Susceptibilities of Mycoplasma hominis, M. pneumoniae, and Ureaplasma urealyticum to GAR-936, dalfopristin, dirithromycin, evernimicin, gatifloxacin, linezolid, moxifloxacin, quinupristin-dalfopristin, and telithromycin compared to their susceptibilities to reference macrolides, tetracyclines, and quinolones.

The susceptibilities of Mycoplasma hominis, Mycoplasma pneumoniae, and Ureaplasma urealyticum to eight new antimicrobial agents were determined by agar dilution. M. pneumoniae was susceptible to the new glycylcycline GAR-936 at 0.12 microg/ml and evernimicin at 4 microg/ml, but it was resistant to linezolid. It was most susceptible to dirithromycin, quinupristin-dalfopristin, telithromycin, reference macrolides, and josamycin. M. hominis was susceptible to linezolid, evernimicin, and GAR-936. It was resistant to macrolides and the ketolide telithromycin but susceptible to quinupristin-dalfopristin and josamycin. U. urealyticum was susceptible to evernimicin (8 to 16 microg/ml) and resistant to linezolid. It was less susceptible to GAR-936 (4.0 microg/ml) than to tetracycline (0.5 microg/ml). Telithromycin and quinupristin-dalfopristin were the most active agents against ureaplasmas (0.06 microg/ml). The new quinolone gatifloxacin was active against M. pneumoniae and M. hominis at 0.12 to 0.25 microg/ml and active against ureaplasmas at 1.0 microg/ml. The MICs of macrolides were markedly affected by pH, with an 8- to 32-fold increase in the susceptibility of M. pneumoniae as the pH increased from 6.9 to 7.8. A similar increase in susceptibility with increasing pH was also observed with ureaplasmas. Tetracyclines showed a fourfold increase of activity as the pH decreased 1 U, whereas GAR-936 showed a fourfold decrease in activity with a decrease in pH.

Association of Mycoplasma genitalium with nongonococcal urethritis in heterosexual men.

Chlamydia trachomatis and Neisseria gonorrhoeae are universally acknowledged as urethral pathogens, yet the etiology in the majority of cases of urethritis is unclear. Our case-control study assessed the association of Mycoplasma genitalium, Ureaplasma urealyticum, and other potential pathogens with acute nongonococcal urethritis (NGU) in heterosexual men presenting to an urban sexually transmitted diseases clinic. M. genitalium was detected in 27 (22%) of 121 NGU case patients and in 5 (4%) of 117 control subjects (P<.01). Although C. trachomatis was detected in 36 (30%) of 121 NGU case patients and in 4 (3%) of 117 control subjects (P<.01), only 3 men with NGU were infected with both C. trachomatis and M. genitalium. U. urealyticum was not associated with NGU. By multivariate analyses, controlling for age, race, history of prior urethritis, and chlamydial infection, M. genitalium was associated with a 6.5-fold increased risk of urethritis (95% confidence interval, 2.1-19.5), which supports a role of this organism in the etiology of NGU.

Sparfloxacin selects gyrase mutations in first-step Mycoplasma hominis mutants, whereas ofloxacin selects topoisomerase IV mutations.

The role of mutations in the genes for GyrA and ParC in quinolone resistance in Mycoplasma hominis was studied. Selection with sparfloxacin gave mutations at GyrA83 (Ser-->Leu; Escherichia coli numbering) or GyrA87 (Glu-->Lys), and mutants had increased levels of resistance to sparfloxacin (8- to 16-fold) but not to ofloxacin. Selection with ofloxacin gave changes at ParC80 (Ser-->Ile) or ParC84 (Glu-->Lys), and mutants were four- to eightfold more resistant to ofloxacin but not to sparfloxacin. Selection of second-step mutants from strains with ParC mutations with either quinolone yielded double mutants with additional mutations at GyrA83 (Ser-->Trp or Ser-->Leu) or GyrA87 (Glu-->Lys). Second-step selection of GyrA mutants gave additional mutations at ParC80 (Ser-->Ile) or ParC84 (Glu-->Lys). Two-step mutants showed high levels of resistance to ofloxacin (MICs, 64 to 128 microg/ml) and moderate levels of resistance to sparfloxacin (MICs, 2 to 8 microg/ml). The primary target of ofloxacin in first-step mutants of Mycoplasma hominis was ParC, whereas that for sparfloxacin was GyrA.

In vitro susceptibilities of Mycoplasma hominis to six fluoroquinolones as determined by E test.

Twenty isolates of Mycoplasma hominis were tested for their susceptibility to six fluoroquinolones by the E test. The MICs at which 90% of the isolates were inhibited (in micrograms per milliliter) were as follows: sparfloxacin, 0.031; clinafloxacin, moxifloxacin, and trovafloxacin, 0.063; levofloxacin, 0.25; and ciprofloxacin, 0.5. Increasing the amount of inoculum or incubation in CO(2) elevated MICs by

Mycoplasma orale infection affects K+ and Cl- currents in the HSG salivary gland cell line.

