Examination of Ureaplasma urealyticum and Mycoplasma hominis in 4082 Chinese patients

The objective of this study was to analyze the infection rate and drug resistance of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in the genitourinary tract of Chinese patients. From December 2018 to June 2019, vaginal secretion or urinary secretion of outpatients in our hospital were selected for culture and drug sensitivity analysis of Ureaplasma urealyticum and Mycoplasma hominis. In 4082 Chinese samples, 1567 Mycoplasma were detected, a detection rate of 38.39%, among which 1366 cases were UU single positive, accounting for 33.47%, 15 cases were MH single positive, accounting for 0.36%, 186 cases were UU and MH mixed positive, accounting for 4.56%. The most affected age groups were 21-30 years and 31-40 years, accounting for 19.09 and 15.05%, respectively. The results of drug sensitivity showed that doxycycline, minocycline, josamycin, clarithromycin, and roxithromycin were more sensitive to mycoplasma infection. The distribution of Ureaplasma urealyticum and Mycoplasma hominis in the human genitourinary system and their sensitivity to antibiotics is different for sex and age groups.     

Comparative in vitro activity of azithromycin,clarithromycin, erythromycin and lomefloxacin againstMycoplasma pneumoniae,Mycoplasma hominis andUreaplasma urealyticum

The in vitro activity of three macrolides, azithromycin, clarithromycin and erythromycin and a new fluoroquinolone, lomefloxacin, against pathogenic mycoplasma (16 to 18 strains ofMycoplasma pneumoniae, 41 to 77 strains ofMycoplasma hominis, 65 to 104 strains ofUreaplasma urealyticum) was compared. The three macrolides were highly active againstMycoplasma pneumoniae. Clarithromycin was the most active macrolide againstUreaplasma urealyticum whereas azithromycin was somewhat more active than erythromycin againstMycoplasma hominis. Lomefloxacin was moderately active against all three mycoplasma species.     

Incidence and antibiotic susceptibility of genital mycoplasmas in sexually active individuals in Hungary

The aim of this study was to examine the incidence and antibiotic sensitivity of Ureaplasma urealyticum and Mycoplasma hominis strains cultured from the genital discharges of sexually active individuals who attended our STD outpatient service. Samples were taken with universal swab (Biolab®, Budapest, Hungary) into the Urea-Myco DUO kit (Bio-Rad®, Budapest, Hungary) and incubated in ambient air for 48 h at 37 °C. The determination of antibiotic sensitivity was performed in U9 and arginin broth using the SIR Mycoplasma kit (Bio-Rad®, Budapest, Hungary) under the same conditions. Between 01.05.2008 and 31.12.2011, 373/4,466 (8.35 %) genito-urethral samples with U. urealyticum and 41/4,466 (0.91 %) genito-urethral samples with M. hominis infection were diagnosed in sexually active individuals in the National STD Center, Semmelweis University. U. urealyticum was isolated in 12.54 % in the cervix and 4.1 % in the male urethra, while M. hominis was isolated in 1.33 % in the cervix and 0.51 % in the male urethra. The affected age group was between 21 and 60 years old. U. urealyticum strains were sensitive to tetracycline (95.9 %), doxycycline (97.32 %), and azithromycin (85.79 %), and resistant to erythromycin (81.23 %), clindamycin (75.06 %), and ofloxacin (25.2 %). Cross-resistance occurred in 38.71 % of patients to erythromycin and clindamycin. M. hominis strains were sensitive to clindamycin, ofloxacin, and doxycycline in more than 95 %, to tetracycline in 82.92 %, and no cross-resistance was detected among the antibiotics. Our study confirms that the continuously changing antibiotic resistance of ureaplasmas and mycoplasmas should be followed at least in a few centers in every country, so as to determine the best local therapy options for sexually transmitted infection (STI) patients.     

Sternotomy infection due toMycoplasma hominis andUreaplasma urealyticum

Mycoplasma hominis infections outside the urogenital tract are uncommon. An unusual case of sternal infection caused by bothMycoplasma hominis andUreaplasma urealyticum is described. This is the first report found in the literature of mixed infection due to these microorganisms at this site. The outcome was favourable after drainage of the surgical wound and antibiotic therapy with clindamycin, gentamicin and doxycycline.     

