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. 2024 Apr 18;100(3):133-137.
doi: 10.1136/sextrans-2023-055950.

Aetiological molecular identification of sexually transmitted infections that cause urethral discharge syndrome and genital ulcer disease in Brazilian men: a nationwide study

Maria Luiza Bazzo  1   2 , Hanalydia de Melo Machado  3   2 , Jessica Motta Martins  3   2 , Marcos André Schörner  3   2 , Ketlyn Buss  3   2 , Fernando Hartmann Barazzetti  3   2 , Pamela Cristina Gaspar  4 , Alisson Bigolin  4 , Adele Benzaken  5   6 , Simone Veloso Faria de Carvalho  7 , Lidiane da Fonseca Andrade  8 , William Antunes Ferreira  9 , François Figueiroa  10 , Rafael Mialski Fontana  11 , Miralba Freire de Carvalho Ribeiro da Silva  12 , Roberto José Carvalho Silva  13 , Luiz Fernando Aires Junior  14 , Lis Aparecida de Souza Neves  15 , Angelica Espinosa Miranda  4   16 , Brazilian-Gasp Network  4   17
Affiliations

Aetiological molecular identification of sexually transmitted infections that cause urethral discharge syndrome and genital ulcer disease in Brazilian men: a nationwide study

Maria Luiza Bazzo et al. Sex Transm Infect. .

Abstract

Background: Little is known about the aetiology of urethral discharge syndrome (UDS) and genital ulcer disease (GUD) in Brazil due to limited access to laboratory tests and treatment based mainly on the syndromic approach.

Objectives: To update Brazilian treatment guidelines according to the current scenario, the first nationwide aetiological study for UDS and GUD was performed.

Methods: Male participants with urethral discharge (UD) and/or genital ulcer (GU) reports were enrolled. Sample collection was performed by 12 sentinel sites located in the five Brazilian regions. Between 2018 and 2020, 1141 UD and 208 GU samples were collected in a Universal Transport Medium-RT (Copan). A multiplex quantitative PCR kit (Seegene) was used to detect UD: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), M. hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Ureaplasma parvum (UP), U. urealyticum (UU) and another kit to detect GU: cytomegalovirus (CMV), Haemophilus ducreyi (HD), herpes simplex virus type 1 (HSV1), herpes simplex virus type 2 (HSV2), lymphogranuloma venereum (LGV), Treponema pallidum (TP) and varicella-zoster virus (VZV).

Results: In UD samples, the frequency of pathogen detection was NG: 78.38%, CT: 25.6%, MG: 8.3%, UU: 10.4%, UP: 3.5%, MH: 3.5% and TV: 0.9%. Coinfection was assessed in 30.9% of samples, with 14.3% of NG/CT coinfection. The most frequent pathogen identified in GU was HSV2, present in 40.8% of the samples, followed by TP at 24.8%, LGV and CMV at 1%, and HSV1 at 0.4%. Coinfection of TP/HSV2 was detected in 4.4% of samples. VZV and HD were not detected. In 27.7% of the GU samples, no pathogen was detected.

Conclusion: This study provided the acquisition of unprecedented data on the aetiology of UDS and GUD in Brazil, demonstrated the presence of a variety of pathogens in both sample types and reaffirmed the aetiologies known to be most prevalent globally.

Keywords: diagnosis; disease transmission, infectious; genital diseases, male; molecular biology; urethritis.

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Conflict of interest statement

Competing interests: None declared.

References