Clinical Signs and Symptoms in Sexually Transmitted Infections Confirmed by Multiplex PCR: Practical Tips for Clinicians

Öz

Objective: Sexually transmitted infections (STIs) pose significant global health challenges due to their often-asymptomatic nature and associated complications. In urological practice, early and accurate diagnosis is essential to prevent sequelae such as chronic prostatitis, urethral strictures, and infertility. Molecular diagnostic methods, particularly Multiplex PCR, offer rapid and sensitive detection of multiple pathogens. Methods: This retrospective study included 194 patients who presented with urogenital symptoms to the Urology and Obstetrics-Gynecology outpatient clinics of a tertiary care university hospital. Urethral and cervical/vaginal swab samples were collected and analyzed using a Multiplex PCR panel targeting 12 STI pathogens. Demographic and clinical data were recorded, and statistical analysis was performed to evaluate symptom-pathogen correlations. Results: Of the participants, 73.2% were male, with a mean age of 43 years. Multiplex PCR detected at least one pathogen in 40.2% of cases, with Ureaplasma parvum, Gardnerella vaginalis, and Haemophilus ducreyi being the most common. Significant correlation was found between some clinical symptoms and PCR positivity. A considerable proportion of positive cases were asymptomatic, highlighting the limitations of symptom-based diagnosis. Conclusion: Multiplex PCR significantly enhances diagnostic accuracy in STI management within urology. Early molecular detection enables targeted therapy, reduces unnecessary antibiotic use, and helps prevent long-term complications. The high rate of asymptomatic infections underscores the necessity for routine molecular screening, especially in high-risk populations. Further research should focus on expanding diagnostic panels and evaluating the cost-effectiveness of molecular testing strategies.

Anahtar Kelimeler

• Sexually transmitted infections
• Multiplex PCR
• Ureaplasma parvum
• Gardnerella vaginalis

Multiplex PCR ile Tanılanan Cinsel Yolla Bulaşan Enfeksiyonlarda Klinik Bulgular ve Semptomlar: Klinisyenler için Pratik Öneriler

Öz

Amaç: Cinsel yolla bulaşan enfeksiyonlar (CYBE), sıklıkla asemptomatik seyretmeleri ve neden oldukları komplikasyonlar nedeniyle küresel ölçekte önemli bir halk sağlığı sorunu oluşturmaktadır. Ürolojik pratikte erken ve doğru tanı, kronik prostatit, üretral darlıklar ve infertilite gibi sekellerin önlenmesi açısından kritik öneme sahiptir. Moleküler tanı yöntemleri, özellikle Multiplex PCR, birden fazla patojeni hızlı ve yüksek duyarlılıkla tespit etme imkânı sunmaktadır. Yöntemler: Bu retrospektif çalışmaya, üçüncü basamak bir üniversite hastanesinin Üroloji ile Kadın Hastalıkları ve Doğum polikliniklerine ürogenital semptomlarla başvuran 194 hasta dâhil edildi. Üretral ve servikal/vajinal sürüntü örnekleri alındı ve 12 CYBE etkenini hedefleyen Multiplex PCR paneli ile etkenler tespit edildi. Hastalara ait demografik ve klinik veriler kaydedildi; semptom–patojen ilişkisini değerlendirmek amacıyla istatistiksel analizler gerçekleştirildi. Bulgular: Katılımcıların %73,2’si erkek olup ortalama yaş 43 idi. Multiplex PCR ile olguların %40,2’sinde en az bir patojen tespit edildi. En sık saptanan patojenler Ureaplasma parvum, Gardnerella vaginalis ve Haemophilus ducreyi idi. Bazı klinik semptomlar ile PCR pozitifliği arasında anlamlı korelasyon tespit edildi. Pozitif vakaların önemli bir kısmının asemptomatik olduğu belirlendi; bu durum, semptom temelli tanının sınırlılıklarını ortaya koymaktadır. Sonuç: Multiplex PCR, ürolojide CYBE yönetiminde tanısal doğruluğu belirgin şekilde artırmaktadır. Erken moleküler tanı, hedefe yönelik tedaviye olanak tanır, gereksiz antibiyotik kullanımını azaltır ve uzun dönem komplikasyonların önlenmesine katkı sağlar. Asemptomatik enfeksiyonların yüksek oranı, özellikle yüksek riskli popülasyonlarda rutin moleküler taramanın gerekliliğini vurgulamaktadır. Gelecek çalışmalar, tanı panellerinin genişletilmesi ve moleküler test stratejilerinin maliyet etkinliğinin değerlendirilmesine odaklanmalıdır.

Anahtar Kelimeler

• Cinsel yolla bulaşan enfeksiyonlar
• Multiplex PCR
• Ureaplasma parvum
• Gardnerella vaginalis

Etik Beyan

This study was approved by the Non-Interventional Clinical Research Ethics Committee of Kafkas University Faculty of Medicine with the following decision date and number (03.01.2025 and 2205/01/09).

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