Beyond Standard Culture: Diagnostic Value of Ureaplasma and Chlamydia in Women with UTI Symptoms
Abstract
OBJECTIVE: This study aimed to determine the prevalence, diagnostic contribution, and antimicrobial susceptibility patterns of atypical sexually transmitted pathogens-Ureaplasma urealyticum (U. urealyticum) and Chlamydia trachomatis (C. trachomatis)-in sexually active women presenting with urinary tract infection symptoms, particularly in cases with pyuria and negative standard cultures.
METHODS: A total of 185 sexually active women aged ≥18 years presenting with lower urinary tract symptoms and pyuria (≥10 WBC/ high-power field were retrospectively evaluated. Patients with fever or flank pain suggesting pyelonephritis were excluded. Conventional urine culture (significant growth ≥105 colony-forming unit (CFU)/mL), colorimetric culture for U. urealyticum (≥104 CCU/mL considered clinically significant), and multiplex real-time polymerase chain reaction for C. trachomatis were performed. Antimicrobial susceptibility of U. urealyticum was assessed using both colorimetric testing and broth microdilution.
RESULTS: Conventional urine culture was positive in 62/185 (33.5%) patients, with Escherichia coli detected in 41/185 (22.2%). Among the 123 culture-negative patients, 60 (48.8%) tested positive for atypical pathogens. Overall prevalence rates were 31.4% for U. urealyticum, 17,8% for C. trachomatis, and 1.6% for co-infection, following correction of previous reporting errors. The addition of molecular testing increased the diagnostic yield from 33.5% to 65.9%. U. urealyticum…
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