{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:41:38Z","timestamp":1783107698637,"version":"3.54.6"},"reference-count":30,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,9,1]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p><jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) and<jats:italic>Mycoplasma genitalium<\/jats:italic>(MG) cause the majority of non-gonococcal urethritis (NGU). The role of<jats:italic>Ureaplasma urealyticum<\/jats:italic>(UU) in NGU is unclear. Prior case\u2013control studies that examined the association of UU and NGU may have been confounded by mixed infections and less stringent criteria for controls. The objective of this case\u2013control study was to determine the prevalence and aetiology of mixed infections in men and assess if UU monoinfection is associated with NGU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 155 men with NGU and 103 controls. Behavioural and clinical information was obtained and men were tested for<jats:italic>Neisseria gonorrhoeae<\/jats:italic>and CT, MG, UU and<jats:italic>Trichomonas vaginalis<\/jats:italic>(TV). Men who were five-pathogen negative were classified as idiopathic urethritis (IU).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve per cent of NGU cases in which a pathogen was identified had mixed infections, mostly UU coinfections with MG or CT; 27% had IU. In monoinfected NGU cases, 34% had CT, 17% had MG, 11% had UU and 2% had TV. In controls, pathogens were rarely identified, except for UU, which was present in 20%. Comparing cases and controls, NGU was associated with CT and MG monoinfections and mixed infections. UU monoinfection was not associated with NGU and was almost twice as prevalent in controls. Men in both the case and control groups who were younger and who reported no prior NGU diagnosis were more likely to have UU (OR 0.97 per year of age, 95% CI 0.94 to 0.998 and OR 6.3, 95% CI 1.4 to 28.5, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mixed infections are common in men with NGU and most of these are UU coinfections with other pathogens that are well-established causes of NGU. UU monoinfections are not associated with NGU and are common in younger men and men who have never previously had NGU. Almost half of NGU cases are idiopathic.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054121","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T21:15:26Z","timestamp":1568322926000},"page":"306-311","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Aetiology and prevalence of mixed-infections and mono-infections in non-gonococcal urethritis in men: a case-control study"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-2566","authenticated-orcid":false,"given":"Stephen J","family":"Jordan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Toh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lora","family":"Fortenberry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle L","family":"LaPradd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry P","family":"Katz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron E","family":"Batteiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa A","family":"Batteiger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,9,12]]},"reference":[{"key":"2024092304052139000_96.4.306.1","doi-asserted-by":"publisher","DOI":"10.1086\/499434"},{"key":"2024092304052139000_96.4.306.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11908-008-0023-x"},{"key":"2024092304052139000_96.4.306.3","unstructured":"Martin D . Urethritis in Males. In: Holmes KK SP , Stamm WE , eds. Sexually transmitted diseases. 4th edn. 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A systematic review and meta-analysis","volume":"9","author":"Zhang","year":"2014","journal-title":"PLoS One"},{"key":"2024092304052139000_96.4.306.13","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-001-0665-1"},{"key":"2024092304052139000_96.4.306.14","doi-asserted-by":"publisher","DOI":"10.1097\/01.OLQ.0000114653.26951.71"},{"key":"2024092304052139000_96.4.306.15","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.040394"},{"key":"2024092304052139000_96.4.306.16","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir517"},{"key":"2024092304052139000_96.4.306.17","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2314"},{"key":"2024092304052139000_96.4.306.18","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6404a1"},{"key":"2024092304052139000_96.4.306.19","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3182354da3"},{"key":"2024092304052139000_96.4.306.20","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/OLQ.0000000000000998","article-title":"Detection of rectal Chlamydia trachomatis in heterosexual men who report cunnilingus","volume":"46","author":"Batteiger","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2024092304052139000_96.4.306.21","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06481-11"},{"key":"2024092304052139000_96.4.306.22","doi-asserted-by":"crossref","unstructured":"Williams JA , Eddleman L , LeMonte A , et al . Evaluation of a laboratory developed test for detection of Trichomonas vaginalis using a modification of the Abbott m2000 RealTime system. Poster session presented at: STI & AIDS World Congress 2013. 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