Chapter 13 : Microbial Communities of the Male Urethra

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Traditionally, the male urethra in healthy men was believed to be sterile or only transiently colonized by microorganisms. This view reflected technical limitations in studying this site that were not easily surmounted until methods for cultivation-independent bacterial identification became available. First, while the obvious analogous compartment to the male urethra may be the female urinary tract, given the function of the penis, the male urethral compartment is most often compared to the vaginal microenvironment. A simple Gram stain of these two body sites demonstrates substantial differences. Vaginal samples from healthy women typically contain significant numbers of epithelial cells and a large number of microorganisms including and species among others (see chapter 12). In contrast, it is unusual to identify similar numbers of microorganisms by simple Gram stain of urethral smears obtained from healthy men. An unintended consequence has been that far less effort has gone into characterizing the relatively sparse microorganisms that are routinely observed, and ignored, in urethral specimens from healthy men. As described later in this chapter, recent cultivation-independent surveys of male urethral swab, urine, and semen specimens have confirmed that the male urethra harbors smaller absolute numbers of microorganisms than the vagina but have also identified a surprisingly diverse array of bacterial taxa, many of which correspond to pathogens and commensal organisms found in the vagina. This has led to the reemerging idea that the microbiology of the male urethra may be more complex than is appreciated and that the composition of urethral microbial communities, collectively the urethral microbiome, might play a role in male urethral health and disease analogous to the role of the vaginal microbiome.

Citation: Van Der Pol B, Nelson D. 2016. Microbial Communities of the Male Urethra, p 146-155. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch13
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Image of FIGURE 1

Sequence diversity before, during, and after an STI. Total number of sequences obtained from samples collected at baseline, 1 month prior to infection with , at the time infection was detected, and 1 month posttreatment.

Citation: Van Der Pol B, Nelson D. 2016. Microbial Communities of the Male Urethra, p 146-155. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch13
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Image of FIGURE 2

Exemplar timeline of community composition changes associated with STI. Example of microbial community changes associated with a common STI (). The male urethral microbiome is diverse and complex prior to onset of partnered sexual behaviors. In a longitudinal study, for some men genera routinely found in the urogenital compartment are notably missing prior to and during infection with chlamydia (e.g., and , values ≤ 0.05), while others (e.g., ) are first detected during chlamydial infection but remain following antibiotic treatment.

Citation: Van Der Pol B, Nelson D. 2016. Microbial Communities of the Male Urethra, p 146-155. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch13
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1. Papp J, Schachter J, Gaydos C, Van Der Pol B , Centers for Disease Control and Prevention . 2014. Recommendations for the laboratory-based detection of Chlamydia trachomatis and Neisseria gonorrhoeae–2014. MMWR Recomm Rep 63( RR-02) : 1 19.[PubMed]
