尿道炎病人合併感染淋病和披衣菌的比率以及治療追蹤

徐易廷¹、莊梓昱²、程威銘^2、3

¹臺北市立聯合醫院仁愛院區 外科部 泌尿科；²臺北市立聯合醫院忠孝院區 外科部 泌尿科³國立陽明交通大學 醫學院 泌尿學科

The prevalence and co-infection rate of gonorrhea and chlamydia in patients with urethritis and treatment outcome

Yi-Ting Hsu¹, Tzu-Yu Chuang², Weiming Cheng^2、3

¹Division of Urology, Department of Surgery, Taipei City Hospital Renai Branch, Taipei, Taiwan;

²Division of Urology, Department of Surgery, Taipei City Hospital Zhongxiao Branch, Taipei, Taiwan;

³Department of Urology, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan

Purpose: Urethritis is a common urinary tract infection. Sexually transmitted infection accounts for a large proportion among sexually active men especially. Bacteria that commonly caused urethritis include gram-negative coccus Neisseria gonorrhea (N. gonorrhea) and Chlamydia trachomatis (C. trachomatis). The primary objective of our study is to assess the prevalence of co-infections and treatment outcome.

Material and methods: A retrospective study was carried out on all male patients with urethritis due to gonorrhea and/or chlamydia at Taipei City Hospital- Zhongxiao Branch from March 2019 to April 2022. The patient's urethritis was confirmed by culture and Polymerase Chain Reaction (PCR) testing of urine for N. gonorrhea and C. trachomatis. Culture for gonococcus was performed followed by antimicrobial susceptibility testing. Patient data were collected and analyzed.

Results: A total of 139 males positive by PCR for gonorrhea and/or chlamydia infection were included in the present study. The mean age of patients was 33.96 ± 8.83 (20-50) years old. There were 55/139 (40%) patients with simple gonorrhea infection, while 66/139 (47%) patients were diagnosed with urethritis solely due to chlamydia infection, and 18/139 (13%) patients had urethritis due to both gonorrhea and chlamydia infection. Of the 73 patients with gonococcal urethritis (mono and chlamydia co-infection): 15 patients (21%) were culture positive, while 58 patients (79%) were positive with gonorrhea by PCR. Antibiogram results of 15 patients diagnosed with gonorrhea showed that 15/15 patients were all were susceptible to cefoxitin, cefotaxime and ceftriaxone. All patients diagnosed with gonococcal urethritis alone or combined with chlamydia recovered after the treatment.

Conclusions: The physician should be aware of the presence of gonorrhea and/or chlamydia and their combination in the diagnosis of urethritis. People who are diagnosed with this disease can be curative by making adequate evaluation and antibiotic treatment with a good outcome.