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Erschienen in: Die Dermatologie 11/2023

17.10.2023 | Urethritis | Leitthema

Urethritis – Erregerspektrum, Diagnostik und Therapie

verfasst von: Dr. Susanne Buder

Erschienen in: Die Dermatologie | Ausgabe 11/2023

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Zusammenfassung

Eine Urethritis kann durch ein breites Spektrum von Bakterien, Pilzen, Protozoen und Viren hervorgerufen werden, wobei insbesondere Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium und Trichomonas vaginalis als klassische Erreger sexuell übertragbarer Infektionen (STI, sexually transmitted infection) im Fokus der diagnostischen Erwägungen stehen. Zur vollständigen Diagnosestellung wird ein stufenweises Vorgehen gewählt. Die Mikroskopie mit Färbepräparat ermöglicht bei symptomatischen Männern eine erste Unterscheidung zwischen gonorrhoischer und nicht-gonorrhoischer Urethritis als POC(Point-of-Care)-Test. Die Diagnostik mittels NAAT (nucleic acid amplification technology) wird zum spezifischen und sensitiven Erregernachweis genutzt und bietet als Multiplexdiagnostik die Möglichkeit zum Nachweis mehrerer Organismen aus derselben Probe. Zudem werden hierbei – im Vergleich zur Kultur – keine vitalen Organismen benötigt, was die Entnahme und Verwendung vielfältigerer und weniger invasiver biologischer Proben (Erststrahlurin beim Mann oder Vaginalabstriche) ermöglicht. Die Empfindlichkeitstestung mittels Kultur bleibt für N. gonorrhoeae bei zunehmender Resistenzentwicklung unerlässlich. Die Therapie einer Urethritis richtet sich nach dem vermuteten oder nachgewiesenen Erreger unter Berücksichtigung der aktuellen Leitlinien. Therapieversagen kann vielfältige Ursachen haben (Koinfektion, mangelnde Therapieadhärenz, Reinfektion oder Resistenz des Erregers) und erfordert ein erneutes diagnostisches und therapeutisches Vorgehen und eine differenzierte Betrachtung.
Literatur
2.
Zurück zum Zitat Frølund M, Lidbrink P, Wikström A, Cowan S, Ahrens P, Jensen JS (2016) Urethritis-associated pathogens in urine from men with non-gonococcal urethritis: a case-control study. Acta Derm Venereol 96:689–694 PubMed Frølund M, Lidbrink P, Wikström A, Cowan S, Ahrens P, Jensen JS (2016) Urethritis-associated pathogens in urine from men with non-gonococcal urethritis: a case-control study. Acta Derm Venereol 96:689–694 PubMed
5.
Zurück zum Zitat Jensen JS (2021) Male urethritis of unknown etiology: piecing together the puzzle. Clin Infect Dis 73(7):e1694–e1695 PubMed Jensen JS (2021) Male urethritis of unknown etiology: piecing together the puzzle. Clin Infect Dis 73(7):e1694–e1695 PubMed
9.
Zurück zum Zitat Sierra Y, González-Díaz A, Tubau F, Imaz A, Cubero M, Càmara J, Ayats J, Martí S, Ardanuy C (2020) Emergence of multidrug resistance among haemophilus parainfluenzae from respiratory and urogenital samples in Barcelona, Spain. Eur J Clin Microbiol Infect Dis 39(4):703–710 PubMed Sierra Y, González-Díaz A, Tubau F, Imaz A, Cubero M, Càmara J, Ayats J, Martí S, Ardanuy C (2020) Emergence of multidrug resistance among haemophilus parainfluenzae from respiratory and urogenital samples in Barcelona, Spain. Eur J Clin Microbiol Infect Dis 39(4):703–710 PubMed
15.
Zurück zum Zitat De Rosa R, Modolo ML, Stano P, Camporese A (2014) When should adenoviral non-gonococcal urethritis be suspected? Two case reports. New Microbiol 37:109–112 PubMed De Rosa R, Modolo ML, Stano P, Camporese A (2014) When should adenoviral non-gonococcal urethritis be suspected? Two case reports. New Microbiol 37:109–112 PubMed
16.
