Results of Multiplex Polymerase Chain Reaction Assay to Identify Urethritis Pathogens

Objective: The purpose of this study was to evaluate the results of multiplex polymerase chain reaction (PCR) test applied to identify the pathogens in male patients who attended our urology clinic with a pre-diagnosis of urethritis related with sexual intercourse. Materials and Methods: In this study, we included a total of 91 male patients, who sought medical advice in our clinic between August 2015 and October 2016 due to complaints of urethral discharge, dysuria and urethral itching, having a visible urethral discharge during the physical examination or a positive leukocyte esterase test (Combur-Test®-Roche) in the first urine sample. In the urethral swab samples of these patients, urethritis pathogens were searched with a multiplex PCR test. The multiplex PCR kit, which is able to identify nine pathogens and produced by PathoFinder® (Holland), was used in the process. The pathogens that could be detected by the kit were Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Gardnerella vaginalis, Trichomonas vaginalis, Treponema pallidum, and Candida albicans. Results: The average age of the subjects was 35.1 (19-57) years. Sixty one out of 91 patients (67%) were found to have a pathogen in the urethral swab sample. In 45 patients (49.4%), only one pathogen, in 12 (13.1%) - two different pathogens and in 4 (4.3%) patients, 3 different pathogens were detected. The pathogens found were as follows: Ureaplasma urealyticum in 22 patients (27.1%), Gardnerella vaginalis in 15 (18.6%), Neisseria gonorrhoeae in 13 (16.1%), Mycoplasma genitalium (10 patients; 12.3%), Mycoplasma hominis (8 patients; 9.9%), Chlamydia trachomatis (8 patients; 9.9%), Trichomonas vaginalis (3 patients; 3.8%), and Candida albicans (2 patients; 2.4%). None of the patients were identified with Treponema pallidum. None of the pathogens were identified in 30 patients (32.9%) whose samples were examined by PCR method. Conclusion: Sexually transmitted pathogens that are quite difficult to identify and that cause urethritis are possibly defined with only one swab sample in a short time using multiplex PCR method providing new possibilities and scopes for the diagnosis

Evaluating the utility of the A.F. genital system test for pathogen diagnosis in acute male urethritis

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.No sponso

Comparison of spermiograms of infertile men before and during the COVID-19 pandemic

This was a clinical study investigating the possible relationship between covid 19 infection and spermiogram in male populationObjective: Since the start of the COVID-19 pandemic, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented for infertility during the pandemic compared with the previous 2 years. Methods: Patients who presented to a urology outpatient clinic for the first time due to infertility were included. The patients' age, semen volume, and spermiogram results were recorded. Based on the presentation date, the patients were divided into prepandemic group 1 (March 2018-February 2019), prepandemic group 2 (March 2019-February 2020), and pandemic group (March 2020-February 2021) for comparison. Results: A total of 594 patients were included. There was no significant difference between the three groups in terms of the number of patients who presented for infertility (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in the prepandemic group 1, 35.5±7.1 in the prepandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There were no differences between the groups in terms of semen volume (p=0.910) or rates of normospermia and pathological spermiogram findings (p=0.222). Conclusions: In the first year of the COVID-19 pandemic, there was no significant difference in the number of patients who presented for infertility or in their spermiogram results compared with 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous 2 years.No sponso