PURPOSE: Chlamydia trachomatis (C. trachomatis) is a well known cause of non-gonococcal urethritis (NGU). No other microorganism has been shown to cause any larger proportion of the remaining NGU cases. As a possible causative organism of NGU, we wanted to evaluate the detection rate of Mycoplasma genitalium (M. genitalium) and its role in NGU using polymerase chain reaction (PCR). MATERIALS AND METHDS: From June 1998 to July 2000, we examined a total of 116 men. Of these men 70 had symptoms and signs compatible with urethritis and 46 were for normal control. In the patient group, two urethral discharge or swab specimens were collected. One was used for Gram stain to detect Gram negative intracellular diplocci. The other was subjected to PCR for C. trachomatis and M. genitalium. In the control group, urethral swab specimen was used to detect C. trachomatis and M. genitalium by PCR based assay. RESULTS: Gonococcal urethritis (GU) was diagnosed in 14 cases (20.0%). Detection rates of M. genitalium and C. trachomatis in urethritis group were 8.6% (6/70), 18.6% (13/70). M. genitalium and C. trachomatis were detected in 7.1% (1/14), 14.3% (2/14) of GU and 8.9% (5/56), 19.6% (11/56) of NGU. Detection rate of M. genitalium in chlamydia-negative NGU was 11.1% (5/45). No patient positive for M. genitalium had a simultaneous chlamydia infection. In control group with no urethral symptom or sign, M. genitalium and C. trachomatis were not detected at all. Compared with chlamydia- positive NGU, M. genitalium-positive urethritis exhibited higher recurrence rate. CONCLUSIONS: M. genitalium was detected in 8.9% of NGU and 11.1% of non-chlamydia NGU. This study suggests that M. genitalium may be one of the causative organisms in NGU. Further studies will be necessary to define its role in NGU.
Chlamydia Infections ; Chlamydia trachomatis ; Humans ; Male ; Mycoplasma genitalium* ; Mycoplasma* ; Polymerase Chain Reaction ; Recurrence ; Urethritis*

Mycoplasma genitalium (MG) was first isolated by Tully from the urinary tract of the male patient with non-gonococcal urethritis (NGU) in 1981. MG is extremely difficult to be cultured and was rarely studied until the development and application of molecular biology technology. The research on MG in China is still in the primary stage. However, relevant studies abroad have found that it is an important pathogen causing human genitourinary tract infection and spreading worldwide. Male MG infection is reportedly related to NGU, prostatitis, epididymitis, balanoposthitis, male HIV infection, and male infertility. This review outlines the advances in the studies of MG in male urogenital diseases.
Balanitis ; microbiology ; China ; Epididymitis ; microbiology ; HIV Infections ; microbiology ; Humans ; Male ; Male Urogenital Diseases ; microbiology ; Mycoplasma Infections ; Mycoplasma genitalium ; Urethritis ; microbiology

This study aims to compare the prevalence of sexually transmitted infections (STIs) with semen quality in men from couples with primary and secondary infertility. Semen samples were collected from 133 men who requested fertility evaluation. Seminal tract infection with Ureaplasma spp. (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and herpes simplex virus-2 (HSV-2) was assessed by PCR-based diagnostic assays. Among all patients, the prevalence of STIs was higher in men from couples with primary infertility than that in men from couples with secondary infertility (39.7% vs 21.7%, P = 0.03). The prevalence of UU was 28.8% and 13.3% in men from couples with primary and secondary infertility, respectively. Men from couples with primary infertility were more likely to be positive for UU than men from couples with secondary infertility (P = 0.04). Regarding the UU subtype, the prevalence of Ureaplasma urealyticum (Uuu) and Ureaplasma parvum (Uup; including Uup1, Uup3, Uup6, and Uup14) did not differ between the two groups. No associations between the prevalence rates of MH, MG, and CT were found in men from either infertility group. A lower sperm concentration was associated with STI pathogen positivity in men with primary infertility according to the crude model (P = 0.04). The crude and adjusted models showed that semen volume (both P = 0.03) and semen leukocyte count (both P = 0.02) were independently associated with secondary infertility. These findings suggest the importance of classifying the type of infertility during routine diagnosis of seminal tract infections.
Female ; Humans ; Infertility, Male/epidemiology* ; Male ; Mycoplasma genitalium ; Mycoplasma hominis ; Prevalence ; Semen ; Semen Analysis ; Sexually Transmitted Diseases/epidemiology* ; Ureaplasma urealyticum

