Association of Ureaplasma urealyticum colonization in male urethra and Condyloma acuminatum

Background: The frequent coexistence of two or more sexually transmitted di seases in one patient has been reported in non-dermatological literature, m ostly in languages other than English. Identification of Ureaplasma urealyt icum, Chlamydia trachomatis and Mycoplasma hominis in men with other STDs i s important, since these bacteria have been implicated in a variety of dise ases such as non-gonococcal urethritis, premature rupture of fetal membrane s, and infertility in female sexual partners of these patients. Objective: To assess the frequency of concomitant STD, particularly urethra l colonization of U. urealyticum, C. trachomatis and M. hominis. in men con sulting for suspected STD-related symptoms. Methods: All patients attending our dermatology clinic for STD-related symp toms during a 12 month period in 1996-97 underwent systematic clinical and laboratory screening for syphilis, gonorrhea, NGU, prostatitis, genital her pes simplex infection, Condyloma acuminatum, urethral carriage of U. urealy ticum, C. trachomatis and M. hominis, as well as serological screening for HIV, and hepatitis B and C infections. Results: A total of 169 men with STD-related symptoms were enrolled in the study. The following clinical diagnoses were established: NGU in 109 men, C . acuminatum in 40, genital herpes simplex in 10, prostatitis in 7, latent syphilis in 6, primary syphilis in 1, and Behcet's disease in 1. No clinica l evidence of STD was found in 13 patients. Of the 169 patients, 39 (23%) h ad two or more concomitant STDs, of whom 27 (69%) had C. acuminatum associa ted with one or more of the urethral pathogens. A positive U. urealyticum c ulture was found in 67.5% (27/40) of the men with C. acuminatum as compared to 42% (40/96) among the patients with NGU who did not have C. acuminatum (P=0.004, chi(2) test). Conversely, the prevalence of C. acuminatum among p atients positive for U. urealyticum was significantly higher than the preva lence among those who were negative -27/75 (36%) vs. 13/94 (14%), P < 0.000 9, chi(2) test. About half of the U. urealyticum-positive patients with C. acuminatum had no clinical signs or symptoms of urethritis. Conclusion: Our findings suggest that patients with C. acuminatum should be assessed for U. urealyticum carriage and, when identified, their sexual co ntacts should be actively sought and treated.