Zurück zum Zitat Hanaoka N, Ito S, Nojiri N, Konagaya M, Yasuda M, Deguchi T, Fujimoto T (2020) Human adenovirus B7d-associated urethritis after suspected sexual transmission, Japan. Emerg Infect Dis 26(10):2444–2447 PubMedPubMedCentral Hanaoka N, Ito S, Nojiri N, Konagaya M, Yasuda M, Deguchi T, Fujimoto T (2020) Human adenovirus B7d-associated urethritis after suspected sexual transmission, Japan. Emerg Infect Dis 26(10):2444–2447 PubMedPubMedCentral
18.
Zurück zum Zitat Fifer H, Saunders J, Soni S, Sadiq ST, FitzGerald M (2020) 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. Int J STD Aids 31(1):4–15 PubMed Fifer H, Saunders J, Soni S, Sadiq ST, FitzGerald M (2020) 2018 UK national guideline for the management of infection with Neisseria gonorrhoeae. Int J STD Aids 31(1):4–15 PubMed
19.
Zurück zum Zitat Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, Chico RM, Smolak A, Newman L, Gottlieb S, Thwin SS, Brouteta N, Taylora MM (2019) Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 97(8):548–562P PubMedPubMedCentral Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, Chico RM, Smolak A, Newman L, Gottlieb S, Thwin SS, Brouteta N, Taylora MM (2019) Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates, 2016. Bull World Health Organ 97(8):548–562P PubMedPubMedCentral
21.
Zurück zum Zitat Jansen K, Steffen G, Potthoff A, Schuppe AK, Beer D, Jessen H, Scholten S, Spornraft-Ragaller P, Bremer V, Tiemann C (2020) MSM screening study group. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect Dis 20(1):110 PubMedPubMedCentral Jansen K, Steffen G, Potthoff A, Schuppe AK, Beer D, Jessen H, Scholten S, Spornraft-Ragaller P, Bremer V, Tiemann C (2020) MSM screening study group. STI in times of PrEP: high prevalence of chlamydia, gonorrhea, and mycoplasma at different anatomic sites in men who have sex with men in Germany. BMC Infect Dis 20(1):110 PubMedPubMedCentral
23.
Zurück zum Zitat Buder S, Dudareva S, Jansen K, Loenenbach A, Nikisins S, Sailer A, Guhl E, Kohl PK, Bremer V, GORENET study group (2018) Antimicrobial resistance of Neisseria gonorrhoeae in Germany: low levels of cephalosporin resistance, but high azithromycin resistance. BMC Infect Dis 18(1):44 PubMedPubMedCentral Buder S, Dudareva S, Jansen K, Loenenbach A, Nikisins S, Sailer A, Guhl E, Kohl PK, Bremer V, GORENET study group (2018) Antimicrobial resistance of Neisseria gonorrhoeae in Germany: low levels of cephalosporin resistance, but high azithromycin resistance. BMC Infect Dis 18(1):44 PubMedPubMedCentral
24.
Zurück zum Zitat Selb R, Buder S, Dudareva S, Tamminga T, Bremer V, Banhart S, Heuer H, Jansen K (2021) Markedly decreasing azithromycin susceptibility of Neisseria gonorrhoeae, Germany, 2014 to 2021. Euro Surveill 26(31):2100616 PubMedPubMedCentral Selb R, Buder S, Dudareva S, Tamminga T, Bremer V, Banhart S, Heuer H, Jansen K (2021) Markedly decreasing azithromycin susceptibility of Neisseria gonorrhoeae, Germany, 2014 to 2021. Euro Surveill 26(31):2100616 PubMedPubMedCentral
25.
Zurück zum Zitat Fifer H, Cole M, Hughes G et al (2018) Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study. Lancet Infect Dis 18(5):573–581 PubMed Fifer H, Cole M, Hughes G et al (2018) Sustained transmission of high-level azithromycin-resistant Neisseria gonorrhoeae in England: an observational study. Lancet Infect Dis 18(5):573–581 PubMed
31.
Zurück zum Zitat Gassowski M, Poethko-Müller C, Schlaud M, Sailer A, Dehmel K, Bremer V, Dudareva S, Jansen K, Chlamydia trachomatis laboratory sentinel team (2022) Prevalence of Chlamydia trachomatis in the general population in Germany—a triangulation of data from two population-based health surveys and a laboratory sentinel system. BMC Public Health 22(1):1107 PubMedPubMedCentral Gassowski M, Poethko-Müller C, Schlaud M, Sailer A, Dehmel K, Bremer V, Dudareva S, Jansen K, Chlamydia trachomatis laboratory sentinel team (2022) Prevalence of Chlamydia trachomatis in the general population in Germany—a triangulation of data from two population-based health surveys and a laboratory sentinel system. BMC Public Health 22(1):1107 PubMedPubMedCentral
33.