Objective: To analyze the relationship of Mycoplasma genitalium (MG) infection with routine semen parameters and sperm DNA integrity in male infertility patients. METHODS: Totally, 114 semen samples, 34 MG-positive and 80 MG-negative, were collected from male infertility patients and subjected to routine semen analysis with the computer-assisted sperm analysis system, Papanicolaou staining for observation of sperm morphology, and sperm chromatin diffusion (SCD) test for detection of sperm DNA integrity. Semen parameters and DNA integrity were compared between the MG-positive and MG-negative groups with SPSS 21.0 statistical software and the relationship between the semen parameters and DNA integrity analyzed by Pearson correlation analysis. RESULTS: The MG-positive samples, compared with the MG-negative ones, showed significantly decreased semen volume (［2.87 ± 0.37］ vs ［3.86 ± 0.43］ ml, P < 0.01), sperm concentration (［29.05 ± 6.17］ vs ［32.56 ± 5.97］ ×10⁶/ml, P < 0.01), and percentages of progressively motile sperm (PMS) (［15.86 ± 2.79］% vs ［23.65 ± 3.47］%, P < 0.01) and morphologically normal sperm (MNS) (［6.35 ± 2.06］% vs ［7.14 ± 1.89］%, P < 0.05), increased proportions of non-halo sperm (［15.02 ± 3.52］% vs ［9.72 ± 2.94］%, P <0.01) and small-halo sperm (［16.37 ± 5.26］% vs ［11.07 ± 1.65］%, P < 0.01) and sperm DNA fragmentation index (DFI) (［31.39 ± 3.16］% vs ［20.79 ± 3.59］%, P < 0.01), and reduced proportion of large-halo sperm (［54.75 ± 8.74］% vs ［64.15 ± 9.76］%, P < 0.01). DFI was negatively correlated with the percentages of PMS (r = －0.516, P < 0.05) and MNS (r = －0.429, P < 0.05) in the MG-positive group, but not correlated with any of the routine semen parameters in the MG-negative patients (P > 0.05). CONCLUSIONS MG infection may be an important factor affecting sperm quality in male infertility patients. Active prevention and treatment of MG infection can help prevent male infertility.
DNA Fragmentation ; Humans ; Infertility, Male/microbiology* ; Male ; Mycoplasma Infections/complications* ; Mycoplasma genitalium ; Semen ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa

OBJECTIVE: This study investigated the prevalence of infections with human papillomavirus, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, and Mycoplasma genitalium in the semen of Korean infertile couples and their associations with sperm quality. METHODS: Semen specimens were collected from 400 men who underwent a fertility evaluation. Infection with above five pathogens was assessed in each specimen. Sperm quality was compared in the pathogen-infected group and the non-infected group. RESULTS: The infection rates of human papillomavirus, C. trachomatis, U. urealyticum, M. hominis, and M. genitalium in the study subjects were 1.57%, 0.79%, 16.80%, 4.46%, and 1.31%, respectively. The rate of morphological normality in the U. urealyticum-infected group was significantly lower than in those not infected with U. urealyticum. In a subgroup analysis of normozoospermic samples, the semen volume and the total sperm count in the pathogen-infected group were significantly lower than in the non-infected group. CONCLUSION: Our results suggest that infection with U. urealyticum alone and any of the five sexually transmitted infections are likely to affect sperm morphology and semen volume, respectively.
Chlamydia trachomatis ; Family Characteristics ; Fertility ; Humans ; Male ; Mycoplasma genitalium ; Mycoplasma hominis ; Prevalence ; Semen ; Semen Analysis ; Sexually Transmitted Diseases ; Sperm Count ; Spermatozoa* ; Ureaplasma urealyticum

