Examination of Ureaplasma urealyticum and Mycoplasma hominis in 4082 Chinese patients

The objective of this study was to analyze the infection rate and drug resistance of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in the genitourinary tract of Chinese patients. From December 2018 to June 2019, vaginal secretion or urinary secretion of outpatients in our hospital were selected for culture and drug sensitivity analysis of Ureaplasma urealyticum and Mycoplasma hominis. In 4082 Chinese samples, 1567 Mycoplasma were detected, a detection rate of 38.39%, among which 1366 cases were UU single positive, accounting for 33.47%, 15 cases were MH single positive, accounting for 0.36%, 186 cases were UU and MH mixed positive, accounting for 4.56%. The most affected age groups were 21-30 years and 31-40 years, accounting for 19.09 and 15.05%, respectively. The results of drug sensitivity showed that doxycycline, minocycline, josamycin, clarithromycin, and roxithromycin were more sensitive to mycoplasma infection. The distribution of Ureaplasma urealyticum and Mycoplasma hominis in the human genitourinary system and their sensitivity to antibiotics is different for sex and age groups.

Bacteriemia por Mycoplasma hominis: un agente etiologico subestimado / Mycoplasma hominis bacteremia: An underestimated etiological agent

Mycoplasma hominis es una bacteria de cultivo exigente y forma parte de la microbiota comensal de la zona urogenital en adultos. Puede ocasionar infecciones del tracto genitourinario, en particular en mujeres, e infecciones sistémicas en neonatos. Además, puede causar infecciones extragenitales graves, en especial en pacientes inmunocomprometidos. Describimos un caso de bacteriemia por M. hominis en una paciente inmunocompetente, luego de un legrado uterino por aborto incompleto. M. hominis está subestimado como agente etiológico de infecciones extragenitales debido a su difícil diagnóstico, ya que al carecer de pared celular no se visualiza por la coloración de Gram, requiere una incubación prolongada en atmósfera de anaerobiosis para su desarrollo y los métodos convencionales de detección pueden fallar. Este es el primer reporte de senal positiva en hemocultivo automatizado (BD BACTEC) con aislamiento de M. hominis.

Mycoplasma hominis is a fastidious bacterium, which usually colonizes the lower urogenital tract and may cause systemic infections in neonates and genital infections in adults. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects. Case Presentation: We describe a case of bacteremia caused by M. hominis in a previously healthy woman after uterine curettage due to incomplete abortion. M. hominis could be an underestimated cause of bacteremia in immunocompetent patients. Mycoplasma organisms have fastidious growth requirements, are often difficult to culture on a cell-free medium and have no cell wall. The conventional method for detection may fail. This is the first report of M. hominis isolation from a positive automated blood culture (BD BACTEC, USA).

Utilidad de la reacción de polimerasa en cadena convencional para la detección de Mycoplasma hominis, Ureaplasma spp. y Trichomonas vaginalis en muestras genitales de mujeres en consulta ambulatoria / Usefulness of conventional polymerase chain reaction for the detection of Mycoplasma hominis, Ureaplasma spp. and Trichomonas vaginalis in female outpatient's genital samples

Introduction: Trichomonas vaginalis, Mycoplasma hominis and Ureaplasma spp. are microorganisms responsible for genitourinary and pregnancy pathologies. Nucleic acid amplification methods have shown several advantages, but have not been widely studied for the detection of these microorganisms. Aim: To implement a conventional polymerase chain reaction (PCR) for the detection of the microorganisms and to compare its results versus the methods currently used at our laboratory. Material and Methods: 91 available samples were processed by PCR, culture (M. hominis y Ureaplasma spp.) and wet mount (T vaginalis). Results were compared and statistically analyzed by kappa agreement test. Results: 85, 80 and 87 samples resulted in agreement for the detection of M. hominis, Ureaplasma spp. y T. vaginalis, respectively. For M. hominis and Ureaplasma spp., agreement was substantial, whereas for T. vaginalis it was moderate, however, for the latter, PCR detected more cases than wet mount. Conclusion: We recommend the implementation of PCR for detection of T. vaginalis whereas culture kit is still a useful method for the other microorganisms.

