Mycoplasma IST Research Articles

Verification of the Mycoplasma IST3 for urogenital mycoplasma culture in comparison to the Mycoplasma IST2

Background: Unlike the Mycoplasma IST2 kit (bioMérieux), the Mycoplasma IST3 kit has been updated to comply with the standardized antimicrobial susceptibility test (AST) method for Ureaplasma spp. (Up) and Mycoplasma hominis (Mh). We aimed to verify the use of the Mycoplasma IST3 kit for genital mycoplasma cultures. Methods: From September 2023 to January 2024, the R1 medium remaining after inoculation with IST2 was refrigerated until the next day. For IST2-positive samples, 300 μL of residual R1 medium was inoculated into the IST3. Species identification, enumeration, and AST results obtained using IST3 were compared with those obtained using IST2. Results: A total of 48 IST2-positive samples were inoculated into IST3, including 35, 1, and 12 Up-only, Mh-only, and both Up- and Mh-positive samples, respectively. Among Up-only samples, 2.8%, 91.4%, and 100.0% were susceptible to ciprofloxacin, tetracycline, and erythromycin, respectively. With IST3, 45 (93.8%) samples grew genital mycoplasmas; 42 (89.4%) of the 47 Up-positive samples and 6 (46.2%) of the 13 Mh-positive samples showed growth of the same organisms. All seven samples that failed to grow Mh were from mixed cultures, of which four Mh concentrations of < 104/mL. Up was susceptible to levofloxacin, tetracycline, and erythromycin at the rates of 64.3 %, 88.1 %, and 95.2 %, respectively. Conclusion: IST3 showed good performance in detecting genital Mycoplasma except for its tendency to not detect Mh of low concentrations in mixed cultures. IST3 is preferable to IST2 because it can accurately screen for erythromycin resistance in Up and reduce falseresistances for fluoroquinolone.

Effect of Ureaplasma/Mycoplasma genital tract infection on preterm labor.

Genitourinary tract infections in pregnant women are one of the causes of abnormal pregnancy development including miscarriages, premature labor or premature rupture of membranes (PPROM). Atypical bacteria responsible for reproductive tract infections include Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum. Identification of pathogens and appropriately selected therapy can improve obstetric outcomes in patients with symptoms of threatened miscarriage or threatened preterm labor. The purpose of our study is to analyze the impact of reproductive tract infections with ureaplasma and mycoplasma bacteria during pregnancy. In the presented study, we retrospectively analyzed the cases of 201 pregnant patients hospitalized in the Obstetrics and Gynecology Department of Poznan Regional Hospital in 2019-2022, who had a swab taken from external os area of the cervix for atypical bacteria - Ureaplasma and Mycoplasma. Only patients with symptoms of threatened miscarriage or threatened preterm labor were included in the study group. Microbiological tests were performed in the hospital laboratory with the Mycoplasma IST 3 test from Biomerieux. We found a higher incidence of preterm labor in patients with symptoms of threatened preterm labor and a genital tract infection with Ureaplasma/Mycoplasma bacteria, compared to patients not infected with Mycoplasma/Ureaplasma - 31.1% vs 20% (p = 0.098). This observation in the case of Ureaplasma/Mycoplasma monoinfection group applied to 6 patients. - 75% of the group. Pregnant patients who had co-infection with other types of bacteria (48 patients in total) gave birth before 37 weeks of pregnancy in 27.1% of cases. We obtained a significant difference (p = 0.007) when comparing groups with positive and negative cultures for Ureaplasma/Mycoplasma by the presence of monoinfection/coinfection and the week of pregnancy in which delivery occurred. We also noted the effect of atypical bacterial infection for PPROM - this complication preceded preterm delivery in 40% of ureaplasma-positive patients, compared to 20% of PPROM without infection. We found a similar rate of preterm labor and pregnancy loss in Ureaplasma/Mycoplasma-positive patients who received antibiotic therapy (35.7%) compared to a group of pregnant women who did not receive treatment (31.6%). Infection of the genital tract with atypical bacteria Ureaplasma and Mycoplasma has a negative impact on the course of pregnancy. Identification of the type of microorganisms in cervical canal secretions of pregnant patients with symptoms of threatened miscarriage or preterm labor seems crucial. The impact of antibiotic therapy though, requires further analysis.

