethritis in Vietnamese men and the association with patients' characteristics, especially their sexual behaviors. This study was conducted on 349 men who presented with symptomatic urethritis and evidence of STIs (determined by multiplex PCR tests) at the Department of Andrology and Sexual Medicine—Hanoi Medical University Hospital. All information regarding medical history, sexual activities, and symptoms of urethritis was documented. C. trachomatis and N. gonorrhoea remained the two most common causative pathogens, followed by an unexpectedly high prevalence of Mycoplasma and Ureaplasma species. Coinfection was significant with a rate of 40.7%. Men who had sex with female sex workers (FSWs) were more likely to be positive with N. gonorrhoea but less likely to be positive with C. trachomatis and M. genitalium than those having sex with only one romantic partner. Our findings suggested the important role of other microorganisms, especially M. genitalium, in the etiology of urethritis in men besides the previously well-known causes of STIs. Since the coinfection rate is quite high, targeted treatment with clear microbial evidence should be considered rather than empiric antimicrobial therapy. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma genitalium is a gram negative, parasitic pathogenic bacterium, usually transmitted sexually into human and frequently causing urethritis in men and women as well as cervicitis and pelvic inflammation in women. This is an extremely small selfreplicating entity whose genome has been sequenced. This genome sequencing is advantageous in understanding pathogenesis and identifying therapeutic targets. In this study different bioinformatics tools and databases were adopted to analyze the functions of different hypothetical proteins from M. genitalium G37. Methodology: A total of 75 hypothetical proteins (HPs) were retrieved from KEGG database, while CDD-BLAST, Pfam, and InterProScan servers were used for conserved domains analysis. After that, those HPs were broadly analyzed for physicochemical properties, subcellular localization, GO annotation, and virulence factors. Results: Based on best score, hypothetical protein MG_476 was selected for homology modelling which produced a fairly good quality 3D model. The active site within MG_476 was predicted using CASTp server that helps to explore the surface features of the protein. Other approaches include the use of NetCTL, IEDB, Bcepred, and ABCpred servers to predict the location of B and T cell epitopes. Among the CD8+ T cell epitopes tested, ILQIIMFIL scored highest (0.23718) in terms of immunogenicity. Conclusion: Moreover, this analysis recommended MG_476 as a non-homologous protein and the data generated in this study may facilitate the experimental designing of novel drug and vaccines against M. genitalium. [ABSTRACT FROM AUTHOR]

Reactive arthritis (ReA) is uncommon. The present case is a Chinese man who has been treated with adalimumab and leflunomide to control ankylosing spondylitis (AS). During the treatment, the patient developed a range of symptoms, including fever, fatigue, pustular rash, suppurative urethritis, genital ulcers, oral ulcers, bilateral uveitis, heel pain and swelling and pain of the knee and ankle joints. The laboratory studies revealed the presence of HLA-B27, and urethral secretions were positive for Ureaplasma urealyticum. The patient was eventually diagnosed with ReA. The development of ReA may be related to the combination of adalimumab and leflunomide, which reduces immune function and triggers activation of potential U. urealyticum. The patient received 3 weeks of antibiotics, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs), resulting in a significant improvement. The dose of corticosteroids was gradually reduced, and adalimumab was reintroduced. The patient was followed up for 3 months without recurrence. [ABSTRACT FROM AUTHOR]

Reactive arthritis is a rare form of spondyloarthropathies occurring after genital or enteric infection. It is most often self‐limited but can progress to chronic spondylarthritis. We report the case of a 30‐year‐old man who presented with acute arthritis occurring 2 months after an episode of urethral discharge. Physical examination revealed polyarthritis, dactylitis, sacroiliac joint involvement, and plantar papulosquamous plaques. The human leukocyte antigen B27 was positive. Detection of Chlamydia trachomatis and Gonococcus in the first catch urine specimen was negative. Hepatitis B and C, Chlamydia trachomatis, human immunodeficiency virus, and syphilis serologic test results were negative. Pelvic magnetic resonance imaging revealed left sacroiliitis. The patient was treated with antibiotics, diclofenac, and sulfasalazine. After 6 months of follow‐up, a significant clinical improvement was obtained without remission, suggesting an evolution to chronic spondylarthritis. Diagnosis of Reactive arthritis is difficult since microbiologic examinations are commonly negative. This disease should be considered in patients with rheumatologic manifestations occurring after a urogenital or enteric infection, mainly when associated with skin manifestations and human leukocyte antigen B27. [ABSTRACT FROM AUTHOR]