In vitro activity of florphenicol

Florphenicol was active at a lower concentration than chloramphenicol against over half of 234 recent clinical bacterial isolates. The majority (98 %) of the isolates were inhibited by florphenicol at a concentration of 8 mg/l or less. Florphenicol was particularly effective against chloramphenicol resistant strains ofHaemophilus influenzae, Klebsiella aerogenes andBacteroides spp. Florphenicol was bacteristatic for salmonellae andEscherichia coli but bactericidal forHaemophilus influenzae. Florphenicol was slightly more active than chloramphenicol againstChlamydia trachomatis, Mycoplasma hominis andMycoplasma pneumoniae but less active againstUreaplasma urealyticum.     

Comparison of polymerase chain reaction assay with culture for detection of genital mycoplasmas in perinatal infections

The polymerase chain reaction (PCR) technique was compared with culture for the detection ofUreaplasma urealyticum, Mycoplasma hominis, andMycoplasma genitalium in clinical samples (vaginal secretions, throat and endotracheal secretions, and skin swabs) obtained from 47 high-risk pregnant women peripartum and eight newborn infants. Detection using PCR with homologous primers was highly specific, as a product with the expected length was consistently amplified with homologous but not with heterologous species. The limit of detection of the PCR assay was 10 color-changing units (CCU) ofMycoplasma strains. The PCR technique facilitated detection ofUreaplasma urealyticum DNA in 31 of 55 patients studied, ofMycoplasma hominis in seven samples, and ofMycoplasma genitalium in two samples. Four PCR-positive patients yielded culture-negative results. In one case a culture-positive sample was negative by PCR. The results show that PCR is a valuable tool for rapid detection of genital mycoplasmas in clinical samples. It is fast, sensitive, specific, and easy to perform, requiring minimal preparation of the clinical sample.     

In vitro activity of new quinolones against Mycoplasma pathogenic to humans

The in vitro activity of new quinolones was evaluated against Mycoplasma pneumoniae (10 strains) and Mycoplasma hominis (approximately equal to 70 strains) by agar dilution, and against Ureaplasma urealyticum (approximately equal to 115 strains) by broth dilution. The static effect of pefloxacin, ofloxacin, ciprofloxacin, enoxacin was investigated for all the strains. Rosoxacin was included in the tests for U. urealyticum and M. hominis. Pefloxacin, ofloxacin, ciprofloxacin and enoxacin were within the same range of sensitivity for M. pneumoniae; the minimal inhibitory concentrations (MICs) of the 10 strains were 1 mg/l for ciprofloxacin, 2 mg/l for pefloxacin, MICs range was (0.05-1 mg/l) for ofloxacin and (0.5-4 mg/l) for enoxacin. Ciprofloxacin was the most active compound against M. hominis; MICs range and mode MICs were respectively in mg/l: (0.1-1) 0.5 for ciprofloxacin, (0.2-2) 0.5 for ofloxacin, (0.5-2) 1 for pefloxacin, (0.5-8) 2 for enoxacin, (2-16) 2 for rosoxacin. Ofloxacin was the most active compound against U. urealyticum; MICs range and mode MICs were respectively in mg/l: (0.2-2) 1 for ofloxacin, (0.1-8) 2 for rosoxacin, (0.5-8) 4 for pefloxacin, (1-16) 4 for ciprofloxacin, (2-32) 8 for enoxacin. No difference could be observed between tetracycline sensitive or resistant strains.     

Bacteremia with<Emphasis Type="Italic"> Mycoplasma hominis</Emphasis> and<Emphasis Type="Italic"> Ureaplasma urealyticum</Emphasis> in Patients Undergoing Hysterectomy

In the study presented here, the aim was to investigate the frequency and clinical significance of bacteremia with urogenital mycoplasmas in immunocompetent patients following gynecological surgery. Among 56 patients undergoing elective hysterectomy (mean age, 55 years; range, 32–82 years), Mycoplasma hominis and Ureaplasma urealyticum were detected in urine by PCR in 2 and 11 patients, respectively. Pre- and postoperative blood samples of the colonized patients were investigated for the colonizing species by PCR. In 4 of the 11 patients colonized by Ureaplasma urealyticum the pathogen was also detected from one of the postoperative blood samples, while no case of bacteremia with Mycoplasma hominis was detected. The postoperative course was uncomplicated in all patients.     