Antimicrobial resistance of genitalmycoplasmas recovered from nonpregnant women in Greece: trends over the last 15years.

Aim: To study antimicrobial susceptibilities of genital mycoplasmas recovered from endocervical samples of reproductive-age, nonpregnant women (n =8,336). Materials & methods: For isolation and susceptibility testing, the Mycoplasma IST2 kit was used. Results: As many as 2093 samples were positive for mycoplasmas. The vast majority (>96%) of Ureaplasma urealyticum remained susceptible to tetracycline, doxycycline, josamycin and pristinamycin, whereas susceptibility rates to azithromycin and fluoroquinolones were significantly decreased. Mycoplasma hominis exhibited high susceptibility rates to doxycycline, pristinamycin and josamycin (98.1-100%), while susceptibilities to tetracycline and fluoroquinolones were considerably lower. Conclusion: Doxycycline remained highly potent for treating mycoplasmas; nevertheless, susceptibilities to other antimicrobials were significantly diminished.

Prevalence and antibiotics resistance of Ureaplasma species and Mycoplasma hominis in Hangzhou, China, from 2013 to 2019.

Ureaplasma spp. and Mycoplasma hominis, frequent colonizers in the lower urogenital tract, have been implicated in various infections, with antibiotic resistance growing and varying regionally. This study aims to investigate the prevalence and antibiotic resistance profiles of Ureaplasma spp. and M. hominis in outpatients in Hangzhou, China, from 2013 to 2019. A total of 135,263 outpatients were examined to determine the prevalence of Ureaplasma spp. and M. hominis, including 48,638 males and 86,625 females. Furthermore, trends in antibiotic susceptibility of Ureaplasma spp. and M. hominis during 1999–2019 were analyzed. The cultivation, identification, and antibiotic susceptibility of the bacteria (ofloxacin, ciprofloxacin, erythromycin, clarithromycin, azithromycin, josamycin, tetracycline, doxycycline, and pristinamycin) were determined using the Mycoplasma IST2 kit. Our study indicated that the overall prevalence of total Ureaplasma spp./M. hominis was 38.1% from 2013 to 2019. Ureaplasma spp. were the most frequently isolated species (overall prevalence, 31.3%), followed by Ureaplasma spp./M. hominis coinfection (6.0%) and single M. hominis infection (0.8%). The prevalence of Ureaplasma spp. and M. hominis was significantly higher in females than in males, and the highest positive rates of total Ureaplasma spp./M. hominis were observed in both female and male outpatients aged 14–20 years. During 2013–2019, josamycin, tetracycline, doxycycline, and pristinamycin maintained exceptionally high activity (overall resistance rates, <5%) against both Ureaplasma spp. and M. hominis, but ofloxacin and ciprofloxacin showed limited activity (overall resistance rates, >70%). During 1999–2019, the rates of resistance to ofloxacin and ciprofloxacin increased against both Ureaplasma spp. and M. hominis but decreased to erythromycin, clarithromycin, azithromycin, tetracycline, and doxycycline against Ureaplasma spp. In conclusion, our study demonstrates a high prevalence of Ureaplasma spp. compared to M. hominis and Ureaplasma spp./M. hominis, and their distribution was associated with sex and age. Josamycin, doxycycline, and tetracycline are promising antibiotics that have remarkable activity against Ureaplasma species and M. hominis.

Determination of the prevalence of Mycoplasma hominis and Ureaplasma species in Bacterial vaginosis patients in association with antibiotic resistance profile in Franceville, Gabon

