In vitro sensitivity to antibiotics of genital mycoplasmas isolated in Toulouse. Study of new molecules (macrolides and quinolones)]

The minimal metabolism-inhibiting concentrations (MMC) of 11 antibiotics were determined for 40 strains each of M. hominis and U. urealyticum using a terminal color change broth method. All strains were recovered in 1990. Resistance to tetracycline (MMC greater than 8 mg/l) was found for 12.5% of strains of M. hominis and U. urealyticum, as compared with 5% in 1985. Rokitamycin was the most active macrolide against M. hominis (MMC 90: 0.06 mg/l). U. urealyticum strains were susceptible to all the macrolides tested, with the greatest activities being seen for rokitamycin and clarithromycin (MMC 90: 0.06 mg/l and 0.12 mg/l respectively). Sparfloxacin was the most active quinolone against both species. Human clinical trials designed to evaluate these new molecules for the treatment of mycoplasmal and ureaplasmal genital infections are warranted.     

Experimental animal infections with Mycoplasma hominis and Ureaplasma urealyticum.

Subcutaneous tissue cavities in mice and guinea pigs were infected with human isolates of Ureaplasma urealyticum and Mycoplasma hominis. The minimal infective dose for M. hominis was as low as less than 10 color-changing units (CCU) for mice and 10(2) CCU for guinea pigs. The minimal infective dose for U. urealyticum was as low as less than 10 CCU for mice and 10(4) CCU for guinea pigs. Mouse infections with either U. urealyticum or M. hominis persisted for 1 day to greater than 4 months. Guinea pigs remained infected for up to 4 weeks. Two M. hominis isolates were similar in their ability to infect subcutaneous tissue cavities but two U. urealyticum isolates varied in their ability to infect the cavities. The histopathology of the M. hominis and U. urealyticum infections was similar: an initial intense polymorphonuclear response with giant cells, followed in 4 weeks by histiocytes and giant cells with some plasma cells and lymphocytes.     

Have Ureaplasma urealyticum and Mycoplasma hominis infections any significant effect on women fertility?

Ureaplasma urealyticum and Mycoplasma hominis are known as sexually transmitted agents. U. urealyticum and M. hominis jeopardize male fertility. However, it is unclear whether these infections significantly contribute to female infertility. In this controlled-study we aimed to establish whether M. hominis and U. urealyticum are risk factors for female fertility and prevalence of infection from these agents in patients attending our infertility clinic. Total 96 married women enrolled in this prospective study; the infertile (study) group consisted of 50 women and fertile (control) group comprised 46 women. The patients were searched about the presence of U. urealyticum and M. hominis by a micro-liquid culture method. The samples were collected from endocervical area with a dacron swab. 28 of 50 (56%) and 18 of 46 (39%) women were evaluated as positive for U. urealyticum culture in the study and control groups respectively. M. hominis was cultured from 4 of 50 (8%) women in the study group as no positive result in controls. There were no statistically significant differences between the groups for both agents (p>0.05), but the higher prevalence of U. urealyticum in infertile women gives emphasis to evaluate these agents in patients that have no any other etiological factor for infertility.     

High rates of genital mycoplasma infection in the highlands of Papua New Guinea determined both by culture and by a commercial detection kit.

Duplicate vaginal swabs were collected from 100 women, and comparisons were made between an in-house broth-agar culture system and a commercially available kit, the Mycoplasma IST kit (bioMérieux), for the detection of Mycoplasma hominis and Ureaplasma urealyticum. There was good agreement between the two systems for detection of the genital mycoplasmas in terms of sensitivity, with values of > 92% being obtained. In terms of specificity, the mutual comparisons were less favorable, though specificity values of > 72% were obtained. Statistically there was no significant difference in the performance of the two tests (P < 0.1 for both M. hominis and U. urealyticum). While the broth-agar culture system was considerably less expensive than the kit, the Mycoplasma IST kit provided additional information on antibiotic susceptibilities and had the advantages of a shelf life of up to 12 months and not requiring the preparation of culture media. The prevalences of colonization obtained for M. hominis and U. urealyticum were extremely high in this randomly selected group of women from periurban and rural settlements in the Eastern Highlands of Papua New Guinea, being > or = 70% for M. hominis and > or = 78% for U. urealyticum. colonization with both genital mycoplasmas simultaneously was also very common, with > or = 60% of women being colonized by both M. hominis and U. urealyticum.     