2. Harkness AH . 1950. Non-gonococcal (nonvenereal) urethritis. Med Illus 4 : 544 548.[PubMed]
3. Harkness AH . 1953. Therapeutics of nongonococcal urethritis. Br J Vener Dis 29 : 134 140.[PubMed]
4. Fowler W . 1958. Chronic benign circumscribed plasma cell balano-posthitis. Br J Vener Dis 34 : 219 222.[PubMed]
5. Stokes EJ . 1958. Anaerobes in routine diagnostic cultures. Lancet 1 : 668 670[CrossRef].[PubMed]
6. Finegold SM, Harada NE, Miller LG . 1965. Lincomycin: activity against anaerobes and effect on normal human fecal flora. Antimicrob Agents Chemother Bethesda 5 : 659 667.[PubMed]
7. Headington JT, Beyerlein B . 1966. Anaerobic bacteria in routine urine culture. J Clin Pathol 19 : 573 576[CrossRef].[PubMed]
8. Al-Hussaini MK, Jones BR, Dunlop EM . 1964. Genital infection in association with tric virus infection of the eye. II. Cytology. Preliminary report. Br J Vener Dis 40 : 25 32.[PubMed]
9. Jones BR, Al-Hussaini MK, Dunlop EM . 1964. Infection of the eye and the genital tract by tric agent. Br J Vener Dis 40 : 19 24.[PubMed]
10. Taylor-Robinson D . 1983. The role of mycoplasmas in non-gonococcal urethritis: a review. Yale J Biol Med 56 : 537 543.[PubMed]
11. Taylor-Robinson D, Csonka GW, Prentice MJ . 1977. Chlamydial and ureaplasma-associated urethritis. Lancet 1 : 903[CrossRef].[PubMed]
12. Taylor-Robinson D, Csonka GW, Prentice MJ . 1977. Human intra-urethral inoculation of ureplasmas. Q J Med 46 : 309 326.[PubMed]
13. Bowie WR, Pollock HM, Forsyth PS, Floyd JF, Alexander ER, Wang SP, Holmes KK . 1977. Bacteriology of the urethra in normal men and men with nongonococcal urethritis. J Clin Microbiol 6 : 482 488.[PubMed]
14. Bowie WR, Wang SP, Alexander ER, Floyd J, Forsyth PS, Pollock HM, Lin JS, Buchanan TM, Holmes KK . 1977. Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum. J Clin Invest 59 : 735 742[CrossRef].[PubMed]
15. Jeansson S, Molin L . 1971. Genital herpes infection and non-specific urethritis. BMJ 3 : 247[CrossRef].[PubMed]
16. Coutts WE, Vargas-Salazar R, Silva-Inzunza E, Olmedo R, Turteltaub R, Saavedra J . 1955. Trichomonas vaginalis infection in the male. BMJ 2 : 885 889[CrossRef].[PubMed]
17. Ambrose SS Jr, Taylor WW . 1953. A study of the etiology, epidemiology, and therapeusis of non-gonococcal urethritis. Am J Syph Gonorrhea Vener Dis 37 : 501 513.[PubMed]
18. Davis G, Smithurst B, Talbot A, Townsend E, Parry A . 1973. Microbiological studies on non-gonococcal urethritis in Brisbane. Med J Aust 2 : 268 271.[PubMed]
19. Furness G, Kamat MH, Kaminski Z, Seebode JJ . 1973. An investigation of the relationship of monsepecific urethritis corynebacteria to the other micoorganisms found in the urogenital tract by means of modified chocolate agar medium. Invest Urol 10 : 387 391.[PubMed]
20. Mehta US, Rana VS, Vaishnav VP . 1967. A bacteriological study of acute urethritis. Indian J Pathol Bacteriol 10 : 170 176.[PubMed]
21. Morrison AI . 1963. Investigation of non-gonococcal urethritis by anaerobic culture. Br J Vener Dis 39 : 118 120.[PubMed]
22. Whittington MJ . 1962. Possible virus aetiology of non-specific urethritis. Br J Vener Dis 38 : 200 208.[PubMed]
23. Sompolinsky D, Harari Z, Solomon F, Caspi E, Krakowski D, Henig E . 1973. A contribution to the microbiology of urethritis. Isr J Med Sci 9 : 438 446.[PubMed]
24. Holmes KK, Handsfield HH, Wang SP, Wentworth BB, Turck M, Anderson JB, Alexander ER . 1975. Etiology of nongonococcal urethritis. N Engl J Med 292 : 1199 1205[CrossRef].[PubMed]
25. Oriel JD, Reeve P, Nicol CS . 1975. Minocycline in the treatment of nongonococcal urethritis: its effect on Chlamydia trachomatis. J Am Vener Dis Assoc 2 : 17 22.[PubMed]