The relations between K+ channel and Cl- channel currents and mycoplasma infection status were studied longitudinally in HSG cells, a human submandibular gland cell line. The K+ channel currents were disrupted by the occurrence of mycoplasma infection: muscarinic activation of K+ channels and K+ channel expression as estimated by ionomycin- or hypotonically induced K+ current responses were all decreased. Similar decreases in ionomycin- and hypotonically induced responses were observed for Cl- channels, but only the latter decrease was statistically significant. Also, Cl- currents could be elicited more frequently than K+ currents (63% of cases versus 0%) in infected cells when tested by exposure to hypotonic media, indicating that mycoplasma infection affects K+ channels relatively more than Cl- channels. These changes occurred in the originally infected cells, were ameliorated when the infection was cleared with sparfloxacin, and recurred when the cells were reinfected. Such changes would be expected to result in hyposecretion of salivary fluid if they occurred in vivo.

Susceptibilities of Mycoplasma pneumoniae, Mycoplasma hominis, and Ureaplasma urealyticum to a new quinolone, trovafloxacin (CP-99,219).

The susceptibilities of mycoplasmas to a new quinolone, trovafloxacin (CP-99,219), were compared with those to sparfloxacin and ofloxacin. Mycoplasma pneumoniae was as susceptible to trovafloxacin (MIC = 0.25 microgram/ml) as to sparfloxacin and fourfold less susceptible to ofloxacin. Mycoplasma hominis was highly susceptible to trovafloxacin (MIC = 0.06 microgram/ml) and sparfloxacin (MIC = 0.03 microgram/ml) and less susceptible to ofloxacin (MIC = 0.5 microgram/ml). Ureaplasma urealyticum was most susceptible to trovafloxacin, with susceptibilities ranging from 0.06 to 0.5 microgram/ml compared with 0.25 to 1.0 microgram of sparfloxacin per ml and 1 to 4 micrograms of ofloxacin per ml.

Susceptibilities of Mycoplasma hominis, Mycoplasma pneumoniae, and Ureaplasma urealyticum to new glycylcyclines in comparison with those to older tetracyclines.

The glycylcyclines are new tetracycline derivatives that include the N,N-dimethylglycylamido derivative of minocycline (DMG-MINO) and the N,N-dimethylglycylamido derivative of 6-demethyl-6-deoxytetracycline (DMG-DMDOT). The susceptibilities of Mycoplasma pneumoniae, Mycoplasma hominis, and Ureaplasma urealyticum to DMG-MINO, DMG-DMDOT, tetracycline, doxycycline, and minocycline were determined by the agar dilution method. The glycylcyclines with MICs at which 50% of the isolates are inhibited of 0.25 to 0.5 micrograms/ml for M. pneumoniae were two- to fourfold more active than tetracycline and had the same activity as minocycline and doxycycline. Tetracycline-susceptible M. hominis strains were four- to eightfold more susceptible to the glycylcyclines (0.12 to 0.25 micrograms/ml) than to tetracycline. Strains of M. hominis known to be resistant to tetracycline, doxycycline, and minocycline because of the tet(M) determinant were as susceptible to the glycylcyclines as the tetracycline-susceptible strains. For tetracycline-susceptible U. urealyticum strains, the glycylcyclines showed the same activity as tetracycline (MICs at which 50% of the isolates are inhibited of 1 to 2 micrograms/ml). Tetracycline-resistant strains of U. urealyticum were resistant to doxycycline and minocycline and showed variable susceptibility to the glycylcyclines (range, 0.5 to 32 micrograms/ml). In view of the increasing resistance of M. hominis and U. urealyticum strains to tetracyclines, the glycylcyclines have promise, pending assessment of their pharmacokinetic and safety profiles.

Evaluation of the detection limits of PCR for identification of Mycoplasma pneumoniae in clinical samples.

The detection limits of the polymerase chain reaction (PCR) for Mycoplasma pneumoniae were determined using specimens from persons known to have had M. pneumoniae pneumonia. Four primers were selected from the known sequence of the P1 gene. The primer pair (P1-178 and P1-809) which generates a 631 fragment gave the lowest detection limit. Nineteen of 21 throat swabs, which contained between 0.06 and 2 colony-forming units (CFU) per microlitre, from culture positive patients, were positive by PCR. The fact that M. pneumoniae grows in broth culture in spherules causes problems for determining the number of CFU detected in PCR. Filtering broth cultures through a 0.6 micron polycarbonate filter increased the number of CFUs two-to-ten-fold compared to unfiltered cultures. The lysis method needed to assay throat swabs differed from that necessary for broth cultures in that proteinase K treatment for 18 h increased the detection limit 10- to 100-fold when compared to NaOH digestion.

Susceptibilities of Mycoplasma hominis, Mycoplasma pneumoniae, and Ureaplasma urealyticum to a new quinolone, OPC 17116.

The susceptibilities of human mycoplasmas to OPC 17116 (Otsuka America Pharmaceutical, Inc., Rockville, Md.) and temafloxacin (Abbott Laboratories, Chicago, Ill.) were determined by the agar dilution method and were compared with those to sparfloxacin and ofloxacin. The MICs of OPC 17116 for 90% of Mycoplasma pneumoniae (0.25 microgram/ml) and Mycoplasma hominis (0.125 micrograms/ml) isolates tested were closely similar to those of sparfloxacin and were four- to eightfold greater than those of ofloxacin. Temafloxacin was two- to fourfold more active than ofloxacin. Ureaplasma urealyticum was less susceptible; the MICs of OPC 17116 and temafloxacin for 90% of isolates tested were 2 and 4.0 micrograms/ml, respectively.

Effect of pH, inoculum size, and incubation time on the susceptibility of Ureaplasma urealyticum to erythromycin in vitro.

Determinations of the susceptibility of Ureaplasma urealyticum to erythromycin in vitro as measured by the broth dilution method have shown wide variations with minimal inhibitory concentrations (MICs) from 0.04 to > or = 8 micrograms/mL, indicating a need for standardization. The effects of pH, inoculum size, and incubation were studied. In the broth dilution test, pH had an important effect. The apparent MIC was 4- to 16-fold higher at pH 6.0 than at pH 7.0, with the MIC falling progressively from values of 8 to > or = 8 micrograms/mL to values of 0.25 to 1 microgram/mL as the pH of the medium was increased in steps to pH 7.0. Large inocula also inflated the MICs 2- to 4-fold. In addition, the time of incubation influenced the apparent MIC, with increases of 4- to 16-fold between days 1 and 5. In agar dilution assays, MICs decreased from 2 micrograms/mL at pH 6.2 to 0.5 microgram/mL at pH 6.6. Since pH, inoculum level, and incubation time appear to be responsible for most of the variation in results, we propose that susceptibility testing for ureaplasmas can be improved by using medium with a more neutral pH than that usually used (pH 6) and by standardizing the inoculum size and incubation period.

Evaluation of viral-lysate enzyme-linked immunosorbent assay kits for detecting human immunodeficiency virus (type 1) infections using human sera standardized by quantitative western blotting.

The first generation of proprietary reagents for detecting antibodies to the Human Immunodeficiency Virus Type 1 (HIV-1) by enzyme-linked immunosorbent assay (ELISA) used as antigen partially purified virus from cell culture lysates. These tests, which are still in use, may vary in their antibody measurement capabilities if different proportions of the viral polypeptides are present in the viral lysate mixtures. We determined the quantities of antibodies in the serum of persons infected with HIV-1 by dilution analysis using 3 ELISA kits: Abbott [A], Du Pont [D], Genetic Systems [G]. The proportionate antibody titres of each serum to p24gag and gp160env/120env were established by quantitative Western blotting. Serum antibody titres were high, frequently over 1:10,000, a result observed both by ELISA and Western blot. For Kit D, sera with high proportions of antibody to p24gag produced antibody titration curves with steep slopes whereas shallower slopes were found in sera with high proportions of antibody to gp160env. In contrast, Kit A gave steeper slopes with sera enriched for gp160env antibodies. Kit G gave results with slopes intermediate between Kits A and D. Serum antibody titres differed between kits depending upon the proportion and concentration of antibodies in a given serum to gp160env and p24gag. The findings that both the concentration and proportion of antibodies to specific viral polypeptides in human sera markedly affect the signal intensity produced by proprietary ELISAs suggest the need for several control sera which reflect the diversity of human serum responses. Standardization of human reference sera by quantitative Western blotting will assist in evaluation and quality control of ELISA tests.

Susceptibilities of Mycoplasma hominis and Ureaplasma urealyticum to two new quinolones, sparfloxacin and WIN 57273.

Mycoplasma hominis was highly susceptible to two new quinolones, with MICs for 90% of isolates tested of 0.004 micrograms/ml for WIN 57273 and 0.063 micrograms/ml for sparfloxacin, which were activities much greater than the 1 microgram/ml found for ofloxacin and tetracycline. Although Ureaplasma urealyticum was less susceptible, the MICs for 90% of isolates tested of 0.25 micrograms/ml for WIN 57273 and 0.5 micrograms/ml for sparfloxacin were four- to eightfold greater than those found for ofloxacin (2 micrograms/ml) and tetracycline (2 micrograms/ml). The finding that U. urealyticum and M. hominis are more susceptible to WIN 57273 and sparfloxacin than they are to other quinolones suggests that these quinolones may be therapeutically useful.

Identification of a mycoplasmal protein which binds immunoglobulins nonimmunologically.

Immunoblotted protein samples from several strains of Mycoplasma hominis and from one strain of Mycoplasma arginini each contain a polypeptide of a molecular mass of 95,000 to 105,000 Da which binds immunoglobulin nonimmunologically. Immunoblots from these organisms were probed with alkaline phosphatase-conjugated goat anti-rabbit immunoglobulin, conjugated goat immunoglobulin G (IgG) Fab fragments, and conjugated goat IgG Fc fragments. The polypeptide bound the goat anti-rabbit molecules and the Fab fragments but not the Fc fragments. These reactions could be blocked with nonimmune unconjugated goat IgG and unconjugated human IgM. Controls probed with alkaline phosphatase alone did not stain. Binding of the conjugated preparations to whole mycoplasmal cells was dependent on concentrations of both conjugate and cells for the goat anti-rabbit preparation and for Fab. The mycoplasmal polypeptide may be a light-chain-specific reactant.

Virulence of ureaplasmal urease for mice.

Ureaplasmas killed mice within 5 min after intravenous injection. The 50% lethal dose of whole ureaplasmal organisms was 32 micrograms per mouse, a value also found for crystalline jackbean urease. The reaction was specific to urease, since protection was afforded by intraperitoneal injection of 200 micrograms of flurofamide, a potent urease inhibitor. The finding that a similar lethal effect was produced by injection of 200 mumol of NH4+ indicates that the toxicity of urease is mediated by ammonium ions or free ammonia.

Susceptibility of Mycoplasma pneumoniae to several new quinolones, tetracycline, and erythromycin.

Mycoplasma pneumoniae (39 strains) was most susceptible to two quinolones, WIN 57273 and sparfloxacin, with MICs for 90% of the strains (MIC90S) of 0.125 and 0.25 micrograms/ml, respectively. It was susceptible to ofloxacin and ciprofloxacin at 2 micrograms/ml and to lomefloxacin and fleroxacin at 4 micrograms/ml. The MIC90 of erythromycin was 0.062 microgram/ml, and that of tetracycline was 1 microgram/ml.

Quantitation of antibody reactivity to human immunodeficiency virus (type 1) proteins and glycoproteins on Western immunoblots by reflectance densitometry.

The human serum antibody response to polypeptides of human immunodeficiency virus type 1 (HIV-1) was quantitated by reflectance densitometry of Western immunoblots by using two commercially available blotting systems. In one system, human antibodies were detected by an avidin-biotin method using peroxidase as the label, and in the other, human antibodies were detected by peroxidase-labeled conjugate against human immunoglobulins. When staining intensity was plotted against the log of the serum dilution, a shallow slope was evident, with a 50% change in staining intensity requiring as much as a 100-fold change in antibody content. The linear range of the staining intensity curves was frequently found in serum dilutions of 1:2,500 to 1:1,000,000, and a plateau was often observed at high antibody concentrations (1:80 to 1:640). When replicate strips were tested, staining intensities varied by +/- 7 to 37%. Antibodies to p24gag and gp160env were readily detectable in several sera diluted 1:1,000,000, a result seen with both blotting systems. If Western blotting were to be used to observe increase or decreases in levels of antibodies to various polypeptides, several widely spaced serum dilutions would need to be tested.

Differences in accumulation of radiolabeled amino acids and polyamines by Mycoplasma and Acholeplasma species.

Four species in the order Mycoplasmatales, Mycoplasma capricolum, Mycoplasma hominis, Mycoplasma arginini, and Acholeplasma laidlawii, were compared for their ability to accumulate radiolabeled amino acids and polyamines. The use of a novel high-molecular-weight (HMW) medium, from which molecules of less than 12,000 molecular weight had been removed by extensive dialysis, allowed us to discern significant differences among the species in their relative accumulations of [3H]methionine and [3H]leucine and of [3H]spermidine and [3H]putrescine. Accumulation of radiolabeled amino acids in control low-molecular-weight (LMW) medium was small (0.2 to 2% of the label), and the species did not differ in their proportional accumulations of methionine and leucine. Accumulation of methionine was significantly enhanced (5- to 12-fold) in all species in HMW medium. In contrast, leucine accumulation was enhanced sevenfold for A. laidlawii but only twofold for M. hominis and M. capricolum in HMW medium. The nonglycolytic species, M. hominis and M. arginini, accumulated radiolabeled putrescine and spermidine in both media, whereas the glycolytic species, M. capricolum and A. laidlawii, accumulated only radiolabeled spermidine. The ability to accumulate putrescine appeared to be a differential characteristic for nonfermentative, arginine-utilizing mycoplasmas. HMW medium was much more effective than LMW medium for use in radiolabeling M. capricolum proteins with [35S]methionine.