BACKGROUND: The multiplex real-time PCR assay is a sensitive test for simultaneous detection of various pathogens of sexually transmitted infections (STIs). We evaluated the performance of two multiplex real-time PCR assays for six STI pathogens. METHODS: DNA samples after being used to conduct PCR for STI pathogens were stored below −70℃. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Trichomonas vaginalis (TV) were detected by multiplex real-time PCR with GeneFinder STD I (CT/NG/UU)/II (MG/MH/TV) Multiplex Real-time PCR Kits (Infopia, Korea; GeneFinder assay) and Real-Q CT&NG/MH&TV/MG&UU Kits (BioSewoom, Korea; Real-Q assay). Discrepant results were resolved by another multiplex real-time assay, Anyplex II STI-7 Detection (Seegene, Korea). Any two positive results for the assays were considered true positive. RESULTS: Among 81 samples, the GeneFinder assay detected 63 pathogens from 45 cases (16 CT, 2 NG, 6 MG, 20 MH, 18 UU, and 1 TV) and Real-Q assay detected 66 pathogens from 47 cases (16 CT, 2 NG, 8 MG, 20 MH, 19 UU, and 1 TV). For the results of positive cases and negative cases, the overall concordance rate between the two multiplex real-time assays was 93.8% (Kappa=0.87). For each pathogen, the agreement rates of the two assays ranged from 97.5 to 100% (Kappa>0.8). CONCLUSION: There was no significant difference between the results of GeneFinder assay and Real-Q assay. Both multiplex real-time PCR assays can be useful methods for the detection of STI pathogens in clinical laboratories.
Chlamydia trachomatis ; DNA ; Korea ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction* ; Sexually Transmitted Diseases* ; Trichomonas vaginalis ; Ureaplasma urealyticum

PURPOSE: Chronic prostatitis frequently occurs in men of all ages. Recent studies suggest that fastidious microorganisms may play a role in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The aim of this study was to evaluate the usefulness and significance of multiplex polymerase chain reaction (PCR) in the diagnosis of CP/CPPS. MATERIALS AND METHODS: First voided urine (FVU) and/or expressed prostatic secretions (EPS) were collected from 92 patients. Multiplex PCR, using Dual Specificity Oligo (DSO(TM)) primers, was used to test for Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV) and Ureaplasma urealyticum (UU). RESULTS: Multiplex PCR can be easily analyzed via visual comparison. Nine (39.1%) of the 23 CP/CPPS IIIa and 12 (17.4%) of the 69 IIIb patients had positive multiplex PCR, with a total of 27 microorganisms isolated, including CT, MH, MG, UU, TV and NG in 9, 7, 4, 4, 2 and 1 case, respectively. Co-infections with 2 or 3 organisms occurred in 5 cases. For the samples collected from 32 patients for both FVU and EPS, 68.7% gave the same results. CONCLUSIONS: Multiplex PCR, using DSO(TM) primers, can be useful for the simple detection of fastidious microorganisms in CP/CPPS. To achieve reliable results with multiplex PCR, feasible guidelines and standardization are of major importance. Further studies will be required to define the usefulness of molecular tests for CP/CPPS in clinical practice.
Chlamydia trachomatis ; Coinfection ; Diagnosis ; Humans ; Male ; Multiplex Polymerase Chain Reaction* ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Pelvic Pain ; Polymerase Chain Reaction ; Prostatitis* ; Sensitivity and Specificity ; Trichomonas vaginalis ; Ureaplasma urealyticum