26. Fontaine EA, Borriello SP, Taylor-Robinson D, Davies HA . 1984. Characteristics of a gram-negative anaerobe isolated from men with non-gonococcal urethritis. J Med Microbiol 17 : 129 140[CrossRef].[PubMed]
27. Fontaine EA, Taylor-Robinson D, Hanna NF, Coufalik ED . 1982. Anaerobes in men with urethritis. Br J Vener Dis 58 : 321 326.[PubMed]
28. Hawkins DA, Fontaine EA, Thomas BJ, Boustouller YL, Taylor-Robinson D . 1988. The enigma of non-gonococcal urethritis: role for Bacteroides ureolyticus. Genitourin Med 64 : 10 13.[PubMed]
29. Kinghorn GR, Jones BM, Chowdhury FH, Geary I . 1982. Balanoposthitis associated with Gardnerella vaginalis infection in men. Br J Vener Dis 58 : 127 129.[PubMed]
30. Masfari AN, Kinghorn GR, Duerden BI . 1983. Anaerobes in genitourinary infections in men. Br J Vener Dis 59 : 255 259.[PubMed]
31. Watson RA . 1985. Gardnerella vaginalis: genitourinary pathogen in men. Urology 25 : 217 222[CrossRef].[PubMed]
32. Iser P, Read TH, Tabrizi S, Bradshaw C, Lee D, Horvarth L, Garland S, Denham I, Fairley CK . 2005. Symptoms of non-gonococcal urethritis in heterosexual men: a case control study. Sex Transm Infect 81 : 163 165[CrossRef].[PubMed]
33. Hafiz S, McEntegart MG, Morton RS, Waitkins SA . 1975. Clostridium defficiel in the urogenital tract of males and females. Lancet 1 : 420 421[CrossRef].[PubMed]
34. Bennett KW, Eley A, Woolley PD, Duerden BI . 1990. Isolation of Bacteroides ureolyticus from the genital tract of men with and without non-gonococcal urethritis. Eur J Clin Microbiol Infect Dis 9 : 825 826[CrossRef].[PubMed]
35. Woolley PD . 2000. Anaerobic bacteria and non-gonococcal urethritis. Int J STD AIDS 11 : 347 348[CrossRef].[PubMed]
36. Woolley PD, Kinghorn GR, Bennett KW, Eley A . 1992. Significance of Bacteroides ureolyticus in the lower genital tract. Int J STD AIDS 3 : 107 110.[PubMed]
37. Bradshaw CS, Tabrizi SN, Read TR, Garland SM, Hopkins CA, Moss LM, Fairley CK . 2006. Etiologies of nongonococcal urethritis: bacteria, viruses, and the association with orogenital exposure. J Infect Dis 193 : 336 345[CrossRef].[PubMed]
38. Manhart LE, Gillespie CW, Lowens MS, Khosropour CM, Colombara DV, Golden MR, Hakhu NR, Thomas KK, Hughes JP, Jensen NL, Totten PA . 2013. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. Clin Infect Dis 56 : 934 942[CrossRef].[PubMed]
39. Manhart LE, Khosropour CM, Liu C, Gillespie CW, Depner K, Fiedler T, Marrazzo JM, Fredricks DN . 2013. Bacterial vaginosis-associated bacteria in men: association of Leptotrichia/Sneathia spp. with nongonococcal urethritis. Sex Transm Dis 40 : 944 949[CrossRef].[PubMed]
40. Shigehara K, Kawaguchi S, Sasagawa T, Furubayashi K, Shimamura M, Maeda Y, Konaka H, Mizokami A, Koh E, Namiki M . 2011. Prevalence of genital Mycoplasma, Ureaplasma, Gardnerella, and human papillomavirus in Japanese men with urethritis, and risk factors for detection of urethral human papillomavirus infection. J Infect Chemother 17 : 487 492[CrossRef].[PubMed]
41. McKechnie ML, Hillman R, Couldwell D, Kong F, Freedman E, Wang H, Gilbert GL . 2009. Simultaneous identification of 14 genital microorganisms in urine by use of a multiplex PCR-based reverse line blot assay. J Clin Microbiol 47 : 1871 1877[CrossRef].[PubMed]
42. Gardner HL, Dukes CD . 1955. Haemophilus vaginalis vaginitis: a newly defined specific infection previously classified non-specific vaginitis. Am J Obstet Gynecol 69 : 962 976.[PubMed]
43. Pheifer TA, Forsyth PS, Durfee MA, Pollock HM, Holmes KK . 1978. Nonspecific vaginitis: role of Haemophilus vaginalis and treatment with metronidazole. N Engl J Med 298 : 1429 1434[CrossRef].[PubMed]
