{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:36:10Z","timestamp":1792449370779,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100006506","name":"Minist\u00e9rio da Sa\u00fade","doi-asserted-by":"publisher","award":["10\/2017\/MoH"],"award-info":[{"award-number":["10\/2017\/MoH"]}],"id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2023,12,13]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Little is known about the aetiology of urethral discharge syndrome (UDS) and genital ulcer disease (GUD) in Brazil due to limited access to laboratory tests and treatment based mainly on the syndromic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To update Brazilian treatment guidelines according to the current scenario, the first nationwide aetiological study for UDS and GUD was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Male participants with urethral discharge (UD) and\/or genital ulcer (GU) reports were enrolled. Sample collection was performed by 12 sentinel sites located in the five Brazilian regions. Between 2018 and 2020, 1141 UD and 208 GU samples were collected in a Universal Transport Medium-RT (Copan). A multiplex quantitative PCR kit (Seegene) was used to detect UD:<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT),<jats:italic>Mycoplasma genitalium<\/jats:italic>(MG),<jats:italic>M. hominis<\/jats:italic>(MH),<jats:italic>Neisseria gonorrhoeae<\/jats:italic>(NG),<jats:italic>Trichomonas vaginalis<\/jats:italic>(TV),<jats:italic>Ureaplasma parvum<\/jats:italic>(UP),<jats:italic>U. urealyticum<\/jats:italic>(UU) and another kit to detect GU: cytomegalovirus (CMV),<jats:italic>Haemophilus ducreyi<\/jats:italic>(HD), herpes simplex virus type 1 (HSV1), herpes simplex virus type 2 (HSV2), lymphogranuloma venereum (LGV),<jats:italic>Treponema pallidum<\/jats:italic>(TP) and varicella-zoster virus (VZV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In UD samples, the frequency of pathogen detection was NG: 78.38%, CT: 25.6%, MG: 8.3%, UU: 10.4%, UP: 3.5%, MH: 3.5% and TV: 0.9%. Coinfection was assessed in 30.9% of samples, with 14.3% of NG\/CT coinfection. The most frequent pathogen identified in GU was HSV2, present in 40.8% of the samples, followed by TP at 24.8%, LGV and CMV at 1%, and HSV1 at 0.4%. Coinfection of TP\/HSV2 was detected in 4.4% of samples. VZV and HD were not detected. In 27.7% of the GU samples, no pathogen was detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provided the acquisition of unprecedented data on the aetiology of UDS and GUD in Brazil, demonstrated the presence of a variety of pathogens in both sample types and reaffirmed the aetiologies known to be most prevalent globally.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2023-055950","type":"journal-article","created":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T18:25:44Z","timestamp":1708021544000},"page":"133-137","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Aetiological molecular identification of sexually transmitted infections that cause urethral discharge syndrome and genital ulcer disease in Brazilian men: a nationwide study"],"prefix":"10.1136","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1292-0974","authenticated-orcid":false,"given":"Maria Luiza","family":"Bazzo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanalydia de Melo","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica Motta","family":"Martins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Andr\u00e9","family":"Sch\u00f6rner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ketlyn","family":"Buss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando Hartmann","family":"Barazzetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela Cristina","family":"Gaspar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisson","family":"Bigolin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Benzaken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone Veloso Faria","family":"de Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidiane da Fonseca","family":"Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Antunes","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Figueiroa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael Mialski","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miralba Freire de Carvalho Ribeiro","family":"da Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto Jos\u00e9 Carvalho","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Fernando","family":"Aires Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lis Aparecida de Souza","family":"Neves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica Espinosa","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brazilian-GASP","family":"Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,15]]},"reference":[{"key":"2025020223001364000_100.3.133.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.228486"},{"key":"2025020223001364000_100.3.133.2","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2019-001875","article-title":"The global and regional burden of genital ulcer disease due to herpes simplex virus: a natural history Modelling study","volume":"5","author":"Looker","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2025020223001364000_100.3.133.3","unstructured":"World Health Organization (WHO) . 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Geneva: WHO; 2022."},{"key":"2025020223001364000_100.3.133.7","doi-asserted-by":"crossref","DOI":"10.3389\/fmed.2022.851635","article-title":"Incidence trends of five common sexually transmitted infections excluding HIV from 1990 to 2019 at the global, regional, and national levels: results from the global burden of disease study 2019","volume":"9","author":"Fu","year":"2022","journal-title":"Front Med"},{"key":"2025020223001364000_100.3.133.8","unstructured":"BRASIL. Minist\u00e9rio da Sa\u00fade . Protocolo cl\u00ednico E Diretrizes terap\u00eauticas para aten\u00e7\u00e3o integral \u00c0s pessoas com infec\u00e7\u00f5es sexualmente transmiss\u00edveis (IST). 2020. 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