ABSTRACT
Limited data are available on the prevalence of genital mycoplasmas and Chlamydia trachomatis (CT) among Indian patients with genital tract infections. The objectives of the study were to determine the prevalence of Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), and CT in patients with genital tract infections. The antimicrobial susceptibilities of UU and MH were also assessed. Endocervical swabs/urethral swabs and first void urine samples of patients (n = 164) were collected. UU and MH were detected by culture and multiplex polymerase chain reaction (PCR). MG and CT were identified by PCR. Ureaplasma isolates were further biotyped and serotyped. Antimicrobial susceptibility was done by microbroth dilution method. UU, MH, MG, and CT were detected in 15.2%, 5.4%, 1.2%, and 6% patients, respectively. Ureaplasma parvum serovar 3/14 was the most prevalent. All isolates of UU and MH were uniformly susceptible to doxycycline and josamycin. Routine screening for these pathogens and antimicrobial susceptibility testing is warranted to prevent sequel of infections and formulate treatment guidelines.
ABSTRACT
Ureaplasma species are the most prevalent genital Mycoplasma isolated from the urogenital tract of both men and women. Ureaplasma has 14 known serotypes and is divided into two biovars‑ Ureaplasma parvum and Ureaplasma urealyticum. The organism has several genes coding for surface proteins, the most important being the gene encoding the Multiple Banded Antigen (MBA). The C‑terminal domain of MBA is antigenic and elicits a host antibody response. Other virulence factors include phospholipases A and C, IgA protease and urease. Besides genital tract infections and infertility, Ureaplasma is also associated with adverse pregnancy outcomes and diseases in the newborn (chronic lung disease and retinopathy of prematurity). Infection produces cytokines in the amniotic fluid which initiates preterm labour. They have also been reported from renal stone and suppurative arthritis. Genital infections have also been reported with an increasing frequency in HIV‑infected patients. Ureaplasma may be a candidate ‘co factor’ in the pathogenesis of AIDS. Culture and polymerase chain reaction (PCR) are the mainstay of diagnosis. Commercial assays are available with improved turnaround time. Micro broth dilution is routinely used to test antimicrobial susceptibility of isolates. The organisms are tested against azithromycin, josamycin, ofloxacin and doxycycline. Resistance to macrolides, tetracyclines and fluoroquinolones have been reported. The susceptibility pattern also varies among the biovars with biovar 2 maintaining higher sensitivity rates. Prompt diagnosis and initiation of appropriate antibiotic therapy is essential to prevent long term complications of Ureaplasma infections. After surveying PubMed literature using the terms ‘Ureaplasma’, ‘Ureaplasma urealyticum’ and ‘Ureaplasma parvum’, relevant literature were selected to provide a concise review on the recent developments.
ABSTRACT
A candidíase vulvovaginal é uma inflamação da mucosa genital que se desenvolve em decorrência de infecção por leveduras do gênero Candida, as quais são habitantes normais do canal vaginal. O quefir é um probiótico que se apresenta em grãos ou grumos, formado por diversos microrganismos, como por exemplo, várias espécies de Lactobacillus e leveduras, que vivem em um complexo sistema de simbiose adsorvidos em uma matriz de polissacarídeos secretados pelo mesmo. O presente estudo foi realizado com o objetivo de isolar e identificar leveduras de vulvovaginites recorrentes e testar in vitro a ação do quefir sobre estes microrganismos. Para o isolamento e identificação utilizou-se CHROMagar-Candida e confirmação bioquímica. O antibiograma foi realizado pela técnica de poços. Das 44 amostras coletadas, 40,91% foram positivas para Candida sp., as quais mostraram prevalência das espécies não-albicans (52,63%) sobre as espécies de C. albicans. No antibiograma, houve uma sensibilidade de 68,42% de ambas as populações à suspensão de quefir, enquanto para o mesmo, veiculado em base não-iônica, houve redução do espectro de ação. Concluiu-se que a suspensão foi mais eficaz em relação à sua associação com base não iônica, o que torna inviável a veiculação desta formulação.
Vulvovaginal candidiasis is an inflammation of the genital mucosa that develops as a result of infection by Candida yeast species, which are normal inhabitants of the vagina. Kefir is a fermented-milk probiotic produced in the form of grains or flakes, by a symbiotic complex of microorganisms, among them several species of lactic-acid bacteria and yeasts, which live encapsulated in a matrix of polysaccharides secreted by the former. This study was conducted to isolate and identify yeasts from recurrent vulvovaginitis and test in vitro the action of kefir on these microorganisms. For the isolation and identification of Candida organisms, CHROMagar-Candida and biochemical confirmation were employed. Overall antimicrobial susceptibility was determined by the agar well diffusion technique. Of the 44 samples, 40.91% were positive for Candida spp., which showed a prevalence of non-albicans species (52.63%) over the species C. albicans. In the antibiogram (in vitro susceptibility test), there was a sensitivity of 68.42% of both populations to the suspension of kefir alone, while for kefir carried in a non-ionic cream base, the spectrum of action was reduced. It was concluded that the suspension was more effective alone than when combined with a non-ionic base, making it impractical to use this formulation.