Mycoplasma hominis and Ureaplasma urealyticum in patients with sterile pyuria

OBJECTIVES: Mycoplasma hominis and Ureaplasma urealyticum are associated with various diseases of the urogenital tract, but they are usually not detected by routine microbiological diagnosis. The aim of this study was to asses the prevalence of these organisms in patients with sterile pyuria. METHODS: From December 2000 to June 2001 all urine samples sent in to microbiological diagnosis, which yielded > or =500 leucocytes/ml and <10(4) bacteria/ml, were collected for this study. Thirty-three samples from 30 patients (female: 21, male: nine; median age: 60 years, range: 23-91 years) met these criteria and were subjected to PCR for detection of M. hominis and U. urealyticum, respectively. RESULTS: M. hominis and U. urealyticum were detected in 2 (7%) and 6 samples (20%), respectively. With regard to the underlying diseases of the patients, glomerulonephritis was significantly associated with the detection of urogenital mycoplasmas (p=0.02). CONCLUSION: The prevalence of M. hominis and U. urealyticum found in this study corresponds to the expected prevalence in the general population. This finding does not indicate an association of sterile pyuria with urogenital mycoplasma infection/colonization.     

Studies on the role of Ureaplasma urealyticum and Mycoplasma hominis in prostatitis

It has definitely been demonstrated that Ureaplasma urealyticum is one etiologic agent of nongonococcal urethritis, a sexually transmitted disease. For this reason it seemed possible that the organisms might cause ascending inflammatory reactions of the prostate. Quantitative determinations of ureaplasmas and Mycoplasma hominis, together with localization studies, were therefore performed to elucidate the importance of these microorganisms in patients with chronic prostatitis. U. urealyticum was found in high numbers in expressed prostatic secretions and urine voided after prostatic massage from 82 (13.7%) of 597 patients with chronic prostatitis. Because numbers of ureaplasmas in first-voided urine and midstream urine were significantly lower, the source of the organisms in these patients was assumed to be the prostate. These data and the results of tetracycline treatment provide sufficient evidence for the etiologic importance of ureaplasmas in chronic prostatitis.     

Ureaplasma urealyticum and Mycoplasma hominis in women with systemic lupus erythematosus.

OBJECTIVE. To determine the prevalence of genitourinary mycoplasma infection in women with systemic lupus erythematosus (SLE). METHODS. Urine specimens from 49 patients with SLE and 22 patients with chronic fatigue syndrome (CFS) were cultured for mycoplasma. Patient records were reviewed for medical history and SLE disease activity. RESULTS. Sixty-three percent of the SLE patients were culture positive, compared with 4.5% of the CFS patients (P less than 0.001). Neither corticosteroid treatment, SLE activity, nor age accounted for this difference. CONCLUSION. Genitourinary mycoplasma colonization occurs significantly more frequently in SLE than in CFS.     

呼和浩特等三地区性病患者解脲脲原体、人型支原体及生殖支原体的检测

Ｕｕ、Ｍｈ是引起人类泌尿生殖道感染的常见病原体 ,而Ｍｇ在泌尿生殖道的感染则是近年来仍在探讨的问题。我们建立了 3种支原体的聚合酶链式反应 (ＰＣＲ)检测方法 ,对不同地区性病患者的泌尿生殖道标本进行了检测 ,报道如下。1　材料和方法1 1　标本来源　采集 1997年 3～ 10月内蒙古医学院一附院皮肤科ＳＴＤ门诊患者 ,张家口医学院一附院皮肤科ＳＴＤ门诊患者 ,北京医科大学第一医院皮肤科门诊患者经临床及实验室确诊的现患性病病人 15 0例 ,其中男性 10 8例 ,女性 42例 ,年龄在 15～ 6 3岁 ,患者中淋病 12 0例 (病程 3天～ 6个月 ,平均…     

Septic arthritis due to dual infection with Mycoplasma hominis and Ureaplasma urealyticum

Acute septic arthritis of a knee and shoulder developed in a 32-year-old renal transplant patient. Cultures yielded Mycoplasma hominis and at least 1, and possibly 2, strains of Ureaplasma urealyticum. Doxycycline therapy controlled the symptoms and signs, and the joints became culture negative. On stopping therapy after 7 months, the arthritis recurred and U. urealyticum was again isolated from the shoulder joint. Cessation of doxycycline almost 4 years after the initial episode resulted in another recurrence. To our knowledge, this is the 1st case in which both M. hominis and U. urealyticum have been isolated from a joint.     

