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Genito-urinary tract infections among males: implications for infertility problems in Aba, Abia State, Nigeria
Abstract
Objective: To determine prospectively in male subjects with infertility problems the potential impact of urogenital tract infections.
Design: Prospective study.
Setting: Gynaecology Clinic, Abia State University Teaching Hospital, Aba, Nigeria.
Subjects: Three hundred and ninety six men with infertility problem attending Gynecology Clinic with their spouses at Abia State University Teaching Hospital, Aba.
Methods: Semen and blood specimen were collected from 396 men who were unable to achieve conceptions with their spouses 5-8 years after marriage. Each semen sample was evaluated for sperm cell count and cultured bacteriologically for isolation of genito-urinary tract pathogens; while the blood samples were tested serologically for Treponema pallidium (syphilis) and HIV infections.
Results: Of the 396 semen samples, 205(51.5%) had normal sperm counts, 63(15.8%) had no sperm cells (azoospermia) and 63(15.8%) had mean sperm cell count of 6.5 ± 1.3 x 106 sperm cell/ml; range, 0.1-19.9 x 106 (oligospermia). Among the males with normal sperm counts 4(0.8%) were infected with HIV, 1(0.5%) with syphilis, 2(1.0%) with E. coli and 37(18.1%) with S. aureus; while among the azoospermia and oligospermia cases, respectively, distributions of the infections were HIV (14.3%, 3.9%), syphilis (7.9%, 2.3%), S. aureus (46.0%, 12.3%), S. pyogenes (30.2%, 5.4%) and E. coli (3.7%, 3.1%). Of the 118 bacterial strains tested for antibiotic susceptibility (117 isolates and 1 typed S. aureus ATCC 25923, control strain), 3.4% were resistant to ofloxacin (OXF), 21.2% to gentamycin (CN), 5.1% to ciprofloxacin (CPF), 25.4% to cefuroxime (CXM), 88.4% to erythromycin (E), and 99.15% to ampicillin and streptomycin, respectively. The control strain, S. aureus ATCC 25923, was susceptible to all the drugs.
Conclusion: The adjudged infertile males (48.7%) in this finding may have arisen on account of the genitourinary and syphyllis infections encountered among men with oligospermia and azoospermia.