Seroprevalence of Chlamydia trachomatis Infection in Women of Procreate Age in the Mayo-Boneye Department in Chad

Introduction: Chlamydia trachomatis infections constitute a major public health problem, particularly in women. The objective of this study is to identify Chlamydia trachomatis to improve the health of women in the Department of Mayo-Boneye. Methodology: This is a prospective observational study that took place from October to December 2021, including 168 patients with their sociodemographic characteristics. The venous blood of the patients was collected in dry tubes and centrifuged to obtain the serum. The Chlamydia IgG Rapid Test Cassette was used for the detection of antibodies to Chlamydia infection. The Epi Info 7TM software was used to perform the statistical analyses. Results: A total of 168 patients were included in this study. The average age was 26.36 ± 9.21 years, the median was 25.5 years with the extremes of 14 years and 70 years. Among these patients, 46.43% were illiterate, 5.95% and 20.83% were primary and secondary school students, respectively, and 26.79% university students. For marital status, 66.67% were single, 16.67% married, 10.71% divorced and 5.95% widowed. Regarding the profession, 26.79% were traders, 8.93% were employees and 64.29% unemployed. In this study, the 168 patients had performed Chlamydia trachomatis serology among whom 02 (1.19%) were excluded for invalid results and 10.71% presented positive cases. The city of Bongor was the most infected with 61% of cases. Among these patients, 54.22% were linked to risk factors for Chlamydia trachomatis. The most infected age group was between 25 and 35 with a seroprevalence of 5.36% of cases. Conclusion: In this study, Chlamydia trachomatis was positive for 10.71% of diagnosed cases. The most affected age groups are young, sexually active women. The State should emphasize the screening of women, the awareness of students and academics.

Tubal Infertility and Chlamydia Trachomatis in a Congolese Infertile Population

Infertility of tubal origin is the most frequent in sub-Saharan area. It is due to tuboperitoneal lesions mainly because of infection;especially sexually transmitted infection. Worldwide, Chlamydia trachomatis is the main pathogen. In our setting, some studies failed to establish the link between tubal infertility and chlamydia trachomatis. The current study aimed to determine the local data related to chlamydia trachomatis role in tubal infertility and the usefulness of Chlamydia trachomatis antibody titer test (CAT) in discrimination of the patients with and without tuboperitoneal lesions. Patients’ average age was 33.9 ± 4.8 years, average coitarche 19.4 ± 4.4 years and average number of partners: 3.1 ± 1.6. The level of CAT is correlated to the tuboperitoneal severity. CAT was more specific (93.3%;CI 95%: 81.7 - 98.6) than sensitive (72.7% CI 95%: 49.8 - 89.3) and discriminated correctly 89% (AUC = 0.89) of the patients with or without tuboperitoneal lesions. In conclusion, as it is stated worldwide, Chlamydia trachomatis is the most frequent sexually transmitted pathogen associated with tubal infertility. CAT has to be used as a tool to select patients to be submitted to invasive investigation, like laparoscopy.

Evaluation of patients with dry eye disease for conjunctival Chlamydia trachomatis and Ureaplasma urealyticum

AIM:To determine the possibility of the development of dry eye disease(DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients.METHODS: This study was conducted on 58 patients of age range 20-50 y,diagnosed with DED confirmed by Schirmer I test and tear breakup time.The non-dry eye control group included 27 subjects of the same age.Ocular specimens were collected as conjunctival scrapings and swabs divided into three groups: the first used for bacterial culture,the second and third taken to detect Chlamydia trachomatis and Ureaplasma urealyticum by direct fluorescent antibody(DFA) assay and polymerase chain reaction(PCR) method. RESULTS: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods respectively.Ureaplasma urealyticum was found in 44.8% of DED infected patients using the PCR method.Both organisms were identified in only 37.9% of DED patients found to be infected.Control subjects had a 22%detection rate of Chlamydia trachomatis by DFA assay versus a 7% detection rate by PCR; while Ureaplasma urealyticum was detected in 3.7% of the controls by PCR method.The conjunctival culture revealed that gram positive microorganisms represented 75% of isolates with coagulase negative Staphylococci the most common(50%) followed by Staphylococcus aureus(20%),whereas gram negative microorganisms occurred in 25% of cases,isolating Moraxella spp.as the most frequent organism. CONCLUSION: Our results tend to point out that Chlamydia trachomatis and Ureaplasma urealyticum were detected in a moderate percentage of patients with DED,and could be a fair possibility for its development.PCR is more reliable in detecting Chlamydia trachomatis than DFA technique.The presence of isolated conjunctival bacterial microflora can be of some potential value.