Non-occurrence ofMycoplasma genitalium in clinical specimens

Five hundred and thirteen clinical specimens, mainly from patients with urogenital inflammations, were examined forUreaplasma urealyticum and mycoplasmas, including cultures forMycoplasma genitalium. The study yielded 95 isolates ofUreaplasma urealyticum, 37 isolates ofMycoplasma hominis and two isolates ofMycoplasma fermentans, but no growth ofMycoplasma genitalium was obtained. It was concluded thatMycoplasma genitalium is a relatively rare inhabitant of the human urogenital tract in Israel.     

Polymerase chain reaction versus culture for detection ofUreaplasma urealyticum andMycoplasma hominis in the urogenital tract of adults and the respiratory tract of newborns

The efficiency of the polymerase chain reaction (PCR) was compared with that of culture for detection ofUreaplasma urealyticum andMycoplasma hominis in 726 clinical specimens comprising 189 gynecological samples, 362 urological samples, and 175 samples from newborn infants. The sensitivity of PCR versus culture was 95% for both organisms, while the sensitivity of culture versus PCR was 91% forUreaplasma urealyticum and 84% forMycoplasma hominis. Furthermore, PCR tests were faster than culture tests, allowing the time to diagnosis to be reduced from two to five days to 24 h.     

Prevalence and antibiotic susceptibility of <Emphasis Type="Italic">Ureaplasma urealyticum</Emphasis> and <Emphasis Type="Italic">Mycoplasma hominis</Emphasis> in Xi’an,China

This study analyzed the prevalence and antibiotic susceptibility of urogenital Ureaplasma urealyticum and Mycoplasma hominis isolated in Xi’an, China. A total of 2161 individuals from 2011 to 2015 were included, and antibiotic susceptibility tests were performed by using the Mycoplasma IST kit. Of the individuals studied, 1018 (47.11 %) were identified to be positive for urogenital mycoplasmas. The single U. urealyticum, single M. hominis, and dual U. urealyticum and M. hominis infections accounted for 772 (75.83 %), 66 (6.48 %), and 180 (17.68 %), respectively. The total positive rate was higher in females than in males (58.76 % vs. 28.86 %, p?<?0.001). The highest total positive rate (48.88 %) was observed in individuals aged 25 years to 30 years. In symptomatic and asymptomatic individuals, the positive rates were both higher in females than in males (67.36 % vs. 31.02 %, p?<?0.001 and 42.58 % vs. 7.69 %, p?<?0.001, respectively) and individuals aged 25 years to 30 years, and those aged 30 years to 35 years had the highest positive rates (54.35 and 57.14 %, respectively). The U. urealyticum and M. hominis identified from single or dual infections displayed low resistance rates to josamycin, doxycycline, and minocycline (<10 %) in both the symptomatic and asymptomatic groups. These results suggest that females and individuals with symptoms and younger age had higher mycoplasma infection rates and that josamycin, doxycycline, and minocycline may be recommended for the clinical treatment of patients infected with urogenital mycoplasmas, irrespective of the symptoms.     

Proteolytic activity of mycoplasmas and ureaplasmas isolated freshly from human saliva

Mycoplasma andUreaplasma strains freshly isolated from human saliva were examined for proteolytic activity. All the strains tested (101 strains ofMycoplasma salivarium, 97 strains ofMycoplasma orale, and 3 strains each ofMycoplasma hominis andUreaplasma urealyticum) decomposed horse serum proteins, bovine albumin, and casein. Ten of theM. salivarium and 8 of theM. orale strains were tested for aminopeptidase activity as well, using L-leucine-p-nitroanilide as a substrate, and were shown to possess the activity. Thus proteolytic activity was suggested to be one of the biological characteristics of these two species. The level of both caseinolytic and aminopeptidase activity was significantly higher inM. salivarium thanM. orale strains.     

