The high incidence of co-infection in Chlamydia trachomatis patients with urogenital gonorrhea has led to recommendations for the prophylactic administration of antichlamydia drugs to patients with gonococcal infection. At the same time, the role of other intracellular pathogens, in particular, Mycoplasma genitalium and Ureaplasma urealyticum in the development of postgonococcal urethritis, is still not clear.

The aim of a prospective study by S. Yokoi et al. (Japan), was to determine the prevalence of co-infection with urogenital mycoplasmas / ureaplasmas in male patients with gonococcal urethritis and assess the etiological role of these microorganisms in the development of postgonococcal urethritis.

The study included data from 390 men with culturally confirmed gonococcal urethritis. The authors used a polymerase chain reaction to detect Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum biovar 1 and Ureaplasma urealyticum biovar 2 in the first portion of urine during the patient's initial visit. The diagnosis of postgonococcal urethritis was made when polymorphic nuclear leukocytes were detected in a smear from the patient's urethra 7 to 14 days after the end of treatment for gonococcal infection. The relationship between the development of urethritis and mycoplasma / ureaplasma infection was assessed using the multivariate logistic regression method.

According to the results, the infection of C. trachomatis, M. genitalium, M. hominis, U. parvum biovar 1 and U. urealyticum biovar 2 was detected in 21.8%, 4.1%, 2.1% and 8.5% of cases, respectively. In the absence of infection, C. trachomatis, co-infection M. genitalium was accompanied by a 14.5-fold increase in the risk of developing urethritis postgonococcal (95% confidence interval (CI) 2.91 to 72.74) and U. urealyticum biovar 2 co-infection - a 3.6-fold increase in risk (CI 95% 1.24-10.63).

M. genitalium or U. ureaplasma biovar 2 co-infection in men with gonococcal urethritis has resulted in a significant increase in the risk of developing postgonococcal urethritis, regardless of the presence of C. trachomatis co-infection. According to the authors of the book, patients suffering from gonococcal urethritis should receive concomitant antibiotic therapy, active not only against C. trachomatis, but also M. genitalium and U. urealyticum biovar 2.