44. Piot P . 1984. Bacterial vaginosis. An evaluation of treatment. Scand J Urol Nephrol Suppl 86 : 229 235.[PubMed]
45. Chambers CV, Shafer MA, Adger H, Ohm-Smith M, Millstein SG, Irwin CE Jr, Schachter J, Sweet R . 1987. Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis. J Pediatr 110 : 314 321[CrossRef].[PubMed]
46. Swartz SL, Kraus SJ, Herrmann KL, Stargel MD, Brown WJ, Allen SD . 1978. Diagnosis and etiology of nongonococcal urethritis. J Infect Dis 138 : 445 454[CrossRef].[PubMed]
47. Willén M, Holst E, Myhre EB, Olsson AM . 1996. The bacterial flora of the genitourinary tract in healthy fertile men. Scand J Urol Nephrol 30 : 387 393[CrossRef].[PubMed]
48. Krieger JN, Ross SO, Limaye AP, Riley DE . 2005. Inconsistent localization of gram-positive bacteria to prostate-specific specimens from patients with chronic prostatitis. Urology 66 : 721 725[CrossRef].[PubMed]
49. Krieger JN, Riley DE, Roberts MC, Berger RE . 1996. Prokaryotic DNA sequences in patients with chronic idiopathic prostatitis. J Clin Microbiol 34 : 3120 3128.[PubMed]
50. Ivanov YB . 2007. Microbiological features of persistent nonspecific urethritis in men. J Microbiol Immunol Infect 40 : 157 161.[PubMed]
51. Ondondo RO, Whittington WL, Astete SG, Totten PA . 2010. Differential association of ureaplasma species with non-gonococcal urethritis in heterosexual men. Sex Transm Infect 86 : 271 275[CrossRef].[PubMed]
52. Ishihara S, Yasuda M, Ito S, Maeda S, Deguchi T . 2004. Mycoplasma genitalium urethritis in men. Int J Antimicrob Agents 24( Suppl 1) : S23 S27[CrossRef].[PubMed]
53. Maeda S, Deguchi T, Ishiko H, Matsumoto T, Naito S, Kumon H, Tsukamoto T, Onodera S, Kamidono S . 2004. Detection of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum (biovar 1) and Ureaplasma urealyticum (biovar 2) in patients with non-gonococcal urethritis using polymerase chain reaction-microtiter plate hybridization. Int J Urol 11 : 750 754[CrossRef].[PubMed]
54. Rane VS, Fairley CK, Weerakoon A, Read TH, Fehler G, Chen MY, Bradshaw CS . 2014. Characteristics of acute nongonococcal urethritis in men differ by sexual preference. J Clin Microbiol 52 : 2971 2976[CrossRef].[PubMed]
55. Schwebke JR, Rompalo A, Taylor S, Seña AC, Martin DH, Lopez LM, Lensing S, Lee JY . 2011. Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens—a randomized clinical trial. Clin Infect Dis 52 : 163 170[CrossRef].[PubMed]
56. Taylor-Robinson D, Jensen JS . 2011. Mycoplasma genitalium: from Chrysalis to multicolored butterfly. Clin Microbiol Rev 24 : 498 514[CrossRef].[PubMed]
57. Mullis KB, Faloona FA . 1987. Specific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Methods Enzymol 155 : 335 350[CrossRef].[PubMed]
58. Lane DJ, Pace B, Olsen GJ, Stahl DA, Sogin ML, Pace NR . 1985. Rapid determination of 16S ribosomal RNA sequences for phylogenetic analyses. Proc Natl Acad Sci USA 82 : 6955 6959[CrossRef].[PubMed]
59. Clarridge JE III . 2004. Impact of 16S rRNA gene sequence analysis for identification of bacteria on clinical microbiology and infectious diseases. Clin Microbiol Rev 17 : 840 862[CrossRef].[PubMed]
60. Köser CU, Ellington MJ, Cartwright EJP, Gillespie SH, Brown NM, Farrington M, Holden MTG, Dougan G, Bentley SD, Parkhill J, Peacock SJ . 2012. Routine use of microbial whole genome sequencing in diagnostic and public health microbiology. PLoS Pathog 8 : e1002824[CrossRef].[PubMed]
61. Riemersma WA, van der Schee CJ, van der Meijden WI, Verbrugh HA, van Belkum A . 2003. Microbial population diversity in the urethras of healthy males and males suffering from nonchlamydial, nongonococcal urethritis. J Clin Microbiol 41 : 1977 1986[CrossRef].[PubMed]
