O termo hemoplasma refere-se ao grupo de micoplasmas que parasitam os eritrócitos do hospedeiro e podem causar anemia. O uso das técnicas baseadas na reação em cadeia da polimerase (PCR) tem sido utilizadas para a melhor compreensão da doença. No Brasil os hemoplasmas Mycoplasma. haemofelis e ‘Candidatus Mycoplasma. haemonminutum já foram identificados, porém dados de prevalência e fatores de risco não foram avaliados até o momento. A espécie ‘Candidatus Mycoplasma turicensis’ já foi descrita em diferentes países, porém a técnica de diagnóstico utilizando PCR em tempo real limita seu estudo no Brasil devido ao custo e necessidade de pessoal especializado. O presente trabalho desenvolveu uma técnica por PCR convencional para a detecção da espécie ‘Candidatus M. turicensis’ e descreve pela primeira vez sua presença infectando gatos domésticos no Brasil e a prevalência, fatores de risco e achados hematológicos da infecção por hemoplasmas foi avaliada. No total de 371 gatos, 79 (21.3%) foram positivos para pelo menos uma espécie de hemoplasma. A infecção por ‘Candidatus M. haemominutum’ foi detectada em 50 (13,48%) dos animais, ‘Candidatus M. turicensis’ e M. haemofelis foram detectados em 10/371 (2.69%) e 8/371 (2.16%) dos animais respectivamente. Coinfecção com M. haemofelis- ‘Candidatus-M. haemominutum’ foi detectada em 4/371 (1.08%), ‘Candidatus M. haemominutum’-‘Candidatus M. turicensis’ em 5/371 (1.35%) e infecção tripla em 2/371 (0.54%). Gatos machos, jovens e com acesso a rua são mais susceptíveis a infecção por hemoplasmas. Anemia é associada à infecção por M. haemofelis e ‘Candidatus M. haemominutum’. O presente trabalho também descreve a infecção por micoplasma hemotrófico similar ao M. haemofelis em um paciente humano HIV positivo e alerta para seu potencial zoonótico. Em conclusão, espécies de hemoplasmas são comuns e importantes agentes de infecções em gatos domésticos no sul do Brasil. Estudos futuros devem ser conduzidos para melhor entender seu impacto em animais de companhia e determinar o seu papel como agentes zoonóticos, particularmente em pessoas imunocomprometidas. / The term haemoplasma refers to the mycoplasmas that parasitize the red blood cells of the host and can cause anemia. Molecular approaches based on the polymerase chain reaction (PCR) have been used to better understand the disease. In Brazil, The species Mycoplasma haemofelis and ‘Candidatus Mycoplasma haemominutum’ were identified, whereas prevalence and risk factor were not evaluated to date. The specie ‘Candidatus Mycoplasma turicensis’ was described in many countries, however the use of real time-PCR for the diagnostic of the infection had limited its use in Brazil and other countries since it is expensive and requires specialized technicians. The current study developed a conventional PCR assay to the diagnosis of ‘Candidatus M. turicensis’ and report for the first time the infection in domestic cats in Brazil. We also evaluated the prevalence, risk factors and hematological findings for the hemoplasma infections. In a total of 371 cat samples, 79 (21.3%) were PCR-positive for at least one species of haemoplasma. ‘Candidatus M. haemominutum’ infection was found in 50 out of 371 (13.48%) positive cats, ‘Candidatus M. turicensis’ and M. haemofelis DNA were found in 10/371 (2.69%) and 8/371 (2.16%) of the cats respectively. Coinfection with M. haemofelis-‘Candidatus M. haemominutum’ was found in 4/371 (1.08%), ‘Candidatus M. haemominutum’-‘Candidatus M. turicensis’ in 5/371 (1.35%) and infection with all 3 haemoplasmas in 2/371 (0.54%). Male cats, younger age and outdoor access were risk factors for haemoplasma infection. Anemia was associated with M. haemofelis and ‘Candidatus M. haemominutum’ infection. The present study also reports a case of a Mycoplasma haemofelis-like organism infection in a HIV positive patient and warns the zoonotic potential of the haemoplasmas. In conclusion, the haemoplasmas are common infectious agent in domestic cats in southern Brazil. Further studies are needed to better understand their impact on companion animals, as well as their role as zoonotic agents, particularly in immunocompromised people.

