Miram Pasini

Antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis

Ureaplasma urealyticum and Mycoplasma hominis are common commensals of the lower genitourinary tract. They are causally linked to prostatitis, epydidimitis, urethral syndrome, cervicitis, urolythiasis, reactive arthritis, infertility, complications during pregnancy and serious infections in newborns and immunocompromised hosts.1 Therefore, the therapeutic use of antimicrobials and susceptibility testing is necessary because it allows adequate treatment. The aim of this study was to determine the susceptibility of U urealyticum and M hominis to tetracycline, erythromycin, clindamycin, doxycycline, ofloxacin and azithromycin. This study was conducted at the …

Metronidazole 1.5 gram dose for 7 or 14 days in the treatment of patients with chronic prostatitis caused by Trichomonas vaginalis : A randomized study

Corresponding author: Prof Višnja Škerk, MD, PhD, University Hospital for infectious Diseases „Dr. Fran Mihaljevich”, Mirogojska 8, 10 000 Zagreb, Croatia. Tel: ++385 1 2826 222; Fax: ++385 1 2826 471; e-mail: vskerk@bfm.hr clinical status including digitorectal prostatic examination, urethral swab specimens and selective samples of urine, VB1, VB2, VB3 and EPs, according to the 4-glass localization test (Meares and stamey’s localization technique). Urethral swab specimens, EPs and VB3 were examined for the presence of TV, Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis. Quantitative segmented cultures and bacterial identification as well as the presence of leukocytes in three voided bladder urine samples and EPs were performed at the Laboratory for Clinical Microbiology of the University Hospital for infectious Diseases “Dr. Fran Mihaljevich”, Zagreb, Croatia, using standard microbiological methods. Diagnosis of TV was confirmed by microscope examination and by culture on Diamond modified medium. C. trachomatis was proven by Hybrid Capture CT-iD DnA Test, version 2.0 (Digene, Gaithersburg, UsA). The diagnosis of urogenital mycoplasma was confirmed by semiquantitative culturing and antimicrobial susceptibility test Mycoplasma duo and s.i.R. Mycoplasma test (Bio Rad Laboratories). A total of 61 patients were included in the study. The mean age of patients was 31±7 years. Patients were randomized to receive metronidazole 3x500 mg orally for 7 days or 3x500 mg orally for 14 days. Female sexual partners were treated with a single dose of 2,0 g metronidazole. Clinical efficacy and tolerability of the administered drug as well as possible adverse events were evaluated during, at the end and 4-6 weeks after completion of therapy according to patients’ responses to earlier and/or new clinical symptoms, clinical examination, including digitorectal prostatic examination and if necessary laboratory blood tests. Bacteriological efficacy of administered drug was evaluated 4-6 weeks after completion of therapy using microbiological methods identical to those used during study enrollment. Clinical response definitions: Cure: complete or incomplete resolution of urethral, prostatic or sexual symptoms, no need for additional therapy. Failure: no apparent response or progression of urethral, prostatic or sexual symptoms, or additional antibiotic therapy needed. Bacteriological response definitions: eradication: eradication of TV at the posttreatment visit. persistence: persistence of TV at the post-treatment visit. statistical significance of observed differences between the two treatment groups was assessed by Yates corrected chisquare test or Fisher’s exact test when appropriate. A total of 8 patients in each treatment group had nausea. Evaluation of clinical and bacteriological efficacy of administrated metronidazole is shown in table 1. in the group of patients with chronic prostatitis caused by TV, a significantly higher percentage of pathogen eradication (p=0.043) and a

Detection of sexually transmitted pathogens in patients with chronic prostatitis/chronic pelvic pain: a prospective clinical study:

In <10% of patients with prostatitis syndrome, a causative uropathogenic organism can be detected. It has been shown that certain organisms that cause sexually transmitted infections can also cause chronic bacterial prostatitis, which can be hard to diagnose and treat appropriately because prostatic samples obtained by prostatic massage are not routinely tested to detect them. We conducted a clinical study to determine the prevalence of Chlamydia, mycoplasma, and trichomonas infection in 254 patients that were previously diagnosed and treated for chronic prostatitis/chronic pelvic pain syndrome due to negative urethral swab, urine, and prostate samples. Urethral swabs and standard Meares–Stamey four-glass tests were done. Detailed microbiological analysis was conducted to detect the above organisms. Thirty-five (13.8%) patients had positive expressed prostatic secretions/VB3 samples, of which 22 (10.1%) were sexually transmitted organisms that were not detected on previous tests.

The significance of Chlamydia trachomatis in prostatitis syndrome

Abstract Research and publication expenses were supported in part by the Croatian Science Foundation and PLIVA Croatia Ltd. (project no. 04/30 ‘Research on the aetiology, epidemiology, diagnostics, and treatment of patients with prostatitis syndrome’).