Introducción: Trichomonas vaginalis, Mycoplasma hominis y Ureaplasma spp. son microorganismos causantes de patología genito-urinaria y durante el embarazo. Los métodos de amplificación de ácidos nucleicos han demostrado numerosas ventajas, pero no han sido ampliamente estudiados para la detección de estos microorganismos. Objetivo: Implementar una reacción de polimerasa en cadena convencional (RPC) para su detección y comparar sus resultados con los métodos actuales de nuestro laboratorio. Material y Métodos: Se procesaron 91 muestras mediante RPC, cultivo (M. hominis y Ureaplasma spp.) y observación microscópica al fresco (T. vaginalis). Los resultados fueron comparados y analizados estadísticamente mediante el test de concordancia kappa. Resultados: 85, 80 y 87 muestras tuvieron resultados concordantes para la detección de M. hominis, Ureaplasma spp. y T. vaginalis, respectivamente. Para M. hominis y Ureaplasma spp. el nivel de concordancia fue considerable mientras que para T. vaginalis fue moderado; sin embargo, para esta última, la RPC detectó más casos que la microscopia al fresco. Conclusión: Se recomienda la implementación de la RPC para la detección de T. vaginalis. Para M. hominis y Ureaplasma spp. el kit de cultivo continúa siendo un buen método.

Molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis clinical isolates

To evaluate the molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis (MH) clinical strains isolated from urogenital specimens. 15 MH clinical isolates with different phenotypes of resistance to fluoroquinolones antibiotics were screened for mutations in the quinolone resistance-determining regions (QRDRs) of DNA gyrase (gyrA and gyrB) and topoisomerase IV (parC and parE) in comparison with the reference strain PG21, which is susceptible to fluoroquinolones antibiotics. 15 MH isolates with three kinds of quinolone resistance phenotypes were obtained. Thirteen out of these quinolone-resistant isolates were found to carry nucleotide substitutions in either gyrA or parC. There were no alterations in gyrB and no mutations were found in the isolates with a phenotype of resistance to Ofloxacin (OFX), intermediate resistant to Levofloxacin (LVX) and Sparfloxacin (SFX), and those susceptible to all three tested antibiotics. The molecular mechanism of fluoroquinolone resistance in clinical isolates of MH was reported in this study. The single amino acid mutation in ParC of MH may relate to the resistance to OFX and LVX and the high-level resistance to fluoroquinolones for MH is likely associated with mutations in both DNA gyrase and the ParC subunit of topoisomerase IV.

Mycoplasmateceae species are not found in fallopian tubes of women with tubo-peritoneal infertility

BACKGROUND: The role of mycoplasmas on the development and sequelae of pelvic inflammatory disease remains controversial. The objective of the present study is to correlate directly the presence of Mycoplasmateceae through polimerase chain reaction (PCR) determinations in cervix and Fallopian tubes of infertile patients with tubo-peritoneal factor diagnosed through laparoscopy. METHODS: Thirty patients with tubo-peritoneal infertility and 30 normal fertile patients were included in the study; cervical samples and tubal flushings were obtained during laparoscopy. PCR determinations for the detection of genetic material of Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealiticum, Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis in cervix and tubal flushings were performed. RESULTS: No Mycoplasmataceae species as "only" microorganisms were found in tubal flushings of tubo-peritoneal infertility patients, whereas three (10%) fertile patients with normal tubes were positive for mycoplasma presence. This difference was not significant (p = 0.237). Among the 30 patients suffering from tubal infertility diagnosed through laparoscopy, Mycoplasmatecae species were not detected in the Fallopian tubes by PCR determinations, while in normal tubes from fertile patients these and other microorganisms could be found without distorting tubal anatomy. CONCLUSION: Mycoplasmateceae species were not detected in Fallopian tubes of women with tubo-peritoneal infertility.