As doenças infecciosas causam importantes perdas econômicas para a produção avícola e para a criação de aves domésticas de subsistência, exóticas e selvagens. No Brasil, há poucos estudos sobre as doenças infecciosas que acometem as aves, que correlacionem às lesões macroscópicas com o exame histopatológico e a identificação do agente presente nos órgãos lesionados. O objetivo desse estudo foi realizar essa tríade de diagnóstico em doenças infecciosas que acometem as aves de produção e ornamentais. O presente estudo resultou em cinco artigos. O primeiro artigo descreve dois surtos de micoplasmose em galinhas de subsistência utilizando a técnica de imuno-histoquímica (IHQ) como método de diagnóstico da infecção por Mycoplasma gallisepticum. A técnica de IHQ apresentou boa concordância com os sinais clínicos, as lesões anatomopatológicas e os resultados da reação em cadeia da polimerase (PCR) em tempo real. O segundo artigo foi realizado em frangos de corte condenados totalmente por colibacilose em um estabelecimento sob Serviço de Inspeção Federal. Em todas as aves condenados observou-se lesões macroscópicas e os órgãos mais acometidos foram fígado e sacos aéreos. Histologicamente, os diagnósticos mais frequentes foram hepatite necrosante aleatória, bronquite fibrino-heterofílica, pericardite aguda e traqueíte linfoplasmocitária. Desses casos isolou-se E. coli, Enterococcus sp., Streptococcus sp. e Staphylococcus sp. A PCR e a IHQ para Mycoplasma gallisepticum e M. synoviae foram negativas. O terceiro artigo descreve um surto de tifo aviário em codornas japonesas, através do isolamento bacteriano, da caracterização anatomopatológica e da IHQ anti-Salmonella. O quarto artigo descreve, através de um estudo retrospectivo, as características anatomopatológicas de 12 casos de clamidiose em psitacídeos e padroniza a técnica de IHQ anti-Chlamydia como método de diagnóstico dessa enfermidade. O quinto artigo relata um caso sistêmico e fatal de toxoplasmose em uma perdiz-da-Califórnia (Callipepla californica), descrevendo as lesões anatomopatológicas, a IHQ anti-Toxoplasma gondii e a genotipagem através da PCR. Portanto, o desenvolvimento de técnicas de diagnóstico que correlacionem as lesões macro e microscópicas com a identificação do agente infeccioso são fundamentais para que as enfermidades nas aves sejam corretamente estudadas e diagnosticadas. / Infectious diseases cause significant economic losses in poultry production and the breeding of domestic birds for subsistence and of exotic or wild birds. In Brazil, there have been few studies on the infectious diseases of birds in which macroscopic lesions have been correlated with histopathological examination and the identification of the agent present in the organs with lesions. The objective of this study was to apply this diagnostic triad to infectious diseases which affect poultry and ornamental birds. The study is reported in a series of five papers. The first paper describes two outbreaks of mycoplasmosis in subsistence farming chickens using the IHC technique as a diagnostic method for infection by Mycoplasma gallisepticum. The IHC technique showed good agreement with the clinical signs, the anatomopathological lesions and the results of the real-time PCR. The second paper describes a study carried out on broiler chickens which were totally condemned due to colibacillosis at an establishment under the control of the Federal Inspection Service. In all of the condemned birds macroscopic lesions were observed and the organs most affected were the liver and air sacs. Histologically, the most frequent diagnoses were random necrotizing hepatitis, fibrinous-heterophilic bronchitis, acute pericarditis and lymphoplasmocitary tracheitis. From these cases Escherichia coli, Enterococcus sp., Streptococcus sp. and Staphylococcus sp. were isolated. The polymerse chain reaction (PCR) and immunohistochemistry (IHC) tests for Mycoplasma gallisepticum and M. synoviae were negative. The third paper describes an outbreak of fowl typhoid in Japanese quails, investigated by bacterial isolation, anatomopathological characterization and anti- Salmonella IHC. The fourth paper describes, through a retrospective study, the anatomopathological characteristics of 12 cases of chlamydiosis in psittacidae and standardizes the anti-Chlamydia IHC technique as a diagnostic method for this disease. The fifth paper reports a systemic and fatal case of toxoplasmosis in a Californian quail (Callipepla californica), describing the anatomopathological lesions, the anti- Toxoplasma gondii IHC and the genotyping through PCR. Thus, the development of diagnostic techniques which correlate the macro and microscopic lesions with the identification of the infectious agent are fundamental for diseases in birds to be properly studied and diagnosed.

