Mycoplasmas recovered from patients with urethritis

Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum

Chlamydia trachomatis, Ureaplasma urealyticum (T-mycoplasma), and Hemophilus vaginalis have previously been considered possible etiological agents in nongonococcal urethritis (NGU). In this study, current C. trachomatis infection was confirmed by culture and (or) micro-immunofluorescence serology in 26 of 69 men experiencing afirst episode of NGU, and 1 of 39 with no urethritis. Serum IgM immunofluorescent antibody to chlamydia was demonstrated in 16 of 20 men with chlamydia culture positive NGU, and 3 of 39 with chlamydia culture negative NG, and none of 34 with no urethritis. 9 of 10 culture positive men with less than or equal to 10 days symptoms developed immunofluorescent antibody seroconversion in paired sera. U. realyticum was isolated significantly more often and in significantly higher concentration from first voided urine from chlamydia-negative cases of NGU than from chlamydia-positive NGU. Ureaplasmacidal antibody titers increased fourfold in six men, four of whom had negative cultures for for unreaplasma. H. vaginalis was isolated from c9 of 33 men with no urethritis and 2 of 69 with NGU. C. trachomatis is susceptible, and U. urealyticum is resistant to sulfonamides. A 10-day course of sulfisoxazole therapy produced improvement in 13 of 13 chlamydia-positive, unreaplasma-negative, and only 14 of 29 chlamydia-negative, unreaplasma-positive NGU cases (P less than 0.002). Thus, culture, serology, and response to therapy support the etiologic role of chlamydia in NGU. Quantitative culture and response to therapy suggest U. unrealyticum may cause many cases of chlamydia-netative NGU.

Non-specific urethritis and the tetracyclines

The possible aetiological factors in non-gonococcal and non-specific urethritis are reviewed. The response of NSU to various courses of different tetracycline drugs is assessed. Prolonged courses of treatment did not give better results than shorter courses. When reviewing the infective aetiology of non-gonococcal urethritis, it was noted that more than one organism (or potential pathogen) would be present in many cases. It is therefore surmised that there may be at times a mixed aetiology and at other times a truly non-specific aetiology. Isolations by different workers have indicated that the following organisms might be expected: Chlamydia 40 per cent.; Mycoplasma-M. hominis 20 per cent., T-strain over 60 per cent.; Trichomonas 15 per cent.; Candida possibly over 5 per cent. Truly non-specific urethritis may account for 25 to 30 per cent. of cases.