Posible papel de Bacteroides fragilis enterotoxigénico en la etiología de la vaginitis infecciosa / Possible role of enterotoxigenic Bacteroides fragilis in the etiology of infectious vaginitis

La vaginitis es un trastorno ginecológico frecuente producido por distintas causas, algunas de las cuales permanecen desconocidas. Bacteroides fragilis es el anaerobio más importante en bacteriología clínica. Algunas cepas son enterotoxigénicas y se asocian con síndromes intestinales y extraintestinales. Recientemente han sido aisladas de pacientes con vaginitis. En este trabajo se planteó investigar la posible asociación de B. fragilis enterotoxigénico con la vaginitis infecciosa. Fueron procesadas 265 muestras de exudado vaginal. 202 de mujeres sintomáticas y 63 mujeres sanas. La identificación de los microorganismos se realizó por métodos convencionales. En 31,2% de las pacientes sintomáticas se identificaron: Gardnerella vaginalis, Candida albicans, Mobiluncus, Mycoplasma hominis, Ureaplasma urealyticum y Streptococcus agalactiae. En 27 pacientes sintomáticas y en 5 mujeres sanas se identificó B. fragilis. Estas cepas fueron cultivadas en medio líquido e incubadas durante 48 h a 36° C en anaerobiosis. La toxicidad en los sobrenadantes se ensayó en células HT-29. 18 cepas de B. fragilis aisladas de pacientes sintomáticas fueron enterotoxigénicas, ya que indujeron alteraciones en la monocapa celular y en las células. No se identificó en mujeres sanas (P<0,05). 77,7% de las cepas de B. fragilis enterotoxigénicas no se encontraron asociadas con otros patógenos específicos. Este hecho sugiere que pudiera ser un agente causante de vaginitis, ya que el efecto de la enterotoxina sobre la E-cadherina del epitelio vaginal podría facilitar la invasión y su posible papel patógeno en la vagina. Esta es la primera investigación que asocia a Bacteroides fragilis enterotoxigénico como posible causa de vaginitis infecciosa.

Vaginitis is a common gynecologic disorder. It is due to several causes, some even unknown. Bacteroides fragilis is the most important anaerobe in clinical bacteriology, some strains of this group are notable for being enterotoxigenic and they have been associated with intestinal and extraintestinal syndromes. They have recently been isolated from patients with vaginitis. The purpose of this study was to investigate a possible association of enterotoxigenic B. fragilis with infectious vaginitis. 265 samples of vaginal exudate were processed, 202 from symptomatic patients and 63 healthy women. The identification of the microorganisms was carried out by conventional methods. In 31.2% of symptomatic patients were identified: Gardnerella vaginalis, Mobiluncus, Candida albicans, Mycoplasma hominis, Ureaplasma urealyticum and Streptococcus agalactiae. B. fragilis was identified in 27 symptomatic patients and 5 healthy women. These strains were cultivated in liquid medium and incubated during 48 h at 36°C in anaerobe chambers. Supernatant activity was assayed in HT-29 cells. Eighteen B. fragilis strains isolated from symptomatic patients were enterotoxigenic, because induced alterations in target cell morphology. It was not identified in healthy women (P<0.05). 77.7% of enterotoxigenic B. fragilis strains were not associated with other specific pathogens. This fact suggests that enterotoxigenic B. fragilis could be a cause for vaginitis. The effect of enterotoxin on E-cadherin of vaginal epithelium could facilitate invasion and its possible pathogenic role in the vagina. This is the first report that associates enterotoxigenic Bacteroides fragilis as a possible cause of infectious vaginitis.

The Prevalence of Vaginal Microorganisms in Pregnant Women with Preterm Labor and Preterm Birth

