Antibiotic resistance among clinical Ureaplasma isolates from Cuban individuals between 2013 and 2018.

Introduction. Acquired resistance against the antibiotics that are active against Ureaplasma species has been described.Hypothesis/Gap Statement. Diagnostics combined with antimicrobial sensitivity testing are required for therapeutic guidance.Aim. To report the prevalence of antimicrobial resistance among Cuban Ureaplasma isolates and the related molecular mechanisms of resistance.Methodology. Traditional broth microdilution assays were used for antimicrobial sensitivity testing in 262 clinical Ureaplasma species isolates from Cuban patients between 2013 and 2018, and a subset of samples were investigated in parallel with the commercial MYCO WELL D-ONE rapid culture diagnostic assay. The underlying molecular mechanisms for resistance were determined by PCR and sequencing for all resistant isolates.Results. Among the tested isolates, the tetracycline and erythromycin resistance rates were 1.9 and 1.5%, respectively, while fluoroquinolone resistance was not found. The tet(M) gene was found in all tetracycline-resistant isolates, but also in two tetracycline-susceptible Ureaplasma clinical isolates. We were unable to determine the underlying mechanism of erythromycin resistance. The MYCO WELL D-ONE kit overestimated tetracycline and erythromycin resistance in Ureaplasma spp. isolates.Conclusions. Although low levels of antibiotic resistance were detected in Cuban patients over a 5-year period, continued surveillance of the antibiotic susceptibility of Ureaplasma is necessary to monitor possible changes in resistance patterns.

The impact of Ureaplasma infections on pregnancy complications.

The aim of this study was to assess if ureaplasmas are associated with pregnancy complications and diseases in newborns. Pregnant women with complaints and threatening signs of preterm delivery were included. A sample, taken from the endocervical canal and from the surface of the cervical portion, was sent to the local microbiology laboratory for DNA detection of seven pathogens: Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Neisseria gonorrhoeae, and Trichomonas vaginalis. The Pearson Chi-Square test was used to determine the difference in unpaired categorical data. A two-sided p value <0.05 was considered to be statistically significant. In all, 50 pregnant women with complaints and threatening signs of preterm delivery were included. Premature rupture of uterine membranes was found in 23 (46%) of the patients and 38 women (76%) had preterm delivery. Ureaplasma infections were associated with a premature rupture of membranes (p < 0.004), the placental inflammation (p < 0.025), a newborn respiratory distress syndrome (p < 0.019). Ureaplasmas could have affected the preterm leakage of fetal amniotic fluid and are associated with the placental inflammation and a newborn respiratory distress syndrome.

Micoplasma hominis y Ureaplasma spp en mujeres que consultan por infertilidad / Mycoplasma Hominis and Ureaplasma Spp. in women attending to infertility consultations

RESUMEN Introducción: Las infecciones por micoplasmas y ureaplasmas pueden producir fallos en la reproducción y vincularse con problemas de infertilidad femenina. Objetivo: Determinar la frecuencia de infecciones por Micoplasma hominis y Ureaplasma spp en mujeres que consultan por infertilidad e identificar si existe asociación entre las infecciones detectadas y los antecedentes de infecciones de transmisión sexual y enfermedad inflamatoria pélvica, procederes ginecológicos y síntomas de infecciones. Métodos: Se realizó un estudio descriptivo transversal, para evaluar muestras de exudados endocervicales de 175 mujeres, con edades entre 20 y 45 años, provenientes de la consulta de infertilidad del Instituto Nacional de Endocrinología, entre junio de 2016 y enero de 2017. Para la detección de micoplasmas urogenitales se utilizó el juego de reactivos Myco Well D-One. Se tuvieron en cuenta los aspectos éticos y se utilizó la prueba Chi Cuadrado para evaluar la significación estadística de las posibles asociaciones. Resultados: De las 175 muestras evaluadas, 102 (58,1 por ciento) mostraron la presencia de infecciones, de ellas 65 correspondieron a Ureaplasma spp (37,1 por ciento), 11 a Micoplasma hominis (6,2 por ciento), y 26 a asociaciones de Micoplasma hominis y Ureaplasma spp (14,8 por ciento). Se identificó asociación entre las infecciones detectadas y la presencia de antecedentes de infecciones de transmisión sexual y enfermedad inflamatoria pélvica, no así con relación a los procederes ginecológicos y síntomas de infecciones. Conclusiones: La frecuencia total de infecciones fue relativamente alta y la especie más frecuente el Ureaplasma spp. Las infecciones detectadas estuvieron asociadas a algunos de los factores estudiados(AU)

ABSTRACT Introduction: Infections caused by Mycoplasmas and Ureaplasmas may result in faults in the reproduction process and can be linked to female infertility. Objective: To determine the frequency of infection by Mycoplasma hominis and Ureaplasma spp. in women who attend to infertility consultations and if these are associated with a history of sexually transmitted infections and pelvic inflammatory disease, gynaecological procedures and symptoms of infections. Methods: A descriptive cross-sectional study was conducted to evaluate samples of endocervical swabs of 175 women between the ages of 20 to 45 years, from the Infertility consultation of the National Institute of Endocrinology, during June 2016 to January 2017. For the detection of urogenital mycoplasmas it was used the reagents kit Myco Well D-One. There were taken into account the ethical aspects and it was used the chi-square test to assess the statistical significance of the possible associations. Results: Of the 175 evaluated samples, 102 (58.1 percent) showed the presence of infections, 65 of them corresponded to Ureaplasma spp (37.1 percent), 11 to Mycoplasma hominis (6.2 percent), and 26 associations of Mycoplasma hominis and Ureaplasma spp (14.8 percent). It was identified association between the detected infections and the presence of a history of sexually transmitted infections and pelvic inflammatory disease, but not with the gynaecological procedures and the symptoms of infections. Conclusions: The total frequency of infection was relatively high and the most prevalent specie was the Ureaplasma spp. The detected infections were associated with some of the factors studied(AU)

Distribution of genital Mollicutes in the vaginal ecosystem of women with different clinical conditions.

