(315) ETIOLOGICAL PROFILE AND ANTIMICROBIAL RESISTANCE OF THE CAUSATIVE AGENTS OF URETHRITIS AND GENITAL ULCERS IN MEN
Authors: Barufaldi F , Elias H , Antonini M , Santana R 
Published: December 2024

Abstract

Introduction
Sexually Transmitted Infections (STIs) are responsible for high rates of urethritis (gonococcal or non-gonococcal) and genital ulcers.

Objective
The aim of this study is to identify the etiological agents causing STIs in urethritis and genital ulcers in male patients in Ribeirão Preto, as well as to characterize the antimicrobial resistance profile using molecular and/or phenotypic tests.

Methods
This is a cross-sectional, observational and descriptive study. This study is part of the Sengono Project developed by the Brazilian Ministry of Health in the city of Ribeirão Preto (São Paulo). Participants were recruited from the care network for individuals diagnosed with STIs in the municipality and underwent collection of biological samples (swab and PCR - Polymerase Chain Reaction) of penile urethral discharge and genital ulcers. The inclusion criteria were: individuals aged 18 or over and admitted to services that are part of the city; STI network. The men were reated in accordance with current national protocols. To analyze the material collected, descriptive data analysis (absolute and relative frequencies) was carried out. To analyze the biological materials collected, the laboratory recovered the samples on Thayer-Martin medium and chocolate agar medium. The morphological characteristics of the pathogen served for its identification and were visualized using a smear stained by the Gram method and the catalase and oxidase reactions. To determine the minimum inhibitory concentration by agar dilution, two rounds were carried out. In the first, the minimum inhibitory concentration(MIC) of the antimicrobials ceftriaxone, cefixime, azithromycin, ciprofloxacin, penicillin and tetracycline were determined using the agar dilution method. Etest concentration gradient strips (bioMérieux®) were used to confirm the MIC. For the second round. For the second round, two new antimicrobials were included Ministry of Health 13 02 (spectinomycin and gentamicin). The results of the MICs were interpreted according to the criteria of the Brazilian Committee for Antimicrobial Sensitivity Testing - BrCast. The difference in the results for each antimicrobial between the previous MICs and the MICs produced in the retest (considering the variations in MIC ±1 log2) was 0.95%, which proved the quality of the Brazilian antimicrobial sensitivity test.

Results
144 men between the ages of 18 and 69 (mean age 29) took part. A total of 126 (88%) urethral ecretion samples and 18 (12%) genital ulcers were collected. Of the urethral secretion samples, 108 (86%) showed the presence of gonococcus, with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in 35 (28%) of the genital ulcers, 4 (21%) did not have the etiologic agent identified, and in the others, Herpes simplex type 2, 7 (38.9%) and Treponema pallidum, 6 (33.3%). In one case, these two agents were co-infected (5.6%). For antimicrobial resistance, 95 strains were available for testing. Antibiotic resistance tests were carried out and those that showed resistance were: penicillin (PEN) (26.09%), ciprofloxacin (CIP) (71.74%) and tetracycline (TET) (43.40%).

Conclusions
The high incidences of CT and NG indicate the need for robust studies on the etiological profile and antimicrobial resistance.

Disclosure
No.