BackgroundGenital mycoplasma are only considered pathogenic at a certain level and are often associated with other pathological situations such as bacterial vaginosis (BV). They may lead to infertility as well as other gynaeco-obstetrical and neonatal problems. Despite numerous reported resistances, macrolides are required to treat pregnant women while non-pregnant women are managed with tetracyclines and fluoroquinolones. This study aimed to establish the prevalence and resistance rates of Mycoplasma hominis (Mh) and Ureaplasma spp. (Uu) in BV positive (BV+) women. Material and methodsVaginal secretions were collected from women aged 14–56 years consulting for a cytobacteriological examination of the vaginal swab associated with a simultaneous search for genital mycoplasma in the medical analysis laboratory of the Research and Medical Analysis Unit (URAM) of CIRMF in Franceville, Gabon. BV was diagnosed using the Nugent score while genital mycoplasma identification and antibiotic susceptibility testing were performed using the Mycoplasma IST 2 kit. ResultsOf the 462 women included in this study, 60.18% (278/462, p = 0.00002) were both BV+ and genital mycoplasma carriers, including 5.19% (24/462) pregnant women. Overall mycoplasma carriage was 33.12% (153/462) for Uu, 1.95% for Mh and 25.11% (116/462) for mixed infections (Uu + Mh). The BV + patients most affected by mycoplasma were those whose age varied from 25 to 35 years with 27.49% (127/462, p = 0.980), those not using condoms with 39.40% (182/462, p = 0.014, OR = 2.35), those non-pregnant but capable of bearing children with 53.90% (249/462, p = 0.967, OR = 1.02). In the overall population, 83.66% and 51.63% of Uu strains were highly resistant to Ciprofloxacin and Azithromycin respectively; 100% and 55.56% of Mh strains were resistant to Azithromycin and Tetracycline respectively; while strong resistance has been observed in mixed infections to Ciprofloxacin (97.41%), Azithromycin (81.90%), Ofloxacin (69.83%) and Tetracycline (68.97%). ConclusionThe prevalence of genital mycoplasma infections is very high in women with bacterial vaginosis. Given the numerous emerging resistance rates to most classes of antibiotics available for the treatment of genital mycoplasma infections in our study, it would be advisable for therapeutic prescriptions to be made based on laboratory results.

DETERMINATION OF UREAPLASMA UREALYTICUM AND ANTIBIOTIC SUSCEPTIBILITY IN SEXUALLY ACTIVE WOMEN WITH DIFFERENT METHODS

Objective: In this study, the presence of Ureaplasma urealyticum (U.urealyticum) in vaginal and urine samples taken from sexually active women was investigated and antibiotic susceptibilities were determined with culturing bacteria and using kits. Material and Method: The vaginal and urine samples taken from 110 women who applied to Başkent University Ankara Gynecology and Obstetrics Clinic were included in this study. U. urealyticum was investigated by the culture method with using two different test kits [Mycoplasma IES (IES-Autobio, China) and Mycoplasma IST2 (IST2) Biomereux, France] and Mycoplasma Agar. Antibiotic susceptibilities of isolates were also determined. Result and Discussion: We compared the results of (IES) and (IST2) used for U. urealyticum detection in 220 clinical samples. U. urealyticum was found to be positive in 82 (74,5%) by classical culture method. U. urealyticum was detected at a rate of 46.8% with the IST 2 and 53.6% with the IES. As a result of the comparison of culture method and commercial kits,it was determined that the IES kit provides a fast and accurate identification in the detection of U.urealyticum,a fast and reliable result in the detection of antibiotic resistance.A significant difference was found in the detection rate of U. urealyticum of the IES compared to the other commercial kit.It was observed that the detection rate of U. urealyticum with the kit from vaginal were significantly higher than urine samples.

Evaluation of Antibacterial Activity of Selected Edible Herbs Against Genital Mycoplasmas Among University Students in Enugu State, Nigeria

