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Introduction: Sexually transmitted infections (STIs) are on the rise globally, yet accurate data regarding infection rates remain scarce. There is the assumption that STIs among women with chronic urinary tract infections (UTIs) have been underestimated. This may arise from the reliance on specialised cultivation or nucleic acid amplification techniques for detection, which are more costly than standard urine culture and are typically only conducted by specialists like urologists. Methods: A retrospective, observational, single-centre study using medical records of patients who received a urethral swab in a German urological practice in the past 5 years has been conducted. Results: 55% of patients had a STI requiring treatment. People with recurrent UTIs had a STI in 35% of the cases. Younger age is associated with the detection of STIs. The female gender is significantly associated with a positive swab result. Conclusion: Distinguishing between cystitis and urethritis, particularly in women with recurrent UTIs experiencing dysuria, presents a clinical challenge. The prevalence of asymptomatic infections suggests that the true burden of urethritis, particularly STIs, may be substantially higher in the general population than currently reported. This underscores the urgency of establishing guidelines for referral and diagnostic evaluation as delayed or inadequate treatment may contribute to escalating infection rates and antibiotic resistance. [ABSTRACT FROM AUTHOR]

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]

Research shows that microbial resistance to antibacterial drugs continues to increase, highlighting the need to find new strategies to combat infections. In this context, previously used antibacterial drugs such as doxycycline have begun to attract renewed attention from the medical community. In addition, recent studies are revealing new properties of this drug that may expand its role in clinical practice, opening up new prospects for use. The review describes the place of doxycycline in the treatment of sexually transmitted infections, presents treatment regimens for urethritis, pelvic inflammatory diseases, as well as the non-antimicrobial properties of the drug.

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]

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.

Background: Mycoplasma genitalium is an emerging pathogen, which has been linked to cervicitis, urethritis and pelvic inflammatory disease (PID). With the advent of multiplex polymerase chain reaction (PCR) panels for sexually transmitted infections, it is increasingly being identified in pregnant women. Objectives: The aim was to review international guidelines, which had explicit recommendations for treatment of M. genitalium infection in pregnancy and breastfeeding. Search Strategy: PubMed, EMBASE and Cochrane databases were reviewed with no age, species, language or date restrictions. Selection Criteria: Studies were included if they had an explicit recommendation for treatment of M. genitalium in pregnancy. Studies were excluded if there was no recommendation in pregnancy, if they referred to other international guideline recommendations or were historical versions of guidelines. Data Collection and Analysis: References were manually reviewed and 50 papers were selected for review. Only four guidelines were included in the final analysis and they were from Europe, UK, Australia and Aotearoa New Zealand. Main Results: All studies recommended azithromycin as first‐line treatment, and advised against moxifloxacin use. The dosing schedule of azithromycin, varied between guidelines, as did the utility/safety of pristinamycin for macrolide resistant infections. Safety data was generally reassuring for azithromycin but inconsistent for pristinamycin. Conclusions: Azithromycin is the first‐line treatment for macrolide susceptible or unknown resistance infections, but there is a lack of consistency regarding dosing of azithromycin or the utility/safety of pristinamycin for macrolide resistant infections in pregnancy/lactation. Synopsis: While international guidelines recommend azithromycin as first‐line treatment for M. genitalium infections in pregnancy, there are inconsistencies around second‐line treatment options and azithromycin dosing. [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]

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]

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]

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]

Introduction: Mycoplasma genitalium is a bacterium associated with sexually transmitted infections that can cause urethritis in men and complications in women, including preterm birth. Increasing macrolide resistance in M. genitalium poses challenges to treatment efficacy. Objective: To present a case of treatment failure of urethritis caused by macrolide-resistant M. genitalium. Case report: This case report describes a 20-year-old man with persistent urethral symptoms despite azithromycin treatment, wherein M. genitalium harbored the A2058G mutation in the 23S rRNA. Subsequent treatment with moxifloxacin resolved symptoms and cleared M. genitalium. Conclusion: The study highlights the importance of resistance testing to guide antimicrobial therapy and emphasizes the need for updated treatment guidelines in Brazil.

