Impact of combined mycoplasmataceae and HPV co-infection on females with cervical intraepithelial neoplasia and carcinoma.

PURPOSE: The concurrent prevalence investigation of human papillomavirus (HPV), Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) in women in order to estimate the association of co-infection with cervical lesions. METHODS: The study cohort comprised 120 women with no cervical lesions (control group) and 62 women with abnormal cytological findings from the cervix (cervical intraepithelial lesion/neoplasia) as study group. A combination of molecular analyses was implemented. RESULTS: The presence of HPV infection was shown in 52/62 (83.9%) of women with abnormal cytology. Women with cervix cytological findings were shown to have 17.6 times higher risk for Mh and Uu co-infection (p=0.001). HPV and Uu co-infection were detected with a higher prevalence among women with CIN 3 and invasive cancer. CONCLUSION: These findings are consistent with the notion that microbial co-infections may play an important role in persistent inflammation and progression of cervical lesions.

Accuracy of urethral swab and urine analysis for the detection of Mycoplasma hominis and Ureaplasma urealyticum in women with lower urinary tract symptoms.

OBJECTIVES: Our objective was to evaluate and compare the accuracy of urethral swabs and urine specimens in the detection of Mycoplasmas in women with lower urinary tract symptoms (LUTS). METHODS: During a urogynecological work-up, including cystometry, we obtained first-void urine, urethral and vaginal swabs in 207 consecutive women at our urogynecological division. Mycoplasma hominis and Ureaplasma urealyticum as well as other microorganisms were detected by standard culture methods. RESULTS: 131 of 207 women reported LUTS. The other 76 formed the controls. Of 207 women 50 (24.2%) had positive cultures for Mycoplasmas. The prevalence of Mycoplasmas in women with LUTS (30.3%) was statistically significant and higher in the group without LUTS (14.5%) (p = 0.011). The detection of M. hominis was most accurate using urethral swab (Specificity 99.9%, PPV 99.6%) compared to the urine specimen (96%, 75%) and vaginal swab (95.1%, 67%). Similar results could be achieved for U. urealyticum (urethral swab: specificity 98.7%, PPV 96.3%; urine specimen: 86.8%, 72%; vaginal swab: 80.5%, 65.2%). CONCLUSION: In the subgroup of women less than 50 years an (detectable) infection due to Mycoplasma or Ureaplasma leads typically to LUTS with normal filling cystometry, whereas no such findings were relevant for the elderly women.

Role of genital mycoplasmata and other bacteria in urolithiasis.

Urease-producing bacteria have been shown to affect the formation of infection stones by splitting urea into ammonia, bicarbonate and carbonate. An increase in alkaline pH results in urinary supersaturation of the ions. The increase in ammonia also causes injury to the urothelial glycosaminoglycan layer. Non-urease-producing bacteria have been speculated to form urinary stones. Midstream voided bladder urine and fractured stone nidus samples from 72 patients undergoing surgery for urolithiasis were cultured on specific media for genital mycoplasmata and on conventional media. Urine samples were obtained from a control group of 40 healthy subjects. Genital mycoplasmata and other bacteria were evaluated with regard to the composition of urinary stones. Compared with other origins of stones, the relation between isolation of Ureaplasma urealyticum and infection stone disease was statistically proven. Isolation of genital mycoplasmata was significantly higher in women than in men in the study group. The urinary stones comprised 84.7% calcium stones, 8.3% uric acid stones and 6.9% infection (magnesium ammonium phosphate) stones. Coagulase-negative Staphylococci, Escherichia coli, Corynebacterium spp., Enterobacterium spp. and U. urealyticum were cultured from stone samples. The results suggests that non-urease-producing bacteria, as well as urease-producing bacteria, may influence the formation of urinary stones.

Mycoplasmal antibodies as determined with an enzyme-linked immunosorbent assay, in tubal factor infertility.

A total of 81 infertile women, who had been referred for diagnostic loparoscopy, were tested for the presence of antibodies to Mycoplasma hominis and T-mycoplasma. Out of 81, 30 had tubal adhesions and 51 had unilateral/bilateral tubal blockage. Antibodies to M. hominis were found in 21/30 (70%) and 14/51 (27.45%) women, antibodies to T-mycoplasma in 12/20 (40% and 39/51 (76.47%) women with tubal disorder. In a control group of 40 pregnant women, antibodies to the same two organisms occurred in 10% and 32.5%. Antibodies to M. hominis and T-mycoplasma were significantly (P < 0.001) more common in women with tubal disorder. Our results confirm the important role of M. hominis and T-mycoplasma in the aetiology of tubal infertility.

Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum infections in women. Prevalence, risks and management at a South African infertility clinic.

Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum infections not only jeopardize fertility but also pose a risk for infertility treatment and resulting pregnancies. Routine screening tests or empirical antibiotic treatment of infertile couples may be justified by the prevalence of these organisms. We studied the wives in 40 consecutive infertile couples. Monoclonal direct immunofluorescence (DIF) for C trachomatis was performed on fixed smears from endocervical swabs. M hominis and U urealyticum were isolated by inoculation of Hayflick (HF) medium, HF broth and Ureaplasma A7 agar with endocervical swabs. Using DIF, 11 (27.5%) specimens were positive, 25 (62.5%) were negative, and 4 (10.0%) were equivocal. DIF was repeated on smears from three of the last four patients; all three were positive for C trachomatis. One patient was lost to follow-up and excluded from the study. For the total 39 specimens the final results were 14 (35.9%) positive and 25 (64.1%) negative. M hominis was isolated from 3 (7.5%) endocervical swabs. None of the endocervical swabs yielded a culture positive for U urealyticum. Statistical analysis showed no correlation between the clinical history and presence of infection with any of the three organisms. The prevalence of 35.9% for C trachomatis was surprisingly high for an infertile population and, if supported by culture confirmation, justifies routine screening. The potential adverse effects of these organisms on the success rate of highly specialized infertility treatments are essentially unresolved. Since our analysis of cost effectiveness as applicable to our unit, all new infertile couples are treated empirically with lymecycline.

[Combined etiological and pathogenetic therapy of urogenital Ureaplasma-Chlamydia-gonococcal infection in men]. / Kombinirovannaia étiologicheskaia i patogeneticheskaia terapiia urogenital'nykh ureaplazmenno-khlamidiino-gonokokkovykh infektsii u muzhchin.

One hundred and sixteen males with mixed Ureaplasma ++, chlamydial and gonorrheal urethritis were treated. 22 of them suffered from recent torpid urethritis and 94 were chronic patients including those with complications. The diagnosis was confirmed by the laboratory tests. The patients were subjected to complex treatment with immunostimulation (by the gonorrhea vaccine, methyluracil and pyrogenal), local therapy and the use of antibiotic combinations on day 8: gentamicin (0.84 g per treatment course) and doxycycline (2.1 g per treatment course). The treatment course was equal to 14 days. Favourable etiological and clinical results were observed in 114 patients. The recovery was confirmed by 3-fold verification. A high efficacy of the developed method studied clinically was stated.

[Mycoplasma infections of the human genital tract]. / Mikoplazmennye infektsii genital'nogo trakta cheloveka.

It has been shown that genital Mycoplasma may cause local and generalized diseases particular in parturients and premature neonates. For better laboratory diagnosis of Mycoplasma-induced infections, it is necessary to organize the production of culture media and diagnostic kits.

[Mycoplasma and Ureaplasma infections in chronic genital inflammatory processes, abortion and infertility]. / Mikoplazmoz i ureaplazmoz pri khronicheskikh vospalitel'nykh protsessakh genitalii, nevynashivanii beremennosti i besplodii.

A total of 43 females including 13 with sterility, 23 with habitual miscarriage and 7 pregnant women with a history of chronic inflammatory diseases were examined by using various tools to detect their Mycoplasma and Ureaplasma infections. The females had been studied for bacterial and chlamydial infections. Forty of them turned out to be infected with M. hominis and U. urealyticum. In some cases, sanation led to the improvement of the patients' status, the occurrence of pregnancy, its favourable course and termination in subjects with sterility and habitual miscarriage. The value of the findings is discussed in the paper.

Wound infections after cesarean section with Mycoplasma hominis and Ureaplasma urealyticum. A report of three cases.

Mycoplasma hominis and Ureaplasma urealyticum were isolated from the surgical wounds of three patients who developed endometritis and a wound infection after cesarean section. In all patients, aspiration of the incision yielded a cloudy serosanguinous exudate. Gram stain of the fluid revealed numerous white blood cells but no bacteria. All patients responded to antibiotic therapy and local wound care.

Mycoplasmas and acholeplasmas isolated from ducks and their possible association with pasteurellas.

