Abstract
Mycoplasma hominis and Ureaplasma species, commonly found in the lower urogenital tract, have been associated with various urogenital infections. This study aimed to estimate the prevalence and antimicrobial susceptibility trend of M. hominis and Ureaplasma sp. in female patients and to evaluate the risk factors for the acquisition of pristinamycin-resistant mycoplasma. Endocervical swab specimens obtained between March 2016 and December 2018 were analyzed using a Mycoplasma IST2 kit. Because pristinamycin and josamycin are not available in South Korea, we conducted an age- and date-matched case-control study to evaluate the risk factors for the acquisition of pristinamycin-resistant isolates. Among 4,035 specimens, 1,589 (39.4%) cases were positive for genital mycoplasma, which included 49 (3.1%) cases of M. hominis, 1,243 (78.2%) cases of Ureaplasma sp., and 297 (18.7%) cases of both M. hominis and Ureaplasma species. Based on antimicrobial susceptibility tests, the antibiotic susceptible rate of both M. hominis and Ureaplasma species to pristinamycin decreased annually during the study period (100%, 97.1%, and 87.3% for 2016, 2017, and 2018, respectively, P < 0.001). According to a multivariate analysis, josamycin resistance (odds ratio, 7.18; 95% confidence interval, 1.20 to 43.00; P = 0.027) and coinfection (odds ratio, 145.38; 95% confidence interval, 21.80 to 3,017.23; P < 0.001) with Candida species were independent risk factors for the acquisition of pristinamycin-resistant isolates. Antibiotic-resistant genital mycoplasmas have been gradually increasing annually. Nationwide surveillance, proper antibiotic stewardship, and appropriate culture-based treatment strategies are required to control this upcoming threat.
Highlights
Mycoplasma hominis and Ureaplasma species, including Ureaplasma parvum and Ureaplasma urealyticum, are facultative anaerobic organisms that are commonly found in the lower urogenital tract
This study aimed to investigate the prevalence and antibiotic resistance profiles of M. hominis and Ureaplasma species isolates from nonpregnant female patients in South Korea
Direct comparison is difficult because there is no existing study assessing the trend of prevalence of genital mycoplasmas in symptomatic female patients in South Korea, Lee et al reported that there was no significant difference in the prevalence of overall genital mycoplasmas between 2009
Summary
Mycoplasma hominis and Ureaplasma species, including Ureaplasma parvum and Ureaplasma urealyticum, are facultative anaerobic organisms that are commonly found in the lower urogenital tract. These organisms are considered etiologic agents causing various urogenital diseases in women, such as cervicitis, cystitis, bacterial vaginosis, pelvic inflammatory disease, chorioamnionitis, postpartum fever, infertility, prematurity, intrauterine growth retardation, and systemic neonatal infections [1]. It is important to identify the prevalence and antibiotic susceptibility profiles of genital mycoplasmas so that sufficient information is available when selecting appropriate empirical antibiotics and when performing antibiotic stewardship. This study aimed to investigate the prevalence and antibiotic resistance profiles of M. hominis and Ureaplasma species isolates from nonpregnant female patients in South Korea
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