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]

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]

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Objective: Urethritis is a common sexually transmitted disease (STD) in developing countries; however, up to 40% of cases have no determined etiology. The characteristics of STDs vary geographically. This study aimed to define the demographic, clinical, and microbiological features of men with urethritis in Cyprus, where current data in the literature are lacking. Methods: We included 138 patients who sought care at a university hospital in Cyprus from 2017 to 2021 and had symptoms suggestive of urethritis or a history of a recent sexual partner with STD. Urethral swab samples of the patients were tested for seven pathogens (Trichomonas vaginalis, Neisseria gonorrhoeae (N. gonorrhoeae), Chlamydia trachomatis (C. trachomatis), Ureaplasma urealyticum (U. urealyticum), Ureaplasma parvum (U. parvum), Mycoplasma genitalium (M. genitalium), Mycoplasma hominis (M. hominis) by multiplex polymerase chain reaction assay. In addition, demographic, clinical, and microbiological data were obtained from the hospital program and analyzed. Results: Pathogens were detected in 59.4% of the cases: U. urealyticum in 26.8%, C. trachomatis in 13%, N. gonorrhoeae in 9.4%, U. parvum in 10.1%, M. genitalium in 10.1%, and M. hominis in 10.9%, with multiple microorganisms detected in 18.1%. Overall, 80.4% of the cases were symptomatic at presentation, and pathogen detection was associated with a history of STD, multiple sexual partners, and unprotected sexual intercourse. Conclusions: Urethritis is a common and heterogeneous clinical condition. U. urealyticum dominates male urethritis in Cyprus, yet many individuals have no detectable microorganisms. Future studies should focus on developing more comprehensive quantitative molecular diagnostic methods with determined cycle threshold values to shed light on the pathogenic roles of commensal microorganisms.

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.

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]

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.

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]

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]

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]

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(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 gonorrhoeae is one of the important pathogens of sexually transmitted infections. N. gonorrhoeae is rapidly becoming antimicrobial resistant, and there are few drugs that are effective in the initial treatment of gonorrhea. To understand the trends of antimicrobial susceptibility of N. gonorrhoeae , the Surveillance Committee of the Japanese Society of Infectious Diseases, the Japanese Society for Chemotherapy, and the Japanese Society of Clinical Microbiology conducted the third nationwide antimicrobial susceptibility surveillance of N. gonorrhoeae isolated from male urethritis. The specimens were collected from male patients with urethritis at 30 facilities from May 2016 to July 2017. From the 159 specimens collected, 87 N. gonorrhoeae strains were isolated, and 85 were tested for susceptibility to 21 antimicrobial agents. All strains were non-susceptible to penicillin G. Seven strains (8.2%) were β-lactamase-producing strains. The rates of susceptibility to cefixime and cefpodoxime were 96.5% and 52.9%, respectively. Three strains were non-susceptible with a minimum inhibitory concentration (MIC) of 0.5 mg/L for cefixime. None of the strains were resistant to ceftriaxone or spectinomycin. The susceptibility rate for ciprofloxacin was 23.5% (20 strains), and no strains showed intermediate susceptibility. The susceptibility rate against azithromycin was 81.2%, with one strain isolated with a MIC of 8 mg/L against azithromycin. The results of this surveillance indicate that ceftriaxone and spectinomycin, which are currently recommended for gonococcal infections in Japan, appear to be effective. It will be necessary to further expand the scale of the next surveillance to understand the current status of drug-resistant N. gonorrhoeae in Japan. [ABSTRACT FROM AUTHOR]

Vulvitis is one of the most common disorders with which people come to visit obstetrician-gynecologist. nonspecific bacterial, atopic, infectious vulvitis and vulvitis associated with helminthiasis are most often found in girls under the age of 3 years. Hyperemic mucous membrane of the external genitalia, pain, burning, itching while urinating and at rest are specific clinical features of the disorder; abnormal genital discharge of various types can be also found. Vulvitis often comes along with perineal and perianal dermatitis. Labial fusion and urinary tract infections are common complications of nonspecific inflammation. obstetricians-gynecologists are recommended to conduct diagnosis, treatment, rehabilitation and further follow-up of such girls in cooperation with other related experts, involve pediatric urologist, gastroenterologist, pediatrician; if necessary – dermatovenerologist, enT physician, dentist, infectious disease specialist.

