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Journal of Clinical Microbiology, February 2001, p. 601-605, Vol. 39, No. 2
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.2.601-605.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Diagnosing Genital Ulcer Disease in a Clinic for Sexually Transmitted Diseases in Amsterdam, The Netherlands

S. M. Bruisten,1,* I. Cairo,2 H. Fennema,2 A. Pijl,1 M. Buimer,1 P. G. H. Peerbooms,1 E. Van Dyck,3 A. Meijer,4 J. M. Ossewaarde,4 and G. J. J. van Doornum1,dagger

GG&GD, Regional Laboratory of Public Health, Nieuwe Achtergracht 100, 1018 WT Amsterdam,1 GG&GD, Clinic for Sexually Transmitted Diseases, Groenburgwal, Amsterdam,2 and RIVM, LIO, 3720 BA Bilthoven,4 The Netherlands, and Institute of Tropical Medicine, Department of Microbiology, Antwerp, Belgium3

Received 20 July 2000/Returned for modification 26 September 2000/Accepted 27 November 2000

The most common etiologic agents of genital ulcer disease (GUD) are herpes simplex virus type 1 (HSV-1), HSV-2, Treponema pallidum, and Haemophilus ducreyi. In an outpatient clinic for sexually transmitted diseases in Amsterdam, The Netherlands, specimens from 372 patients with GUD were collected from February to November 1996. Sera were collected at the time of the symptoms and, for most patients, also during follow-up visits. Swabs in viral transport medium were used for HSV culture and for detection of DNA. The most prevalent pathogen found was HSV-2, which was detected by culture in 35% of the patients and by PCR in 48% of the patients. Also, HSV-1 infection was more often detected by PCR (7.8%) than by culture (5.6%). Evidence for an active infection with T. pallidum was found in 1.9% of the patients, using serological tests. A multiplex PCR for simultaneous T. pallidum and H. ducreyi DNA detection was positive for T. pallidum in 3.3% of the samples and for H. ducreyi in only 0.9% (3 out of 368) of the samples. The sensitivity of the PCR was superior to that of culture for HSV detection and to that of serology for T. pallidum detection. Specific H. ducreyi immunoglobulin G antibodies were detected in sera of 5.2% of the patients, with no concordance between serology and PCR. In 37% of the cases, none of the tested microorganisms was detected. Performance of PCR in addition to conventional techniques significantly improved the diagnosis of GUD.

* Corresponding author. Mailing address: GG&GD, Regional Public Health Laboratory, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. Phone: 31-20-555.5376. Fax: 31-20-555.5533. E-mail: sbruisten{at}gggd.amsterdam.nl.

dagger Present address: Academic Hospital Rotterdam, Department of Virology, Dr. Molewaterplein 40, Rotterdam, The Netherlands.

Journal of Clinical Microbiology, February 2001, p. 601-605, Vol. 39, No. 2
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.2.601-605.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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