Lab Med Online.  2016 Apr;6(2):79-87. 10.3343/lmo.2016.6.2.79.

Prevalence and Antimicrobial Susceptibility of Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum in Individuals With or Without Symptoms of Genitourinary Infections

Affiliations
  • 1Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea. cpworld@cau.ac.kr
  • 2Department of Urology, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Department of Urology, St. Vincent's Hospital, the Catholic University of Korea, Suwon, Korea.
  • 4Department of Urology, St. Mary's Hospital, the Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND
The aim of this study was to determine the prevalence and antimicrobial susceptibility of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum among patients displaying symptoms of genitourinary infections and asymptomatic volunteers.
METHODS
Genitourinary samples were collected from 897 participants (365 symptomatic patients and 532 asymptomatic volunteers). The samples were analyzed using multiplex real-time PCR (Anyplexâ„¢ II, Seegene, Korea), multiplex PCR (Seeplex®, Seegene), and Mycoplasma IST 2 Kit (bioMerieux, France).
RESULTS
The prevalence of M. hominis, U. urealyticum, and U. parvum in the genitourinary samples of symptomatic patients compared with asymptomatic volunteers was 9.9% vs. 5.5%, 12.3% vs. 9.0%, and 36.4% vs. 30.8%, respectively. After eliminating cases of co-infections with other pathogens, there was a significant difference in the prevalence of M. hominis between symptomatic patients and asymptomatic volunteers (9.1% vs. 5.2%, P<0.05), but not in the prevalence of U. urealyticum and U. parvum organisms. When tested for antimicrobial susceptibility, more than 95.5% of each species were susceptible to tetracycline, doxycycline, josamycin, and pristamycin. More than 78.9% of Ureaplasma spp. were susceptible to azithromycin, erythromycin, and clarithromycin; however less than 4.2% of M. hominis were susceptible to these antibiotics. When tested with ofloxacin and ciprofloxacin, 40.9-58.9% and 9.1-25.0% of the three species were susceptible to these drugs, respectively.
CONCLUSIONS
M. hominis is the leading causative pathogen for genitourinary infection; however the involvement of Ureaplasma spp. is debatable. For optimal antimicrobial therapy, the accurate detection of these organisms and determination of antimicrobial susceptibility is crucial considering their diverse antimicrobial susceptibility patterns.

Keyword

Mycoplasma hominis; Ureaplasma urealyticum; Ureaplasma parvum; Genitourinary; Prevalence; Antimicrobial susceptibility

MeSH Terms

Anti-Bacterial Agents
Azithromycin
Ciprofloxacin
Clarithromycin
Coinfection
Doxycycline
Erythromycin
Humans
Josamycin
Multiplex Polymerase Chain Reaction
Mycoplasma hominis*
Mycoplasma*
Ofloxacin
Prevalence*
Real-Time Polymerase Chain Reaction
Tetracycline
Ureaplasma urealyticum*
Ureaplasma*
Volunteers
Anti-Bacterial Agents
Azithromycin
Ciprofloxacin
Clarithromycin
Doxycycline
Erythromycin
Josamycin
Ofloxacin
Tetracycline

Reference

References

1. Washington CW, Stephen DA, et al. eds. Koneman's color atlas and textbook of diagnostic microbiology. 6th ed.Lippincott Williams & Wilkins;2006.
2. Waites K and Taylor-Robinson D. Mycoplasma and Ureaplasma. Versalovic J, editor. Manual of clinical microbiology. 10th ed.Washington DC: ASM Press;2006. p. 970–85.
3. Maruška M, Darja K, Jovan M, Mojca M. Clinical role of Ureaplasma parvum and Ureaplasma urealyticum presence in female lower urogenital tract: is there a place for routine screening and treatment? Zdrav Vestn. 2014; 83:629–37.
4. Shepard MC. The recovery of pleuropneumonia-like organisms from Negro men with and without nongonococcal urethritis. Am J Syph Gonorrhea Vener Dis. 1954; 38:113–24.
5. Shepard MC, Lunceford C, Ford DK, Purcell R, Taylor-Robinson D, Ra-zin S. Ureaplasma urealyticum gen. nov., sp. nov.: Proposed Nomenclature for the Human T (T-Strain) Mycoplasmas. Int J Syst Bacteriol. 1974; 24:160–71.
Article
6. Robertson JA, Stemke GW, Davis JW Jr, Harasawa R, Thirkell D, Kong F, et al. Proposal of Ureaplasma parvum sp. nov. and emended description of Ureaplasma urealyticum (Shepard et al. 1974) Robertson et al. 2001. Int J Syst Evol Microbiol. 2002; 52:587–97.
Article
7. Kataoka S, Yamada T, Chou K, Nishida R, Morikawa M, Minami M, et al. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy. J Clin Microbiol. 2006; 44:51–5.
Article
8. De Francesco MA, Negrini R, Pinsi G, Peroni L, Manca N. Detection of Ureaplasma biovars and polymerase chain reaction-based subtyping of Ureaplasma parvum in women with or without symptoms of genital infections. Eur J Clin Microbiol Infect Dis. 2009; 28:641–6.
Article
9. Gardella C, Riley DE, Hitti J, Agnew K, Krieger JN, Eschenbach D. Identification and sequencing of bacterial rDNAs in culture-negative amniotic fluid from women in premature labor. Am J Perinatol. 2004; 21:319–23.
Article
10. Ekiel AM, Friedek DA, Romanik MK, Jóźwiak J, Martirosian G. Occurrence of Ureaplasma parvum and Ureaplasma urealyticum in women with cervical dysplasia in Katowice, Poland. J Korean Med Sci. 2009; 24:1177–81.
Article
11. Workowski KA, Berman S, Centers for Disease Control and Prevention (CDC). Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59:1–110.
12. Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005; 18:757–89.
Article
13. Beeton ML, Chalker VJ, Maxwell NC, Kotecha S, Spiller OB. Concurrent titration and determination of antibiotic resistance in ureaplasma species with identification of novel point mutations in genes associated with resistance. Antimicrob Agents Chemother. 2009; 53:2020–7.
14. Chung HK, Park SY, Park MH, Kim YJ, Chun SH, Cho SJ, et al. Association of genital Mycoplasmas infection in women who had preterm delivery and outcomes in premature infants. Korean J Obstet Gynecol. 2012; 55:158–65.
15. Cho Y, Ko J, Lee C, Choi H, Kim B. Analysis of cervical colonization of Ureaplasma urealyticum by PCR in pregnant women with preterm labor. Korean J Fet Med. 2007; 3:237–45.
16. Moon SJ, Choi JK, Park KI. Comparison of the anyplex II STI-7 and seeplex STD6 ACE detection kits for the detection of sexually transmitted infections. J Lab Med Qual Assur. 2013. 87–92.
17. Bae HG, Heo WB, Lee NY, Lee WK, Koo TB. Detection of Ureaplasma urealyticum and Mycoplasma hominis in pregnant women using MYCOFAST(R) evolution 2 and PCR. Korean J Clin Microbiol. 2003; 6:74–80.
18. Choi M and Park I. Genetic classification and antimicrobial resistance of Ureaplasma urealyticum isolated from urine. J Bacteriol Virol. 2012; 42:156–61.
19. Koh E, Kim S, Kim IS, Maeng KY, Lee SA. Antimicrobial susceptibilities of Ureaplasma urealyticum and Mycoplasma hominis in pregnant women. Korean J Clin Microbiol. 2009; 12:159–62.
20. Choe HS, Lee DS, Lee SJ, Hong SH, Park DC, Lee MK, et al. Performance of Anyplex™II multiplex real-time PCR for the diagnosis of seven sexually transmitted infections: comparison with currently available methods. Int J Infect Dis. 2013; 17:e1134–40.
21. Clinical and Laboratory Standards Institute. Methods for antimicrobial susceptibility testing for human mycoplasmas; approved guideline. CLSI document M43-A. Wayne, PA: Clinical and Laboratory Standards Institute;2011.
22. Kim SJ, Lee DS, Lee SJ. The prevalence and clinical significance of urethritis and cervicitis in asymptomatic people by use of multiplex polymerase chain reaction. Korean J Urol. 2011; 52:703–8.
Article
23. Iwasaka T, Wada T, Kidera Y, Sugimori H. Hormonal status and mycoplasma colonization in the female genital tract. Obstet Gynecol. 1986; 68:263–6.
24. Embil JA and Pereira LH. Prevalence of Chlamydia trachomatis and genital mycoplasmas in asymptomatic women. Can Med Assoc J. 1985; 133:34–5.
25. Denise MC, Luciana L, Fernanda AM, Itatiana R, Erika AK, Bianca B, et al. Prevalence of cases of Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Chlamydia trachomatis in women with no gynecologic complaints. Reprod Med Biol. 2012; 11:201–5.
Article
26. Kong F, