ABSTRACT
Introduction. Mycoplasma genitalium is an emerging cause of sexually transmitted infections (STIs) and has been implicated in non-gonococcal urethritis in men and cervicitis in woman. The aim of this study is determinate the incidence and pathogenicity of M. genitalium within the diagnosis of STIs detected from clinical samples in a third level hospital. Material and methods. A total of 8,473 samples from endocervix, urethra, vagina, rectum and others were processed applying Allpex STI Essential Assay. More than 190 records were reviewed to determinate M. genitalium pathogenicity. Results. M. genitalium was detected in a rate 2.8%. Co-infections were detected in 20% of the patients. Conclusions. M. genitalium is considered a STI emerging pathogen thanks to the renewal of multiplex-PCR tests although with a low incidence in our approach. Emerging from our experience and the institutional recommendations both detection of acid nucleic techniques (NAATs) and gonococcal culture might be implemented accurately and coexist to adequate prescriptions. (AU)
Introducción. Mycoplasma genitalium es un patógeno emergente causante de infecciones de transmisión sexual (ITS) y se ha relacionado con uretritis no gonocócica en hombres y cervicitis en mujeres. El objetivo de este estudio es determinar la incidencia y patogenicidad de M. genitalium en el seno del diagnóstico de ITS detectadas a partir de muestras clínicas en un hospital terciario. Métodos. Se procesaron 8.473 muestras de endocérvix, uretra, vagina, recto y otros, aplicando Allpex STI Essential Assay. Se revisaron más de 190 historias clínicas para determinar la patogenicidad de M. genitalium. Resultados. Se detectó M. genitalium en 2,8% de casos. Hubo coinfecciones en 20% de los pacientes. Conclusiones. M. genitalium a pesar de la baja incidencia en nuestra revisión, actualmente es un patógeno de valor en alza gracias al desarrollo de técnicas moleculares como PCRmultiplex. A partir de nuestra experiencia y las recomendaciones institucionales, tanto las técnicas de detección de ácidos nucleicos (NAATs) como los cultivos para gonococo deberían implementarse y coexistir para adecuar los tratamientos (AU)
Subject(s)
Humans , Mycoplasma genitalium , Sexually Transmitted Diseases , Primary Health Care , Spain , Urethritis , Uterine CervicitisSubject(s)
Invasive Fungal Infections , Mycoses , Asia , Fungi , Humans , Surveys and QuestionnairesABSTRACT
Mutations in quinolone targets were studied together with quinolone efflux pump activation and plasmid-mediated quinolone resistance determinants in nalidixic-acid-resistant isolates of Aeromonas caviae and Aeromonas veronii. Among 135 clinical Aeromonas spp. isolated from stools of patients with gastrointestinal symptoms, 40 nalidixic acid-resistant strains belonging to A. caviae and A. veronii were selected and their susceptibility to different quinolones (ciprofloxacin, norfloxacin, ofloxacin) further evaluated. Susceptibility to nalidixic acid and ciprofloxacin in the presence/absence of Phe- Arg-ß-naphthylamide was also determined. The 16 nalidixic-acid-resistant strains identified as A. caviae were more resistant than the 24 A. veronii bv. sobria strains to ciprofloxacin, norfloxacin, and ofloxacin. All strains showed a mutation (single or double) at position 83 of the QRDR sequence of gyrA, with Ser-83 â Ile as the most frequent substitution. By contrast, no mutations were found at position 87 of gyrA. Double substitutions (GyrA-ParC) were detected in 50% of A. veronii bv. sobria isolates and in 43.75% of A. caviae strains. Both species showed decreases in the MICs of ciprofloxacin. A qnrS gene was found in an A. caviae strain. Thus, in the two species of nalidixic-acid-resistant Aeromonas isolates examined, resistance mediated by efflux pumps contributed only slightly to ciprofloxacin resistance. While two isolates were positive for the aac(6')-Ib gene, no -cr variants were detected.
Subject(s)
Aeromonas/drug effects , Anti-Bacterial Agents/pharmacology , Drug Resistance, Bacterial , Gram-Negative Bacterial Infections/microbiology , Quinolones/pharmacology , Aeromonas/classification , Aeromonas/isolation & purification , Amino Acid Substitution/genetics , DNA Gyrase/genetics , DNA Topoisomerase IV/genetics , Dipeptides/metabolism , Feces/microbiology , Humans , Microbial Sensitivity Tests , Mutation, Missense , Nalidixic Acid/pharmacology , PlasmidsABSTRACT
Mutations in quinolone targets were studied together with quinolone efflux pump activation and plasmid-mediatedquinolone resistance determinants in nalidixic-acid-resistant isolates of Aeromonas caviae and Aeromonas veronii.Among 135 clinical Aeromonas spp. isolated from stools of patients with gastrointestinal symptoms, 40 nalidixic acid-resistantstrains belonging to A. caviae and A. veronii were selected and their susceptibility to different quinolones (ciprofloxacin,norfloxacin, ofloxacin) further evaluated. Susceptibility to nalidixic acid and ciprofloxacin in the presence/absence of Phe-Arg-β-naphthylamide was also determined. The 16 nalidixic-acid-resistant strains identified as A. caviae were more resistantthan the 24 A. veronii bv. sobria strains to ciprofloxacin, norfloxacin, and ofloxacin. All strains showed a mutation (single ordouble) at position 83 of the QRDR sequence of gyrA, with Ser-83 → Ile as the most frequent substitution. By contrast, nomutations were found at position 87 of gyrA. Double substitutions (GyrA-ParC) were detected in 50% of A. veronii bv. sobriaisolates and in 43.75% of A. caviae strains. Both species showed decreases in the MICs of ciprofloxacin. A qnrS gene wasfound in an A. caviae strain. Thus, in the two species of nalidixic-acid-resistant Aeromonas isolates examined, resistancemediated by efflux pumps contributed only slightly to ciprofloxacin resistance. While two isolates were positive for theaac(6′)-Ib gene, no -cr variants were detected (AU)