Submitted by (edna.saturno@ufrpe.br) on 2016-10-19T14:41:27Z No. of bitstreams: 1 Melania Loureiro Marinho.pdf: 672807 bytes, checksum: 000062f3c512fab676ae388d8a3d3f00 (MD5) / Made available in DSpace on 2016-10-19T14:41:27Z (GMT). No. of bitstreams: 1 Melania Loureiro Marinho.pdf: 672807 bytes, checksum: 000062f3c512fab676ae388d8a3d3f00 (MD5) Previous issue date: 2008-02-01 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The goal of this paper was to evaluate of biotherapy of Mycoplasma agalactiae in the treatment of goats with natural infection of Contagious Agalactia (CA) of sheep and goats from Cariri region of Paraiba state. Mastitis, agalactia, arthritis and keratoconjunctivitis were the principal clinical signs observed in animals with natural infection. The diagnosis of CA was made by bacterial isolation with modified Hayflick medium. All isolates produced not only the displayed fried-egg colony morphology but also films and spots. Fermentation of glucose, and arginine in liquid medium were not observed. The biotherapic was made from M. agalactiae isolated from milk of goat with natural infection. The animals received the biotherapic dinamized at 30D diluted in water by oral via three times a day during eight weeks. The results showed not only the absence of clinical signs in the treated animals, but also they get back the productivity, good performance status and the disappearance of outbreak in the study region. At the end of 12 months post treatment no clinical signs of the disease and bacteriological isolation were observed. These results indicate that Mycoplasma nosode showed high efficacy to control the contagious agalactia in goats from different epidemiological situations. / Este trabalho foi realizado em criações de caprinos de municípios do estado da Paraíba, com o objetivo de avaliar a ação terapêutica do bioterápico de Mycoplasma agalactiae em caprinos com Agalaxia Contagiosa dos Ovinos e Caprinos (ACOC). Os sinais clínicos mais frentes observados nos animais foram: mastite seguida de agalaxia, poliartrite e ceratoconjuntivite. O diagnostico etiológico foi realizado através do isolamento de Mycoplasma agalactiae por meio do cultivo de leite em meio Hayfick modificado que resultou em colônias com aspecto de ovo frito, com presença de manchas e filmes, não fermentadores de glicose e arginina. Estas características foram observadas em todas as colônias dos animais testados suspeitos de ACOC. O Mycoplasma agalactae foi utilizado no preparo do bioterápico na D30, administrado três vezes ao dia, via oral, durante oito semanas. A eficácia do tratamento com o bioterápico foi observada através do desaparecimento dos sinais clínicos em todos os animais. Observou-se concomitantemente retorno da capacidade produtiva e ausência de surtos na região. Doze meses após a administração do bioterápico todas as culturas foram negativadas. A utilização do bioterápico de M. agalactiae teve uma ação eficiente no tratamento da ACOC nos animais estudados, devendo ser avaliado em surtos com diferentes situações epidemiológicas.