<i>The prevalence rates of Mycoplasma hominis and Ureaplasma Spp</i> and the evaluation of edible herbs against genital mycoplasmas were determined among university students in Enugu state, Nigeria. Specimens from 2400 subjects comprising of 1200 male and female subjects were tested for <i>Mycoplasma hominis</i> and <i>Ureaplasma Spp</i>. Cultures were done on Mycoplasma agar, A7agar and urea-arginine LYO2 broth. Antimicrobial susceptibility pattern was determined by Mycoplasma IST2 kit. Preliminary qualitative phytochemical analysis was done using standard methods to reveal the presence of basic phytochemicals. Rizomes of <i>Curcuma longa</i>, garlic and ginger, cloves and seeds of <i>Garcina kola</i> were extracted with water, methanol and ethanol sequentially and reconstituted with dimethyl -sulfoxide to concentrations (mg/ml) of 200, 100, 50, 25, 12.5, 6.25, 3.125 and 1.56. Mycoplasma isolates were screened for sensitivity to the extracts using agar well diffusion and broth diffusion methods. <i>Mycoplasma hominis</i> occurred more in women at (81.6%) while <i>Ureaplasma Spp</i> occurred more in men at (88%). <i>Mycoplasma hominis</i> (98%) and <i>Ureaplasma Spp</i> (91.6%) showed high sensitivityto ciprofloxacin. The test plants all showed presence of alkaloids, tannis, flavonoids, terpenoids, saponins, phenols and cardiac glycosides. At 200mg/ml <i>Garcina kola</i> and <i>Curcurma longa</i> showed higher zones of inhibition at 35mm on <i>Mycoplasma hominis</i> and <i>ureaplasma Spp</i>. Syngestic activities of ethanolic extracts of Curcuma longa and garlic showed high zones of inhibition at 45mm on <i>Mycoplasma hominis</i> while at 200mg/ml <i>Garcina kola</i> and cloves showed zones of inhibition at 45mm on <i>ureaplasma spp</i>. The minimum inhibitory concentration (MIC) results of the syngestic plants were 1.56mg/ml on all the isolates. The Results from the study showed that there is high prevalence of <i>Mycoplasma hominis</i> in women while <i>Ureaplasma Spp</i> while <i>Ureaplasma Spp</i> occurred more in men in the study area. The synergistic activities of selected edible plants showed higher efficacy on resistant isolates and suggest its use in the treatment of genital Mycoplasmas.

Prevalence and Antibiotic Susceptibility Patterns of Mycoplasma hominis and Ureaplasma urealyticum in Females with Genital Infections from Central Kerala, India

Introduction: Genital mycoplasmas namely Mycoplasma Hominis and Ureaplasma Urealyticum are sexually transmitted disease pathogens which are associated with genital infections, infertility, obstetric and neonatal complications. The pathogenesis, prevalence, epidemiology and antibiotic resistance of genital mycoplasmas in Indian women have been studied very minimally. Aim: To determine the prevalence and antibiotic susceptibility pattern of M.hominis and U.urealyticum among females presenting with genital tract infections Materials and Methods: The hospital-based descriptive cross- sectional study was carried out among 120 females of reproductive age group (15-49 years) attending Outpatient Department of Obstetrics and Gynaecology of a tertiary care centre in central Kerala, India, from January 2018 to December 2018. Endocervical/ vaginal/urethral samples were collected depending on the clinical presentation. Detection, quantitation and antibiotic sensitivity pattern of M.hominis and U.urealyticum were performed using Mycoplasma IST 2 Kit. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 11.5 and statistical association was analysed using Chi-square test. Results: The prevalence of genital mycoplasmas was 25.83%. U.urealyticum infection was present in 20 (20.8%) and M.hominis infection was present in 12 (10%) of the patients. Age group of 26-35 years was commonly affected. All isolates showed high susceptibility rates to doxycycline, josamycin and pristinamycin. Intermediate to high resistance was noted to commonly prescribed macrolides and quinolones. Conclusion: Genital mycoplasmas are prevalent in one-fourth of the study population with U.urealyticum infections being more common than M.hominis infections. The increased resistance rates to quinolones and macrolides warrants the need for routine screening and antibiotic susceptibility testing of these pathogens.

Prevalence and antimicrobial susceptibility profile of Mycoplasma hominis and Ureaplasma urealyticum in female population, Gabon

Mycoplasma hominis and Ureaplasma urealyticum are microorganisms involved in many pathologies and intrauterine infections. Vaginal wall swabs were taken from 278 women for mycoplasma detection and to study the antimicrobial susceptibility using the Mycoplasma IST2 Kit (bioMerieux). We were able to document in 278 women enrolled in the study, 64.7% have infections caused by U. urealyticum, 22.7% by M. hominis, and 19.4 % of coinfections involving both germs. Such infections were observed in age groups between 18 and 42 years. Other socio-demographic characteristics studies have been conducted, which allowed to document that single women were the majority population with 68.7% against 16.5% who were living in couple. In response to our questionnaire, 131 single women enrolled in the study never protected themselves during sexual intercourse compared with 52.9% who reported using at least condom. A total of 260 (93.5%) of women reported having only one partner versus 6.5% having more. The study of strains susceptibility to antibiotics revealed a resistance of approximately 80% for macrolides and 100% for fluoroquinolones. All our isolated strains had a sensitivity of about 90% for Pristinamycin and 70% for Josamycin. This study shows that carriage of mycoplasma infection is high in female population in Franceville and vicinities, what should be an element of cautious use of antibiotic during probabilistic therapy treatment of mycoplasma.

