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Introduction: Nongonococcal urethritis is the most common sexually transmitted infection in men, with vast majority of the etiological agents such as Chlamydia trachomatis, followed by urogenital mycoplasmas. The aim of this study was to determine the prevalence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis in nongonococcal urethritis in men, and to examine infections associated with these agents. Material and methods 299 sexually active, heterosexual men with nongonococcal urethritis were included into the study. Urethral samples were taken with a dacron swab placed into the urethra up to 2-3 cm. The Direct immunofluorescence technique was performed for identification of Chlamydia trachomatis. Ureaplasma urealyticum and Mycoplasma hominis were detected with Mycoplasma IST assay., Results: Chlamydia trachomatis was detected in 22.75%, Uraeplasma urealyticum in 21.08% and Mycoplasma hominis in 8.02% cases. We found no significant differences in prevalence between Chlamydia trachomatis and Ureaplasma urealyticym (p > 0.05). Monoinfections were found in 51.85% with significantly higher rate (p < 0.01) than associated infections (11.70%). Among associated infections, coinfection of Chlamydia trahomatis and Ureaplasma urealyticum was predominant. Association of Chlamydia trachomatis with urogenital mycoplasmas was significantly higher (p < 0.05) than the one between Ureaplasma urealyticum and Mycoplasma hominis. In 36.45% patients no patogenic microorganisms were detected., Conclusion: These results confirmed the etiological role of Chlamydia trachomatis and urogenital mycoplasmas in nongonococcal urethritis with prevalence of 51.85% in monoinfections and 11.70% in associated infections. In 36.45% of cases the etiology of urethritis was not elucidated. These results suggest that more sensitive diagnostic tool should be applied when searching for the derailed etiology of nongonococcal urethritis.

Chlamydia trachomatis is an ubiquitous bacterium, strictly intracellular organism. The D-K serovars urethritis, cervicitis, endometritis, salpingitis, periappendicitis and perihepatitis, in women, urethritis, prostatitis, epididymitis and Reiter's syndrome in 1-2% of cases in men. Sterility is the most serious complication in both sexes. Chlamydial infections are sexually transmitted diseases, often asymptomatic, prone to recurrences. Cure occurs only when both sexual partners are treated simultaneously. We treated 40 patients, 24 women and 16 men, from 1991-1994, who presented in nephrologic offices with symptoms of chlamydial urethritis. Detection of Chlamydia trachomatis was performed by direct fluorescent antibody stain. All patients had positive urethral swab, six women had chlamydial cervicitis too, one man had Reiter's syndrome, one man orchiepididymitis, and five men prostatitis. Optimal therapy for Chlamydia trachomatis infections consists of a 10-14 day regimen of quinolone, of tetracycline, and macrolides. We used sulfonamide rarely. Because of very serious sequelae of initial infection with Chlamydia trachomatis, every patient with urethritis should be examined by urethral swab for Chlamydia testing. Both partners should be examined and treated simultaneously.

We evaluated the direct immunofluorescence technique in the diagnosis of nongonococcal urethritis caused by Chlamydia trachomatis. Urethral swabs taken from 210 patients with urethritis were investigated by this method. The results were compared with the results obtained from the same patients by conventional method - cell culture. Of 210 patients with nongonococcal urethritis Chlamydia trachomatis was established in 114 (54.3%) cases by cell culture method and in 113 (53.8%) by direct imunofluorescence method. Compatibile results were found in 195 (92.8%) of cases. A good coorelation (Rxy = = 0.86) between the results obtained by the examined method and the referentain vas found. The direct immunofluorescence technique is a specific and sensitive method in the diagnosis of chlamydia urethritis. The direct immunofluorescence technique is an alternative diagnostic method of the harder and lengthy cell procedure. It is very important in routine clinical practice.