Journal Information
Vol. 110. Issue 1.
Pages 2-3 (January - February 2019)
Vol. 110. Issue 1.
Pages 2-3 (January - February 2019)
DOI: 10.1016/j.adengl.2018.11.019
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Is the Current Classification of Urethritis as Gonococcal or Nongonoccal Becoming Obsolete?
¿Se está quedando obsoleta la clasificación de las uretritis en gonocócicas y no gonocócicas?
V.M. Leis-Dosil
Servicio de Dermatología, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, España
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Actas Dermosifiliogr. 2019;110:38-4210.1016/j.adengl.2018.11.011
J. Magdaleno-Tapial, C. Valenzuela-Oñate, M.M. Giacaman-von der Weth, B. Ferrer-Guillén, Á. Martínez-Domenech, M. García-Legaz Martínez, J.M. Ortiz-Salvador, D. Subiabre-Ferrer, P. Hernández-Bel
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The findings reported by Magdaleno-Tapial and coworkers1 oblige us to reflect upon the current approach to the management of urethritis patients.

The authors report a higher frequency of isolation of Haemophilus species in urethritis patients than that reported in another Spanish study of a similar design.2 An even more striking finding is the high percentage of urethritis cases in which only Haemophilus species were isolated. This observation points to Haemophilus species as the main causative agent of urethritis in certain cases, and not merely a secondary agent, which it was believed to be until recently.

The profile of antibiotic sensitivity and resistance described by the authors is also striking, and calls into question the usefulness of currently recommended first-line empirical treatments for nongonococcal urethritis, in good agreement with the findings of a recently published study.3 It is possible that the current classification system, whereby urethritis is considered gonococcal or nongonococcal, is no longer practical; these cases of Haemophilus urethritis, which account for a considerable proportion of nongonococcal urethritis cases, were characterized by a purulent clinical presentation similar to that of gonococcal urethritis, and a high rate of resistance to first-line antibiotics for nongonococcal urethritis.

Given the conflicting results reported in the literature, and the important implications of these findings for the treatment of urethritis, a prospective, multicenter study of adequate statistical power should be conducted with a view to updating current guidelines for empirical antibiotic treatment of urethritis. We encourage the authors to lead such a study, perhaps under the auspices of the Sexually Transmitted Infections and AIDS (ETS/SIDA) Research Group of the Spanish Academy of Dermatology and Venereology (AEDV).

J. Magdaleno-Tapial, C. Valenzuela-Oñate, M.M. Giacaman-von der Weth, B. Ferrer-Guillén, A. Martínez-Domenech, M. García-Legaz Martínez, et al.
Aislamiento de Haemophilus spp. en exudados uretrales como posible agente etiológico de uretritis aguda: estudio de 38 casos.
Actas Dermosifiliogr, 110 (2019), pp. 37-41
G. Deza, G. Martín-Ezquerra, J. Gómez, J. Villar-García, A. Supervia, R.M. Pujol.
Isolation of Haemophilus influenzae and Haemophilus parainfluenzae in urethral exudates from men with acute urethritis: a descriptive study of 52 cases.
Sex Transm Infect, 92 (2016), pp. 29-31
T. Deguchi, S. Ito, K. Hatazaki, K. Horie, M. Yasuda, K. Nakane, et al.
Antimicrobial susceptibility of Haemophilus influenzae strains isolated from the urethra of men with acute urethritis and/or epididymitis.
J Infect Chemother, 23 (2017), pp. 804-807

Please cite this article as: Leis-Dosil V. Is the Current Classification of Urethritis as Gonococcal or Nongonoccal Becoming Obsolete?. Actas Dermosifiliogr. 2019;110:2–3.

Actas Dermo-Sifiliográficas (English Edition)

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