Mycoplasma hominis and Ureaplasma urealyticum infections in the immediate post-lung transplant period: A case series and literature review

Mycoplasma hominis and Ureaplasma species infections in the post-transplant setting are believed to be donor-derived and can be associated with poor outcomes. Difficulty in culturing and identifying these organisms is a significant barrier to diagnosis and early intervention. Tetracyclines, macrolides and fluoroquinolones are the mainstay treatments to cure these infections; however, there are increasing reports of antibiotic resistance. In this case series, we report our single-centre experience with M. hominis and U. urealyticum infection after lung transplantation (9 recipients, all men, mean age 56 years). Delayed diagnosis was common. Young donor age (mean age 23 yrs) and high-risk donor social history (67%) were repeatedly noted in these cases, and all infections were associated with significant morbidity (anastomosis and sternal wound infection, empyema, mediastinitis, pericarditis). Two patients died; with one directly related to Ureaplasma urealyticum infection. In conclusion post lung transplant M. hominis, and U. urealyticum infections are challenging and carry high morbidity. More prospective studies are required to assess the true prevalence, full spectrum of complications and utility of molecular diagnostics to aid early diagnosis and identify antibiotic susceptibility of Mycoplasma and Ureaplasma infections in the post-lung transplant setting.

     

深圳市泌尿生殖道解脲支原体和人型支原体感染状况及药物敏感性分析

目的 了解深圳市泌尿生殖道支原体感染状况及耐药性变化趋势，指导临床合理用药。方法 用Mycoplasma IST试剂盒对深圳市2002年8460例泌尿生殖道感染患者，取尿道(宫颈)分泌物进行了解脲支原体(UU)和人型支原体(Mh)的培养鉴定及药敏检测。结果 UU单独感染2067例，Mh单独感染54例，UU和Mh混合感染678例。男性感染率为27．2％，女性感染率为40．2％。药敏试验显示：UU对氧氟沙星的敏感性下降至36．1％，Mh对红霉素和四环素的敏感性分别降至9．3％和48．1％，原始霉素、交沙霉素对两种支原体都保持稳定的高敏感性。结论 支原体的混合感染、耐药性上升趋势十分严重，交沙霉素应作为目前治疗泌尿生殖道UU和Mh感染的首选，支原体耐药性的长期监测是指导临床治疗的重要依据。     

Serologic studies of human genital mycoplasmas: distribution of titers of mycoplasmacidal antibody to Ureaplasma urealyticum and Mycoplasma hominis in pregnant women

Titers of mycoplasmacidal antibody to the human genital mycoplasmas Ureaplasma urealyticum and Mycoplasma hominis were determined using genital isolates from pregnant patients as antigens and comparing these isolates with the 11 prototypic reference strains for U. urealyticum and the seven reference strains for M. hominis. Virtually all titers that were detected with use of the patient's own isolates were detected by the 11 reference strains of U. urealyticum and by the seven reference strains of M. hominis. Serologic surveys of pregnant women who harbored either or both mycoplasmas in vaginal cultures indicated that antibody to M. hominis was found more commonly than antibody to U. urealyticum. It was demonstrated that significant postpartum rises in titers of antibody to M. hominis were correlated with the presence of these mycoplasmas in genital cultures. Postpartum rises in titer of antibody were particularly likely to occur in women with low titers of mycoplasmacidal antibody in serum at the time of delivery. Approximately 88% of the women who were colonized with M. hominis showed significant changes in titer of antibody to M. hominis throughout an apparently normal pregnancy; only 40% of the women who were colonized with U. urealyticum showed such changes in titers to U. urealyticum. Statistical analysis showed that mean log titers of antibody to both mycoplasmas at the first prenatal visit were significantly associated with the number of pregnancies experienced by these women.     