On March 11, 2020, the World Health Organization recognized the SARS-CoV-2 infection as a pandemic. The pandemic itself in addition to its containment measures affects individuals' lifestyles and welfare including their sexual behaviors. Thus, we hypothesized that sexually transmitted infection (STI) incidence may be changed and so we evaluate urethritis incidence as the most common STI in men and some other related factors. Two cross-sectional surveys during the first 6 months of 2019 and 2020 were undertaken and data were collected from 11 urology offices located in different parts of the capital city. In total, 34,611 male participants were included in our study, and 191 (.55%) patients' clinical diagnoses were urethritis. The urethritis incidence significantly decreased from 149 of 17,950 (.83%) to 42 of 16,661 (.25%) individuals in the same period of the years 2019 and 2020, respectively (p -value <.001). There was a higher percentage of single (p -value =.049) and older (p -value <.001) urethritis patients in the first 6 months of the year 2020 compared with 2019. Our survey provided urethritis incidence, demographics, symptoms, and treatment characterization. As our results show, the proportion of urethritis patients in all populations admitted to urologist offices had dramatically decreased during the COVID-19 pandemic compared with prior. The indirect effects of the pandemic and its containment measures on people's sexual health should be noticed and an appropriate reaction and policy-making are recommended to manage issues properly in different aspects of sexual health. [ABSTRACT FROM AUTHOR]

Background. Male urethritis is one of the most common genital tract syndromes. Though the number of patients with urethritis is increasing worldwide, the cause of many cases of non-gonococcal urethritis (NGU) is still unknown. Objectives. This study aimed to delineate the association between Trichomonas vaginalis (T. vaginalis) infection and male urethritis. Methods. The literature was searched in PubMed, Scopus, and Web of Science databases using the search terms "urethritis," "Trichomonas vaginalis," "trichomoniasis," and "male urethritis" up to February 2020. Overall risk difference(RD) was applied to assess the relationship between T. vaginalis infection and male urethritis. Results. In total, seven articles were included in this systematic review and meta-analysis study. Our meta-analysis involved the review of case-control studies, including 2,242 urethritis cases and 929 individuals as controls. Among subjects examined for trichomoniasis, in the case group, 211 males were infected, and in the control group, 32 individuals were infected. The overall risk difference (RD) was 0.06, and the total reported p value was 0.00001. Although the result of our meta-analysis was not significant, it was shown that the risk of urethritis is 0.06 more in trichomoniasis patients than in the non-exposed group. Conclusion. Findings from the included papers showed that trichomoniasis is not a risk factor for male urethritis. Although trichomoniasis alone is not the main cause of urethritis, it can be considered one of the risk factors in male urethritis. Therefore, in the future, it is necessary to perform further studies to clarify the detailed association between T. vaginalis infection and urethritis risk in male patients. [ABSTRACT FROM AUTHOR]

Introduction: Neisseria gonorrhoeae and Chlamydia trachomatis are the primary pathogens causing urethritis. A cross-sectional study was carried out in the Department of Microbiology in conjunction with the Department of Dermatology and STD of our hospital. The aim of the study was to detect N. gonorrhoeae and C. trachomatis among men with urethritis and to determine the anti-microbial susceptibility of the N. gonorrhoeae isolates. Material and Methods: All cases were subjected to direct Gram's smear examination and culture of urethral discharge (N. gonorrhoeae), real-time polymerase chain reaction and direct fluorescent antibody test (C. trachomatis). All N. gonorrhoeae isolates were subjected to anti-microbial susceptibility testing and were tested for ß-lactamase production by chromogenic cephalosporin test. Statistical Analysis Used: Data were expressed as percentages. Fisher's exact test was used to evaluate statistical significance in the case of unpaired categorical data. Agreement between the methods was assessed by using kappa statistics. Results: Gonococcal infection was detected in 58.1% cases, and C. trachomatis was detected in 14% cases. However, both were detected in 12% cases. The sensitivity, specificity, positive predictive value, and negative predictive value of direct Gram's smear examination and culture of urethral discharge were found to be 100% when compared to culture for N. gonorrhoeae. Direct fluorescent antibody (DFA) test proved to be a valuable test aiding in the diagnosis of chlamydial urethritis with a majority of positive cases showing 20–30 elementary bodies. We detected our first gonococcal isolate with decreased susceptibility to third-generation cephalosporins, ceftriaxone, cefixime, and cefpodoxime (MIC for ceftriaxone = 0.19 μg/ml). Conclusions: Optimal management of urethritis and strategies to prevent its transmission depend on accurate detection of infected persons. Our study demonstrates the utility and limitations of different laboratory tests including anti-microbial sensitivity testing for N. gonorrhoeae and C. trachomatis. [ABSTRACT FROM AUTHOR]