Mycoplasma hominis and Ureaplasma urealyticum in different gynecologic diseases

The incidence of Mycoplasma hominis (M. hominis) y Ureaplasma urealyticum (U. urealyticum) was investigated in 113 endocervical samples obtained from women who were seen for different gynecological pathologies. Forty-seven (42%) patients were positive to these microorganisms; 26 cases (23%) were positive for M. hominis and 21 (19%; p = NS) for U. urealyticum. Average age was 32.1 +/- 7.7 years; the average number of sexual partners was 1.7 +/- 1.1. Eleven of 17 patients with 3 o more sexual partners were positive for Genital Mycoplasma (GM), and U. urealyticum was found more often in this group. A higher incidence of GM was found in women between 26 and 30 years (34%); 57.5% of the patients with positive cultures for GM had begun sexual activity before 20 years of age. M. Hominis was found in 61% of women with no parity and U. urealyticum in 71% of parous women. The cultures were positive in 10 of 14 patients with pelvic inflammatory diseases (PID). A cervical biopsy was taken from 52 cases and the diagnosis of cervical intraepithelial neoplasia (CIN) was made in 49 (94%) but only 24 of them were positive for GM (50%). Thirty-five patients suffered sterility, and 12 (34%) were positive for GM, however all positive cases consulted because of primary sterility. The conclusions obtained from this study are: 1) Near half of the patients was positive for GM and none of the species was predominant over the other. 2) The more sexual partners the higher was the incidence of GM, especially U. Urealyticum. 3) The lower the age of the first sexual intercourse the higher the probability of contamination with these microorganisms. 4) M. hominis was more common in nulliparous women and U. urealyticum was found more often in parous patients; the number of deliveries did not have influence in these findings. 5) A statistical significance between GM and PID was found (p = 0.03). 6) GM have no influence on spontaneous abortion. 7) No statistical significance was found between GM and the beginning and evolution of CIN. 8) No relation statistically significative was found between GM and sterility.     

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.     

Antibiotic sensitivity of Mycoplasma pathogenic for man

Human pathogen mycoplasmas (Mycoplasma pneumoniae, Mycoplasma hominis, Ureaplasma urealyticum) are intrinsically resistant to antibiotics which inhibit the cell wall biosynthesis (beta-lactams, vancomycin, bacitracin), to polymyxins, rifamycins, sulfonamides, trimethoprim, 5-nitroimidazoles, nitrofurans and to presently available quinolones. These three species are moderately susceptible to aminoglycosides, susceptible to chloramphenicol and highly susceptible to tetracyclines. M. pneumoniae is susceptible to macrolides, lincosamins and streptogramins. M. hominis is resistant to early macrolides (erythromycin, oleandomycin, spiramycin) and susceptible to new macrolides (josamycin, midecamycin, rosaramicin), lincosamins and streptogramins. U. urealyticum is resistant to lincosamins and susceptible to macrolides and streptogramins. Discordant results from various reports can be explained by differences in methods and breakpoint concentration values. In M. pneumoniae species, two strains resistant to macrolides and lincosamins have been described. In M. hominis species, one strain resistant to tetracyclines and another one resistant to tetracyclines and chloramphenicol have been reported. Two to ten percent of U. urealyticum strains are resistant to tetracyclines. These resistances are likely to be plasmid-mediated.     

Systematic screening tests for Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in urogenital specimens of infertile couples

We conducted a prospective study on 100 couples consulting for infertility at the teaching Hospital of Tours, with the scope to determine if there is a benefit for systematic screening of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum among genito-urinary specimen when exploring couples infertility. C. trachomatis was detected by PCR on sperm, endocervix and urine specimen. M. hominis and U. urealyticum were detected by culture on A7 agar medium and with minigaleries on sperm and endocervix specimen. Standard cultures were also performed on sperm, endocervix, vaginal and urine specimen. Only one specimen (sperm) was positive for C. trachomatis. Three percent of the specimen were positive for U. urealyticum (from which 2,5% of the sperm specimen). No specimen was positive for M. hominis. Our results show that screening of C. trachomatis, M. hominis and U. urealyticum is not systematically required for among check up of infertile couples, given the prevalence of chlamydiosis among the population studied. However, it would be interesting to perform it on a targeted population, according to anamnestic or clinical criteria. In addition, an important modification of vaginal flora was observed in 12% of cases, and 2 vaginosis were diagnosed; the putative consequences of this disequilibrium has to be further investigated.     