Two hundred and sixty-three cases of clinically diseased ducks of all ages were examined for the presence of mycoplasmas. Mycoplasmas and acholeplasmas belonging to more than eight serogroups were cultured from 68 of them, and comprised 12 M anatis, one M columbinasale, two M gallinaceum, two M gallinarum, nine M synoviae, three unidentified Mycoplasma species, 37 Acholeplasma laidlawii and one unclassified acholeplasma belonging to each of serogroups 7 and 8. They were identified by biochemical characterisation, disc growth inhibition and agar gel diffusion tests. Fifty-three (78 per cent) of the isolates occurred with species of Pasteurella: 33.8 per cent with Pasteurella anatipestifer, 32.4 per cent with P multocida and 11.8 per cent with both P anatipestifer and P multocida. Nine of the isolates (13.2 per cent) were in pure culture and six (8.8 per cent) with other agents. Of the ducks negative for mycoplasmas 33.3 per cent were infected with P anatipestifer, 25.1 per cent with P multocida and 14.4 per cent with both P anatipestifer and P multocida. There was no correlation between the infections with mycoplasmas and P anatipestifer but there was a weak association between the infections with mycoplasmas, especially M anatis and P multocida.

[Mycoplasma infections in marital infertility]. / Mikoplazmennaia infektsiia pri besplodii v brake.

Evaluation of 302 infertile married couples has identified Mycoplasma infection in 106 (35.5%) of women and 96 (31.8%) of men. The infection was associated primarily with cervical and endometrial abnormalities in the women and sperm abnormalities in the men. Tetracycline treatment resulted in clinical improvement both in the women and men. This study suggests Mycoplasma infection to be an etiological factor in infertile marriage.

Evaluation of the significance of Mycoplasma hominis and Ureaplasma urealyticum in female genital tract infection--a retrospective case note study.

Routine screening for sexually transmitted diseases in new patients attending the Genitourinary Clinic in Stoke-on-Trent includes a culture for Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU). A retrospective study was carried out on 400 female patients to ascertain whether there were any significant differences between the group positive for MH and UU and the negative control group. The positive group were found to be younger on average, but to have similar sexual histories to the negative control group. An association was found between the presence of genital mycoplasmas and Gardnerella vaginalis. An odourous vaginal discharge was more common in the positive group. Erythromycin was ineffective in eradicating the organisms in 62.5% of patients with MH, and 70% of those with UU. Continuing work is required to identify those women in whom the presence of MH or UU could have pathogenic effects. Treatment regimens for this group of women need to be carefully reassessed, in the light of increasing antibiotic resistance.

[Ocular findings in infection-linked immune phenomena and secondary diseases (the so-called Reiter's syndrome)]. / Okuläre Befunde bei infektionsassoziierten Immunphänomenen und Nachkrankheiten (sog. "Reiter-Syndrome").

Between 1981 and 1987 the authors saw 12 patients with Reiter's syndrome. Lesions included 6 cases of bilateral conjunctivitis in patients with chlamydial infection, 3 of unilateral serofibrinous iridocyclitis in patients with Yersinia enterocolitica, 1 case of bilateral iridocyclitis in a patient with positive chlamydial complement-binding reaction, 1 case of bilateral follicular conjunctivitis following acute gonococcal urethritis, and one case of unilateral serofibrinous iridocyclitis, in a patient with Ureaplasma urealyticum. Immunohistologic work-up of the conjunctival biopsy from the patient with Urea-plasma urealyticum urethritis revealed IgM deposits in the vascular endothelium of conjunctival vessels, C-3 deposits in the conjunctival stroma, and intercellular IgG in the conjunctival epithelium. Since Reiter's syndrome is interpreted as a sequela of secondary immune diseases following a primary infection that may persist in HLA-B27-positive patients, the patients were treated with both topical and systemic anti-infectious and anti-inflammatory agents.

Comparison of the incidence of Ureaplasma urealyticum in infertile men and in donors of semen.

569 infertile patients and 75 fertile men (donors of semen) were included in our study from 1985 to 1987. We compared the frequency of Ureaplasma urealyticum in semen specimens in these two groups: 40 infertile men (7%) and 4 donors of semen (5.3%) had U. urealyticum in semen cultures. This difference was not statistically significant. We concluded that U. urealyticum was not more frequent in infertile than in fertile men. We also report the results of semen cultures for other bacteria and the parameters of routine semen analysis in these two groups. All infertile patients infected by U. urealyticum were treated with doxycycline: the infection was eradicated in 77.5% of them.

Clinicopathologic diagnosis of mycoplasma endometritis.

Chronic endometritis and its association with cervical colonization by Ureaplasma urealyticum was investigated in a group of 28 infertile patients treated for infertility problems. Twenty had positive cervical cultures for U. urealyticum and eight had negative cultures. There was focal chronic endometritis in 11 of the endometrial biopsies of the 20 cases with positive mycoplasma cultures. Ten of these biopsies were in the secretory phase, and one was in proliferative phase. No case with a negative culture showed endometritis.