P3-S7.14 The association of Ureaplasma urealyticum with male non-gonococcal urethritis

Background The aetiology of non-gonococcal urethritis (NGU) is unexplained in 30–50% of cases. The role of ureaplasmas is not clear. We detected Ureaplasma urealyticum (Uu) and U parvum (Up) by quantitative PCR in the urine of men with and without NGU to show a possible association with urethritis. Methods Urine samples from 158 male STD-clinic attendees with symptomatic NGU (>5 PMNL/hpf) and 77 asymptomatic men without NGU ( Results Ct and Mg were found in 22 and 30% of NGU, respectively, and were associated with NGU (p 0.99). The median Uu bacterial DNA load was higher in men with NGU than in men without (223 genome equivalents (geq) and 10 geq, respectively; p=0.002). Using ROC-curve analysis to determine the optimal cut-off, patients with >53 geq were more likely to have urethritis (p=0.02). In men with NGU of unknown aetiology, there was no difference in the rate of Uu detection when compared to controls (p=0.26). The corresponding median Uu bacterial DNA load were significantly higher in this group than in controls (p=0.01), and using a cut-off of >53 geq, men with NGU of unknown aetiology were more likely to harbour Uu (14%) than were men from the control group (1%), (p=0.005). Up was detected in 14% of NGU cases and 19% of controls (p=0.34). There was no difference in the detection rate of Up or in the median Up bacterial load in any of the groups. HSV-1 was detected in 3% of cases and 1% of controls. HSV-2 was found in 2% of NGU cases. All urine samples were negative for adenovirus. Cases and controls had similar median number of partners within 6 months (2 partners) and age (28 and 29 years, respectively). Conclusion The bacterial load of U urealyticum in men with NGU and in men with NGU of unknown aetiology was higher than in men without NGU, and the presence of >53 geq of Uu was associated with urethritis in both groups. In accordance with other studies, U parvum was not associated with urethritis. (Preliminary results were presented at the ASM general meeting, San Diego 2010).