The rapidly advancing technology of modern molecular microbiology has greatly improved our understanding of the epidemiology of sexually transmitted infections and the etiology and pathogenesis of the diseases they cause. It is now clear that Mycoplasma genitalium accounts for a significant proportion of nonchlamydial nongonococcal urethritis (NGU) cases. DNA sequencing of Ureaplasma spp has revealed a new species, Ureaplasma parvum. This organism may account for much of the colonization observed in asymptomatic men, which confounded many past studies of the role of Ureaplasma spp in NGU. At long last, we can say that Ureaplasma urealyticum is a true pathogen. The use of polymerase chain reaction technology has shown that Trichomonas vaginalis occurs more frequently in men with NGU than had been thought; however, such studies also have demonstrated that it is more prevalent in asymptomatic men. Finally, recent studies have shown that adenovirus should be added to the list of viral causes of NGU.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
References and Recommended Reading
Robertson JA, Stemke GW, Davis JW Jr, et al.: Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticum (Shepard et al. 1974) Robertson et al. 2001. Int J Syst Evol Microbiol 2002, 52:587–597.
Martin DH: Urethritis in males. In Sexually Transmitted Diseases. 4th ed. Edited by Holmes KK, Sparling PF, Stamm W, et al. New York: McGraw-Hill; 2007.
Deguchi T, Yoshida T, Miyazawa T, et al.: Association of Ureaplasma urealyticum (biovar 2) with nongonococcal urethritis. Sex Transm Dis 2004, 31:192–195.
Povlsen K, Bjornelius E, Lidbrink P, et al.: Relationship of Ureaplasma urealyticum biovar 2 to nongonococcal urethritis. Eur J Clin Microbiol Infect Dis 2002, 21:97–101.
Yoshida T, Deguchi T, Meda S, et al.: Quantitative detection of Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in urine specimens from men with and without urethritis by real-time polymerase chain reaction. Sex Transm Dis 2007, 34:416–419.
Yoshida T, Ishiko H, Yasuda M, et al.: Polymerase chain reaction-based subtyping of ureaplasma parvum and ureaplasma urealyticum in first-pass urine samples from men with or without urethritis. Sex Transm Dis 2005, 32:454–457.
Tully JG, Taylor-Robinson D, Cole RM, et al.: A newly discovered mycoplasma in the human urogenital tract. Lancet 1981, 1:1288–1291.
Jensen JS: Mycoplasma genitalium: the aetiological agent of urethritis and other sexually transmitted diseases. J Eur Acad Dermatol Venereol 2004, 18:1–11.
Yokoi S, Maeda S, Kubota Y, et al.: The role of Mycoplasma genitalium and Ureaplasma urealyticum biovar 2 in postgonococcal urethritis. Clin Infect Dis 2007, 45:866–871.
Mena L, Wang X, Mroczkowski TF, et al.: Mycoplasma genitalium infections in asymptomatic men and men with urethritis attending a sexually transmitted diseases clinic in New Orleans. Clin Infect Dis 2002, 35:1167–1173.
Totten PA, Schwartz MA, Sjostrom KE, et al.: Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men. J Infect Dis 2001, 183:269–276.
Morency P, Dubois MJ, Gresenguet G, et al.: Aetiology of urethral discharge in Bangui, Central African Republic. Sex Transm Infect 2001, 77:125–129.
Hjorth SV, Bjornelius E, Lidbrink P, et al.: Sequence-based typing of Mycoplasma genitalium reveals sexual transmission. J Clin Microbiol 2006, 44:2078–2083.
Falk L, Fredlund H, Jensen JS: Tetracycline treatment does not eradicate Mycoplasma genitalium. Sex Transm Infect 2003, 79:318–319.
Wikstrom A, Jensen JS: Mycoplasma genitalium: a common cause of persistent urethritis among men treated with doxycycline. Sex Transm Infect 2006, 82:276–279.
Bradshaw CS, Jensen JS, Tabrizi SN, et al.: Azithromycin failure in Mycoplasma genitalium urethritis. Emerg Infect Dis 2006, 12:1149–1152.
Joyner JL, Douglas JM Jr, Ragsdale S, et al.: Comparative prevalence of infection with Trichomonas vaginalis among men attending a sexually transmitted diseases clinic. Sex Transm Dis 2000, 27:236–240.
Schwebke JR, Hook EW 3rd: High rates of Trichomonas vaginalis among men attending a sexually transmitted diseases clinic: implications for screening and urethritis management. J Infect Dis 2003, 188:465–468.
Wendel KA, Erbelding EJ, Gaydos CA, et al.: Use of urine polymerase chain reaction to define the prevalence and clinical presentation of Trichomonas vaginalis in men attending an STD clinic. Sex Transm Infect 2003, 79:151–153.
US Centers for Disease Control and Prevention: Sexually Transmitted Diseases Treatment Guidelines, 2006. MMWR Morb Mortal Wkly Rep 2006, 55(RR-11):1–94.
Bradshaw CS, Tabrizi SN, Read TR, et al.: Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis 2006, 193:336–345.
Azariah S, Reid M: Adenovirus and non-gonococcal urethritis. Int J STD AIDS 2000, 11:548–550.
Bradshaw CS, Denham IM, Fairley CK: Characteristics of adenovirus associated urethritis. Sex Transm Infect 2002, 78:445–447.
Lautenschlager S, Eichmann A: Urethritis: an underestimated clinical variant of genital herpes in men? J Am Acad Dermatol 2002, 46:307–308.
O’Mahony C: Adenoviral non-gonococcal urethritis. Int J STD AIDS 2006, 17:203–204.
Urra E, Alkorta M, Sota M, et al.: Orogenital transmission of Neisseria meningitidis serogroup C confirmed by genotyping techniques. Eur J Clin Microbiol Infect Dis 2005, 24:51–53.
Ferris MJ, Masztal A, Aldridge KE, et al.: Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis. BMC Infect Dis 2004, 4:5.
Fredricks DN, Fiedler TL, Marrazzo JM: Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005, 353:1899–1911.
Keane FE, Thomas BJ, Whitaker L, et al.: An association between non-gonococcal urethritis and bacterial vaginosis and the implications for patients and their sexual partners. Genitourin Med 1997, 73:373–377.
Riemersma WA, van der Schee CJ, van der Meijden WI, et al.: Microbial population diversity in the urethras of healthy males and males suffering from nonchlamydial, nongonococcal urethritis. J Clin Microbiol 2003, 41:1977–1986.
About this article
Cite this article
Martin, D.H. Nongonococcal urethritis: New views through the prism of modern molecular microbiology. Curr Infect Dis Rep 10, 128–132 (2008). https://doi.org/10.1007/s11908-008-0023-x
- Herpes Simplex Virus
- Bacterial Vaginosis
- Genital Herpes
- Neisseria Meningitidis