Prevalence and Antimicrobial Susceptibility of Mycoplasma hominis and Ureaplasma Species in Nonpregnant Female Patients in South Korea Indicate an Increasing Trend of Pristinamycin-Resistant Isolates.

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.

An Observational Study: Is N-Acetylcysteine Helpful in Performance Improvement of Mycoplasma IST2 Testing through Sample Homogenization?

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.

Mycoplasma hominis profile in women: Culture, kit, molecular diagnosis, antimicrobial resistance, and treatment

ObjectivesMycoplasma hominis (M.hominis) infections are sexually transmitted and usually associated with urogenital and respiratory diseases. The aim of our study was to (i) detect M. hominis in the vaginal and urine samples of sexually active women using three different detection methods and (ii) to determine the antimicrobial susceptibility and recurrence after the treatment. MethodsBoth vaginal and urine samples were collected from 110 sexually active women at the Obstetrics and Gynecology Clinic, Başkent University Ankara Hospital, Turkey, between March 2015 and February 2016. The presence of M. hominis in the vaginal and urine samples was detected by in vitro culture, two biochemical diagnostics kits (Mycoplasma IES (Autobio, China) and Mycoplasma IST–2 (BioMérieux, France) and PCR. The antibiotic susceptibility of each sample was tested using the kits. The women positive for M. hominis were treated either singly or along with their sexual partners by tetracycline. ResultsM. hominis was detected in 72 of 220 (32.7%) samples (both vaginal and urine). Of which 37 showed contrary results with two different kits and then were confirmed by PCR. In 13 samples the IES kit identified M. hominis missed by IST-2, and in 8 samples the MIST-2 kit identified M. hominis missed by IES, while both kits missed 6 samples that were agar culture positive for M. hominis.” The highest susceptibility rate was observed against pristinamycin (100%), followed by 91%, 83%, and 75% for doxycycline, tetracycline, and josamycin, respectively. Twenty-five patients treated with tetracycline were followed after one month. The recurrence of M. hominis was not observed in any of the 18 cases where both sexual partners were treated but recurred in 5 of the 7 singly treated women. ConclusionsThe rate of M. hominis detection was significantly higher in the vaginal samples compared to the urine samples. The probability of detecting M. hominis by IST–2 kit was 1.18 times less than IES kit (p < 0.001). When the relationship between the samples was examined, the difference between IES and IST–2 for detecting M. hominis was statistically significant (p < 0.01). Antibiotic susceptibility tests indicated that the tetracycline group of antibiotics was effective in eliminating M. hominis when given to both the sexual partners.

Detection of Ureaplasma spp. serovars in genital tract of infertile males.

BackgroundThe colonization of Ureaplasma species in genital tract is related with male infertility. However, it has been postulated based upon limited study that virulence is related to serotype specificity. The aim of this study was to determine the distribution of Ureaplasma serovars in genital tract of infertile males and analyze their role in male infertility.MethodsA total of 358 urethral swabs samples were obtained from infertile males. The culture of Ureaplasma species were performed using a commercially available Mycoplasma IST 2 kit. Serovars were determined by real‐time polymerase chain reaction (real‐time PCR).ResultsA total of 92 (25.7%) infertile males were positive for Ureaplasma spp; among them, Ureaplasma parvum (UPA) was detected in 73 (79.3%) isolates, and Ureaplasma urealyticum (UUR) was detected in 19 (20.7%) isolates. Serovars 1, 6, or in combination accounted for 63.0% (46/73) of UPA isolates. Serovar 9 (alone and in combination of other serovars) was the most common serovar in UUR (47.4%, 9/19). Multiple serovars were detected in 21 (22.8%) isolates, and serovars 4, 5, 7, and 12 were not detected in any sample.ConclusionThe distribution of 14 Ureaplasma serovars in genital tract of infertile males was identified for the first time by real‐time PCR assay. UPA serovars 1 and 6, and UUR serovar 9 are the most common serovars colonization in urogenital tract of infertile males.