62. Zhou X, Bent SJ, Schneider MG, Davis CC, Islam MR, Forney LJ . 2004. Characterization of vaginal microbial communities in adult healthy women using cultivation-independent methods. Microbiology 150 : 2565 2573[CrossRef].[PubMed]
63. Hyman RW, Fukushima M, Diamond L, Kumm J, Giudice LC, Davis RW . 2005. Microbes on the human vaginal epithelium. Proc Natl Acad Sci USA 102 : 7952 7957[CrossRef].[PubMed]
64. Verhelst R, Verstraelen H, Claeys G, Verschraegen G, Delanghe J, Van Simaey L, De Ganck C, Temmerman M, Vaneechoutte M . 2004. Cloning of 16S rRNA genes amplified from normal and disturbed vaginal microflora suggests a strong association between Atopobium vaginae, Gardnerella vaginalis and bacterial vaginosis. BMC Microbiol 4 : 16[CrossRef].[PubMed]
65. Verstraelen H, Verhelst R, Claeys G, Temmerman M, Vaneechoutte M . 2004. Culture-independent analysis of vaginal microflora: the unrecognized association of Atopobium vaginae with bacterial vaginosis. Am J Obstet Gynecol 191 : 1130 1132[CrossRef].[PubMed]
66. Fredricks DN, Fiedler TL, Marrazzo JM . 2005. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 353 : 1899 1911[CrossRef].[PubMed]
67. Zhou Y, Gao H, Mihindukulasuriya KA, La Rosa PS, Wylie KM, Vishnivetskaya T, Podar M, Warner B, Tarr PI, Nelson DE, Fortenberry JD, Holland MJ, Burr SE, Shannon WD, Sodergren E, Weinstock GM . 2013. Biogeography of the ecosystems of the healthy human body. Genome Biol 14 : R1[CrossRef].[PubMed]
68. van de Wijgert JH, Borgdorff H, Verhelst R, Crucitti T, Francis S, Verstraelen H, Jespers V . 2014. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One 9 : e105998[CrossRef].[PubMed]
69. Masue N, Deguchi T, Yokoi S, Yamada T, Ohkusu K, Ezaki T . 2007. System for simultaneous detection of 16 pathogens related to urethritis to diagnose mixed infection. Int J Urol 14 : 39 42[CrossRef].[PubMed]
70. Dong Q, Nelson DE, Toh E, Diao L, Gao X, Fortenberry JD, Van der Pol B . 2011. The microbial communities in male first catch urine are highly similar to those in paired urethral swab specimens. PLoS One 6 : e19709[CrossRef].[PubMed]
71. Cole JR, Chai B, Farris RJ, Wang Q, Kulam-Syed-Mohideen AS, McGarrell DM, Bandela AM, Cardenas E, Garrity GM, Tiedje JM . 2007. The ribosomal database project (RDP-II): introducing myRDP space and quality controlled public data. Nucleic Acids Res 35( Database) : D169 D172[CrossRef].[PubMed]
72. Danielsson D, Teigen PK, Moi H . 2011. The genital econiche: focus on microbiota and bacterial vaginosis. Ann N Y Acad Sci 1230 : 48 58[CrossRef].[PubMed]
73. Datcu R, Gesink D, Mulvad G, Montgomery-Andersen R, Rink E, Koch A, Ahrens P, Jensen JS . 2014. Bacterial vaginosis diagnosed by analysis of first-void-urine specimens. J Clin Microbiol 52 : 218 225[CrossRef].[PubMed]
74. Nelson DE, Van Der Pol B, Dong Q, Revanna KV, Fan B, Easwaran S, Sodergren E, Weinstock GM, Diao L, Fortenberry JD . 2010. Characteristic male urine microbiomes associate with asymptomatic sexually transmitted infection. PLoS One 5 : e14116[CrossRef].[PubMed]
75. Nelson DE, Dong Q, Van der Pol B, Toh E, Fan B, Katz BP, Mi D, Rong R, Weinstock GM, Sodergren E, Fortenberry JD . 2012. Bacterial communities of the coronal sulcus and distal urethra of adolescent males. PLoS One 7 : e36298[CrossRef].[PubMed]
76. Weiss HA, Thomas SL, Munabi SK, Hayes RJ . 2006. Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis. Sex Transm Infect 82 : 101 109, discussion 110[CrossRef].[PubMed]
77. Voelkerding KV, Dames SA, Durtschi JD . 2009. Next-generation sequencing: from basic research to diagnostics. Clin Chem 55 : 641 658[CrossRef].[PubMed]