Study of the prevalence and association of ocular chlamydial conjunctivitis in women with genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans attending outpatient clinic

AIM: To determine the association between chlamydial conjunctivitis and genital infection by Chlamydia trachomatis, Mycoplasma genitalium and Candida albicans, in addition to the possible relationship between cultured bacterial pathogens and oculogenital chlamydial infection.METHODS: This study was performed on 100(50 symptomatic and 50 asymptomatic) women attending the Gynecological and Obstetric outpatient clinic of Alzahra hospital, Alazhar University. Simultaneously a conjunctival swab was taken from these patients.Polymerase chain reaction(PCR) was done on DNA extracted from both vaginal and conjunctival swab samples. Culture for both vaginal and conjunctival swabs was also done.RESULTS: Candida albicans was the predominant organism isolated by culture in 20% and 40% of conjunctival and vaginal swabs respectively. By the PCR method, ocular Chlamydia trachomatis was present in 60% of symptomatic women, while genital Chlamydia trachomatis infection was present in 30% of symptomatic women. The results of this method also indicated that 25/50(50%) vaginal swabs were positive with PCR for Candida albicans versus 15/50(30%) were PCR positive in conjunctival swab. Mycoplasma genitalium was present in only 10% of vaginal swabs.Concomitant oculogenital PCR positive results for Chlamydia trachomatis and Candida albicans were 30% and 28% respectively.CONCLUSION: Ocular Chlamydia trachomatis was associated with genital Chlamydia trachomatis in a high percentage of women followed by Candida albicans.Cultured bacterial organisms do not play a role in enhancement of Chlamydia trachomatis infection.

High frequency of latent Chlamydia trachomatis infection in patients with rhegmatogenous retinal detachment

AIM: To determine the frequency of detection of ocular and extraocular Chlamydia trachomatis(CT) infection in non-high myopes with rhegmatogenous retinal detachment(RRD).METHODS: This was a single-center, nonrandomized,prospective, case-control study. One hundred and four patients were divided into a study group with RRD(n =63) and a control group with traumatic retinal detachment(n =41). Samples of subretinal fluid(SFR), conjunctival,urethral/cervical swabs, and blood were collected. The frequency of detection of CT infection in SRF samples was determined by polymerase chain reaction(PCR),direct fluorescence assay(DFA) and cell culture, whereas that in conjunctival swabs was determined by PCR and DFA, and those in urethral/cervical swabs and blood were determined by DFA. Yates Chi-square test(with Bonferroni correction) and two-tailed Student's t-test were used for statistical analysis. RESULTS: SRF CT infection was detected more frequently in the study group(50.8%-71.4%) than in the control group(9.8%-12.2%) by all the methods used(P <0.01). The frequency of detection of conjunctival CT infection by DFA was higher in the RRD patients compared with the controls(81.0% vs 24.4%, P =0.004).The PCR detected conjunctival CT infection more often in the study group than in the controls(46.0% vs 9.8%, P =0.007). The DFA detected CT in blood specimens almost as frequently as in urogenital specimens, for the RRD patients(61.2% vs 63.5%) and the controls(7.3% vs 9.8%). CONCLUSION: CT infection is detected with high frequency in non-high myopes with RRD.