Occurrence of Ureaplasma urealyticumin in Women in the Northeast of Iran: Characterization of Resistance Trends

Objectives: The present study surveyed the prevalence of antibiotic resistance among Ureaplasma urealyticum in isolates from Gonabad (in the northeast of Iran) including susceptibility testing for U. urealyticum to different antibiotics. Materials and Methods: In this research, a total of 95 vaginal swab specimens were aseptically collected from women who were admitted to the Bohlool Teaching Hospital and Jahad Daneshgahi Center from April 2016 to April 2017. Culture and subsequently antibiotic susceptibility testing were performed according to the Mycoplasma IST 2 kit. Then the cupules were read and interpreted in 24 and 48 hours according to kit guidelines. Results: In the studied patients, 38 (40.4 %), 12 (12.8 %), and 11 (11.7%) cases were single positive for U. urealyticum, single positive for Mycoplasma hominis (M. hominis), and dually positive for U. urealyticum and M. hominis, respectively. The positive rates of genital U. urealyticum in the symptomatic and asymptomatic groups were 86.8% and 13.2%, respectively. The highest positive rate (42.1%) was found in the 26-30-year-old group. In addition, tetracycline (TET) and doxycycline (DOT) were the most effective antibiotics against isolates, and one strain was multi-drug resistant. The U. urealyticum resistance rates were more than 39% to erythromycin and pristinamycin, and more than 55% to ciprofloxacin. All U. urealyticum isolates with &lt;104 CFU/specimen were sensitive to all tested drugs. Conclusions: Although the emerging resistance to TETs among our isolates is alarming, these data show that the standard therapeutic regimen for urogenital infections caused by U. urealyticum is DOT, TET, and clarithromycin, leading to better outcomes in most respective patients.

Prevalence and Antimicrobial Susceptibility of Ureaplasma spp. and Mycoplasma hominis in Asymptomatic Individuals in Korea.

This study investigated the prevalence and antibiotic resistance of Ureaplasma spp. and Mycoplasma hominis isolated from asymptomatic individuals in Korea. Endocervical swabs from women and urine from men, from a total of 5,781 asymptomatic individuals, were analyzed using a Mycoplasma IST2 Kit. Of the 4,825 specimens tested from females, 486 (10.1%) were positive culture. In these positive specimens, 437 (9.1%) were positive only for Ureaplasma spp., 17 (0.4%) were positive only for M. hominis, and 32 (0.7%) were positive for both Ureaplasma spp. and M. hominis. In males, of the 956 tested specimens, only 4 (0.42%) were positive for Ureaplasma spp. and no M. hominis colonization was identified. In antimicrobial susceptibility tests, more than 93.2% of both M. hominis and Ureaplasma spp. was susceptible to tetracycline, doxycycline, josamycin, and pristinamycin. However, M. hominis isolates were found to be highly resistant to erythromycin, azithromycin, and clarithromycin (82.4%, 70.6%, and 76.5%, respectively). Ofloxacin and ciprofloxacin, which have recently exhibited increasing resistance rates, showed rates of 17.7% and 35.3%, respectively, in M. hominis, and 50.6% and 27.4%, respectively, in Ureaplasma spp. In conclusion, accurate antimicrobial susceptibility tests of the genital mycoplasmas should be conducted for each case to select the appropriate antibiotics. Fluoroquinolone-based drugs should be avoided in the initial treatment of urogenital mycoplasmas because of the increasing rate of resistance to quinolones, although the susceptibility to tetracycline remains high in Korea.

Prevalence and antimicrobial resistance of Ureaplasma spp. and Mycoplasma hominis isolated from semen samples of infertile men in Shanghai, China from 2011 to 2016.