Zurück zum Zitat Fode M, Fusco F, Lipshultz L, Weidner W (2016) Sexually transmitted disease and male infertility: a systematic review. Eur Urol Focus 2:383–393 PubMed Fode M, Fusco F, Lipshultz L, Weidner W (2016) Sexually transmitted disease and male infertility: a systematic review. Eur Urol Focus 2:383–393 PubMed
34.
Zurück zum Zitat Lautenschlager S (2015) Non-gonococcal infectious urethritis : pathogen spectrum and management. Hautarzt 66(1):12–18 PubMed Lautenschlager S (2015) Non-gonococcal infectious urethritis : pathogen spectrum and management. Hautarzt 66(1):12–18 PubMed
35.
Zurück zum Zitat Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M (2018) Should we be testing for urogenital mycoplasma hominis, ureaplasma parvum and ureaplasma urealyticum in men and women?—a position statement from the European STI guidelines editorial board. J Eur Acad Dermatol Venereol 32(11):1845–1851. https://​doi.​org/​10.​1111/​jdv.​15146 CrossRefPubMed Horner P, Donders G, Cusini M, Gomberg M, Jensen JS, Unemo M (2018) Should we be testing for urogenital mycoplasma hominis, ureaplasma parvum and ureaplasma urealyticum in men and women?—a position statement from the European STI guidelines editorial board. J Eur Acad Dermatol Venereol 32(11):1845–1851. https://​doi.​org/​10.​1111/​jdv.​15146 CrossRefPubMed
38.
Zurück zum Zitat Taylor-Robinson D, Jensen JS (2011) Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin Microbiol Rev 24:498–514 PubMedPubMedCentral Taylor-Robinson D, Jensen JS (2011) Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin Microbiol Rev 24:498–514 PubMedPubMedCentral
39.
Zurück zum Zitat Andersen B, Sokolowski I, Ostergaard L, Kjølseth Møller J, Olesen F, Jensen JS (2007) Mycoplasma genitalium: prevalence and behavioural risk factors in the general population. Sex Transm Infect 83:237–241 PubMed Andersen B, Sokolowski I, Ostergaard L, Kjølseth Møller J, Olesen F, Jensen JS (2007) Mycoplasma genitalium: prevalence and behavioural risk factors in the general population. Sex Transm Infect 83:237–241 PubMed
40.
Zurück zum Zitat Oakeshott P, Aghaizu A, Hay P et al (2010) Is mycoplasma genitalium in women the “New Chlamydia?” A community-based prospective cohort study. Clin Infect Dis 51:1160–1166 PubMed Oakeshott P, Aghaizu A, Hay P et al (2010) Is mycoplasma genitalium in women the “New Chlamydia?” A community-based prospective cohort study. Clin Infect Dis 51:1160–1166 PubMed
41.
Zurück zum Zitat Manhart LE, Holmes KK, Hughes JP, Houston LS, Totten PA (2007) Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection. Am J Public Health 97:1118–1125 PubMedPubMedCentral Manhart LE, Holmes KK, Hughes JP, Houston LS, Totten PA (2007) Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection. Am J Public Health 97:1118–1125 PubMedPubMedCentral
42.
Zurück zum Zitat Sonnenberg P, Ison CA, Clifton S et al (2015) Epidemiology of mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third national survey of sexual attitudes and lifestyles (Natsal-3). Int J Epidemiol 44:1982–1994 PubMedPubMedCentral Sonnenberg P, Ison CA, Clifton S et al (2015) Epidemiology of mycoplasma genitalium in British men and women aged 16–44 years: evidence from the third national survey of sexual attitudes and lifestyles (Natsal-3). Int J Epidemiol 44:1982–1994 PubMedPubMedCentral
43.
Zurück zum Zitat Unemo M, Jensen JS (2017) Antimicrobial-resistant sexually transmitted infections: gonorrhoea and mycoplasma genitalium. Nat Rev Urol 14(3):139–152 PubMed Unemo M, Jensen JS (2017) Antimicrobial-resistant sexually transmitted infections: gonorrhoea and mycoplasma genitalium. Nat Rev Urol 14(3):139–152 PubMed
44.