Reactive arthritis (ReA), previously known as Reiter syndrome, belongs to a group of related arthropathies classified as spondyloarthritis. The classical triad of ReA consisted of arthritis, urethritis, and conjunctivitis. However, the triad is not typically present in all patients. The diagnosis criteria of ReA in Indonesia are based on the 1999 American College of Rheumatology guidelines. The disease is relatively rare and can be easily overlooked if clinical suspicion is not high on presentation. However, it is an easily manageable disease. We present a case of ReA in adult male who manifested arthritis and urethritis with a history of previous gastrointestinal infection. Advanced laboratory examination could not be conducted. After receiving treatment, the patient’s condition had improved considerably.

Diagnosing and managing lower urinary tract infections (UTIs) in women aged 65 years and over is important to ensure their health and wellbeing. This article explores how to diagnose lower UTI, considering alternative diagnoses especially in older adults, as their symptoms may mimic UTI but may indicate other underlying conditions. It also looks at how to manage and treat uncomplicated lower UTI and provides guidance on recurrent UTI, usually denned as three or more episodes in a year. [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]

Objective To explore the microbial etiology of urethritis in Vietnamese men and the association with patients’ characteristics, especially their sexual behaviors. Methods 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. Results 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. Conclusions 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.

Ying Liu, Jia He, Jingjing Jiang, Yujuan Wang, Ting Liu Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, Nanchong, People’s Republic of ChinaCorrespondence: Ting Liu, Department of Dermatology, Affiliated Hospital of North Sichuan Medical College, No. 1 Maoyuan South Road, Shunqing District, Nanchong, Sichuan Province, 637000, People’s Republic of China, Tel +8615082780013, Email 332656467@qq.comAbstract: 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.Keywords: reactive arthritis, Reiter syndrome, ankylosing spondylitis, urethritis, arthritis, uveitis, HLA-B27

Mycoplasma genitalium (MG) is a bacterium that can be spread through sexual contact with another person who is infected. If misdiagnosed and left untreated, this newer, emerging sexually transmitted infection (STI) can cause complications such as urethritis and pelvic inflammatory disease (PID) in bothmen andwomen. In males, MGcan be asymptomatic and undetectable. In females, MGmay present with nonspecific symptoms, such as dysuria, vaginal discharge, and/or pelvic pain. In addition to chlamydia and gonorrhea, MG may result in PID. Due to the complications of MG, health care providers in the emergency department setting need to consider this as a differential diagnosis when performing STI and vaginitis screenings on sexually active patients who may present with urinary or vaginal complaints. As patients with pelvic pain are frequently seen in the emergency department, providers need to be aware of the role that MG may play in STIs and the subsequent sequelae if not treated properly. [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]

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]

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]

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]

