Ureaplasmas in acute and persistent urethritis: clinical implications

描述（由申请人提供）：项目摘要。非淋菌性尿道炎（NGU）是美国男性最常见的性传播疾病综合征，但高达50%的病例没有明确的病因。持续性或复发性尿道炎的病因学更是知之甚少，这也是常见的。解脲脲原体可能是这些特发性病例的原因，但关于该病原体的致病性及其与急性或持续性NGU相关程度的证据是相互矛盾的。与沙眼衣原体的血清型相似，脲原体血清型可能表现出不同程度的致病性，最近的系统发育分析表明，两个主要的脲原体生物型分组实际上是不同的物种。联合parvum已被指定为生物变型1，而U.生物变型2保留溶脲菌。有限的数据表明，美国。溶脲脲原体（biovar 2），而非溶脲脲原体（U.小孢子虫与NGU有关，但需要进一步的研究来证实这一观察结果，以及评估这两个物种对NGU常用抗生素治疗方案的不同反应，并确定这种生物体在持续性或复发性NGU中的作用。为了解决这些问题，我们将进行一系列的研究，并结合正在进行的另一种生殖道支原体M的随机治疗试验。生殖器具体来说，我们将1）评估美国的协会。溶脲脲原体（biovar 2）和溶脲脲原体（U.急性非淋菌性尿道炎; 2）在我们正在进行的随机双盲试验中，确定阿奇霉素和多西环素根除U的相对疗效。溶脲脲原体（biovar 2）和溶脲脲原体（U.目的：探讨非淋菌性尿道炎（NGU）男性患者微小支原体感染情况，并评估药物MIC与U. p.持续性的关系。溶脲脲原体（biovar 2）和溶脲脲原体（U.评估持续性或复发性NGU与U的关系。溶脲脲原体（biovar 2）和溶脲脲原体（U.小的本案无关NGU是每年超过200，000次医生办公室访问的主题（CDC，2001），并且代表了一个重要的公共卫生问题。这项研究的结果可能导致识别这种综合征的另一个原因，提供治疗决策的指导，并阐明持续和复发病例的病因。

DESCRIPTION (provided by applicant): Project Summary. Nongonococcal urethritis (NGU) is the most common sexually transmitted disease syndrome seen in men in the United States, yet up to 50% of cases have no defined etiology. Even less is known about the etiology of persistent or recurrent urethritis, which is also frequent. Ureaplasma urealyticum may be responsible for some of these idiopathic cases, but evidence regarding pathogencity of the organism and the degree to which it is associated with acute or persistent NGU is conflicting. Similar to the serovars of Chlamydia trachomatis, Ureaplasma serovars may exhibit varying degrees of pathogenicity, and recent phylogenetic analyses have demonstrated that the two major Ureaplasma biovar groupings are actually distinct species. U. parvum has been designated biovar 1, while the name U. urealyticum was retained for biovar 2. Limited data suggest that U. urealyticum (biovar 2), but not U. parvum is associated with NGU, but further studies are required to confirm this observation, as well as to assess the differential response of these two species to common antibiotic treatment regimens for NGU, and to identify the role of this organism in persistent or recurrent NGU. To address these questions, we will conduct a series of studies in conjunction with an ongoing randomized treatment trial of another genital Mycoplasma, M. genitalium. Specifically, we will 1) Assess the association of U. urealyticum (biovar 2) and U. parvum with acute NGU; 2) Determine, in our ongoing randomized double-blind trial, the relative efficacy of azithromycin and doxycycline in eradicating U. urealyticum (biovar 2) and U. parvum infection among men with NGU, and assess the relationship of the MIC of the drug used to persistence of U. urealyticum (biovar 2) and U. parvum; and 3) Evaluate the association of persistent or recurrent NGU with U. urealyticum (biovar 2) and U. parvum. Relevance. NGU is the subject of over 200,000 physician office visits per year (CDC, 2001), and represents a significant public health problem. The results of this study may lead to the identification of an additional cause of this syndrome, provide guidance on treatment decisions, and shed light on the etiology of persistent and recurrent cases.