Zurück zum Zitat Dumke R, Thürmer A, Jacobs E (2016) Emergence of mycoplasma genitalium strains showing mutations associated with macrolide and fluoroquinolone resistance in the region Dresden, Germany. Diagn Microbiol Infect Dis 86(2):221–223 PubMed Dumke R, Thürmer A, Jacobs E (2016) Emergence of mycoplasma genitalium strains showing mutations associated with macrolide and fluoroquinolone resistance in the region Dresden, Germany. Diagn Microbiol Infect Dis 86(2):221–223 PubMed
46.
Zurück zum Zitat Ito S, Tsuchiya T, Yasuda M, Yokoi S, Nakano M, Deguchi T (2012) Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis. Int J Urol 19:234–238 PubMed Ito S, Tsuchiya T, Yasuda M, Yokoi S, Nakano M, Deguchi T (2012) Prevalence of genital mycoplasmas and ureaplasmas in men younger than 40 years-of-age with acute epididymitis. Int J Urol 19:234–238 PubMed
47.
Zurück zum Zitat Anagrius C, Lore B, Jensen JS (2005) Mycoplasma genitalium: prevalence, clinical significance, and transmission. Sex Transm Infect 81:458–462 PubMedPubMedCentral Anagrius C, Lore B, Jensen JS (2005) Mycoplasma genitalium: prevalence, clinical significance, and transmission. Sex Transm Infect 81:458–462 PubMedPubMedCentral
48.
Zurück zum Zitat Falk L, Fredlund H, Jensen JS (2005) Signs and symptoms of urethritis and cervicitis among women with or without mycoplasma genitalium or chlamydia trachomatis infection. Sex Transm Infect 81:73–78 PubMedPubMedCentral Falk L, Fredlund H, Jensen JS (2005) Signs and symptoms of urethritis and cervicitis among women with or without mycoplasma genitalium or chlamydia trachomatis infection. Sex Transm Infect 81:73–78 PubMedPubMedCentral
49.
Zurück zum Zitat Lis R, Rowhani-Rahbar A, Manhart LE (2015) Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Clin Infect Dis 61:418–426 PubMed Lis R, Rowhani-Rahbar A, Manhart LE (2015) Mycoplasma genitalium infection and female reproductive tract disease: a meta-analysis. Clin Infect Dis 61:418–426 PubMed
50.
Zurück zum Zitat Bjartling C, Osser S, Persson K (2012) Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service. Am J Obstet Gynecol 206:476–478 Bjartling C, Osser S, Persson K (2012) Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service. Am J Obstet Gynecol 206:476–478
51.
53.
Zurück zum Zitat Meyer T, Eberle J, Roß RS, Schüttler CG, Baier M, Buder S, Kohl PK, Münstermann D, Hagedorn HJ, Nick S, Jansen K, Bremer V, Mau M, Brockmeyer NH (2020) Rapid diagnosis of sexually transmitted infections : joint statement of DSTIG, RKI, and PEI, as well as the reference centers for HIV, HBV, and HCV and consulting laboratories for Chlamydia, gonococci, and treponema pallidum. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 63(10):1271–1286 PubMed Meyer T, Eberle J, Roß RS, Schüttler CG, Baier M, Buder S, Kohl PK, Münstermann D, Hagedorn HJ, Nick S, Jansen K, Bremer V, Mau M, Brockmeyer NH (2020) Rapid diagnosis of sexually transmitted infections : joint statement of DSTIG, RKI, and PEI, as well as the reference centers for HIV, HBV, and HCV and consulting laboratories for Chlamydia, gonococci, and treponema pallidum. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 63(10):1271–1286 PubMed
56.
Zurück zum Zitat Nathan B, Appiah J, Saunders P, Heron D, Nichols T, Brum R, Alexander S, Baraitser P, Ison C (2015) Microscopy outperformed in a comparison of five methods for detecting trichomonas vaginalis in symptomatic women. Int J STD Aids 26(4):251–256 PubMed Nathan B, Appiah J, Saunders P, Heron D, Nichols T, Brum R, Alexander S, Baraitser P, Ison C (2015) Microscopy outperformed in a comparison of five methods for detecting trichomonas vaginalis in symptomatic women. Int J STD Aids 26(4):251–256 PubMed
57.
Zurück zum Zitat Rietmeijer CA, Mettenbrink CJ (2012) Recalibrating the Gram stain diagnosis of male urethritis in the era of nucleic acid amplification testing. Sex Transm Dis 39:18–20 PubMed Rietmeijer CA, Mettenbrink CJ (2012) Recalibrating the Gram stain diagnosis of male urethritis in the era of nucleic acid amplification testing. Sex Transm Dis 39:18–20 PubMed
58.