Trichomonas vaginalis and Chlamydia trachomatis Prevalence,Incidence and Associated Factors in Pregnant Adolescents from Belém City,in the Brazilian Amazon

Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing serious consequences for their reproductive health. Therefore, we aimed to determine the prevalence and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon. Methods: This prospective study enrolled 199 adolescents up to 20 weeks of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks of pregnancy. Sociodemographic and behavioral data were obtained by interview. Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and multivariate analyses were performed to test the association of prevalent/incident CT and TV with the variables. Results: Prevalence of cervical CT infection was 33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical ectopy increased the risk for prevalent CT (OR, 1.93;95% CI, 1.01 - 3.70), while having treated vaginal discharge in the past (OR, 0.51;95% CI, 0.26 - 0.98) and being married (OR, 0.10;95% CI, 0.01 - 0.83) were protective against current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed follow-up, 15 cases of incident CT were identified. Incident CT was associated with having a formal or informal job (OR, 28.4;95% CI, 2.1 - 391.6) and bacterial vaginosis treatment at the baseline (OR, 0.08;95% CI, 0.01 - 0.69). Conclusion: Prevalence and incidence rates of TV and CT are high in this population devoid of STI routine screening. Treatment of bacterial vaginosis may benefit this population by reducing risk for CT acquisition.

Detection of <i>Chlamydia trachomatis</i>and <i>Neisseria gonorrhoeae</i>in Egyptian Women Suffering from Infertility

Chlamydial and gonococcal infections are recognized as two of the major causes of sexually transmissible human bacterial infection which may lead to infertility. In this cross sectional study, we aimed to determine the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis among Egyptian women using different microbiological methods. One hundred and fifty cervical swabs were collected, of which 100 were from infertile women. Culture and ELISA technique were used for screening of Neisseria gonorrhoeae and Chlamydia trachomatis individually. In addition, PCR was used for all examined samples. For C. trachomatis, 3 cases were positive for antigen detection by ELISA. Moreover, in obtained results of PCR, DNA was detected in 4 samples, and three of them from infertile group. So based on PCR results, the sensitivity and specificity of ELISA were 75% and 100% respectively. Furthermore, 3 samples were positive for gonococcal infections by PCR, and two of them were taken from infertile women. Positive results of two samples were verified by culture. The estimated sensitivity and specificity of culture method were 66.7% and 100% respectively. Results of this study indicate that PCR is a valuable method for detection of gonococcal and chlamydial infection and it is suitable for the confirmation of ELISA results for C. trachomatis diagnosis. Culture method is less sensitive than PCR for detection of N. gonorrhoeae. The prevalence of such infections is higher among infertile women.

The Association between <i>Chlamydia Trachomatis</i>and Ectopic Pregnancy in Lagos, Nigeria—A Case Control Study

Objectives: To determine the seropositivity of Chlamydia antibody in patients with ruptured ectopic pregnancy compared to normal pregnant women and the risk factors for ectopic pregnancy. Study Design: This was a prospective case-control study of 85 cases of ruptured ectopic pregnancy and 100 cases of second trimester on-going intrauterine pregnant controls presenting in Lagos State University Teaching Hospital (LASUTH) between September 2009 and March 2010. Study Site: This was at the gynaecological emergency room and antenatal clinic in the Department of Obstetrics and Gynaecology. Ethical approval was sought and granted by the ethics review committee of LASUTH. Study Participants: Patients presenting with ruptured ectopic pregnancy were recruited as cases while the controls were made up of those with uncomplicated second trimester intrauterine pregnancy. A semi-structured questionnaire containing socio-demographic and clinical characteristics was administered following informed consent. Five milliliters of venous blood was taken from each participant and tested for?Lymphogranuloma Venerum?(LGV) type 2 broadly reacting antigen of?Chlamydia trachomatis.?Data Analysis: Data gathered from the case notes and laboratories were imputed into the computer and analyzed using the statistical package?Epi-Info 3.51, Atlanta, USA. Frequency tables were generated for continuous variables and?chi-square analysis used to determine association between variables, with p values <0.05 considered statistically significant. Results: There were 91 cases of ectopic pregnancy among a total of 2468 deliveries giving an incidence of 3.68% or 1 in 27 deliveries. Factors which significantly contributed to increased incidence of ectopic pregnancy in this study were: level of education (p = 0.001), socio-economic status (p = 0.001), parity (p = 0.005), early age of sexual debut (p = 0.001), multiple sexual partners (p = 0.001), previous pelvic inflammatory disease (p = 0.003), previous induced abortion (p = 0.013) and previous?postabortal/puerperal sepsis (p = 0.013). The seropositivity of?Chlamydia IgG (62.4%) in the cases was significantly higher than that of 29% in the control (p < 0.0001). Conclusion: There was a high incidence of ectopic during the period of study and the seropositivity of Chlamydia IgG antibody was significantly higher amongst the cases. Risk factors identified were low level of education, low socio-economic status, low parity, early age of sexual debut, multiple sexual partners, previous history of pelvic inflammatory disease, previous induced abortion and previous postabortal/puerperal sepsis.