性高危人群感染解脲脲原体和人型支原体分析

目的　探讨泌尿生殖道支原体在性高危人群中的感染状况。方法　采用培养法对 4 6 8例按摩妇女、95例性乱者、2 12例性病伴侣进行解脲脲原体 (Uu)和人型支原体 (Mh)的检测。结果　按摩妇女、性乱者、性病伴侣泌尿生殖道支原体感染率分别为 6 6 .7%、35 .8%、39.2 % ,与健康人群 (13.5 % )比较 ,差异均有非常显著的统计学意义 (χ2 =174 .5 6、2 0 .91、37.98,P均 <0 .0 0 5 )。按摩妇女支原体感染率与性乱者、性病伴侣比较 ,差异有非常显著的统计学意义 (χ2 =31 78、4 5 .37,P均 <0 .0 0 5 ) ,性乱者与性病伴侣比较 ,差异无显著的统计学意义 (χ2 =0 .31,P>0 .0 5 )。Uu感染率 (2 1.0 % )与Mh(8.0 % )比较 ,前者非常明显地高于后者 (χ2 =33.16 7,P <0 .0 0 5 )。女性支原体感染率 (6 3.0 % )非常明显地高于男性 (2 4 .5 % ) (χ2 =74 .5 5 ,P <0 .0 0 5 )。男性Uu感染率 (9.0 % )与女性(2 0 .0 % )比较 ,女性非常明显地高于男性 (χ2 =10 .19,P <0 .0 0 5 )。Uu和Mh混合感染率 (2 9.6 % )非常明显地高于Uu(17.8% )或Mh(8.0 % )的感染率 (χ2 =2 9.5 6、117.99,P均 <0 .0 0 5 )。结论　Uu、Mh在按摩妇女、性乱者、性病伴侣中流行广、感染率高 ,在性病的防治和监测工作中应加以重视。     

Relevant prevalence of Mycoplasma hominis and Ureaplasma urealyticum serogroups in HIV-1 infected men without urethritis symptoms

M. hominis and U. urealyticum are the better-known mycoplasma species pathogenic to the human genitourinary tract, causing mainly urethritis, bacterial vaginosis and pregnancy complications. In HIV-infected patients, the prevalence and role of these species is still not well known. The aim of this work was to determinate the prevalence of these species in this group of male patients (HIV group), in comparison to a group of men with clinical symptoms of urethritis (STD group). M. hominis was isolated from 7.5% patients (8/106) and U. urealyticum from 18.9% patients (20/106) from the HIV group, being among these 62.5% and 85% in significant concentrations, respectively. In the STD group these rates were 0.9% (1/110) for M. hominis and 13.6% (15/110) for U. urealyticum, being 100% and 93.3% in significant concentrations, respectively. We could demonstrate infection rates by these mycoplasma species in the HIV group as high as the one found in the STD one, what may indicate the occurrence of opportunistic infections in our population. This fact is discussed here because in immunosuppressed patients, specially M. hominis has been reported causing severe infections, even systemically.     

Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with non-gonococcal urethritis

The aim of present study was to evaluate the occurrence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in non-gonococcal urethritis (NGU) and to determine the bacterial resistance to six antibiotics in order to determine the most suitable treatment strategy. A total of 50 patients were enrolled into the study. Urethral samples were taken with a dacron swab placed into urethra 2 - 3 cm in males, and vaginal samples were taken from the endocervical region in women. The patient samples that did not grow Neisseria gonorrhoeae were accepted as NGU. Direct immunofluorescence technique was used for the investigation of C. trachomatis. Mycoplasma IST was used for the isolation of M. hominis and U. urealyticum. U. urealyticum was isolated from 24 patients. Thirteen of them had only U. urealyticum, and the rest had mixed pathogen organisms (7 U. urealyticum + M. hominis; 3 U. urealyticum + C. trachomatis, and 1 U. urealyticum + M. hominis + C. trachomatis). C. trachomatis was detected in 12 patients. While 8 patients had C. trachomatis only, the rest had a mixture of the pathogen organisms listed above. Partner examinations could be performed for only 22 patients' partners. In the evaluation of antibiotic susceptibility, higher resistance was obtained against ofloxacin in U. urealyticum, and against erythromycin with M. hominis. Our results indicated that doxycycline or ofloxacin should be the first choice when empirical treatment is necessary.     

244例解脲和人型支原体浓度及药敏分析

目的 调查非淋菌性尿道炎、宫颈炎患者解脲和人型支原体浓度及对临床常用10种抗菌素耐药情况。方法 采取男性尿道、女性宫颈拭子进行支原体培养、浓度测定和药敏试验。结果 244例支原体阳性样本中,浓度≥104ccu/ml者占91.8％,对支原体敏感的药物依次为交沙霉素、强力霉素、阿奇霉素、左旋氧氟沙星等。结论 耐药率较高的药物依次为氧氟沙星、红霉素、乙酰螺旋霉素、四环素。支原体对左旋氧氟沙星耐药性有增强趋势。     

Ureaplasma urealyticum and mycoplasma hominis in women with systemic lupus erythematosus

Objective. To determine the prevalence of genitourinary mycoplasma infection in women with systemic lupus erythematosus (SLE). Methods. Urine specimens from 49 patients with SLE and 22 patients with chronic fatigue syndrome (CFS) were cultured for mycoplasma. Patient records were reviewed for medical history and SLE disease activity. Results. Sixty-three percent of the SLE patients were culture positive, compared with 4.5% of the CFS patients (P < 0.001). Neither corticosteroid treatment, SLE activity, nor age accounted for this difference. Conclusion. Genitourinary mycoplasma colonization occurs significantly more frequently in SLE than in CFS.     