Zurück zum Zitat Rietmeijer CA, Mettenbrink CJ (2017) The diagnosis of nongonococcal urethritis in men: can there be a universal standard? Sex Transm Dis 44:195–196 PubMed Rietmeijer CA, Mettenbrink CJ (2017) The diagnosis of nongonococcal urethritis in men: can there be a universal standard? Sex Transm Dis 44:195–196 PubMed
59.
Zurück zum Zitat Moi H, Hartgill U, Skullerud KH, Reponen EJ, Syvertsen L, Moghaddam A (2017) Microscopy of stained urethral smear in male urethritis: which cutoff should be used? Sex Transm Dis 44:189–194 PubMed Moi H, Hartgill U, Skullerud KH, Reponen EJ, Syvertsen L, Moghaddam A (2017) Microscopy of stained urethral smear in male urethritis: which cutoff should be used? Sex Transm Dis 44:189–194 PubMed
61.
Zurück zum Zitat Bickley LS, Krisher KK, Punsalang A et al (1989) Comparison of direct fluorescent antibody, acridine orange, wet mount, and culture for detection of trichomonas vaginalis in women attending a public sexually transmitted diseases clinic. Sex Transm Dis 16:127–131 PubMed Bickley LS, Krisher KK, Punsalang A et al (1989) Comparison of direct fluorescent antibody, acridine orange, wet mount, and culture for detection of trichomonas vaginalis in women attending a public sexually transmitted diseases clinic. Sex Transm Dis 16:127–131 PubMed
62.
Zurück zum Zitat Kreiger JN, Tam MR, Stevens CE et al (1988) Diagnosis of trichomoniasis: comparison of conventional wet-mount examination with cytological studies, cultures, and monoclonal antibody staining of direct specimens. JAMA 259:1223–1227 Kreiger JN, Tam MR, Stevens CE et al (1988) Diagnosis of trichomoniasis: comparison of conventional wet-mount examination with cytological studies, cultures, and monoclonal antibody staining of direct specimens. JAMA 259:1223–1227
63.
Zurück zum Zitat Nathan B, AppiahSaunders JP, Saunders P et al (2015) Microscopy outperformed in a comparison of five methods for detecting trichomonas vaginalis in symptomatic women. Int J STD Aids 26:251–256 PubMed Nathan B, AppiahSaunders JP, Saunders P et al (2015) Microscopy outperformed in a comparison of five methods for detecting trichomonas vaginalis in symptomatic women. Int J STD Aids 26:251–256 PubMed
64.
Zurück zum Zitat Nye MB, Schwebke JR, Body BA (2009) Comparison of APTIMA trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women. Am J Obstet Gynecol 200:188–197 Nye MB, Schwebke JR, Body BA (2009) Comparison of APTIMA trichomonas vaginalis transcription-mediated amplification to wet mount microscopy, culture, and polymerase chain reaction for diagnosis of trichomoniasis in men and women. Am J Obstet Gynecol 200:188–197
65.
Zurück zum Zitat Hobbs MM, Lapple DM, Lawing LF et al (2006) Methods for detection of trichomonas vaginalis in the male partners of infected women: implications for control of trichomoniasis. J Clin Microbiol 44:3994–3999 PubMedPubMedCentral Hobbs MM, Lapple DM, Lawing LF et al (2006) Methods for detection of trichomonas vaginalis in the male partners of infected women: implications for control of trichomoniasis. J Clin Microbiol 44:3994–3999 PubMedPubMedCentral
67.
Zurück zum Zitat Dize L, Barnes P Jr, Barnes M, Hsieh YH, Marsiglia V, Duncan D, Hardick J, Gaydos CA (2016) Performance of self-collected penile-meatal swabs compared to clinician-collected urethral swabs for the detection of chlamydia trachomatis, Neisseria gonorrhoeae, trichomonas vaginalis and mycoplasma genitalium by nucleic acid amplification assays. Diagn Microbiol Infect Dis 86(2):131–135 PubMedPubMedCentral Dize L, Barnes P Jr, Barnes M, Hsieh YH, Marsiglia V, Duncan D, Hardick J, Gaydos CA (2016) Performance of self-collected penile-meatal swabs compared to clinician-collected urethral swabs for the detection of chlamydia trachomatis, Neisseria gonorrhoeae, trichomonas vaginalis and mycoplasma genitalium by nucleic acid amplification assays. Diagn Microbiol Infect Dis 86(2):131–135 PubMedPubMedCentral
68.