<i>Chlamydia trachomatis</i>in a girl suspected of sexual abuse in the city of Córdoba, Argentina

Chlamydia trachomatis (C.tr) infections are the most prevalent bacterial sexually transmitted infections worldwide. They are often asymptomatic and therefore underdiagnosed as there is no routine screening surveillance. This case supports the possibility of sexual abuse as a route of transmission of C.tr. It is well known that nearly one third of sexually assaulted children are at risk for infection by a sexually transmitted agent. This is why in cases of sexual abuse, it is standardized that C.tr positive results by Nucleic Acid Amplification Techniques (NAATs) should be confirmed looking for another C.tr target;for this reason, we used a Polimerase Chain Reaction (PCR) directed to cryptic plasmid of C.tr. Confirmation was specified by the use of another PCR with a different genetic target (ompA) and sequencing. We concluded that our patient’s oral lesions were probably originated by her father’s sexual abuse.

Research Progress on Chlamydia trachomatis Infection and Related Cytokines

Chlamydia trachomatis (Ct) infection can induce host cells to produce numerous cytokines.Cytokines play important roles in inflammatory response. Although inflammation can protect the body, persistent inflammation can lead to pathological changes and tissue damages. Further research should determine whether cytokine production directly affects development and outcomes of inflammation. This study summarizes Ct infection and related cytokines.

Study on vertical transmision of Chlamydia trachomatis using PCR and DNA sequencing

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Chlamydia trachomatis infection in the genital tractis associated with inflammation and hypospermia inthe infertile male of China

Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlikethat in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective studywas to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels,and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile malesubjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT− group), in our hospital betweenJanuary 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility,morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between theCT+ and CT− groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, aswell as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males;otherroutine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affectedby CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impairsperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.

Suboptimal Chlamydia trachomatis Detection Method Is Still Widely Used in China: Results of External Quality Assessments from 2013 to 2018

