Causative Microbial and Susceptibilities of Male Purulent Urethritis

Abstract

Objective: Purulent urethritis in the male patients is frequently found in the urological out-patient clinic, Neisseria gonorrhoeae is the most common causative microbial. The symptoms usually are dysuria, frequency accompanied with purulent urethral discharge about 7-10 days after sex exposure. The only way to treat these patients' symptoms and prevent these infectious diseases spreading successfully is using appropriate antibiotics. We try to identify the common causative microbial of the purulent urethral discharge and the antimicrobial susceptibilities.Methods: Between June 2007 and November 2008, those patients visited our clinic (a regional hospital in Taoyuan, Taiwan) who sustained purulent urethral discharge. The swab was obtained from the urethral meatus after we disinfected the glans and sent to the laboratory immediately. The first-catch urine was also collected for culture. If the cultured microorganism≧ 10^4/cumm, antimicrobial agents susceptibility will be checked.Results: By data mining, one hundred and twenty patients were enrolled in this study, 94 patients with 103 strains microbial were cultured (9 patients had 2 kinds of microbial infection). The total number of positive discharges swab culture is 92 (76.7%). However, only 21 (17.5%) patients had positive first-catch urine culture. The 5 the most common causative microbial of the male purulent urethritis were Neisseria gonorrhoeae (40, 38.8%), Group Denterococcus faecalis (18, 17.5%), Coagulase negative staphylococcus (9, 8.7%), Group B streptococcus (9, 8.7%) and Escherichia coli (6, 5.8%). By the susceptibility test, 22.5% (9/40) of our Neisseria gonorrhoeae strains were sensitive to the ciprofloxacin. The 3 most common susceptible oral form antibiotics to Neisseria gonorrhoeae are amoxicillin-clavulanic acid (100%), nitrofurantoin (100%) and cefazolin (97.5%).Conclusions: Based on our preliminary experiences, we found the swab from the urethral meatus can offer more available information than the first-catch urine sample. We also recommend the oral form amoxicillin-clavulanic acid, nitro-furantoin or cefazolin as the first aid for the purulent urethritis before the culture susceptibility reported.