Reiter's syndrome includes: urethritis, arthritis and conjunctivitis. Affecting the joint apparatus is preceded by urethritis or diarrhea. Skin-mucosal involvement is observed in about 10% of cases. We present five patients (male, active athletes, aged 25 to 29 years), all with asymmetric oligoarthritis within 20 days of past urethral inflammation. In 5 patients, the urethritis was the result of casual sexual contact without a condom, and they all self-medicated without visiting a doctor. Between 10--14 day of the onset of arthritis, a reddish rash on the palms and soles began to develop, subsequently the rashes became painful plaques, and all patients had conjunctivitis. The appearance of a rash forced patients to contact the general practitioner. Tests performed revealed positive antibodies against Chlamydia trachomatis (IgA and IgG), HLA-B27 positive, HIV negative, syphilis negative and elevated CRP (C-reactive protein). In one of the patients, permanent changes in the knee joint were observed, due to which he stopped actively playing sports. It is important to explain to all patients that self-medication and neglect of diseases can lead to lasting consequences for the body. The role of the general practitioner is to keep this rare syndrome in mind when running laboratory tests. [ABSTRACT FROM AUTHOR]

The article describes the case of a 14-year old boy with gross hematuria. It refers to blood sports on underwear after urination and urine discoloration as additional complementary findings on exam for terminal hematuria. It identifies differential diagnosis of terminal hematuria including infections, disorders in the posterior urethra, bladder neck or trigone area, as well as causes of terminal hematuria. Treatment options for gross hematuria include oral antihistamine and optical steroids.

Background Cross-protective immunity between Neisseria meningitidis (Nm) and Neisseria gonorrhoeae (Ng) may inform gonococcal vaccine development. Meningococcal serogroup B (MenB) outer membrane vesicle (OMV) vaccines confer modest protection against gonorrhea. However, whether urethral Nm infection protects against gonorrhea is unknown. We examined gonorrhea risk among men with US Nm urethritis clade (US_NmUC) infections. Methods We conducted a retrospective cohort study of men with urethral US_NmUC (n = 128) between January 2015 and April 2018. Using diagnosis date as the baseline visit, we examined Ng status at return visits to compute urethral Ng risk. We compared these data to 3 referent populations: men with urethral Ng (n = 253), urethral chlamydia (Ct) (n = 251), and no urethral Ng or Ct (n = 255). We conducted sensitivity analyses to assess varied approaches to censoring, missing data, and anatomical site of infection. We also compared sequences of protein antigens in the OMV-based MenB-4C vaccine, US_NmUC, and Ng. Results Participants were primarily Black (65%) and heterosexual (82%). Over follow-up, 91 men acquired urethral Ng. Men with urethral US_NmUC had similar Ng risk to men with prior urethral Ng (adjusted hazard ratio [aHR]: 1.27; 95% CI:.65–2.48). Men with urethral US_NmUC had nonsignificantly increased Ng risk compared with men with urethral Ct (aHR: 1.51; 95% CI:.79–2.88), and significantly increased Ng risk compared with men without urethral Ng or Ct (aHR: 3.55; 95% CI: 1.27–9.91). Most of the protein antigens analyzed shared high sequence similarity. Conclusions Urethral US_NmUC infection did not protect against gonorrhea despite substantial sequence similarities in shared protein antigens. [ABSTRACT FROM AUTHOR]