BACKGROUND: To investigate the risk factors for vaginal infections and antimicrobial susceptibilities of vaginal microorganisms among women who experienced preterm birth (PTB), we compared the prevalence of vaginal microorganisms between women who experienced preterm labor (PTL) without preterm delivery and spontaneous PTB. METHODS: Vaginal swab specimens from 126 pregnant women who experienced PTL were tested for group B streptococcus (GBS), Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, Treponema pallidum, herpes simplex virus (HSV) I and II, and bacterial vaginosis. A control group of 91 pregnant women was tested for GBS. Antimicrobial susceptibility tests were performed for GBS, M. hominis, and U. urealyticum. RESULTS: The overall detection rates for each microorganism were: U. urealyticum, 62.7%; M. hominis, 12.7%; GBS, 7.9%; C. trachomatis, 2.4%; and HSV type II, 0.8%. The colonization rate of GBS in control group was 17.6%. The prevalence of GBS, M. hominis, and U. urealyticum in PTL without preterm delivery and spontaneous PTB were 3.8% and 8.7% (relative risk [RR], 2.26), 3.8% and 17.3% (RR, 4.52), and 53.8% and 60.9% (RR, 1.13), respectively, showing no significant difference between the 2 groups. The detection rate of M. hominis by PCR was higher than that by culture method (11.1% vs. 4.0%, P=0.010). The detection rates of U. urealyticum by PCR and culture method were 16.7% and 57.1%, respectively. CONCLUSIONS: There was no significant difference in the prevalence of GBS, M. hominis, and U. urealyticum between the spontaneous PTB and PTL without preterm delivery groups.

Antibiotic susceptibility profiles of Mycoplasma hominis and Ureaplasma urealyticum isolated during a population-based study concerning women infertility in northeast Romania

The study was carried out on 1068 infertile women under initial evaluation. For Mycoplasma hominis, the highest resistance rates were registered for ciprofloxacin (72.22 percent), followed by macrolides and ofloxacin. For Ureaplasma urealyticum, the ciprofloxacin resistance was also high (51.72 percent), while the resistance rates to other tested antibiotics were significantly lower.

[Prevalence of mycoplasma hominis and ureaplasma urealyticum in infertile women and their husbands]

Mycoplasma hominis and Ureaplasma urealyticum microorganisms may play a role in infertility. The aim of this study is to determine prevalence of Mycoplasma hominis and Ureaplasma urealyticum microorganisms in infertile women and their husbands. In this Cross-sectional study presence of Mycoplasma hominis and Ureaplasma urealyticum were examined in infertile couples who have been referred to infertility clinics [Avicenna Institute in Tehran] by gynecologists. Referred patients with cervical smear and their husbands with semen fluid culture were asked to fill in a questionnaire. The samples were sent to microbiology laboratories. Data were analyzed using SPSS and Chi-square, Mann-Whitney and T-test methods. 56 infertile women and their husbands were studied and compared. The average age in subjects was 30.41 year and their marriage age was 22.96 year. Prevalence of Mycoplasma hominis in women was 27.39% [22 out of 56] and in their husbands was 19.64% [11]. Prevalence of Ureaplasma urealyticum in women was 58.92% [33] and in their husbands was 46.42% [26]. There was no statistically significant differences between the infection and patient age, marriage age, educational levels and infertility duration. This study showed a high prevalence of mycoplasma hominis and ureaplasma urealyticum infection in both infertile women and their husbands. However, the prevalence of infections in women was higher than their husbands. We concluded that treatment of infected women is necessary and further studies are required to be done to better understand the role of these infections in infertility of women

Mycoplasma hominis e Ureaplasma sp. em amostras do trato genitourinário e sua relação com sintomas de infecção genital / Mycoplasma hominis and Ureaplasma sp. in genitourinary specimens and their association with symptoms of genital infection

Mycoplasma hominis e Ureaplasma sp. são espécies de micoplasmas comensais pertencentes à microflora do trato geniturinário humano. No entanto, existem evidências do papel etiológico destas bactérias em diversas infecções. O objetivo deste estudo foi avaliar a ocorrência de M. hominis e Ureaplasma sp. em pacientes atendidos no Laboratório de Ensino e Pesquisa em Análises Clínicasde Maringá – PR e sua relação com sintomas de infecção genital. Amostras genitais de 1553 pacientes foram pesquisadas para micoplasmas e outros agentes comumente envolvidos em doenças sexualmente transmissíveis (DST). Positividade para micoplasma, em concentração clinicamente significativa, foi observada em 47,1 dos pacientes. O isolamento exclusivo de M. hominis ou Ureaplasma sp. foi observado em 36 pacientes (2,32) e 536 (34,51), respectivamente. Em 159 pacientes (10,24) foram isoladas ambas as espécies. Da totalidade de mulheres estudadas, 1371 (94,5) relataram sintoma de infecção genital e destas 678 (49,5) apresentaramcultura positiva para micoplasma. A alta positividade de M. hominis e Ureaplasma sp. e a associação com sintomas de infecção genital, observada neste estudo, pode contribuir para evidenciar a importância destes microrganismos como agentes de infecção genital.