This study was conducted to estimate the prevalence and antimicrobial resistance rate of Ureaplasma spp. and Mycoplasma hominis that were isolated from the semen samples of infertile males in Shanghai, China from 2011 to 2016. A total of 5016 infertile males and 412 healthy male controls were examined. The cultivation, identification, and antimicrobial susceptibilities of Ureaplasma spp. and M. hominis were assessed by using a Mycoplasma IST kit that was performed in parallel to selective solid agar cultivation. The positive rate of genital Mycoplasma infections in infertile men from 2011 to 2016 was 30-55%, which initially decreased during the first four years and then increased in the last two. Two distinct high-risk age ranges of Mycoplasma infections were observed: 26-30years (37.8%) and 31-35years (30.7%). Semisynthetic tetracyclines and macrolide antibiotics were the most effective agents against Ureaplasma spp. Among the fluoroquinolones, sparfloxacin and levofloxacin were also effective. Antibiotic resistance of Ureaplasma spp. against tetracyclines and macrolide antibiotics in the last six years did not vary significantly. However, the rate of resistance to fluoroquinolones (except norfloxacin) and spectinomycin decreased in the last two years. The rate of genital Mycoplasma presence in infertile patients between the ages of 26 and 35 years in Shanghai was high. The prevalence of genital Mycoplasma decreased during the first four years and then increased, with a peak in 2016. Doxycycline, minocycline, josamycin, and sparfloxacin can be recommended for first-line empirical treatment of Mycoplasma infections in infertile men in Shanghai, China.

Co-infection Of Ureaplasma urealyticum And Human Papilloma Virus In Asymptomatic Sexually Active Individuals.

This study aimed to determine the role of asymptomatic bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis (Ct), Mycoplasma genitalium (Mg), Mycoplasma hominis (Mh), and Ureaplasma urealyticum (Uu) in human papillomavirus (HPV) infection.In total, 264 asymptomatic outpatients aged between 21 and 80 years were prospectively enrolled in this study during routine gynecological screening tests. Specimens collected with a Cervex Brush were routinely analyzed with the Hybrid Capture 2 assay for HPV. Simultaneously, a specimen obtained with an endocervical swab was used to detect Ct and Mg with a monoplex real-time polymerase chain reaction (PCR) and to confirm Mh and Uu with a Mycoplasma IST 2 kit.The detection rates (%) of HPV, Ct, Mg, Mh, and Uu were 82/264 (31.1), 6/264 (2.3), 5/264 (1.9), 16/264 (6.1), and 95/264 (36.0), respectively. Of 95 Uu, 32 (33.7%) showed high density colonization (HDC, ≥104 color-changing units/mL). HDC-Uu was significantly associated with HPV infection (p=0.014, chi-square test). Mg infection and Mh infection were not associated with HPV infection (p=0.981 and p=0.931, chi-square test). Age was not associated with HPV infection or bacterial infection.Our data suggested that asymptomatic HDC-Uu was closely associated with HPV infection. Therefore, simultaneous evaluation for Uu and HPV should be performed during gynecological screening, even in asymptomatic individuals.

A twelve–year retrospective analysis of prevalence and antimicrobial susceptibility patterns of Ureaplasma spp. and Mycoplasma hominis in the province of Lower Silesia in Poland

ObjectiveGenital mycoplasmas are opportunistic pathogens that have been associated with urogenital infections in humans. Only a few groups of antimicrobials are available for treatment of urogenital tract infections caused by genital mycoplasmas. However, emerging resistance of mycoplasmas to antimicrobial agents has been reported worldwide. The aim of the study was a retrospective analysis of the prevalence and antimicrobial susceptibility patterns of M. hominis and Ureaplasma spp. in patients with urogenital tract infections during a twelve-year period between 2003 and 2015. Study designMycoplasma IST2 test was used for the detection, enumeration, identification and antimicrobial susceptibility testing of genital mycoplasmas in 1182 samples from 778 women and 404 men with genitourinary tract infection. Indicative enumeration in the test determines whether the mycoplasma count in the sample is equal or higher than the threshold set at 104 colony forming units. ResultsA total of 152 (12.8%) samples were found to be positive for genital mycoplasmas. M. hominis was detected only in three samples and Ureaplasma spp. in 141 samples. Both, M. hominis and Ureaplasma spp. were detected in the remaining eight samples. In the analyzed period between 2003 and 2015, a gradually increasing resistance of ureaplasmas to ciprofloxacin and clarithromycin and decreasing resistance to ofloxacin, erythromycin and tetracycline were observed. Pristinamycin, josamycin and doxycycline were most active against Ureaplasma spp. In contrast, fluoroquinolones had the lowest efficacy against Ureaplasma spp. and as many as 116 (82.3%) and 77 (54.6%) of Ureaplasma spp. isolates were resistant to ciprofloxacin and ofloxacin, respectively. M. hominis isolates were uniformly resistant to azithromycin, clarithromycin and erythromycin but susceptible to josamycin, ofloxacin, doxycycline and pristinamycin. One-third of these isolates were resistant to ciprofloxacin and tetracycline. ConclusionIn the study Ureaplasma spp. and M. hominis were detected with relatively low frequency in comparison with other studies however, most of these isolates were resistant to ciprofloxacin indicating the need for better management of ciprofloxacin prescription. Important limitations of Mycoplasma IST2 assay concerning antimicrobial susceptibility testing and divergences between breakpoints in the test and EUCAST guidelines point the need to introduce new methodologies to improve evaluation of resistant strains at our region.