Aim: Mycoplasma hominis and Ureaplasma urealyticum species, which are the most frequently isolated microorganisms from the urogenital system, are thought to cause urogenital diseases (urethritis, cervicitis, cystitis, bacterial vaginosis). The prevalence of these microorganisms, which are often isolated from the genital tract of sexually active women, differs between studies. In addition, the antibiotic susceptibility of these microorganisms also shows regional variations. In this study, it was aimed to determine the frequency of genital U. urealyticum and M. hominis, distribution by gender, and antibiotic resistance profile in patients with pre-diagnosis of urethritis and vaginitis. Material and Method: This study is a retrospective observational study. Data were obtained retrospectively from hospital records. In the study, genital samples studied in the microbiology laboratory of a private hospital in Antalya for a period of three years between January 2017 and December 2019 were evaluated. Samples were taken into tubes that containing transport medium with sterile swabs. The presence of M. hominis and U. urealyticum was investigated using the AF Genital System (Liofilchem, Italy) (http://www.liofilchem.net/login/pd/ifu/74156_IFU.pdf) kit. Doxycycline, ofloxacin, erythromycin, tetracycline, clarithromycin, and clindamycin susceptibilities of the agents were determined in the samples which growth observed. Sowing of the swab samples taken from the patients was done in accordance with the manufacturer's recommendations. The strips were incubated at 37°C for 24–48 hours. At the end of the incubation, the results were evaluated according to the color changes. Results: A total of 245 patients, 147 (60%) men, with a mean age of 31±10.22 years, were included in the study. Of the 245 genital sample material cultures sent, only M. hominis was isolated in 55 (22.4%), only U. urealyticum was isolated in 27 (11.02%), and both bacteria were isolated in 87 (35.5%). Antibiotics with the highest susceptibility rates of the studied strains were which, for M. hominis doxycycline (83.1%), clindamycin (69.7%), tetracycline (61.9%) while for U. urealyticum was doxycycline (79.8%), clindamycin (71%), and tetracycline (65.7%). In the evaluation of factors according to gender, the rate of cultural positivity was statistically higher in women (p

Resumen: Actualmente las infecciones de transmisión sexual (ITS) son un problema de salud pública importante debido a su elevada prevalencia y a que precisan de un diagnóstico y un tratamiento precoces para evitar complicaciones.En los últimos años se está observando un aumento exponencial de los casos de infecciones causadas por Chlamydia trachomatis y gonococo en población menor de 25 años. También se ha detectado un aumento de la incidencia de sífilis y de hepatitis C (VHC), sobre todo en hombres que tienen sexo con hombres (HSH).El herpes genital sigue siendo la segunda ITS más frecuente en el mundo, por detrás del condiloma acuminado, y la primera causa de úlcera genital en España en la población sexualmente activa.Durante el año 2020 se observó un descenso de los casos notificados de VIH, pero casi la mitad de estos nuevos casos presentaban un diagnóstico tardío (

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]

Sexually transmitted infections (STIs) are a global health problem. The STI Committee of the Colombian Infectious Diseases Association (ACIN) developed this document aimed primarily at medical professionals at different levels of healthcare throughout Colombia, with the objective of providing clear and concrete recommendations for a timely diagnosis and treatment of patients with STIs and their contacts. These protocols were designed based on the available scientific evidence and existing guidelines prepared by national and international scientific societies and government groups. The most common STIs were classified into the following sections: urethritis, genital ulcer, vaginal discharge with infectious etiology, proctitis, cervicitis, hepatitis B, and high-risk human papillomavirus. For each protocol, we present the definition, etiology, conditions for collecting clinical samples, diagnostic tests by etiological agent and level of care, and treatment by etiological agent.

The article focuses on the diverse challenges and responsibilities in general practice through case-based insights and expert reviews. Topics include evolving medical professionalism and patient trust, managing common conditions like depression and pre-eclampsia, and addressing diagnostic complexities in areas such as renal disease and urethritis in men.