Objective:Laboratory capacity for Chlamydia trachomatis (C.trachomatis) detection is important in the diagnosis and treatment of C.trachomatis infection,appropriate clinical management of patients,and providing evidence for prevention programs.We conducted this study to assess laboratory capabilities for detecting C.trachomatis in China by analysis of external quality assessment (EQA) results from 2013 to 2018.Methods:Overall,310/1,048 (29.58%) laboratories at national sexually transmitted disease (STD) sentinel site with 252-272 laboratories per time participated in six times of EQA.Each laboratory was requested to test the samples from EQA organization by the common method used,and the test results were reported to EQA organization for assessment.Z test and multinomial logistic regression analyses were used for data analyses.Results:Immunochromatographic test,nucleic acid amplification test (NAAT),and ELISA were used and accounted for 76.69%,21.54%,1.77%,respectively of all participating laboratories from 2013 to 2018.The total specificity for negative samples was 94.76%,the sensitivity for positive samples with medium and high concentration of C.trachomatis samples were 94.31% and 95.51%,respectively,but the sensitivity for sample with low concentration of Co trachomatis was 36.89%,and the immunochromatographic test had the worst sensitivity for detection of this sample (21.17% [95% C/s:18.93%-23.60%]) among the three methods.Three factors were found to be significantly associated with the sensitivity of the low-concentration sample:the location of laboratories (East China:adjusted odds ratio [AOR] =2.98,95% C/s:1.69-5.25,P < 0.05;South China:AOR =3.34,95% CIs:1.38-5.48,P < 0.05;Southwest China:AOR=2.75,95% CIs:1.37-5.48,P<0.05,as compared with Northwest China);the types of hospitals (prevention and control agencies:AOR =0.56,95% CIs:0.40-0.80,P < 0.05,as compared with general hospitals);and the method used (NAAT:AOR=46.99,95% CIs:28.49-77.48,P< 0.050;ELISA:AOR=5.42,95% CIS:2.40-12.25,P<0.05,as compared with immunochromatographic test).Conclusion:Immunochromatographic test is widely used for C.trachomatis antigen in China;however,based on its suboptimal detection sensitivity,methods with high sensitivity such as NAAT-based point-of-care diagnostic method are recommended to apply for C.trachomatis detection,and efforts should be performed to promote the high-sensitivity methods among laboratories.

Etiology of trachoma:a great success in isolating and cultivating chlamydia trachomatis

To review the studies on the etiology of trachoma and to honor Professor Tang Feifan (Prof FF Tang) He is the first scientist who was successful in isolating and cultivating chlamydia trachomatis in 1946 Data sources The principal literatures are cited from Tang’s papers published from the 1930s to the 1950s Earlier literatures concerning early hypotheses for trachoma pathogenic agent are also studied Study selection and data extraction Only important and conclusive breakthroughs in Tang’s papers are selected and extracted Results and conclusions In the 1930s Tang was intending to repeat Noguchi’s experiments in isolating bacterium granulosis from cases of trachoma in China and to employ bacterium granulosis isolated by Noguchi in 1928 for reproducing experimental trachomatous human clinical manifestations in China Both experiments showed negative results In the 1950s, before isolated chlamydia trachomtas, Tang and his colleagues had finished two fundamental studies: (1) the histological nature of trachoma, their relationship to etiological agent as well as to the host cells; and (2) the clinical manifestations and the morphological pictures of trachoma in monkeys Eventually chlamydia trachomatis was isolated successfully and cultivated

Yinjia pill inhibits persistent Chlamydia trachomatis infection

To the Editor:Chlamydia trachomatis(C.trachomatis)is obligate intracellular pathogens,often resulting in development of chronic disease and tissue damage as a consequence of the host inflammatory immune response as well as persistent infections,[1]which is associated with the activation of mitogen-activated protein kinase(MAPK)and extracellular regulated protein kinases(ERK)mediated by Toll-like receptors(TLRs)and myeloid differentiation primary response gene 88(MyD88).[2]Furthermore,C.trachomatis has evolved the ability to block the apoptosis of its host cells involving the interaction of autophagy and apoptosis.[3]Novel strategies to prevent and treat C.trachomatis infection effectively are needed.

Co-Infection of Chlamydia trachomatis and Neisseria gonorrhoeae on Adult Conjunctivitis:A Case Report

Introduction Chlamydia trachomatis(CT)and Neisseria gonorrhoeae(NG)infections are the most prevalent sexually transmitted infections among adults globally,1 and most commonly cause urogenital infections but also ocular infections,which often occur in newborns but rarely in adults.We herein report such a case of adult conjunctivitis caused by CT and NG coinfection.