Prevalence and antimicrobial susceptibility of genital Mycoplasmas detected by Mycoplasma IST 2 from urogenital samples in Padua, Italy, between January 2014 and December 2015

&lt;em&gt;Background and aims.&lt;/em&gt; The aim of this study is to define the epidemiology and the antimicrobial resistance profile of &lt;em&gt;Ureaplasma&lt;/em&gt; spp. and &lt;em&gt;Mycoplasma hominis&lt;/em&gt; isolated from urogenital specimens of patients attending the Microbiology and Virology Unit of Padua between January 2014 and December 2015. &lt;br /&gt;&lt;em&gt;Materials and methods&lt;/em&gt;. The analysis was carried out on a total of 10861 samples. Species identification and antimicrobial susceptibility tests were performed using bioMérieux Mycoplasma IST 2. &lt;br /&gt;&lt;em&gt;Results&lt;/em&gt;. 2668 samples (24.6%) from 2043 patients were positive: 2466 samples positive for &lt;em&gt;Ureaplasma&lt;/em&gt; spp. (1897 patients) and 8 samples positive for &lt;em&gt;M. hominis&lt;/em&gt; (8 patients), while in 194 samples (138 patients) was detected a coinfection. As for antimicrobial susceptibility of &lt;em&gt;Ureaplasma&lt;/em&gt; spp. we found a resistance (R+I) rate of 90.6% for ciprofloxacin, of 74,1% for ofloxacin, of 52.8% for azithromycin and of 47.0% for erythromycin.&lt;br /&gt;&lt;em&gt;Conclusions&lt;/em&gt;. Our report shows a high prevalence of &lt;em&gt;Ureaplasma&lt;/em&gt; spp. in the study population. Surveillance of antibiotic resistance is critical for an appropriate therapeutic approach, which must always be contextualized with patient’s symptomatology.

Analysis of mutations in DNA gyrase and topoisomerase IV of Ureaplasma urealyticum and Ureaplasma parvum serovars resistant to fluoroquinolones

This study aims to determine the prevalence of fluoroquinolone resistance of Ureaplasma biovars and serovars isolated from urogenital clinical samples and determine the underlying molecular mechanism for quinolone resistance for all resistant isolates.Of 105 samples confirmed as positive for U. urealyticum/U. parvum, 85 were resistant to quinolones by the Mycoplasma–IST2 kit. However, only 43 out of 85 quinolone resistant isolates had amino acid substitutions in GyrA, GyrB, ParC and ParE proteins underlining that this assay have mis-identified as fluoroquinolone resistant 42 isolates. The known ParC E87K and ParC S83L mutations were found in 1 and 10 isolates, respectively. An original mutation of ureaplasmal ParC (E87Q, 1 isolate) was found. Furthermore, we found a ParE R448K mutation in one isolate, already described. Among the additional alterations detected, the most prevalent mutation found was L176F in GyrA protein in 18 isolates with single infection and in 3 isolates with mixed ureaplasma infections. Mutations in GyrB (E502Q, 4 isolates), ParE (Q412K, Q412P, Q412T, 3 independent isolates), whose role is unknown, were also found. Other sporadic mutations in the four genes were identified.This investigation is the result of monitoring the data for molecular fluoroquinone resistance in Ureaplasma spp. in Italy. Resulting that this acquired resistance is high and that continued local epidemiological studies are essential to monitor and document their antimicrobial resistance trends.