Ureaplasma urealyticum (UU), Ureaplasma parvum (UP), Mycoplasma hominis (MH) and Mycoplasma genitalium (MG) are the most common Mollicutes of the female genital tract. Although many studies have addressed their possible role in the vaginal ecosystem, many aspects remain to be elucidated. The aim of this study was to evaluate the vaginal presence of ureaplasmas/mycoplasmas in women with different clinical conditions. By means of quantitative PCR assays, the prevalence and load of each Mollicute were assessed in different groups of pre-menopausal women: 'healthy' (n=29), women with bacterial vaginosis (BV) (n=21), patients with Chlamydia trachomatis (CT) infection (n=25) and subjects with vulvo-vaginal candidiasis (VVC) (n=23). Globally, UP was the most prevalent Mollicutes in the vagina (67.3%), followed by MH (14.3%), UU (9.2%) and MG (3.1%). The presence of UU and UP was almost never associated. MH showed a significantly higher prevalence and higher bacterial loads in BV-positive women (P<0.05), whereas patients with CT and VVC were characterized by a Mollicutes pattern similar to healthy women. Mollicutes can be frequently found in the vaginal ecosystem, even in asymptomatic 'healthy' women. Although its presence is not a strict requirement, MH displays a significant role in the pathogenesis of BV.

Prevalence and antimicrobial resistance of genital Mollicutes in Italy over a two-year period.

Knowledge of the prevalence and antimicrobial susceptibility of genital Mollicutes is crucial to offer guidelines for empirical treatments. The aim of this study was to investigate the prevalence and the resistance profile of Mycoplasma hominis (MH) and Ureaplasma urealyticum/Ureaplasma parvum (UU/UP) in genital samples over a two-year period in Bologna, Italy. From January 2015 to December 2016, data on all the subjects providing uro-genital specimens for Mollicutes detection by culture were analyzed. A total of 4660 subjects (84.4% females) were enrolled and an overall Mollicutes prevalence of 30.9% was found. Women turned positive for Mollicutes infection twice as often as men (33.3% vs 17.8%) and the detection rate progressively decreased with increasing age. Ureaplasmas represented the commonest species isolated (overall prevalence: 24.2%), whereas mixed infections (6.5%) and MH single infections (3.9%) were far less common. Ureaplasma species showed significant levels of quinolone resistance, especially to ciprofloxacin (77%), whereas MH strains were non-susceptible to azithromycin and roxithromycin in about 90% of cases. Mollicutes co-infections showed a more severe resistance pattern than single infections. Over time, the resistance rate for azithromycin and roxithromycin increased significantly. Globally, our results revealed that minocycline and doxycycline can still be first-line drugs for Mollicutes treatment.

Isolamento e PCR para detecção de Mollicutes em muco vaginal e sua associação com problemas reprodutivos em ovinos criados na região de Piedade, São Paulo, Brasil / Mollicutes isolation and PCR on ovine vaginal mucous and its association with reproductive problems in Piedade, SP, Brazil

Pesquisou-se Mycoplasma spp, Ureaplasma spp e Acholeplasma laidlawiii em amostras de muco vaginal de 60 ovinos, criados na região de Piedade no Estado de São Paulo, Brasil, que apresentavam ou não vulvovaginite no exame específico do sistema genital. A caracterização desses microrganismos baseou-se no cultivo e detecção do respectivo DNA pela Reação da Polimerase em Cadeia (PCR) com os primers para classe Mollicutes (GPO e MGSO), para o gênero Ureaplasma (UGPF e UGPS) e a espécie Acholeplasma laidlawii (UNI e ACH3). A presença de micoplasmas não foi associada com distúrbios do trato reprodutivo dos animais, entretanto todos os isolados obtidos de Ureaplasma spp foram provenientes de animais com distúrbios reprodutivos, sugerindo o possível envolvimento desse agente nas enfermidades da reprodução. A PCR para a espécie Acholeplasma laidlawii detectou somente uma amostra positiva.

It was evaluated the presence of Mycoplasma spp, Ureaplasma spp and Acholeplasma laidlawiii in 60 samples of ovine vaginal mucous with the presence or absence of vulvovaginitis in the specific exam of the reproductive tract. The microorganisms were characterized based on bacteriological culture and DNA detection by Polymerase Chain Reaction (PCR) with specific primers to Mollicutes (GPO and MGSO), Ureaplasma (UGPF and UGPS) and Acholeplasma laidlawii (UNI and ACH3). The presence of mycoplasmas could not be associated with reproductive disorders in animals. The PCR to Acholeplasma laidlawii detected only one positive sample. However, all isolations of Ureaplasma spp were from animals presenting reproductive disorders, suggesting a possible involvement of this agent in reproductive diseases.