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Acute nongonococcal urethritis (NGU) is one of the commonest sexually transmitted infections affecting men and women. The diagnosis of NGU has traditionally required microscopic evidence of urethritis. However, a significant proportion of patients with urethral symptoms do not have microscopic evidence of urethritis. The purpose of the present study was to evaluate the analytical performance of the UF1000i, a recently introduced fluorescence flow cytometer intended for urinalysis purposes which provides new analytical features that seem particularly suitable for microbiological diagnostics, for ruling out NGU or predicting the presence of infection. The Sysmex UF1000i is a flow cytometry analyzer capable of quantifying a lot of particles, including bacteria (BACT) and white blood cells (WBCs). To evaluate the analytical performance of the UF1000i as a method for ruling out NGU, we examined 200 urethral smear samples, collected in a new liquid transport medium (Copan), and compared the UF1000i results with standard culture/molecular and microscopic Gram stain results. With instrument cut-off values of 200 BACT x 10^6/L and 500 WBCs x 10^6/L, we obtained a sensitivity of 84%, a specificity of 82%, and a high negative predictive value (96%). Culture/molecular detection of pathogens remains the gold standard technique for the diagnosis of NGU. However, the Sysmex UF1000i is capable of improving the efficiency of NGU presumptive diagnosis, providing results in a few minutes, with a high negative predictive value and high values of sensitivity.

By using immunofluorescent technique the Authors have observed that high titer circulating antibodies reacting with membrane or cytoplasmic structures of T. vaginalis occur in the majority (42/45) of women presenting because of trichomonas vaginitis. Only exceptionally high titer antibodies have been detected in serum of male subjects affected by urethral trichomoniasis. Low titer antibodies are found in serum of noninfected subjects and are supposed to be induced by cross reacting flagellate group antigens. The contribution of these findings to a better understanding of the natural history of trichomoniasis is briefly discussed.

The authors relate serological inquires (micro-immunofluorescent assay), for valuing the specifical antibody response anti-Chlamydia trachomatis, in acute urethritis. In 53% of cases a immunological response was present and in 18% of the cases was high and significant. Medium title was 1:28. In normal people the medium title was 1:10, and antibodies to Chlamydia were present in 8% of cases. The authors point out the importance and utility of a correct operative protocol for an efficacious diagnosis and for a correct therapy.