BACKGROUND: Sexually transmitted infections (STI) encompass a variety of clinical syndromes caused by many pathogens that are transmitted through sexual activity. Multiplex PCR is frequently used to detect STI. In this study, two multiplex real-time PCR-based assays were used to detect STI in clinical specimens, and the concordance of the results obtained by each method was evaluated. METHODS: A total of 626 specimens were tested using the Anyplex II STI-7 (Seegene, Korea) and Seeplex STD6 ACE Detection kits (Seegene). RESULTS: Among the 626 individuals tested, 227 (44.2%) tested positive for STI by using Anyplex II STI-7. The prevalence rates of the various infectious microorganisms detected were as follows: Chlamydia trachomatis (C. trachomatis), 19.2% (120/626); Neisseria gonorrhoeae (N. gonorrhoeae), 5.6% (35/626); Trichomonas vaginalis (T. vaginalis), 0.2% (1/626); Mycoplasma genitalium (M. genitalium), 8.1% (51/626); Mycoplasma hominis (M. hominis), 2.9% (18/626); Ureaplasma urealyticum (U. urealyticum), 17.6% (110/626); and Ureaplasma parvum, 3.7% (23/626). The concordance rates for the STI-7 and STD6 assays in detecting the various types of microorganism were as follows: C. trachomatis, (99.5%); N. gonorrhoeae, (99.7%); T. vaginalis, (100%); M. genitalium, (100%); M. hominis, (100%); and U. urealyticum (99.2%). CONCLUSIONS: A high degree of concordance was observed between the results obtained using the Anyplex II STI-7 kits and those obtained using the Seeplex STD6 ACE Detection kits.
Chlamydia trachomatis ; Methods ; Multiplex Polymerase Chain Reaction ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Prevalence ; Sexual Behavior ; Sexually Transmitted Diseases ; Trichomonas vaginalis ; Ureaplasma ; Ureaplasma urealyticum

Fitz-Hugh-Curtis syndrome has been described as focal perihepatitis accompanying pelvic inflammatory disease caused by Neisseria gonorrhea and Chlamydia trachomatis. The highest incidence occurs in young, sexually active females. However, the syndrome has been reported to occur infrequently in males, according to the foreign literature. The predominant symptoms are right upper quadrant pain and tenderness, and pleuritic right sided chest pain. The clinical presentation is similar in men and women. In women, the spread of infection to liver capsule is thought to occur directly from infected fallopian tube via the right paracolic gutter. In men, hematogenous and lymphatic spread is thought to be postulated. Recently, we experienced a case of Fitz-Hugh-Curtis syndrome occurred in a man. As far as we know, it is the first report in Korea, and we report a case with a review of the literature.
Adult ; Anti-Bacterial Agents/therapeutic use ; Humans ; Male ; Mycoplasma Infections/*diagnosis/drug therapy ; *Mycoplasma genitalium ; Ofloxacin/therapeutic use ; Pelvic Infection/*diagnosis/drug therapy ; Tomography, X-Ray Computed

BACKGROUND: The female genital tract is equipped to deal with a variety of foreign substances including a wide array of microorganisms. It is important to consider Candida-bacterial interactions in balance between healthy colonization versus vaginitis. The objectives of this study were to evaluate the association between microorganism distribution and vaginitis, and to investigate the possibility of an interaction between vaginal Candida and other microorganisms in female genital tract. METHODS: A total of 516 vaginal secretions were collected between October 2008 and June 2010 from patients with suspected vaginitis. Identification of Candida species and detection of 6 fastidious microorganisms (Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum) were performed using a VITEK 2 system (bioMerieux, Inc., Hazelwood, MO, USA) and multiplex PCR (Seegene, Biotechnology, Inc., Seoul, Korea), respectively. RESULTS: M. genitalium, U. urealyticum, and C. trachomatis were more often detected in association with vaginal candidiasis. A statistically significant association between Candida and M. genitalium was observed (P<0.05). N. gonorrhoeae was detected less often in women with vaginal candidiasis. CONCLUSION: The results of this study suggest the possibility that vaginal Candida may associate with some microorganisms in patients with vaginitis. Further studies will be required to define the Candida-bacterial interactions and its mechanisms.
Bacteria ; Biotechnology ; Candida ; Candidiasis ; Chlamydia trachomatis ; Colon ; Female ; Humans ; Microbial Interactions ; Multiplex Polymerase Chain Reaction ; Mycoplasma genitalium ; Mycoplasma hominis ; Neisseria gonorrhoeae ; Trichomonas vaginalis ; Ureaplasma ; Vaginitis