Background: Chlamydia trachomatis (CT) is the agent of the most common bacterial sexually transmitted infection worldwide. Until now, little information is available about the microbial composition of urine samples during CT urethritis. Therefore, in this study, we characterized the microbiome and metabolome profiles of first-void urines in a cohort of women with CT urethral infection attending an STI clinic. Methods: Based on CT positivity by nucleic acid amplification techniques on urine samples, the enrolled women were divided into two groups, i.e., "CT-negative" (n = 21) and "CT-positive" (n = 11). Urine samples were employed for (i) the microbiome profile analysis by means of 16s rRNA gene sequencing and (ii) the metabolome analysis by 1H-NMR. Results: Irrespective of CT infection, the microbiome of first-void urines was mainly dominated by Lactobacillus, L. iners and L. crispatus being the most represented species. CT-positive samples were characterized by reduced microbial biodiversity compared to the controls. Moreover, a significant reduction of the Mycoplasmataceae family—in particular, of the Ureaplasma parvum species—was observed during CT infection. The Chlamydia genus was positively correlated with urine hippurate and lactulose. Conclusions: These data can help elucidate the pathogenesis of chlamydial urogenital infections, as well as to set up innovative diagnostic and therapeutic approaches. [ABSTRACT FROM AUTHOR]

To investigate the incidence, clinical manifestations, and treatments of gonococcal tysonitis in men. We enrolled men with gonococcal tysonitis and men with gonococcal urethritis from January 2000 to December 2020. Demographic data, interval from non-marital sexual contact to the onset of symptoms of gonococcal tysonitis, occurrence sites, and manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with sinus-like lesions. Incision and drainage were performed in patients with non-ruptured abscesses. Fifteen patients with gonococcal tysonitis (0.29%; 95% confidence interval: 0.15–0.44%) were observed among 5087 patients with gonococcal urethritis. The mean age was 38.64 years (range, 17–74 years). The mean gonococcal tysonitis incubation period was 6.02 ± 1.37 days (range, 2–11 days). Lesions were present in the right side of the preputial frenulum in seven patients (46.67%), in the left side of the preputial frenulum in six patients (40%), and in both sides of preputial frenulum in two patients (13.33%). The lesions manifested as abscesses in 7 patients (46.67%), nodules in six patients (40%), and sinus-like lesions in two patients (13.33%); all lesions exhibited tenderness. All 15 patients were cured after treatment. Gonococcal tysonitis is a rare local complication of gonorrhea. Gonococcal urethritis with concurrent gonococcal tysonitis was less common than gonococcal urethritis with concurrent paraurethral gonococcal infection or gonococcal urethritis with concurrent gonococcal epididymitis. Gonococcal tysonitis lesions manifest as abscesses, nodules, and sinus-like lesions. Treatment with ceftriaxone is effective for gonococcal tysonitis. [ABSTRACT FROM AUTHOR]

This study evaluated the effectiveness of the A.F. Genital System (Liofilchem®, Italy) in detecting pathogens compared with multiplex real‐time polymerase chain reaction (PCR) in men with acute urethritis. Men diagnosed as having acute urethritis between 1 April 2021 and 31 December 2021 were included. Urethral swab samples were obtained for A.F. Genital System and PCR testing in a randomly determined order. The efficacy of the A.F. Genital System was analysed by comparing the results of the two tests. The study included 83 patients (mean age 34.1 ± 11.3 years). A urethritis pathogen was detected in 69 patients (83.1%) by PCR and only 15 patients (18.1%) with the A.F. Genital System. The sensitivity of the A.F. Genital System in detecting acute urethritis pathogens was 21.7% (95% confidence interval [CI]: 13.6–32.8), and the specificity was 100% (95% CI: 78.5–100). Its sensitivity was 20% (95% CI: 7.1–45.2) in the diagnosis of gonococcal urethritis and 19.1% (95% CI: 11.2–30.4) in the diagnosis of non‐gonococcal urethritis. PCR detected two or more urethritis pathogens in 9 patients (13.0%), while no polymicrobial infection was detected with the A.F. Genital System. Based on the results of multiplex real‐time PCR, the A.F. Genital System had very low sensitivity in the detection of pathogens in acute male urethritis. It should be kept in mind that using this test in patients with acute urethritis may result in a high missed diagnosis rate for urethritis pathogens. [ABSTRACT FROM AUTHOR]