女性生殖道支原体感染与药敏试验分析

目的探讨女性生殖道支原体感染状况及对药物的敏感性、耐药性。方法采用支原体培养试剂盒对281例女性拟诊为生殖道支原体感染患者的阴道分泌物进行培养及药敏试验。结果 281例标本中,支原体阳性87例,阳性率为28.8%,其中解脲支原体(Uu)66例(75.9%),人型支原体(Mh)7例(8.0%)及UU+Mh昆合感染14例(16.1%)。敏感率由高到低依次为强力霉素(92.0%),交沙霉素(90.8%),克拉霉素(82.8%),美满霉素(75.9%);耐药率由低到高依次为阿奇霉素(89.7%),红霉素、司帕沙星、左氧氟沙星(94.3%),氧氟沙星(98.9%)、诺氟沙星(100.0%)。结论女性生殖道支原体感染以Uu为主,其次是Uu+Mh混合感染;在支原体感染治疗上应根据药敏试验选择抗生素,强力霉素、交沙霉素、克拉霉素和美满霉素在治疗女性生殖道支原体感染时可作为首选用药。     

A study of Ureaplasma urealyticum pathogenicity in human genitourinary tract]

Ureaplasma urealyticum was investigated in urine from 765 outpatients who visited Jikei University Affiliated Hospital and Tokyo Metropolitan Taito Hospital from June, 1988 to December, 1989 in order to clarify the pathogenicity of U. urealyticum in human genitourinary tract. U. urealyticum in urine was detected by means of Taylor-Robinson's method. The positive rates of U. urealyticum were 31.5% in 146 patients with gonococcal urethritis, 33.8% in 334 patients with non-gonococcal urethritis, 17.5% in non-bacterial chronic prostatitis and 27.5% in the other patients without infectious diseases, respectively; no significant difference was seen among these groups. U. urealyticum was detected in the urine from 32.1% of the 28% patients who were younger than 12. However, U. urealyticum was detected in the urine from 5.6% of the 18 patients who were older than 70. Therefore, there was no relationship between the age and U. urealyticum-positive rate in urine. Furthermore, there was no relationship between the detection of U. urealyticum and the subjective and objective findings in the patients with urethritis before and after the treatment. From these results, it is presumed that U. urealyticum has no pathogenicity in human genitourinary tract.     

The association of Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma genitalium with bacterial vaginosis: observations on heterosexual women and their male partners

The prevalence of 3 mycoplasmas (Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma genitalium) was determined in a cohort of women with or without bacterial vaginosis (BV) and in their respective male partners. Heterosexual women with or without BV and their male partners were recruited and genital sampling for these microorganisms was performed. Seventeen women with BV and 21 women with normal flora, and their respective male partners, were recruited. M. hominis was present in 9 (53%) of 17 women with BV compared with none of 21 women without BV (P=0.0001). Of the 17 male partners of women with BV, 8 (47%) had M. hominis compared to 5 (24%) of 21 male partners of women without BV (not significant [n/s]). U. urealyticum was detected in 11 (65%) of 17 women with BV in comparison with 10 (48%) of 21 women without BV (n/s). U. urealyticum was present in 4 (24%) of 17 male partners of women with BV compared to 6 (29%) of 21 male partners of women without BV (n/s). M. genitalium was not detected in any of 15 women with BV and in only 2 (12%) of 17 women without BV (n/s). M. genitalium was present in 4 (25%) male partners of 16 women with BV in comparison with 3 (16%) male partners of 19 women without BV (n/s). Thus, M. hominis was the only mycoplasma detected significantly more often in women with, rather than in those without, BV. None of the mycoplasmas was found significantly more often in male partners of women with, rather than those without, BV. Overall, M. genitalium behaved somewhat similar to Chlamydia trachomatis. It was the least commonly occurring mycoplasma, a reflection perhaps of the relatively low incidence of partner change in this study population.