Abstract
Background Culture is still the gold standard for the detection of genital mycoplasma which could cause urogenital infections in humans. Mycoplasma IST2 is a commercial kit widely used for the detection of M. hominis and Ureaplasma species. Its accuracy was partially impaired because clinical specimens are usually mixed with purulent or transparent mucus. We aimed to solve this problem through sample homogenization by N-acetylcysteine (NAC) treatment. Methods Twenty-two endocervical swab samples were collected from 22 female patients with suspected mycoplasma infection, while 11 of these specimens were with purulent or transparent mucus. Mycoplasma IST2 testing kit was used for mycoplasma culture and AST for the control group and NAC-treated group. Results Genital mycoplasma was detected in 15 of 22 samples for both groups. The colony number in 6 out of 11 purulent specimens (54.5%) was more than 104 CFU/ml of genital mycoplasma for the NAC-treated group, while only one of 11 (9.1%) for the control group. For the nonpurulent specimens, no significant difference had been found in colony counting of genital mycoplasma between the control group and NAC-treated group (P > 0.05). The results of antimicrobial susceptibility testing for the NAC-treated group were highly similar to those for the control group. Conclusions Our results demonstrate that NAC is helpful in sample homogenization and NAC treatment can improve the detection efficiency of mycoplasma with Mycoplasma IST2 testing.
Highlights
IntroductionUreaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium are common urogenital pathogens, which could cause a large variety of infections in adults and infants [1]. e first two mycoplasma species are responsible for nongonococcal urethritis and bacterial vaginosis and are associated with postpartum fever, chorioamnionitis, low weight, and preterm birth [2]. e last two mycoplasma species are causative agents of nongonococcal urethritis and have been associated with bacterial vaginosis, cervicitis, pelvic inflammatory disease (PID), postpartum septicemia, endometritis, and epididymitis [2].Laboratory diagnosis of urogenital mycoplasma is usually by culture, but it may take 8 weeks for M. genitalium to grow into visible colonies [3]. erefore, M. genitalium is detected mainly by nucleic acid amplification in clinical laboratory. ere have been some commercial diagnostic kits for culture, identification, and antimicrobial susceptibility testing (AST) of urogenital mycoplasma species, such as Mycoplasma IES kit, Mycofast Revolution kit, MycoplasmaCanadian Journal of Infectious Diseases and Medical MicrobiologyDuo kit, Mycoview kit, and Mycoplasma IST2 kit [1, 4]. ese assays are based on liquid broth cultures and similar with regard to growth judgment by pH-sensitive color indicator
U. urealyticum, U. parvum, M. hominis, and M. genitalium are commonly referred to as genital mycoplasmas because they are transmitted by sexual contact [5]
Traditional culture is considered the gold standard in the detection of Ureaplasma and M. hominis, while the laboratory diagnosis of M. genitalium is almost exclusively carried out using nucleic acid amplification tests as high failure rate and lengthy incubation times [9]
Summary
Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium are common urogenital pathogens, which could cause a large variety of infections in adults and infants [1]. e first two mycoplasma species are responsible for nongonococcal urethritis and bacterial vaginosis and are associated with postpartum fever, chorioamnionitis, low weight, and preterm birth [2]. e last two mycoplasma species are causative agents of nongonococcal urethritis and have been associated with bacterial vaginosis, cervicitis, pelvic inflammatory disease (PID), postpartum septicemia, endometritis, and epididymitis [2].Laboratory diagnosis of urogenital mycoplasma is usually by culture, but it may take 8 weeks for M. genitalium to grow into visible colonies [3]. erefore, M. genitalium is detected mainly by nucleic acid amplification in clinical laboratory. ere have been some commercial diagnostic kits for culture, identification, and antimicrobial susceptibility testing (AST) of urogenital mycoplasma species, such as Mycoplasma IES kit, Mycofast Revolution kit, MycoplasmaCanadian Journal of Infectious Diseases and Medical MicrobiologyDuo kit, Mycoview kit, and Mycoplasma IST2 kit [1, 4]. ese assays are based on liquid broth cultures and similar with regard to growth judgment by pH-sensitive color indicator. Mycoplasma IST2 is widely used for the detection of M. hominis and Ureaplasma species, including U. urealyticum and U. parvum. Mycoplasma IST2 is a commercial kit widely used for the detection of M. hominis and Ureaplasma species. Mycoplasma IST2 testing kit was used for mycoplasma culture and AST for the control group and NACtreated group. E colony number in 6 out of 11 purulent specimens (54.5%) was more than 104 CFU/ml of genital mycoplasma for the NAC-treated group, while only one of 11 (9.1%) for the control group. No significant difference had been found in colony counting of genital mycoplasma between the control group and NAC-treated group (P > 0.05). Our results demonstrate that NAC is helpful in sample homogenization and NAC treatment can improve the detection efficiency of mycoplasma with Mycoplasma IST2 testing
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