Gardnerella vaginalis: Is it an underestimated cause of urinary symptoms in males?

Abstract

Objective: This study aimed to investigate the detection rate of Gardnerella vaginalis by multiplex PCR test in the genitourinary samples of male patients with suspected urethritis and related symptoms. Materials and Methods: A total of 144 male patients who presented to our department between February 2021 and October 2021, either with urinary symptoms or concerns following unprotected sex, were included in the study. A total of 128 (88.9%) first-void urine samples, 15 (10.4%) urethral swabs, and one (0.7%) semen sample were obtained. NeoPlex STI-14 Detection Multiplex PCR Kit (GeneMatrix Inc. Seongnam, South Korea) was used to investigate any of the following pathogens: Candida albicans, Chlamydia trachomatis, G. vaginalis, Mycoplasma genitalium, Mycoplasma hominis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma parvum, Ureaplasma urealyticum, herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), Treponema pallidum, Streptococcus agalactiae, and Haemophilus ducreyi. The patients with positive results for G. vaginalis were retrospectively analyzed. Results: The patients’ median age was 37 (range: 21 to 71 years old). G. vaginalis was the most frequently detected microorganism (n=23; 15.9%). Other microorganisms found in order of frequency were U. urealyticum (n=19; 13.2%), U. parvum (n=15; 10.4%), C. trachomatis (n=11; 7.6%), M. genitalium (n=8; 5.6%), HSV-2 (n= 7; 4.9%), N. gonorrhoeae (n=6; 4.2), HSV-1 (n=2; 1.4%), M. hominis (n=1, 0.7%), and C. albicans (n=1, 0.7%). Fifteen patients (65%) were positive for one or two microbial agents together with G. vaginalis, while in eight patients (35%), G. vaginalis was the only isolated agent. Six of these eight patients and 14 of the remaining 15 were symptomatic. Conclusion: With the introduction of multiplex PCR tests, including those for G. vaginalis, we can expect a higher detection rate of these species of bacteria in male genitourinary samples, which could be the cause of unexplained urinary/urethral symptoms.