Ureaplasmas in acute and persistent urethritis: clinical implications

解脲支原体在急性和持续性尿道炎中的临床意义

• 批准号: 7268263
• 负责人: Lisa E Manhart
• 金额: $ 37.41万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7268263
• 关键词: Acute; Address; Adenoviruses; Antibiotic Resistance; Antibiotic Therapy; Azithromycin; Biological Assay; Caring; Case-Control Studies; Centers for Disease Control and Prevention (U.S.); Chlamydia trachomatis; Chronic; Clinic; Clinical; Clinical Treatment; Complement; Conflict (Psychology); Data; Detection; Doctor of Philosophy; Double-Blind Method; Doxycycline; Drug usage; Dysuria; Enrollment; Etiology; Exhibits; Face; Failure; Funding; Genes; Genital system; Gonococcal urethritis; Grouping; Infection; Lead; Light; Measures; Methods; Mycoplasma; Mycoplasma genitalium; Names; Neisseria gonorrhoeae; Nucleic Acid Amplification Techniques; Office Visits; Organism; Participant; Pathogenicity; Patients; Phylogenetic Analysis; Play; Polymerase Chain Reaction; Pruritus; Public Health; Publishing; Randomized; Recruitment Activity; Recurrence; Relative (related person); Reporting; Reproductive Tract Infections; Research Personnel; Resistance; Role; Series; Sexually Transmitted Diseases; Simplexvirus; Symptoms; Syndrome; Testing; Tetracycline; Tetracyclines; Today; Treatment Failure; Treatment Protocols; Trichomonas vaginalis; United States; Ureaplasma; Ureaplasma urealyticum; Urethra; Urethritis; Urination; Urine; Virus Diseases; Visit; Week; day; experience; follow-up; male; men; programs; response; treatment trial

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.

描述（由申请人提供）：项目摘要。非淋菌性尿道炎 (NGU) 是美国男性中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。对于持续性或复发性尿道炎的病因知之甚少，这种情况也很常见。解脲脲原体可能是其中一些特发性病例的原因，但有关该生物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。与沙眼衣原体血清型相似，解脲支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，两个主要的解脲支原体生物变型群实际上是不同的物种。 U. parvum 被指定为生物变种 1，而 U. urealyticum 名称则保留为生物变种 2。有限的数据表明 U. urealyticum（生物变种 2）而非 U. parvum 与 NGU 相关，但需要进一步研究来证实这一观察结果，以及评估这两个物种对 NGU 常见抗生素治疗方案的差异反应，并确定该微生物在持续性或复发性 NGU 中的作用。为了解决这些问题，我们将结合正在进行的另一种生殖器支原体（生殖支原体）的随机治疗试验，进行一系列研究。具体来说，我们将 1) 评估解脲支原体（生物变种 2）和微小 U. parvum 与急性 NGU 的关联； 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在根除 NGU 男性中解脲支原体（生物变种 2）和小支原体感染方面的相对功效，并评估所用药物的 MIC 之间的关系解脲脲原菌（生物变种 2）和小球脲菌的持续存在； 3) 评估持续性或复发性 NGU 与解脲支原体（生物变种 2）和小支原体的关联。关联。 NGU 是每年超过 200,000 名医生就诊的对象（CDC，2001），并且是一个重大的公共卫生问题。这项研究的结果可能有助于确定该综合征的另一个原因，为治疗决策提供指导，并阐明持续性和复发性病例的病因。