Susceptibilidad antimicrobiana en muestras urogenitales de ureaplasma urealyticum, el principal agente en infección intramaniótica / Antimicrobial susceptibility in urogenital samples of ureaplasma urealyticum, the main agent in intramaniotic infection

RESUMEN OBJETIVO: Ureaplasma urealyticum es el agente más frecuentemente aislado en infección intraamniótica. Los macrólidos son los antimicrobianos de primera elección en embarazadas. Se ha descrito el aumento de resistencia, pudiendo limitar las opciones terapéuticas durante la gestación. El propósito del estudio es evaluar susceptibilidad antimicrobiana de Ureaplasma urealyticum aislado en mujeres en edad fértil, que se atienden en Clínica Alemana Temuco, Araucanía, Chile. METODO: Se estudian todas las muestras de orina y flujo vaginal para cultivo de U. urealyticum, de pacientes entre 18 y 40 años, recibidas en el Laboratorio de Microbiología Clínica Alemana Temuco, en período Abril 2013 a Enero 2015. Se procesan las muestras con kit Mycoplasma IST 2 de Biomerieux. En las que resultan positivas, se estudia susceptibilidad a macrólidos, tetraciclinas y quinolonas. RESULTADOS: 426 muestras de orina y flujo vaginal (390 pacientes). 197 pacientes resultaron positivas para U. urealyticum. (50,5%). La susceptibilidad fue 88,4% (174 pctes) a Eritromicina, 87,9% (173 pctes) a Claritromicina y 91,9% (181 pctes) a Azitromicina (NS). 15 de 197 pacientes (7,6%) fueron resistentes a los 3 macrólidos. La susceptibilidad a Quinolonas fue 55,3% a Ciprofloxacino, y 94% a Ofloxacino. El 100% resultó susceptible a Tetraciclinas. CONCLUSIONES: Cerca del 10% de U. urealyticum aislados en nuestra serie son resistentes a macrólidos, contribuyendo a la no erradicación de la infección en tratamientos empíricos. Dentro de ellos, azitromicina aparece con la mayor efectividad. El aumento de resistencia limitará opciones terapéuticas, con gran impacto perinatal en futuro. La vigilancia de susceptibilidad en cada hospital es fundamental para elección terapéutica.

ABSTRACT INTRODUCTION: Ureaplasma urealyticum is the most frequently isolated microorganism in intra-amniotic infection. The macrolides are the first choice antimicrobials for treat this infection in pregnancy. The increasing resistance has been described worldwide, seriously limiting therapeutic options in pregnancy. The aim of the study is to evaluate antimicrobial susceptibility of U. urealyticum aislated in fertile-age women in Clínica Alemana Temuco, Araucania region, Chile. METHOD: Urine and vaginal samples were analyzed for U. urealyticum, from every 18 to 40 years old patients, received at Microbiology Laboratory of Clínica Alemana Temuco, between April 2013 to January 2015. The samples are processed with Mycoplasma IST 2 kit of Biomerieux. If they became positives, susceptibility to macrolides, tetracyclines and quinolones was studied. RESULTS: 426 urine and vaginal samples were collected (390 patients). 197 patients were positive for U. urealyticum (50.5%). The susceptibility was 88.4% (174 pts) to Erythromicyn, 87.9% (173 pts) to Clarithromycin and 91.9% (181 pts) to Azithromycin (NS). Resistance to all macrolides was observed in 15 out of 197 patients (7.6%). The susceptibility to Quinolones was 55.3% to Ciprofloxacin, and 94% to Ofloxacin. The 100% was susceptible to Tetracyclines. DISCUSSION: Near to 10% of isolated Ureaplasma spp in our serie were resistant to some macrolide, being a factor for failing to eradicate the infection in empirical treatment. Azithromycin was the most effective. The increasing resistance will limit therapeutic options, with great perinatal impact in the future. Susceptibility surveillance in each hospital is very important for therapeutic options.

Age and marital distributions of genitourinary candidiasis among symptomatic women in Nigeria

Candida-positive genital specimens [n=585] examined by direct mount wet preparation, consisting of/ugh vaginal swabs [83%,], endocervical swabs [/4%,] and urine [2.9%,] collected from symptomatic female genitourinary candidiasis patients attending hospitals and medical laboratories in seven Nigerian cities. Age and marital status of each patient were documented at time of specimen collection. Each specimen was then cultured on Sabouraud Glucose Agar at 37°C for 48 hours and examined under X40 power of a light microscope. Candida species were further identified by the CHROM Agar method. Results showed that the married accounted for 55.1% of cases while 44.9% were unmarried. Among the married the age group 26-30 years had the highest occurrence of 25.8% [significant atp0.05]. Fifteen-twenty years age group had 1.1% while 41 years plus were represented by 0.8%. The unmarried were represented by 10.3% in the age group 15-20 years. The married also had higher occurrences in all the seven cities though the differences were insignificant. Marital factor seems to play a role in the distribution of genitourinary candidiasis in the most vulnerable age group

Genital infections among women using various contraceptive methods in Basra, Iraq

A survey of women with abnormal vaginal discharge was conducted among patients attending an obstetrics and gynaecology clinic at Basra Hospital, Basra, Iraq, from September 1995 to June 1996. Out of 260 women examined, 250 [96.2%] were found to be infected with sexually transmitted and other genitourinary diseases, with a 16.2% incidence of multiple infections. This study compares the rate of infection by age group and contraception methods used. Significant findings include a 25.0% occurrence of Candida spp. among women using oral contraception and higher occurrence of Gardnerella sp. and Klebsiella spp. for women using an IUD as compared to nonusers