[ survey of contamination with genital mycoplasma in women with bacterial vaginalis by PCR method]

Genital mycoplasmas can cause infection of the genitourinary tract. These organisms are associated with bacterial vaginosis, pelvic inflammatory disease, endometritis, cervicitis, Nongonococcal urethritis. Spontaneous abortion, premature birth, neonatal pneumonia and meningitis, and infertility. The aim of this study was to determine the ability of PCR method for diagnosis and identification of genital mycoplasma in culture negative samples taken from women suffering from bacterial vaginosis. 174 genital samples were taken from women suffering from bacterial vaginosis during January until December 2005. Two genital swabs were taken from each patient. One of them was cultured on the mycoplasma specific media for isolation of mycoplasma. The other swab was immersed in PBS buffer and frozen until DNA extraction. To detect the presence of mycoplasma and ureaplasma in genital DNA Samples: a 520-bp fragment of the 16S rRNA was amplified. The specific primers used for this purpose were: MGSO, UGSO, MY- ins. From 174 samples,71 samples [40.8%] were positive by culture for mycoplasma and ureaplasma. From 103 culture negative samples. According to PCR results, 14 samples [13.6%] were positive and 89 Samples [86.4%] were negative for mycoplasma and ureaplasma. This study showed that PCR method is more sensitive than culture for detection genital mycoplasma, Therefore PCR is a rapid, sensitive and easy method to detect genital mycoplasmas in urogenital swabs

Mycoplasma hominis and ureaplasma urealyticum vaginosis in pregnant women

The main feature of BV is a change in vaginal flora from predominant Lactobacilli to overgrowth of other microorganisms like; Mycoplasma hominis [M. hominis] and Ureaplasma urealyticum [U. urealyticum]. M. hominis and U. urealyticum vaginosis has been associated with abortion, intraamniotic infection, premature rupture of membranes [PROM] and intrapartum fever in pregnant women. This study was carried out on 100 pregnant women complaining of abnormal vaginal discharge in addition, 50 normal healthy pregnant women were included as a control. Vaginal specimens were collected from all studied women. The incidence of BV among pregnant women was [39%] whereas none of the controls has BV. There was positive correlation between the number of pregnancy but not its duration. M. hominis was detected in BV cases [38.5%] and U. urealyticum in [46.2%]. As regarding the susceptibility, M. hominis was more sensitive to norfioxacin and tetracycline [100% for each] and also, U. urealyticum isolates were more sensitive to norfioxacin and tetracycline [94.4, 88.9%] respectively, but they were resistant to Amoxicillin and Amoxacillin/Culvunate

Prevalencia de Chlamydia trachomatis, micoplasmas urogenitales y sus asociaciones en un grupo de mujeres promiscuas / Prevalence of Chlamydia trachomatis, urogenital micoplasmas and their association to a group of promiscuous women

Chalamydia trachomatis, Ureaplasma urealyticum y Mycoplasma hominis son microorganismos responsables de infecciones urogenitales. Son aislados con considerable frecuencia del tracto genital femenino. En este trabajo se estudiaron 100 exudados vaginales de mujeres promiscuas que concurrieron a la división de Bacteriología del Hospital Central de Río Cuarto. En todas las muestras se investigó la presencia de C. trachomatis, U. urealyticum, M. hominis. La prevalencia hallada fue: C. trachomatis 17 por ciento; U. urealyticum 57 por ciento; M. hominis 21 por ciento y Neisseria gonorrhoeae 2 por ciento. Las asociaciones más frecuentes fueron: C. trachomatis-Trichomonas vaginalis, micoplasmas-T. vaginalis y Gardnerella vaginalis-Candida albicans con un 18 por ciento, 15 por ciento y 8 por ciento respectivamente

