Multiplex PCR assay: comparison with culture for detection of genital mycoplasma

ABSTRACT

Urea plasma, spp, Mycoplasma genitalia and Mycoplasma hominis are associated with infection of genitourinary tract and reproductive failure. The aim of this work was to determine the sensitivity, specificity and predictive values of multiplex PCR versus culture for detection of genital Mycoplasmas in clinical samples. 95 patients [60 males and 35 females] seen at Gynecology and Urology clinics aged from 20 to 50 years. They were complaining from urinary, gynecological, sexual or infertility problems. The studied specimens were distributed as 40 urine samples, 36 urethral swabs and 19 endocervical swabs.. The specimens were cultured on PPLO media, the remaining material were frozen at -70 for multiplex PCR. The results of this study showed that 45.3% and 51.6% of studied samples were positive for genital mycoplasmas by culture and PCR. Respectively. Recovery of genital mycoplasmas by biochemical reactions [i.e., pH change in PPLO broth] was significantly higher than that by culture and staining. There was statistically significant agreement between culture and multiplex PCR in Recovery of genital mycoplasmas from urine samples and urethral swabs. Recovery of Mycoplasma spp from urine samples and endocervical swabs. Recovery of Urea plasma urealyticum from urine samples and urethral swabs. Recovery of Mycoplasma hominis from cases of cystitis and female infertility. Recovery of Urea plasma urealyticum from cases of cystitis, vaginal discharge and male infertility. Multiplex PCR assay was found to have the following values regarding sensitivity, specificity, PPV and NPV of compared with culture 81.4% , 73.1% , 71.4% and 82.6% in detection of genital mycoplasmas in urogenital specimens. 73.1% , 89.9% , 73.1% and 89.9% respectively in detection of M. hominis in urogenital specimens. 80.6% , 84.4% , 71.4% and 90.0% respectively in detection of U. urealyticum in urogenital specimens. In conclusion, Multiplex PCR assay is a rapid and accurate alternative of culture for detection of genital Mycoplasma species in clinical samples. We recommended that further studies should be done to identify M. genitalium, an extremely fastidious organism that could not be detected in the present study while it is reported to be implicated in several infections especially non-gonococcal urethritis and cervicitis