Amostras de sangue total e suabes de orofaringe e conjuntiva foram coletadas de 57 felídeos Neotropicais (1 Leopardus geoffroyi, 17 L. wiedii, 22 L. tigrinus, 14 L. pardalis e 3 Puma yagouaroundi) mantidos em cativeiro no Refúgio Bela Vista, Foz do Iguaçu. Dados clínicos, hemograma e histórico dos animais foram disponibilizados. Materiais clínicos obtidos a partir dos suabes de orofaringe e conjuntiva foram submetidos ao cultivo para Mycoplasma spp em meio específico. DNA do sangue e suabes foram extraídos por meio de um kit comercial e pelo método de fervura, respectivamente. DNA extraído de amostras de sangue foram submetidos à PCR para detecção de Mycoplasma haemofelis (Mhf), Candidatus M. haemominutum (CMhm), DNA proviral do vírus da leucemia felina (FeLV) e Bartonella spp. DNA extraído dos suabes foram submetidos à PCR para detecção de Mollicutes e M. felis. Foi realizada uma análise de associação entre alterações clínicas e a infecção por Bartonella spp e um estudo de fator de risco da infecção por esse microrganismo. Apenas 1 (1,75%) animal foi positivo a reação para Mhf e nenhum foi positivo a reação para CMhm. Dois (3,5%) animais foram positivos a reação para FeLV e 6 (10,52%) foram positivos para Bartonella spp. Não houve co-infecção entre os agentes pesquisados nas amostras de sangue. Foram obtidos 5 (8,77%) isolados de Mycoplasma spp da orofaringe e nenhum de conjuntiva. DNA de Mollicutes foi detectado em 53 (93%) e 27 (47,36%) amostras de orofaringe e conjuntiva, respectivamente. Nenhuma amostra apresentou resultado positivo na detecção de DNA alvo de M. felis. Não houve associação entre as alterações hematológicas (anemia, desidratação, leucocitose, leucopenia, histórico de anemia) e a infecção por Bartonella spp. Machos apresentam maior risco de adquirir bartonelose do que fêmeas. Este é o primeiro relato da presença de DNA proviral de FeLV em L. tigrinus e L. pardalis no sul do aís, de DNA de B. henselae em L. tigrinus, L. pardalis, L. geoffroyii e P. yagouaroundi, e de um estudo de fator de risco associado a infecção por Bartonella spp em felídeos neotropicais. / Total blood samples and oropharinx and conjunctival swabs were collected from 57 neotropical felids (1 Leopardus geoffroyi, 17 L. wiedii, 22 L. tigrinus, 14 L. pardalis and 3 Puma yagouaroundi) maintained in captivity at Refúgio Bela Vista, Foz do Iguaçu. Clinical data, hemogram and clinical history of these animals were available. Clinical materials obtained from oropharinx and conjunctiva were cultured in specific media for Mycoplasma spp isolation. DNA of blood and swabs were extracted using a commercially available kit and a boiling method, respectively. DNA samples from swabs were submitted to a PCR for the detection of Mollicutes and M. felis. DNA samples from blood were submitted to a PCR for detection of Mycoplasma haemofelis (Mhf), Candidatus M. haemominutum (CMhm), feline leukemia virus (FeLV) proviral DNA , and Bartonella spp. The association between hematological alterations and bartonella infection was evaluated and a risk factor analysis was performed. Only 1 (1.75%) animal was positive for Mhf reaction, whereas all animals were negative for CMhm detection. Two (3.5%) animals were positives for FeLV and 6 (10.52%) animals were positive for Bartonella spp, by PCR. Co-infections among these agents were not observed. Five (8.77%) mycoplasma isolates were obtained from oropharinx samples and none was obtained from conjunctival samples. Mollicutes DNA was detected in 53 (93%) and 27 (47.36%) samples from oropharinx and conjunctiva, respectively. All samples were negative for M. felis detection. Hematological alterations (anemia, dehydration, leukocytosis, leucopenia, history of anemia) were not associated to Bartonella spp infection. Males are more likely to be infected than females. This is the first report of FeLV proviral DNA in L. tigrinus and L. pardalis in Southern Brazil, of B. henselae DNA in L. trigrinus, L. pardalis, L. geoffroyi and P. yagouaroundi, and the first study of risk factors for Bartonella spp infection in neotropical felids.