Zurück zum Zitat Meyer T (2016) Diagnostic procedures to detect chlamydia trachomatis infections. Microorganisms 4:e25 Meyer T (2016) Diagnostic procedures to detect chlamydia trachomatis infections. Microorganisms 4:e25
69.
Zurück zum Zitat Dudareva-Vizule S, Haar K, Sailer A, Chlamydia trachomatis laboratory sentinel team et al (2016) Establishment of a voluntary electronic chlamydia trachomatis laboratory surveillance system in Germany, 2008 to 2014. Euro Surveill 22(6):30459 Dudareva-Vizule S, Haar K, Sailer A, Chlamydia trachomatis laboratory sentinel team et al (2016) Establishment of a voluntary electronic chlamydia trachomatis laboratory surveillance system in Germany, 2008 to 2014. Euro Surveill 22(6):30459
70.
Zurück zum Zitat Gaydos CA (2017) Mycoplasma genitalium: accurate diagnosis is necessary for adequate treatment. J Infect Dis 216(2):S406–S411 PubMedPubMedCentral Gaydos CA (2017) Mycoplasma genitalium: accurate diagnosis is necessary for adequate treatment. J Infect Dis 216(2):S406–S411 PubMedPubMedCentral
72.
Zurück zum Zitat Tabrizi SN, Unemo M, Golparian D et al (2013) Analytical evaluation of GeneXpert CT/NG, the first genetic point-of-care assay for simultaneous detection of Neisseria gonorrhoeae and chlamydia trachomatis. J Clin Microbiol 51:1945–1947 PubMedPubMedCentral Tabrizi SN, Unemo M, Golparian D et al (2013) Analytical evaluation of GeneXpert CT/NG, the first genetic point-of-care assay for simultaneous detection of Neisseria gonorrhoeae and chlamydia trachomatis. J Clin Microbiol 51:1945–1947 PubMedPubMedCentral
73.
Zurück zum Zitat Chen X, Huang L, Zhou Q, Tan Y, Tan X, Dong S (2021) A nanoparticle-based biosensor combined with multiple cross displacement amplification for the rapid and visual diagnosis of Neisseria gonorrhoeae in clinical application. Front Microbiol 12:747140 PubMedPubMedCentral Chen X, Huang L, Zhou Q, Tan Y, Tan X, Dong S (2021) A nanoparticle-based biosensor combined with multiple cross displacement amplification for the rapid and visual diagnosis of Neisseria gonorrhoeae in clinical application. Front Microbiol 12:747140 PubMedPubMedCentral
74.
Zurück zum Zitat Chen X, Zhou Q, Wu X, Wang S, Liu R, Dong S, Yuan W (2021) Visual and rapid diagnosis of Neisseria gonorrhoeae using loop-mediated isothermal amplification combined with a polymer nanoparticle-based biosensor in clinical application. Front Mol Biosci 8:702134 PubMedPubMedCentral Chen X, Zhou Q, Wu X, Wang S, Liu R, Dong S, Yuan W (2021) Visual and rapid diagnosis of Neisseria gonorrhoeae using loop-mediated isothermal amplification combined with a polymer nanoparticle-based biosensor in clinical application. Front Mol Biosci 8:702134 PubMedPubMedCentral
76.
Zurück zum Zitat Carter E, Davis SA, Hill DJ (2022) Rapid detection of Neisseria gonorrhoeae genomic DNA using gold nanoprobes which target the gonococcal DNA uptake sequence. Front Cell Infect Microbiol 12:920447 PubMedPubMedCentral Carter E, Davis SA, Hill DJ (2022) Rapid detection of Neisseria gonorrhoeae genomic DNA using gold nanoprobes which target the gonococcal DNA uptake sequence. Front Cell Infect Microbiol 12:920447 PubMedPubMedCentral
77.
Zurück zum Zitat Tabrizi SN, Su J, Bradshaw CS et al (2017) Prospective evaluation of ResistancePlus MG, a new multiplex quantitative PCR assay for detection of mycoplasma genitalium and macrolide resistance. J Clin Microbiol 55(6):1915–1919 PubMedPubMedCentral Tabrizi SN, Su J, Bradshaw CS et al (2017) Prospective evaluation of ResistancePlus MG, a new multiplex quantitative PCR assay for detection of mycoplasma genitalium and macrolide resistance. J Clin Microbiol 55(6):1915–1919 PubMedPubMedCentral
80.
