Clinical and Bacteriological Profile of Male Patients with Urethral Discharge at Western Regional Hospital, Nepal
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Keywords

Ceftriaxone
drug resistance
gonorrhoea
Sexually Transmitted Infection
urethritis

Abstract

Background: Urethral discharge is a symptom of
urethritis. Common organisms causing urethral discharge
are Neisseria gonorrhea and Chlamydia trachomatis.
Cephalosporines, Macrolides and Tetracycline groups of
drugs are commonly used for the treatment.


Materials and Method: This was a prospective, cross
sectional, observational study. The patients were enrolled
from the Sexually Transmitted Infections clinic and also
from the hospital laboratory in between the period of one
year. All the male cases with urethral discharge at STI
clinic in between this period were included for clinical
examination and laboratory testing. All urine and discharge
specimens of urethral discharge patients as referred from
other departments directly to the hospital laboratory for
relevant tests were also included for the study.


Results: Neisseria gonorrhea was the most common
agent of urethral discharge in male patients. Urethral
discharge, dysuria and inguinal lymphadenopathy were
common symptoms. All the NG isolates were sensitive to
Ceftriaxone and Imipenam.


Conclusion: Continuous monitoring with culture
sensitivity testing of urethral discharge cases is required.



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References

Vigneswaran HT, Baird G, Hwang K, Renzulli

J, Chan PA. Etiology of symptomatic urethritis in

men and association with sexual behaviors. R I Med

J 2013. 2016 Jun 1;99(6):37–40.

Bachmann LH, Manhart LE, Martin DH, Seña

AC, Dimitrakoff J, Jensen JS, et al. Advances in the

Understanding and Treatment of Male Urethritis.

Clin Infect Dis. 2015 Dec 15;61(suppl_8):S763-9.

Gonococcal Infections - 2015 STD Treatment

Guidelines [Internet]. 2018 [cited 2018 Sep 18]. Available from: https://www.cdc.gov/std/tg2015/

gonorrhea.htm

World Health Organization, Reproductive

Health and Research. WHO guidelines for the

treatment of Neisseria gonorrhoeae. [Internet].

[cited 2018 Sep 18]. Available from: http://

www.ncbi.nlm.nih.gov/books/NBK379221/

Judson FN. Gonococcal Urethritis-Diagnosis

and Treatment. Arch Androl. 1979 Jan; 3(4):329–

Chernesky MA. The laboratory diagnosis of

Chlamydia trachomatis infections. Can J Infect Dis

Med Microbiol. 2005;16(1):39–44.

Keegan MB, Diedrich JT, Peipert JF. Chlamydia

trachomatis Infection: Screening and Management.

J Clin Outcomes Manag JCOM. 2014 Jan;21(1):30–

Nayak AK, Anoop TV, Sacchidanand S.

A clinico-etiological study of urethritis in men

attending sexually transmitted disease clinic at a

tertiary hospital. Indian J Sex Transm Dis AIDS.

;38(2):136–41.

Hill SA, Masters TL, Wachter J. Gonorrhea -

an evolving disease of the new millennium. Microb

Cell. 2016;3(9):371–389. Published 2016 Sep 5.

doi:10.15698/mic2016.09.524.

Gonorrhoea & its co-infection with other

ulcerative, non-ulcerative sexually transmitted &

HIV infection in a Regional STD Centre [Internet].

[cited 2019 Aug 27]. Available from: https://www.

ncbi.nlm.nih.gov/pmc/articles/PMC3103165/

Johnson RE, Newhall WJ, Papp JR, Knapp

JS, Black CM, Gift TL, et al. Screening tests

to detect Chlamydia trachomatis and Neisseria

gonorrhoeae infections--2002. MMWR Recomm

Rep Morb Mortal Wkly Rep Recomm Rep. 2002

Oct 18;51(RR-15):1–38; quiz CE1-4.

Lama L, Kayestha BMM. Gonococcal culture

and drug sensitivity pattern in patients with urethral discharge and vaginal discharge with cervicitis.

Post-Grad Med J NAMS [Internet]. 2017 Sep 7

[cited 2018 Aug 14];13(2). Available from: https://

pmjn.org.np/index.php/pmjn/article/view/222

Epidemiological Trends of Antibiotic Resistant

Gonorrhoea in the United Kingdom [Internet].

[cited 2019 Aug 27]. Available from: https://www.

ncbi.nlm.nih.gov/pmc/articles/PMC6165062/

Ohnishi M, Golparian D, Shimuta K, Saika T,

Hoshina S, Iwasaku K, et al. Is Neisseria gonorrhoeae

Initiating a Future Era of Untreatable Gonorrhea?:

Detailed Characterization of the First Strain with

High-Level Resistance to Ceftriaxone. Antimicrob

Agents Chemother. 2011 Jul;55(7):3538–45.

Buder S, Dudareva S, Jansen K, Loenenbach A,

Nikisins S, Sailer A, et al. Antimicrobial resistance

of Neisseria gonorrhoeae in Germany: low levels

of cephalosporin resistance, but high azithromycin

resistance. BMC Infect Dis. 2018 17;18(1):44.

Lee RS, Seemann T, Heffernan H, Kwong JC,

Gonçalves da Silva A, Carter GP, et al. Genomic

epidemiology and antimicrobial resistance

of Neisseria gonorrhoeae in New Zealand. J

Antimicrob Chemother. 2018 Feb 1;73(2):353-64.

Kulkarni SV, Bala M, Muqeeth SA, Sasikala

G, Nirmalkar AP, Thorat R, et al. Antibiotic

susceptibility pattern of Neisseria gonorrhoeae

strains isolated from five cities in India during

-2016. J Med Microbiol. 2018 Jan;67(1):22–8.

Wi T, Lahra MM, Ndowa F, Bala M, Dillon

J-AR, Ramon-Pardo P, et al. Antimicrobial resistance

in Neisseria gonorrhoeae: Global surveillance

and a call for international collaborative action.

PLoS Med [Internet]. 2017 Jul 7 [cited 2019 Aug

;14(7). Available from: https://www.ncbi.nlm.

nih.gov/pmc/articles/PMC5501266/

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