[Male genital tract infection: the point of view of the bacteriologist].
ABSTRACT Male genital tract infection and inflammation have been associated to 8 to 35% of male infertility cases in various studies. Their investigation is part of a multi-disciplinary process including new techniques as DNA integrity study. Bacterial seminal infection can cause transient or chronic persistent inflammation, and the microbiological investigations, as well as leukospermia, secretory chlamydial IgA and inflammatory cytokines help to approach the responsibility of inflammation in infertility or pathological condition, leading to antibiotic and anti-inflammatory treatment. In Assisted Reproductive Techniques (ART), bacteriospermia must be eradicated for a safe semen preparation to inseminate or to fertilize oocytes. Leukocytes cannot be completely eliminated by sperm preparation and the presence of antibiotics and antioxydants in the culture media is questionned.
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ABSTRACT: The role of inflammation and/or infection of the male accessory sex glands is very important for the potential effects that these conditions have on male fertility. The clinical Andrologist should be aware of the pathophysiological role of the main determinants of sperm damage when these conditions occur, in particular seminal leukocytes, oxidative stress, and cytokines. In addition, it is important to have a good knowledge of the methodologies to be used in the clinical practice. This article summarizes the methods used to look for and to identify the microorganisms responsible for male urogenital tract infections. These include sperm culture, urine culture, urethral swab, Meares-Stamey test, and balanopreputial swab. In the last part, we discussed the role of human papillomavirus (HPV) infection in male infertility.Journal of Medical Microbiology 09/2013; 63. DOI:10.1099/jmm.0.062968-0 · 2.27 Impact Factor
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ABSTRACT: The purpose of this study was threefold: to compare semen and first void urine (FVU) specimens from asymptomatic infertile men for the detection of Chlamydia trachomatis, genital ureaplasma, and genital mycoplasma infections using in-house inhibitor-controlled polymerase chain reaction (PCR)-microtiter plate hybridization assay; to determine the prevalence of those organisms in infertile men in Tunisia; and to study the relationship between these bacteria and male infertility. Paired urine and semen specimens from 104 patients were examined by in-house PCR for the presence of DNA of Chlamydia trachomatis, genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and genital mycoplasmas (Mycoplasma hominis and Mycoplasma genitalium). Semen analysis was assessed according to the guidelines of the World Health Organization. Nominal scale variables, the Mann-Whitney test, and the Kruskal-Wallis nonparametric analysis of variance test were used for statistical analysis. There was a very high concordance (>95%) and a very good agreement (kappa > 0.9) between the detection of Chlamydia trachomatis, genital ureaplasmas, and Mycoplasma hominis in semen and corresponding FVU specimens. Our findings also show a high concordance (81.1%) and a good agreement (kappa = 0.79) between the detection of Mycoplasma genitalium in both specimens. C trachomatis, genital mycoplasmas, and genital ureaplasmas were found to be widespread among infertile male patients in Tunisia, as shown by their respective prevalences of 43.3%, 18.3%, and 14.4%. The mean values of seminal volume, sperm concentration, sperm viability, sperm motility, sperm morphology, and leukocyte count were not significantly related either to the detection of C trachomatis DNA or to that of genital ureaplasma or mycoplasma DNA in semen specimens. Using our in-house PCR, both semen and FVU were found to be sensitive diagnostic specimens for the detection of C trachomatis, ureaplasmas, and mycoplasmas. The FVU, a less invasive and self-collected specimen, can serve as a marker for the presence of these organisms in the genital tract and can be used as a reliable way of detecting asymptomatic carriers of infection.Journal of Andrology 09/2007; 29(2):198-206. DOI:10.2164/jandrol.107.003566 · 1.69 Impact Factor
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ABSTRACT: Local genital tract inflammation stimulates leukocyte activity and causes HIV shedding, potentially increasing HIV sexual infectiousness. Although there are available clinical markers for genital tract inflammation, such as urinary leukocyte esterase, none have yet been examined in relation to HIV sexual risk behaviours. We sought to examine the association between urinary leukocyte esterase and sexual practices. Sexually active men living with HIV and receiving antiretroviral therapy (ART, N = 290) provided urine specimens and completed behavioural health assessments. HIV RNA tests and CD4 cell counts were abstracted from medical records. Urine specimens were analysed for leukocyte esterase using a standard point-of-care dipstick test. Thirty-one (10.6%) participants tested positive for leukocyte esterase. Logistic regression models did not indicate differences between men with elevated and un-elevated leukocyte activity on demographic, health, recent sexually transmitted infection symptoms and diagnoses or substance use. However, men with elevated leukocyte activity indicated significantly greater sexual behaviour in the previous three months, including more recent unprotected sexual intercourse. A simple over-the-counter urine test may serve as an indicator of sexual HIV infectiousness to inform further evaluation and treatment of genital tract inflammation, as well as condom use decisions during times of increased genital tract inflammation.International Journal of STD & AIDS 05/2014; 26(5). DOI:10.1177/0956462414536147 · 1.04 Impact Factor