Zurück zum Zitat Podbielski A, Mauch H, Kniehl E, Herrmann M, Rüssmann H (Hrsg) (2011) MIQ 11a: Genitalinfektionen, Teil II Infektionserreger: Bakterien, Qualitätsstandards in der mikrobiologisch-infektiologischen Diagnostik, 2. Aufl. Urban & Fischer Verlag, München Podbielski A, Mauch H, Kniehl E, Herrmann M, Rüssmann H (Hrsg) (2011) MIQ 11a: Genitalinfektionen, Teil II Infektionserreger: Bakterien, Qualitätsstandards in der mikrobiologisch-infektiologischen Diagnostik, 2. Aufl. Urban & Fischer Verlag, München
84.
Zurück zum Zitat Unemo M, Golparian D, Eyre DW (2019) Antimicrobial resistance in Neisseria gonorrhoeae and treatment of gonorrhea. Methods Mol Biol 1997:37–58 PubMed Unemo M, Golparian D, Eyre DW (2019) Antimicrobial resistance in Neisseria gonorrhoeae and treatment of gonorrhea. Methods Mol Biol 1997:37–58 PubMed
88.
Zurück zum Zitat Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M, Murray G, Chow EPF, Low N, Garland SM, Vodstrcil LA, Fairley CK, Hocking JS, Zhang L, Bradshaw CS (2020) Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis 20(11):1302–1314 PubMed Machalek DA, Tao Y, Shilling H, Jensen JS, Unemo M, Murray G, Chow EPF, Low N, Garland SM, Vodstrcil LA, Fairley CK, Hocking JS, Zhang L, Bradshaw CS (2020) Prevalence of mutations associated with resistance to macrolides and fluoroquinolones in mycoplasma genitalium: a systematic review and meta-analysis. Lancet Infect Dis 20(11):1302–1314 PubMed
89.
Zurück zum Zitat Dumke R, Spornraft-Ragaller P (2021) Antibiotic resistance and genotypes of mycoplasma genitalium during a resistance-guided treatment regime in a German university hospital. Antibiotics 10(8):962 PubMedPubMedCentral Dumke R, Spornraft-Ragaller P (2021) Antibiotic resistance and genotypes of mycoplasma genitalium during a resistance-guided treatment regime in a German university hospital. Antibiotics 10(8):962 PubMedPubMedCentral
95.
Zurück zum Zitat Molina JM, Charreau I, Chidiac C, Pialoux G, Cua E, Delaugerre C, Capitant C, Rojas-Castro D, Fonsart J, Bercot B, Bébéar C, Cotte L, Robineau O, Raffi F, Charbonneau P, Aslan A, Chas J, Niedbalski L, Spire B, Sagaon-Teyssier L, Carette D, Mestre SL, Doré V, Meyer L, ANRS IPERGAY Study Group (2018) Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial. Lancet Infect Dis 18(3):308–317. https://​doi.​org/​10.​1016/​S1473-3099(17)30725-9 CrossRefPubMed Molina JM, Charreau I, Chidiac C, Pialoux G, Cua E, Delaugerre C, Capitant C, Rojas-Castro D, Fonsart J, Bercot B, Bébéar C, Cotte L, Robineau O, Raffi F, Charbonneau P, Aslan A, Chas J, Niedbalski L, Spire B, Sagaon-Teyssier L, Carette D, Mestre SL, Doré V, Meyer L, ANRS IPERGAY Study Group (2018) Post-exposure prophylaxis with doxycycline to prevent sexually transmitted infections in men who have sex with men: an open-label randomised substudy of the ANRS IPERGAY trial. Lancet Infect Dis 18(3):308–317. https://​doi.​org/​10.​1016/​S1473-3099(17)30725-9 CrossRefPubMed
96.