Design: A descriptive cross-sectional study. Aim: The current study aims to assess the knowledge, attitude and practice of urinary tract infection among female in Aseer region. Methods: A descriptive cross-sectional study was conducted targeting all women in Aseer region aging 18 years or more. All accessible women in general population were invited to fill the uploaded questionnaire consecutively during the period from April-2021 to October 2021 The questionnaire included women personal data, women knowledge of UTI, attitude and perception and practice regarding UTI. Questionnaire was uploaded online using social media platforms by the researchers and their relatives and friends. Results: A total of 855 females fulfilling the inclusion criteria completed the study questionnaire. Female ages ranged from 18 to more than 40 years with mean age of 31.6 ± 9.7 years old. Exact of 615 71.9% females were married and 205 24% were single. Exact of 80.5% of the study participants know what is UTI. A total of 14.6% defined UTI as inflammation of the balder, 9.9% defined it as inflammation of the urethra, and 74.3% defined as inflammation of bladder, kidney and urethra. As for causes of UTI, only 108 12.6% correctly reported for personal hygiene while 73.3% told about bacteria. A total of 569 66.5% participants reported experiencing UTI which was for only once per year among 58.3% of them, and for 2 times per year among 18.6%. Ad for symptoms experienced, 76.1% had pain in urination, 71.2% complained of abdominal pain, 56.6% had urge, 50.4% experienced frequent urination, while 41.5% had fever. Conclusion: The study revealed that nearly two out of each three women were knowledgeable regarding UTIs and about one out of each two showed good perception and attitude. Women practice regarding UTIs was also satisfactory especially for seeking for medical consultation and fluid intake. [ABSTRACT FROM AUTHOR]

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Objective: The purpose of this review was to summarize the current literature on the assessment and treatment of radiation urethritis and cystitis (RUC) for the development of an evidenced-based management algorithm. Material and Methods: The PubMed/MEDLINE database was searched by a multidisciplinary group of experts in January 2021. Results: In total, 48 publications were identified. Three different types of RUC can be observed in clinical practice: inflammation-predominant, bleeding-predominant, and the combination of inflammation- and bleeding-RUC. There is no consensus on the optimal treatment of RUC. Inflammation-predominant RUC should be treated symptomatically based on the existence of bothersome storage or voiding lower urinary tract symptom as well as on pain. When bleeding-predominant RUC has occurred, hydration and hyperbaric oxygen therapy (HOT) should be used first and, if HOT is not available, oral drugs instead (sodium pentosane polysulfate, aminocaproic acid, immunokine WF 10, conjugated estrogene, or pentoxifylline + vitamin E). If local bleeding persists, focal therapy of bleeding vessels with a laser or electrocoagulation is indicated. In case of generalized bleeding, intravesical installation should be initiated (formalin, aluminium salts, and hyaluronic acid/chondroitin). Vessel embolization is a less invasive treatment with potentially less complications and good clinical outcomes. Open- or robot-assisted surgery is indicated in patients with permanent, life-threatening bleeding, or fistulae. Conclusions: Treatment of RUC, if not self-limiting, should be done according to the type of RUC and in a stepwise approach. Conservative/medical treatment (oral and topic agents) should primarily be used before invasive (transurethral) treatments. [ABSTRACT FROM AUTHOR]

Copyright of Bezmialem Science is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Design: A descriptive cross-sectional study. Aim: The current study aims to assess the knowledge, attitude and practice of urinary tract infection among female in Aseer region. Methods: A descriptive cross-sectional study was conducted targeting all women in Aseer region aging 18 years or more. All accessible women in general population were invited to fill the uploaded questionnaire consecutively during the period from April-2021 to October 2021 The questionnaire included women personal data, women knowledge of UTI, attitude and perception and practice regarding UTI. Questionnaire was uploaded online using social media platforms by the researchers and their relatives and friends. Results: A total of 855 females fulfilling the inclusion criteria completed the study questionnaire. Female ages ranged from 18 to more than 40 years with mean age of 31.6 ± 9.7 years old. Exact of 615 71.9% females were married and 205 24% were single. Exact of 80.5% of the study participants know what is UTI. A total of 14.6% defined UTI as inflammation of the balder, 9.9% defined it as inflammation of the urethra, and 74.3% defined as inflammation of bladder, kidney and urethra. As for causes of UTI, only 108 12.6% correctly reported for personal hygiene while 73.3% told about bacteria. A total of 569 66.5% participants reported experiencing UTI which was for only once per year among 58.3% of them, and for 2 times per year among 18.6%. Ad for symptoms experienced, 76.1% had pain in urination, 71.2% complained of abdominal pain, 56.6% had urge, 50.4% experienced frequent urination, while 41.5% had fever. Conclusion: The study revealed that nearly two out of each three women were knowledgeable regarding UTIs and about one out of each two showed good perception and attitude. Women practice regarding UTIs was also satisfactory especially for seeking for medical consultation and fluid intake. [ABSTRACT FROM AUTHOR]