Relevant prevalence of Mycoplasma hominis and Ureaplasma urealyticum serogroups in HIV-1 infected men without urethritis symptoms

M. hominis and U. urealyticum are the better-known mycoplasma species pathogenic to the human genitourinary tract, causing mainly urethritis, bacterial vaginosis and pregnancy complications. In HIV-infected patients, the prevalence and role of these species is still not well known. The aim of this work was to determinate the prevalence of these species in this group of male patients (HIV group), in comparison to a group of men with clinical symptoms of urethritis (STD group). M. hominis was isolated from 7.5 per cent patients (8/106) and U. urealyticum from 18.9 per cent patients (20/106) from the HIV group, being among these 62.5 per cent and 85 per cent in significant concentrations, respectively. In the STD group these rates were 0.9 per cent (1/110) for M. hominis and 13.6 per cent (15/110) for U. urealyticum, being 100 per cent and 93.3 per cent in significant concentrations, respectively. We could demonstrate infection rates by these mycoplasma species in the HIV group as high as the one found in the STD one, what may indicate the occurrence of opportunistic infections in our population. This fact is discussed here because in immunosuppressed patients, specially M. hominis has been reported causing severe infections, even systemically.

Infección y parto prematuro: enlace epidemiológico y bioquímico / Infection and preterm birth: epidemiological and biochemical linkage

Esta revisión define parto prematuro e infección intrauterina (origen, vías y estadios). Resumimos las asociaciones epidemiológicas entre parto prematuro y los diferentes microorganismos. Se discute la interacción entre productos bacterianos y el sistema monocitomacrófago del huésped, los atributos de las citoquinas proinflamatorias y el papel desempeñado en el mecanismo del parto y el síndrome de respuesta inmune fetal

Detección por técnicas de biología molecular de Mycoplasma hominis y Ureaplasma urealyticum en muestras urogenitales / Detection by molecular biology techniques of Mycoplasma hominis and Ureaplasma urealyticum in urogenital samples

Mycoplasma homonis y Ureaplasma urealyticum están estrechamente relacionadas con enfermedades del tracto urogenital como pielonefritis, uretritis no-gonocóccica, cálculos urinarios, epididimitis, inflamaciones pélvicas, infertilidad, abortos y fiebre post-parto; en recién nacidos también pueden causar neumonías y meningitis. Estas bacterias pueden ser diagnosticadas por diferentes métodos. En este trabajo utilizamos la hibridación de ácidos nucléicos y la reacción en cadena de la polimerasa para analizar 22 muestras de pacientes con diferentes síntomas urogenitales, en busca de micoplasmas y ureaplasmas. Como resultado obtuvimos 10 muestras positivas y 12 negativas. Entre las muestras positivas se identificaron 2 como Mycoplasma hominis, 2 como Ureaplasma urealyticum y 6 con ambas especies. los resultados obtenidos por las técnicas moleculares fueron comparados con los métodos de referencia, encontrándose en 18 muestras resultados coincidentes, mientras que en 4 los resultados fueron discordantes, siendo esta diferencia estadísticamente no significativa

Detection of mycoplasmas in urethral swabs from HIV-1 infected patients and control individuals using culture techniques and polymerase chain reaction

O objetivo do presente estudo foi determinar a prevalência de determinadas espécies de micoplasmas, tais como, Mycoplasma hominis, Ureaplasma urealyticum e Mycoplasma penetrans, em swabs uretrais de pacientes infectados com HIV-1 comparando com um grupo controle. Micoplasmas foram detectados por técnicas padräo de cultivo e pela reacäo de polimerase em cadeia para a qual foram utilizados "primers" genericos obtidos da regiäo conservada 16sRNA e "primers" nos dois metodos foi comparavel. Contudo, o PCR mostrou ser mais sensivel nas condicöes empregadas enquanto que o cultivo permitiu a quantificacäo dos isolados. Os resultados demonstraram näo haver diferenças significantes (p<0,05) nas taxas de positividade entre os metodos empregados para a detecçäo dos micoplasmas