Memoria para optar al Título Profesional de Médico Veterinario / La micoplasmosis aviar es una infección que afecta la salud y productividad de las aves comerciales. Las pruebas serológicas de enzimoinmunoensayo, son útiles para el monitoreo de micoplasmosis, puesto que son capaces de identificar y cuantificar anticuerpos en los sueros de un grupo de individuos en poco tiempo. La evaluación y validación de kits comerciales antes de utilizarlos como métodos diagnósticos de control, es necesaria para estandarizar cualquier proceso de monitoreo serológico, ya que garantiza la efectividad de las pruebas. Por ello, el Servicio Agrícola y Ganadero del Ministerio de Agricultura solicitó el estudio de validación de kits de enzimoinmunoensayo indirecto para la detección de micoplasmosis en aves comerciales. En esta memoria de título se documenta parte de este estudio oficial. El objetivo fue ampliar la variedad diagnóstica, puesto que en la actualidad, solo la marca IDEXX está autorizada y forma parte del Programa Oficial de Control de micoplasmosis aviar. Se evaluó la efectividad de seis kits comerciales a través de la sensibilidad y la especificidad, utilizando sueros de referencia, de acuerdo al patógeno a identificar (MG, MS o MM). De acuerdo a los resultados obtenidos, en su mayoría los kits obtienen valores de sensibilidad y especificidad aceptables a excepción de uno. Este estudio puede servir de modelo para que a futuro, se realicen más estudios de validación de otros kits de diagnóstico serológico, para ampliar las alternativas diagnósticas, o en su defecto reducir las alternativas, eliminando aquellas que no resulten ser aptas para el control de infecciones en animales de producción chilena

Philosophiae Doctor - PhD / Sexually transmitted infections (STIs) are a problem for both developed and developing countries. Sub-Saharan Africa has the highest rates in the 15-49 years old group. The discovery that these infections playa vital role in the transmission of HIV raised their profile and made their control one of the central strategies of stopping the HIV/AIDS epidemic. In response to the challenge of improving the quality of care for people infected with STIs in the public health sector, the South African Ministry of Health adopted the syndromic management approach, recommended by the World Health Organisation as suitable for resource-poor settings, for use in primary health care clinics. In addition to providing guidelines on clinical management of STIs, the syndromic approach requires health providers to counsel and educate patients about STIs, encourage patients to complete treatment even if symptoms abate, promote condom use and the treatment of all sexual partners. While the management guidelines are clear and detailed around the diagnostic and medication issues, the processes of education and counseling are not as clearly outlined. Furthermore, although the syndromic approach is a viable way of providing good quality care to larger sections of the population than could be serviced through dedicated STI clinics, it requires health providers working in primary health care clinics, most of whom are professional nurses, to perform some tasks for which they may not be adequately trained. This study evaluated the quality of care for persons infected with ST!s by examining the extent to which the syndromic approach was being implemented in primary health care clinics. Interviews, using semi-structured interview schedules, were conducted with ST! patients and health providers in twenty-four clinics located in four provinces. In depth qualitative interviews were also conducted with a sub-sample of the patients. For further triangulation the methods of participant observation, through the use of simulated patients, and focus group discussions with various community groups were used. The findings of the study indicate that although primary health care clinics in South Africa are well-resourced, the management of patients with ST!s is inadequate. Adherence to the various aspects of syndromic management was poor. Similar to other studies in South Africa, the attitudes of health providers towards patients with ST!s were found to be problematic, a finding that has implications for health-seeking behaviours. The thesis argues that a large part of the problem is related to the multiple roles that nurses have to play in primary health care settings, as well as the content and methodology of the training of nurses who manage ST! patients. It further argues for the constitution of the basic health team at primary health clinics to be multi-disciplinary, and for a multi-disciplinary input in the training of health providers.

No description available.

Background: Community acquired pneumonia causes 5,9% of deaths in elderly South Africans. Mortality rates are increased in those in whom initiation of therapy with an appropriate agent has been delayed. Whereas Mycoplasma pneumoniae and Legionella pneumophila are sensitive to the macrolides or tetracycline, they do not respond to the currently recommended first-line agents for community acquired pneumonia, penicillin or a cephalosporin. It was therefore necessary to assess the prevalence of exposure to these 2 organisms in the elderly in order to determine whether a modification in the recommendations may be justified. Methods: Study population and survey: Subjects were residents of 4 old age homes in Cape Town who were older than 60 years and willing to participate. Written consent was obtained, a demographic and medical history questionnaire was completed, and a sample of blood was drawn. Laboratory methods: The indirect fluorescent antibody tests (Zeus Scientific Inc, New Jersey, USA) were used to detect the presence of antibodies to Mycoplasma pneumoniae and Legionella pneumophila. Results: The participation rate in this study was high, with 88,4% (677/766) taking part. Seropositivity for both of these organisms was low. There were 17 participants (2, 51 %) with antibodies to mycoplasma (IgG only in 8, IgM only in 1, and both IgG and IgM in the remaining 8). Titres were low with only 1 IgM titre of 16, and only 3 IgG titres of 64. Antibodies to Legionella were demonstrated in only 9 participants (1,33%). All these titres were 128 or above. Conclusions: It is concluded that first-line therapy for community acquired pneumonia should adhere to the current guidelines published by the South African Pulmonology Society. There is no indication for the routine use of agents active against Legionella or mycoplasma. Clearly, these antibiotics should be introduced if specific pointers to infection with one of these organisms are found. Because of the low seropositivity rate, the indirect fluorescent antibody test for these 2 agents has a high specificity in this population. This may be of use in making a diagnosis in an acute infection Further studies are required to elucidate the immunological response to these organisms in elderly persons. A further survey should be done to determine the seropositivity rate to these agents in community dwelling elderly.