FQ-PCR检测尿道炎病原体的临床应用及评价

目的为临床提供一次反应可同时检测由奈瑟氏淋球菌(Neissria gonorrhea,NG)、解脲支原体(Ureaplasma urealyticum,UU)及沙眼衣原体(Chlamydia trachomatis,CT)引起的淋菌性尿道炎和非淋菌性尿道炎的荧光定量PCR实验方法。对不同的试剂盒进行评价、比较,优化其荧光定量PCR反应条件。方法在一次荧光定量PCR反应中,利用任意一套标准品同时检测三种病原体,进行χ2检验。将同样的标本分别用三种不同试剂盒试验,将结果进行χ2检验。优化反应条件,比较结果有无差异,进行t检验。结果用同一厂家试剂盒的一套标准品分别同时检测三种病原体,结果无统计学差异,P>0.05。三个厂家试剂盒无明显差异,P>0.05。将某些反应条件优化,结果无显著影响,t=1.1806,P>0.05。结论用同一厂家试剂盒的一套标准品分别同时检测三种病原体,可减少标准品的使用量,且优化反应条件后又可以节省时间,为临床提供了快速、简便、经济的检测方法。

ApoB-containing lipoproteins promote infectivity of chlamydial species in human hepatoma cell line

AIM:To evaluate the direct binding of two main chlamydial biovars(C.trachomatis and C.pneumoniae) to plasma lipoproteins and its effect on chlamydial infection rate in human hepatoma cell line(HepG2 cells). METHODS:Murine plasma lipoproteins were fractionated and isolated using fast-performance liquid chromatography(FPLC),spotted on nitrocellulose membrane and incubated with chlamydial suspensions. Direct binding of chlamydial particles to lipoprotein fractions has been studied using lipopolysaccharide-specific antibodies in immuno-dot blot binding assay and immunoprecipitation analysis.Immunostaining protocol as well as flow cytometry analysis have been employed to study the infectivity rate of chlamydial species in HepG2 cells. RESULTS:Elementary bodies of both C.trachomatis and C.pneumoniae bind ApoB-containing fractions of plasma lipoproteins.That binding becomes stronger when heat-denatured FPLC fractions are used, suggesting a primary role of apolipoproteins in interaction between chlamydial particle and lipoprotein. Both chlamydial biovars efficiently propagate in human hepatoma cell line-HepG2 cells even in serum free conditions forming late-stage inclusion bodies and releasing extracellular elementary bodies.Preincubation of C.trachomatis and C.pneumoniae with native ApoB-containing lipoproteins enhances the rate of chlamydial infection in HepG2 cells.CONCLUSION:A productive infection caused by C. trachomatis and C.pneumoniae may take place in human-derived hepatocytes revealing hepatic cells as possible target in chlamydial infection.Obtained results may suggest the participation of lipoprotein receptors in the mechanism of attachment and/or entry of chlamydial particles into target cells.

The relationship between sexually transmitted microorganisms and seminal quality in asymptomatic men

Objective:To detect DNA of different microorganisms,in semen samples from apparently healthy men and correlate their presence with seminal quality.Methods:Semensamples from 81 healthy volunteers were collected,and semen parameters were analyzed.DNA extraction was performed using the phenol-chloroform technique,and the micro-organisms were detected by the amplification of specific primers using polymerase chain reaction.Results:DNA from at least one of the microorganisms was detected in 78 samples.The most frequent microorganism found in semen were:Lactobacillus spp.(70%),Neisseria gonorrhoeae(N.gonorrhoeae)(36%),Streptococcus epidermidis(64%),Klebsiella pneumoniae(56%),Staphylococcus aureus(32%),Chlamydia trachomatis(C.trachomatis)(28%),Pseudomonas aeru-ginosa(27%).The seminal parameters of all semen samples were over the lower reference values fornormal semenanalysis.To compare with negative samples,seminal volume was higher for the Escherichia coli positive samples and lower for Pseudomonas aeruginosa positive samples.Semen samples positive for Staphylococcus aureus had worse sperm morphology.The frequency of progressive motility was higher in positive samples for N.gonorrhoeae and C.trachomatis.Positive semen samples for C.trachomatis had a higher concentration per milliliter.Conclusion:It is common to find microorganisms in semen of asymptomatic men,including those responsible for sexually transmitted infections.Antimicrobial treatment is recommended only in those individuals with a sexually transmitted infection(C.trachomatis and N.gonorrhoeae)and always promote condom use.