The Evaluation of Urethritis in Men Caused by Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis: Ten-year Retrospective Data from Turkey

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.