Molecular Diagnosis of Sexually Transmitted Infection Reveals a High Frequency of Neisseria gonorrhoeae Infection among Male Urethritis Patients and Highlights the Usefulness of Molecular Testing for Clinical Diagnosis in Burkina Faso

Abstract

Sexually transmitted infections (STIs) represent a public health problem due to their high prevalence worldwide and the emergence of multidrug resistance of responsible microorganisms. Medical laboratory diagnosis of sexually transmitted genital infections by traditional methods as culture remains extremely delicate, difficult or impossible (to find extremely fragile organisms that can be cultured). Thus, molecular techniques constitute an alternative to improve accurate diagnostic, personalized patient treatment, and public health. A total of 83 clinical samples including urethral discharge and urine samples from individual patients with symptoms of urethritis received were analyzed using traditional methods and a commercial real-time PCR (qPCR) method. Out of 83 urethritis patients, n = 55 (66.26%) were positive for at least one of the STI pathogens detected by qPCR. qPCR assay was more sensitive (50/83, positive cases) compared to culture (15/83, positive cases) and light microscopy (28/83, positive cases). The most prevalent NTD pathogen in the suspected patients was N. gonorrhoeae with 60.24% (50/83) based on real-time PCR diagnosis. Among the positive cases of STI pathogens, Neisseria gonorrhoeae had the highest frequency 49/55 (89.01%) followed by low frequencies of Trichomonas vaginalis 4/55 (7.27%) and Chlamydia trachomatis 1/55 (1.82%). This highlights the high prevalence of N. gonorrhoeae infection in male urethritis patients and a very important misdiagnosis using traditional routine methods in Burkina Faso by medical laboratories. Thus, this situation may negatively impact patients’ personalized treatment and care and public health with the possible rapid emergence of multidrug-resistant strains. This study also highlights the urgent need to optimize culture for the diagnosis of NTD pathogens in Burkina Faso and the usefulness and the need for the introduction of molecular diagnostic methods in routine diagnosis for the detection of NTD pathogens in the medical laboratories in Burkina Faso.