Zurück zum Zitat Berçot B, Charreau I, Rousseau C, Delaugerre C, Chidiac C, Pialoux G, Capitant C, Bourgeois-Nicolaos N, Raffi F, Pereyre S, Le Roy C, Senneville E, Meyer L, Bébéar C, Molina JM, ANRS IPERGAY Study Group. (2021) High prevalence and high rate of antibiotic resistance of mycoplasma genitalium infections in men who have sex with men: a substudy of the ANRS IPERGAY pre-exposure prophylaxis trial. Clin Infect Dis 73(7):e2127–e2133. https://​doi.​org/​10.​1093/​cid/​ciaa1832 CrossRefPubMed Berçot B, Charreau I, Rousseau C, Delaugerre C, Chidiac C, Pialoux G, Capitant C, Bourgeois-Nicolaos N, Raffi F, Pereyre S, Le Roy C, Senneville E, Meyer L, Bébéar C, Molina JM, ANRS IPERGAY Study Group. (2021) High prevalence and high rate of antibiotic resistance of mycoplasma genitalium infections in men who have sex with men: a substudy of the ANRS IPERGAY pre-exposure prophylaxis trial. Clin Infect Dis 73(7):e2127–e2133. https://​doi.​org/​10.​1093/​cid/​ciaa1832 CrossRefPubMed
97.
Zurück zum Zitat Luetkemeyer AF, Donnell D, Dombrowski JC, Cohen S, Grabow C, Brown CE, Malinski C, Perkins R, Nasser M, Lopez C, Vittinghoff E, Buchbinder SP, Scott H, Charlebois ED, Havlir DV, Soge OO, Celum C, DoxyPEP Study Team (2023) Postexposure doxycycline to prevent bacterial sexually transmitted infections. N Engl J Med 388(14):1296–1306. https://​doi.​org/​10.​1056/​NEJMoa2211934 CrossRefPubMedPubMedCentral Luetkemeyer AF, Donnell D, Dombrowski JC, Cohen S, Grabow C, Brown CE, Malinski C, Perkins R, Nasser M, Lopez C, Vittinghoff E, Buchbinder SP, Scott H, Charlebois ED, Havlir DV, Soge OO, Celum C, DoxyPEP Study Team (2023) Postexposure doxycycline to prevent bacterial sexually transmitted infections. N Engl J Med 388(14):1296–1306. https://​doi.​org/​10.​1056/​NEJMoa2211934 CrossRefPubMedPubMedCentral
98.
Zurück zum Zitat Sánchez-Busó L, Cole MJ, Spiteri G, Day M, Jacobsson S, Golparian D, Sajedi N, Yeats CA, Abudahab K, Underwood A, Bluemel B, Aanensen DM, Unemo M, Centre for Genomic Pathogen Surveillance and the Euro-GASP study group (2022) Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study. Lancet Microbe 3(6):e452–e463. https://​doi.​org/​10.​1016/​S2666-5247(22)00044-1 CrossRefPubMed Sánchez-Busó L, Cole MJ, Spiteri G, Day M, Jacobsson S, Golparian D, Sajedi N, Yeats CA, Abudahab K, Underwood A, Bluemel B, Aanensen DM, Unemo M, Centre for Genomic Pathogen Surveillance and the Euro-GASP study group (2022) Europe-wide expansion and eradication of multidrug-resistant Neisseria gonorrhoeae lineages: a genomic surveillance study. Lancet Microbe 3(6):e452–e463. https://​doi.​org/​10.​1016/​S2666-5247(22)00044-1 CrossRefPubMed
105.
Zurück zum Zitat Buder S, Lautenschlager S (2020) Gonorrhea and urethritis. In: Plewig G, French L, Ruzicka T, Kaufmann R, Hertl M (Hrsg) Braun-Falco’s dermatology, 1. Aufl. Springer, Berlin, Heidelberg Buder S, Lautenschlager S (2020) Gonorrhea and urethritis. In: Plewig G, French L, Ruzicka T, Kaufmann R, Hertl M (Hrsg) Braun-Falco’s dermatology, 1. Aufl. Springer, Berlin, Heidelberg
106.
Zurück zum Zitat Serra-Pladevall J, Caballero E, Roig G et al (2015) Comparison between conventional culture and NAATs for the microbiological diagnosis in gonococcal infection. Diagn Microbiol Infect Dis 83:341–343 PubMed Serra-Pladevall J, Caballero E, Roig G et al (2015) Comparison between conventional culture and NAATs for the microbiological diagnosis in gonococcal infection. Diagn Microbiol Infect Dis 83:341–343 PubMed
Metadaten
Titel
Urethritis – Erregerspektrum, Diagnostik und Therapie
verfasst von
Dr. Susanne Buder
Publikationsdatum
17.10.2023

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