Ureaplasma urealyticum Is Associated With Nongonococcal Urethritis Among Men With Fewer Lifetime Sexual Partners: A Case-Control Study

• Published in: The Journal of infectious diseases Vol. 204; no. 8; pp. 1274 - 1282
• Main Authors: Wetmore, Catherine M., Manhart, Lisa E., Lowens, M. Sylvan, Golden, Matthew R., Jensen, Nicole L., Astete, Sabina G., Whittington, William L. H., Totten, Patricia A.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 15.10.2011
• Subjects: Adolescent; Adult; Aged; BACTERIA; Bacteriology; Biological and medical sciences; Case control studies; Etiology; Female; Fundamental and applied biological sciences. Psychology; Humans; Infections; Infectious diseases; Logistic Models; Major and Brief Reports; Male; Medical sciences; Men; Microbiology; Middle Aged; Miscellaneous; Multivariate Analysis; Polymerase chain reaction; Sexual Partners; Sexually transmitted diseases; Ureaplasma; Ureaplasma - isolation & purification; Ureaplasma Infections - epidemiology; Ureaplasma Infections - microbiology; Ureaplasma urealyticum; Ureaplasma urealyticum - isolation & purification; Urethritis; Urethritis - epidemiology; Urethritis - microbiology; Urine; Washington - epidemiology; Young Adult; Washington; Mollicutes; Human; Infection; Mycoplasmatales; Non gonococcal urethritis; Ureaplasma urealyticum; Bacteria; Case control study; Male genital diseases; Mycoplasmataceae
• ISSN: 0022-1899; 1537-6613; 1537-6613
• DOI: 10.1093/infdis/jir517

Background. Ureaplasmas have been inconsistently associated with nongonococcal urethritis (NGU). We evaluated the association of the newly differentiated species Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) with NGU using 2 separate control groups. Methods. Case patients were men who attended a sexually transmitted disease (STD) clinic in Seattle, Washington, during the period 2007-2009 with NGU (defined as visible urethral discharge and/or ≥ 5 polymorphonudear neutrophils per high-powered field; n = 329). Control subjects were STD clinic attendees (n = 191) and emergency department (ED) attendees (n = 193) without NGU. Polymerase chain reaction assays detected UU and UP in ureaplasma culture-positive urine. Multivariable logistic regression was used to assess the associations of UU and UP with NGU. Results. UU was only marginally associated with NGU in aggregate multivariable analyses, irrespective of control group (adjusted odds ratio [aOR] STD-control > 1.6 [95% confidence interval {CI}, 0.9-2.8]; aOR ED _ con trob 1.7 [95% CI, 0.97-3.0]). This association was significantly stronger when analyses were restricted to men with fewer lifetime sex partners (< 10 vaginal partners: aORsxD-controi » 2.9 [95% CI, 1.2-6.7]; aOR ED.contro, 3.2 [95% CI, 1.3-7.6]; < 5 vaginal partners: aOR ST D-controi> 6.2 [95% CI, 1.8-21.0]; aOR ED. controb, 5.2 [95% CI, 1.3-20.2]). UP was not positively associated with NGU overall or among subgroups. Conclusions. The absence of an association of UU with NGU among men with more lifetime sex partners suggests that adaptive immunity may attenuate the clinical manifestation of UU infection. Similar relationships were not observed with UP, which suggests that it is not a urethral pathogen.