Drift of tetM determinant in urogenital microbiocenosis containing mycoplasmas during treatment with a tetracycline antibiotic

We studied the correlation between genetic transfer of tetM determinant in Tn916 conjugative transposon by urogenital mycoplasmas (Mycoplasma hominis and Ureaplasma urealyticum) and changes in the bacterial repertoire during treatment with a tetracycline antibiotic. Basic conditions favoring the nonspecific transfer of tetM determinant into mollicute cells are determined and the allele polymorphism of tetM determinant in clinical strains of M. hominis and U. urealyticum is evaluated. The structure of tetM gene in clinical mycoplasma and ureaplasma strains is characterized by a peculiar mosaic pattern and differs from all previously described alleles of this gene. The results suggest that tetracycline resistance in mollicutes is determined by mechanisms alternative to genetic transfer of tetM determinant.     

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.     

Comparison of commercially available media for detection and isolation of Ureaplasma urealyticum and Mycoplasma hominis.

The Mycotrim Triphasic flask system (Irvine Scientific, Irvine, Calif.) was compared with a system composed of Mycotrim GU broth (Irvine Scientific) and A7 or A8 agar (Remel, Lenexa, Kans.) for the ability to detect Ureaplasma urealyticum and Mycoplasma hominis from 129 genital specimens. Of the 64 specimens positive for U. urealyticum, 25, 98, and 100% were detected on Mycotrim Triphasic agar and A7 and A8 agars, respectively. All 18 specimens that grew M. hominis were detected by A7 and A8 agars, and 94% grew on Mycotrim Triphasic agar. Mycotrim GU broth detected all of the positive specimens, and Mycotrim Triphasic broth detected all but one. Mycotrim GU broth inoculated simultaneously with either A7 or A8 agar was found to be more sensitive and cost-effective than the Mycotrim Triphasic flask system.     

Occurrence of mycoplasmas in urinary tracts of patients with acute pyelonephritis

Mycoplasma hominis was isolated from the upper urinary tract in 7 of 80 patients with acute pyelonephritis and from 0 of 60 patients with noninfectious diseases of the urinary tract, a significant difference. In four cases M. hominis was isolated in pure culture, in one it was isolated together with Ureaplasma urealyticum, and in two it was isolated with bacteria. U. urealyticum was isolated from the upper urinary tract of five patients, all with acute pyelonephritis; this was not significantly different from the control group.     

Experimental Mycoplasma Infection in Monkeys

Experimental mycoplasma infection was studied in Papio hamadryas, Macaca mulatta, and Macaca nemestrina infected with Mycoplasma (M. pneumoniae and M. hominis) and Ureaplasma (U. urealyticum).     

Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy

To examine the association between colonization by two newly classified species of genital ureaplasmas (Ureaplasma parvum and U. urealyticum) in early pregnancy and subsequent late abortion or preterm birth at <34 weeks of gestation, four species of genital mycoplasmas--Mycoplasma genitalium, M. hominis, U. parvum, and U. urealyticum--as well as Chlamydia trachomatis and Neisseria gonorrhoeae were examined by PCR-based methods in a prospective cohort study of 877 women with singleton pregnancies at <11 weeks of gestation. Antibiotics were used only in cases in which C. trachomatis and/or N. gonorrhoeae was detected. Multivariate logistic-regression analysis was used to assess independent risk factors after taking maternal low body weight and past history of preterm birth into account. M. genitalium, M. hominis, U. parvum, U. urealyticum, C. trachomatis, and N. gonorrhoeae were detected in 0.8%, 11.2%, 52.0%, 8.7%, 3.2%, and 0.1% of these 877 women, respectively. Twenty-one (2.4%) women experienced late abortion or preterm birth at <34 weeks of gestation. Three factors-detection of U. parvum in the vagina (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1 to 8.5); use of antibiotics, such as penicillin and cefatrizine, for incidental inflammatory complications before 22 weeks of gestation (OR, 4.2; 95% CI, 1.6 to 10.0); and past history of preterm birth (OR, 10.4; 95% CI, 2.7 to 40.5)-were independently associated with late abortion and preterm birth. In conclusion, vaginal colonization with U. parvum, but not U. urealyticum, is associated with late abortion or early preterm birth.     