Mycoplasmas are a group of bacteria which are small in size, lack a cell wall, and have small genomes in comparison to other bacteria. The members of the group that are pathogenic utilize several mechanisms to evade the host's immune system. These processes affect surveillance and control mechanisms such as serologic testing and vaccination. Many of these organisms cause diseases of livestock, which heavily impact production parameters such as weight gain, milk yield, and egg production. Mycoplasmas also cause disease in people. Mycoplasma spp. can cause mastitis, metritis, pneumonia, and arthritis. The currently documented routes of transmission of Mycoplasma spp. are through fomites and by direct animal contact. The existence of environmental sources for Mycoplasma spp. and their role in transmission are poorly characterized. Mycoplasma spp. (confirmed as M. bovis using PCR) was found in recycled bedding sand from a dairy experiencing an outbreak of mycoplasma mastitis. The possibility of a persistent environmental source of Mycoplasma spp. in recycled bedding sand was further investigated using recycled sand from the dairy. Study objectives included determining factors associated with the persistence of Mycoplasma spp. in recycled bedding sand and the duration of survival of mycoplasmas in the sand. We also evaluated 2 disinfectants at 2 different concentrations each for the elimination of Mycoplasma spp. from contaminated sand. Mycoplasma spp. survived in the sand pile intermittently over a period of 8 months. The concentration of Mycoplasma spp. within the sand pile was directly related to temperature and precipitation. The survival of Mycoplasma spp. at a greater than expected range of temperatures suggests the formation of a biofilm. Ideal temperatures for replication of Mycoplasma spp. occurred between 15 °C and 20 °C. Moisture in the sand and movement of the sand pile also appeared to play a role in replication of mycoplasmas. Sodium hypochlorite (0.5%) and chlorhexidine (2%) were efficacious in eliminating Mycoplasma spp. from contaminated bedding sand. Recycled bedding sand could be an environmental source of Mycoplasma spp. infections, including M. bovis, in dairy cows. Future studies should investigate the contribution of this environmental source to the epidemiology of mycoplasma infections in dairy cattle and other ruminants.

Indiana University-Purdue University Indianapolis (IUPUI) / Inflammation of the urethra—urethritis—is commonly diagnosed in men and women who have sexually transmitted infections (STI). Characteristic signs and symptoms of urethritis include urethral discharge and burning pain during urination (dysuria). However, these findings are non-specific and can be elicited by STI for which optimal treatment approaches differ. We wanted to investigate if immunoglobulins (antibodies) in the urine of men with acute urethritis could determine the etiologies of these cases. Previously, we conducted an observational case-control study of biological males to compare the urethral microbiota of participants with unambiguous, laboratory-confirmed urethritis (cases) and participants without urethral inflammation (controls). This revealed that nearly 2 in 5 men with nongonococcal urethritis tested negative for all common STI. We identified atypical urethral pathogens in approximately 1/3 of these STI-negative individuals using shotgun metagenomic sequencing. However, we did not detect microorganisms suspected to be urethral pathogens in the remaining 2/3 of STI-negative participants. We hypothesized that these men with “pathogen-negative” urethritis had persisting inflammation from a recent STI that already cleared spontaneously by the time of testing. We observed that urine IgA antibodies against Chlamydia trachomatis (Ctr) infectious particles were significantly more prevalent among men with pathogen-negative urethritis compared to controls. In contrast, we found that the prevalence of urine anti-Ctr IgA was similar between controls and urethritis cases with atypical infections. However, our efforts to detect antibodies against another common STI, Mycoplasma genitalium (Mgen), were complicated by low abundance in urine and the unexpected prevalence of Mgen-reactive antibodies among controls. Collectively, our results suggest that signs and symptoms of urethritis can continue after the causative STI(s) have been eliminated. Furthermore, male urine represents a practical, non-invasive source of pathogen-reactive antibodies that could be evaluated using point-of-care diagnostic tests to elucidate urethritis etiologies. Importantly, our results also suggest that sexual partners of men with pathogen-negative, nongonococcal urethritis are an unrecognized chlamydia reservoir. / 2024-05-22