Ureaplasma: Current perspectives

Ureaplasma species are the most prevalent genital Mycoplasma isolated from the urogenital tract of both men and women. Ureaplasma has 14 known serotypes and is divided into two biovars- Ureaplasma parvum and Ureaplasma urealyticum. The organism has several genes coding for surface proteins, the most important being the gene encoding the Multiple Banded Antigen (MBA). The C-terminal domain of MBA is antigenic and elicits a host antibody response. Other virulence factors include phospholipases A and C, IgA protease and urease. Besides genital tract infections and infertility, Ureaplasma is also associated with adverse pregnancy outcomes and diseases in the newborn (chronic lung disease and retinopathy of prematurity). Infection produces cytokines in the amniotic fluid which initiates preterm labour. They have also been reported from renal stone and suppurative arthritis. Genital infections have also been reported with an increasing frequency in HIV-infected patients. Ureaplasma may be a candidate ‘co factor’ in the pathogenesis of AIDS. Culture and polymerase chain reaction (PCR) are the mainstay of diagnosis. Commercial assays are available with improved turnaround time. Micro broth dilution is routinely used to test antimicrobial susceptibility of isolates. The organisms are tested against azithromycin, josamycin, ofloxacin and doxycycline. Resistance to macrolides, tetracyclines and fluoroquinolones have been reported. The susceptibility pattern also varies among the biovars with biovar 2 maintaining higher sensitivity rates. Prompt diagnosis and initiation of appropriate antibiotic therapy is essential to prevent long term complications of Ureaplasma infections. After surveying PubMed literature using the terms ‘Ureaplasma’, ‘Ureaplasma urealyticum’ and ‘Ureaplasma parvum’, relevant literature were selected to provide a concise review on the recent developments.     

Detection of Chlamydia trachomatis,Ureaplasma urealyticum and Mycoplasma hominis in infertile Bulgarian men with multiplex real‐time polymerase chain reaction

The effect of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis over the sperm quality is still unclear. The aim of this study was to determine their prevalence in infertile Bulgarian men. A total of 281 men were examined by applying mRT‐PCR. The registered prevalence was as follows: C. trachomatis – 13.9%, U. urealyticum – 19.2%, M. hominis – 9.9%. Co‐infection was established in eight swabs. This first in Bulgaria to study for detection of chlamydia and mycoplasmas in infertile men by mRT‐PCR demonstrates higher prevalence of the tested microorganisms in the infertile group toward the control one.     

Clinical efficacy of ciprofloxacin versus doxycycline in the treatment of non-gonococcal Urethritis in males

In a randomised study the clinical efficacy of ciprofloxacin was compared with that of doxycycline administered in two different dosage schemes to male patients suffering from non-gonococcal urethritis. Fourteen days after completion of therapy (day 21) pyuria was absent in 30 of 100 patients in the ciprofloxacin group;Chlamydia trachomatis was isolated from five andUreaplasma urealyticum from eight patients. In the 100 mg doxycycline group (n=60) pyuria was absent in 36 patients (60 %) andUreaplasma urealyticum was isolated from six patients on day 21. In the 200 mg doxycycline group (n=45) pyuria was absent in 18 patients (40 %) andUreaplasma urealyticum was isolated from two patients on day 21. Side-effects were mild and transient in all groups. It is concluded that ciprofloxacin given in a dosage of 1 g for seven days is not effective in the treatment of non-gonococcal urethritis.     

Development of multiplex real-time quantitative PCR for simultaneous detection of Chlamydia trachomatis,Mycoplasma hominis,Ureaplasma urealyticum,and Mycoplasma genitalium in infertile women

PurposeSexually Transmitted Diseases (STDs) can cause sterility and many other problems for women planning pregnancy. Currently, almost 340 million people worldwide suffer from Sexually Transmitted Infections (STIs). This study made attempts to quickly identify STDs' most critical infectious agents using dedicated primers and probes.MethodsThe present study was done on the cervical samples of 200 infertile women. After extracting the total DNA of Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium, quantitative methods were employed to determine the rate of target bacteria using multiplex real-time PCR.ResultsThe multiplex qPCR showed the rates of 47%, 16%, 46%, and 16.5% for Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum, and Mycoplasma genitalium in infertile women, respectively. In some patients, there were co-infections with two or three bacteria. The diagnostic approach used in our research could be employed as an alternative detection tool to identify the four most common STD-associated bacterial agents while detecting mixed infections.ConclusionsInfertile women with no biological problems could have their genital tract checked using this newly designed identification technique and get proper treatment for their infections as quickly as possible.     