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。     

Cytokine concentrations in seminal plasma from subfertile men are not indicative of the presence of Ureaplasma urealyticum or Mycoplasma hominis in the lower genital tract

The inflammatory response to the presence of Ureaplasma urealyticum or Mycoplasma hominis in the lower genital tract of subfertile men without any signs or symptoms of infection was investigated by measuring the concentrations of interleukin (IL)-6, IL-8, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) in seminal plasma. Semen samples were collected from 30 culture-positive subfertile males and 23 culture-negative subfertile males. Enzyme-linked immunosorbent assays showed that IL-8 was present in relatively high concentrations (0.12-4.8 ng/ml) in all semen samples investigated. In contrast, the other cytokines were only detectable in 72% (IFN-gamma), 44% (IL-6) and 19% (TNF-gamma) of the samples and were present in relatively low concentrations (1-410 pg/ml). Seminal plasma cytokine concentrations were similar in samples from culture-positive and culture-negative males. These data strongly indicate that the presence of U. urealyticum or M. hominis in the lower genital tract of subfertile males reflects a silent colonisation rather than infection.     

Isolation of mycoplasmas from female genitalia

The author tested ways of collection, transport and storage of material for mycoplasmatological examination. The use of tampons on a stick during transport in urea substrate medium proved useful. The site of maximum occurrence of mycoplasmas was the posterior vaginal vault. On examination of the vaginal secretion of 804 women Mycoplasma hominis was isolated in 29.6% and Ureaplasma urealyticum in 65.2% of the cases. Concurrent isolation of Mycoplasma hominis and Ureaplasma urealyticum was recorded in 22.1% of the women. The results of the examination do not suggest the participation of mycoplasmas in the development of aminocolpitis. In pregnant women there is a greater probability of colonization of the vagina by U. urealyticum.     

In vitro activity of Septivon-Lavril toward mycoplasma pathogenic to humans

Septivon-Lavril is bactericidal in vitro towards species of mycoplasmas responsible for vaginal infections and their complications (U. urealyticum and M. hominis) and for the Stevens-Johnson syndrome (M. pneumoniae). As the active doses are inferior to those recommended for external use, this product, Trichlorocarbanilide, presents a clinical interest.     

Isolation of genital mycoplasmas from the blood of neonates and women with pelvic infection using conventional SPS-free blood culture media

Standard blood culture media used in our laboratory were tested for their ability to support the growth of Mycoplasma hominis and Ureaplasma urealyticum. Small inocula (approximately 10 colony forming units per ml) of both organisms grew in diphasic tryptone soya medium but not in any of several media containing sodium polyanetholesulphonate (SPS) including a modified Schaedler broth (RWH anaerobic medium) and two BACTEC media (6B and 7D). Both organisms were inhibited even by very low concentrations of SPS but grew well in the Royal Women's Hospital (RWH) anaerobic medium when SPS was omitted. During a 22-month period, routine "blind" plating of the aerobic blood cultures on to mycoplasma agar resulted in isolation of M. hominis or U. urealyticum from 12 women with postpartum or postoperative pelvic infection, and from 3 neonates. Genital mycoplasmas represented 35% of significant isolates from adult blood cultures.     

Lack of association between genital mycoplasmas and infertility

We studied the relation between colonization with Mycoplasma hominis and Ureaplasma urealyticum, and the results of infertility studies in 205 women with involuntary infertility of at least one year's duration. Isolation of M. hominis (but not of U. urealyticum) was significantly (P = 0.002) more common in patients with a history of pelvic inflammatory disease. However, no relation could be shown between these genital mycoplasmas and any of the following: evidence of prior pelvic inflammatory disease as determined by hysterosalpingography and laparoscopy; cervical inflammation; numbers and motility of spermatozoa on postcoital test; pyosemia; quality of cervical mucus; whether the cause of infertility was related to male or female factors, both, or neither; and occurrence and outcome of subsequent pregnancy. Mycoplasmas were cultured from only 10 of 203 endometrial biopsy specimens (4.9 per cent), and in no instance was inflammation associated with this finding. Out studies do not support a role for genital mycoplasmas in the cause of infertility.