Resumen: Objetivo: Describir los cambios en el comportamiento de las ITS durante la situación de alerta sanitaria por la pandemia SARS-CoV-2. Material y métodos: Se recogieron datos demográficos, cronológicos y clínicos de todos los pacientes que solicitaron atención médica por ITS en los hospitales La Paz y Costa del Sol, y en los Centros Sandoval y de Diagnóstico Médico, entre el 14/03/2020 y el 30/06/2020. Resultados: Documentamos 674 casos de ITS. La mediana de edad fue de 33 años. El mayor porcentaje de casos se dio en el rango de 30-40 años y en hombres que tenían sexo con hombres. Los diagnósticos más frecuentes fueron: proctitis (36,5%), sífilis (16%), uretritis no gonocócica (13,3%) y gonocócica (11,3%), herpes genital (8,8%), vulvovaginitis/cervicitis (8,3%) y condilomas (4,2%). En el 77% de los casos hubo confirmación microbiológica, siendo los microorganismos más frecuentes Chlamydia trachomatis (35,7%), Neisseria gonorrhoeae (31,4%) y Treponema pallidum (17,2%). Se constató un incremento del número de casos de ITS tras el desconfinamiento, explicable por las mayores libertades y el aumento de consultas. Comparando los registros de ITS del Centro Sandoval y del Hospital La Paz en los cuatrimestres de marzo a junio de 2019 frente a 2020, se observó una disminución en 2020 de todos los diagnósticos, de hasta el 81% menos que en 2019. Conclusiones: Las medidas de distanciamiento y limitación de movilidad aparentemente generaron una disminución de la incidencia de ITS, pero sin llegar a una inhibición completa de las conductas sexuales de riesgo. Abstract: Objective: To describe changes in sexually transmitted infection (STI) diagnoses during the first wave of the COVID-19 pandemic in Spain. Material and methods: We collected demographic, chronological, and clinical data for all patients seen for a possible STI at Hospital La Paz, Centro Sanitario Sandoval, and Centro de Diagnóstico Médico in Madrid and Hospital Costa del Sol in Malaga between March 14, 2020 and June 30, 2020. Results: We identified 674 STI diagnoses. The median age of the patients was 33 years. Most cases were observed among people aged 30 to 40 years and among men who have sex with men. The most common diagnoses were proctitis (36.5%), syphilis (16%), nongonococcal (13.3%) and gonococcal (11.3%) urethritis, genital herpes (8.8%), vulvovaginitis/cervicitis (8.3%), and genital warts (4.2%). A microbiologically confirmed diagnosis was on record for 77% of cases. The main microorganisms identified were Chlamydia trachomatis (35.7%), Neisseria gonorrhoeae (31.4%) and Treponema pallidum (17.2%). The number of STI diagnoses increased after the easing of lockdown restrictions, which resulted in greater freedom of movement and more consultations. On comparing the 2019 and 2020 STI registries from Centro Sanitario Sandoval and Hospital La Paz for the period March to June, we observed reductions (of up to 81%) in all STI diagnoses. Conclusions: Physical distancing and movement restrictions appear to have resulted in a reduction in the incidence of STIs, although these measures did not completely eliminate sexual risk behaviors.

Objective:Sexually transmitted diseases are one of the most important health issues that cause economic and social problems. Urethritis is one of the most common clinical manifestations. Patients who are especially asemptomatically infected with resistant microorganisms continue to infect others; thus, surveillance is important. Our study retrospectively evaluated urethritis cases in males over 10 years for causative agents and their antibiotic susceptibilities.Methods:This study included 748 male patients with urethritis. Urethral discharge swab and ejaculation samples were examined for isolation and antibiotic susceptibilities of N. gonorrhoeae (Biomerieux, France), M. hominis, and U. urealyticum (Mycoplasma IES, Autobio). Additionally, rapid chromatographic immunoassay (Ultimed) was used for C. trachomatis antigen detection.Results:Of 748 patients, 166 (22.2%) were positive for at least one microorganism, whereas 28 showed a mixed infection. The most prevalent microorganism was U. urealyticum (114 patients, 58.8%), followed by N. gonorrhoeae (43 patients, 21.6%), M. hominis (24 patients, 12.4%), and C. trachomatis (10 patients, 5.2%). Most of the N. gonorrhoeae strains were susceptible (92.3-100%) to cefuroxime, ceftriaxone, penicillin, levofloxacin, ciprofloxacin, and tetracycline. The great majority of U. urealyticum strains were resistant to clindamycin (89.6%) and ciprofloxacin (78.5%). M. hominis strains were resistant to erythromycin (100%), clarithromycin (90%), clindamycin (70%), and ciprofloxacin (43.8%).Conclusion:This study revealed that these microorganisms and their antibiotic resistance patterns remain a major public health concern for the last decade.

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]

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]

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]