78. Dunne WM Jr, Westblade LF, Ford B . 2012. Next-generation and whole-genome sequencing in the diagnostic clinical microbiology laboratory. Eur J Clin Microbiol Infect Dis 31 : 1719 1726[CrossRef].[PubMed]
79. Christodoulides M . 2014. Neisseria proteomics for antigen discovery and vaccine development. Expert Rev Proteomics 11 : 573 591[CrossRef].[PubMed]
80. Horner P, Thomas B, Gilroy CB, Egger M, Taylor-Robinson D . 2001. Role of Mycoplasma genitalium and Ureaplasma urealyticum in acute and chronic nongonococcal urethritis. Clin Infect Dis 32 : 995 1003[CrossRef].[PubMed]
81. Robertson JA, Stemke GW, Davis JW Jr, Harasawa R, Thirkell D, Kong F, Shepard MC, Ford DK . 2002. Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticum (Shepard et al. 1974) Robertson et al. 2001. Int J Syst Evol Microbiol 52 : 587 597[CrossRef].[PubMed]
82. Wetmore CM, Manhart LE, Lowens MS, Golden MR, Jensen NL, Astete SG, Whittington WLH, Totten PA . 2011. Ureaplasma urealyticum is associated with nongonococcal urethritis among men with fewer lifetime sexual partners: a case-control study. J Infect Dis 204 : 1274 1282[CrossRef].[PubMed]
83. Workowski KA, Berman S , Centers for Disease Control and Prevention (CDC) . 2010. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 59( RR-12) : 1 110.[PubMed]
84. Reischl U, Straube E, Unemo M . 2009. The Swedish new variant of Chlamydia trachomatis (nvCT) remains undetected by many European laboratories as revealed in the recent PCR/NAT ring trial organised by INSTAND e.V., Germany. Euro Surveill 14 : 19032.[PubMed]
85. Unemo M, Clarke IN . 2011. The Swedish new variant of Chlamydia trachomatis. Curr Opin Infect Dis 24 : 62 69[CrossRef].[PubMed]
86. Seth-Smith HMB, Harris SR, Skilton RJ, Radebe FM, Golparian D, Shipitsyna E, Duy PT, Scott P, Cutcliffe LT, O'Neill C, Parmar S, Pitt R, Baker S, Ison CA, Marsh P, Jalal H, Lewis DA, Unemo M, Clarke IN, Parkhill J, Thomson NR . 2013. Whole-genome sequences of Chlamydia trachomatis directly from clinical samples without culture. Genome Res 23 : 855 866[CrossRef].[PubMed]
87. Smith NH, Maynard Smith J, Spratt BG . 1995. Sequence evolution of the porB gene of Neisseria gonorrhoeae and Neisseria meningitidis: evidence of positive Darwinian selection. Mol Biol Evol 12 : 363 370.[PubMed]
88. Jonsson A-B, Ilver D, Falk P, Pepose J, Normark S . 1994. Sequence changes in the pilus subunit lead to tropism variation of Neisseria gonorrhoeae to human tissue. Mol Microbiol 13 : 403 416[CrossRef].[PubMed]
89. Walcher M, Skvoretz R, Montgomery-Fullerton M, Jonas V, Brentano S . 2013. Description of an unusual Neisseria meningitidis isolate containing and expressing Neisseria gonorrhoeae-Specific 16S rRNA gene sequences. J Clin Microbiol 51 : 3199 3206[CrossRef].[PubMed]
90. Wain J, Mavrogiorgou E . 2013. Next-generation sequencing in clinical microbiology. Expert Rev Mol Diagn 13 : 225 227[CrossRef].[PubMed]
91. Pfefferle PI, Renz H . 2014. The mucosal microbiome in shaping health and disease. F1000Prime Rep 6 : 11[CrossRef].[PubMed]
92. Mazuecos J, Aznar J, Rodriguez-Pichardo A, Marmesat F, Borobio M, Perea EJ, Camacho F . 1998. Anaerobic bacteria in men with urethritis. J Eur Acad Dermatol Venereol 10 : 237 242.


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Potential diagnostic and clinical utility

Citation: Van Der Pol B, Nelson D. 2016. Microbial Communities of the Male Urethra, p 146-155. In Persing D, Tenover F, Hayden R, Ieven M, Miller M, Nolte F, Tang Y, van Belkum A (ed), Molecular Microbiology. ASM Press, Washington, DC. doi: 10.1128/9781555819071.ch13

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