152株解脲支原体对9种抗生素药物敏感性检测

目的了解深圳地区解脲支原体（UU）对常用9种抗生素的药物敏感情况，指导临床合理用药。方法采用UU培养和药敏试剂盒检测UU的体外抗菌活性。结果152株UU对9种抗生素的敏感性依次为原始霉素、多西环素、交沙霉素、克拉霉素、阿奇霉素、红霉素、四环素、氧氟沙星、环丙沙星，其总的耐药发生率为33．92％。结论对UU耐药性的检测，对指导临床合理用药具有重要意义。     

Evaluation of the Mycoplasma Plus and the SIR Mycoplasma kits for quantitative detection and antibiotic susceptibility testing of genital mycoplasma

We compared the results obtained with two commercially available systems (Diagnostics Pasteur) for the quantitative identification and the antibiotic susceptibility testing of the genital mycoplasmas. Ureaplasma urealyticum and Mycoplasma hominis with established methodologies, i.e. isolation on agar with enumeration by dilutions in broth medium and MIC determinations. The Mycoplasma Plus system, consisting of six cups, was designed for the identification and quantitation of genital mycoplasmas and the detection of yeasts. Used in parallel in 150 clinical specimens, it detected U. urealyticum in 42 out of 43 and M. hominis in 10 out of 11 specimens positive by the established methodology. The SIR Mycoplasma antibiogram, consisting of 16 cups, provided for the testing of 1 or 2 concentrations (micrograms/ml) of each of 8 antibiotics: doxycycline, minocycline and lymecycline (4-8); erythromycin (1-4); josamycin (2-8); clindamycin (2); pristinamycin (2); and ofloxacin (1-4). Using an inoculum of about 10(4)-10(5) organisms/ml, we found that major part of the results was in accord with those obtained with the MIC determined in broth for U. urealyticum and on agar for M. hominis. Strains intermediate or resistant to the tetracyclines were identified. Both systems seemed suitable for clinical laboratory use.     

泌尿生殖道支原体感染检测、鉴定及耐药性分析

目的 探究泌尿生殖道支原体感染情况及对常用抗菌药物的耐药情况,为指导临床合理应用抗菌药物提供科学依据。方法 本研究使用支原体培养、鉴定及药敏检测试剂盒（液基型）,对临床收集的489例疑似泌尿生殖道感染患者的标本进行支原体培养、鉴定及药敏检测。结果 发现在489例标本中,支原体阳性有202例,阳性率为41.30%,人型支原体单一阳性有24例,占11.88%,解脲支原体单一阳性有171例,占84.65%,混合感染有7例,占3.47%。女性、男性支原体检出率分别为52.36%、17.44%,女性明显高于男性。阳性患者以20~35岁为主,占66.83%。支原体对交沙霉素、强力霉素和美满霉素敏感性最高,敏感率分别为89.60%、88.12%和84.65%,对红霉素、司巴沙星、环丙沙星、氧氟沙星和左氧氟沙星敏感性较低,敏感率分别为18.81%、10.40%、1.49%、6.44%和5.94%。结论 本研究证实支原体感染中主要由解脲支原体感染为主。临床应参考药敏结果合理用药,经验用药时交沙霉素、强力霉素和美满霉素最好,应避免使用司巴沙星、环丙沙星、氧氟沙星和左氧氟沙星。     

Ureaplasma species and preterm birth: current perspectives

Abstract

Preterm birth is the leading cause of neonatal morbidity and mortality worldwide, and the human Ureaplasma species are most frequently isolated from the amniotic fluid and placenta in these cases. Ureaplasma colonisation is associated with infertility, stillbirth, histologic chorioamnionitis, and neonatal morbidities, including congenital pneumonia, bronchopulmonary dysplasia, meningitis and perinatal death. The human Ureaplasma spp. are separated into Ureaplasma urealyticum and Ureaplasma parvum with 14 known serotypes. The small genome has several genes, which code for surface proteins; most significantly the Multiple Banded Antigen (MBA) where an antigenic C-terminal domain elicits a host antibody response. Other genes code for various virulence factors such as IgA protease and urease. Ureaplasma spp. infection is diagnosed by culture and polymerase chain reaction (PCR) and commercial assays are available to improve turnaround time. Microbroth dilution assays are routinely used to test antimicrobial susceptibility of clinical Ureaplasma spp. especially against doxycycline, azithromycin, ofloxacin and josamycin. Resistance to macrolides, fluoroquinolones and tetracyclines has been reported. A concise review of Ureaplasma spp. and their role in pregnancy outcomes, especially preterm birth, offers insight into the early diagnosis and appropriate antibiotic therapy to prevent long-term complications of Ureaplasma spp. infections.