| Recalibrating the gram stain diagnosis of male urethritis in the era of nucleic Acid amplification testing. | |
| | |
MedLine Citation:
|
PMID: 22183839 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
BACKGROUND: : Criteria for diagnosis of male urethritis based on a Gram-stained smear (GSS) of urethral discharge were developed before the era of nucleic acid amplification testing (NAAT) for Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct) and may be too stringent when considering the higher sensitivity of NAAT. OBJECTIVE: : To evaluate Ct and Ng positivity at different strata of polymorphonuclear cells (PMN) per high power field (hpf) GSS microscopy. METHODS: : A retrospective analysis of the electronic medical record system of the Denver Metro Health Clinic between March 1, 2005 and December 31, 2010; all men with a GSS test during this period had an NAAT for Ct and Ng and had GSS results recorded at 1 PMN/hpf increments. RESULTS: : A total of 13,520 GSS were available for analysis. For Ct, a statistically significant trend was observed along the PMN/hpf incremental spectrum, and a significant increase in positivity was observed between the 1 and 2 PMN/hpf strata (from 6.5% to 16.2%). For men diagnosed with Ng, no such trend was observed, and >95% of GSS results fell in the >10 strata. A subanalysis to control for laboratory technician variance and difference in NAAT technology showed similar results. CONCLUSION: : Our data support lowering the diagnostic criteria of the GSS diagnosis of male urethritis to ≥2 PMN/hpf. At this level, the Ct positivity (16.2%) is similar or higher than positivity in men who receive presumptive chlamydia treatment as a contact to patients diagnosed with gonorrhea, pelvic inflammatory disease, or mucopurulent cervicitis. |
| | |
Authors:
|
Cornelis A Rietmeijer; Christie J Mettenbrink |
Related Documents
:
|
12132939 - Ptv margin determination in conformal srt of intracranial lesions. 21717299 - Evaluation of image quality on a per-patient, per-vessel, and per-segment basis by noni... 21791729 - Detection of a coronary artery vessel wall: performance of 0.3 mm fine-cell detector co... 10199909 - A survey of post-discharge side effects of conscious sedation using chloral hydrate in ... 1749469 - Low-dose ct and inflammatory disease of the paranasal sinuses. 19467609 - An airway phantom to standardize ct acquisition in multicenter clinical trials. 21785249 - Angiocentric glioma and surrounding cortical dysplasia manifesting as intractable front... 12452919 - Hydatid disease of bone: a mimic of other skeletal pathologies. 1574459 - Magnetic resonance imaging in carcinoma of the prostate. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Sexually transmitted diseases Volume: 39 ISSN: 1537-4521 ISO Abbreviation: Sex Transm Dis Publication Date: 2012 Jan |
Date Detail:
|
Created Date: 2011-12-20 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7705941 Medline TA: Sex Transm Dis Country: United States |
Other Details:
|
Languages: eng Pagination: 18-20 Citation Subset: IM |
Affiliation:
|
From the *Denver Public Health Department and †Colorado School of Public Health, University of Colorado Denver, Denver, Colorado. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Sexually Transmitted Escherichia coli Urethritis and Orchiepididymitis.
Next Document: Clinical and Virologic Response to Episodic Acyclovir for Genital Ulcers Among HIV-1 Seronegative, H...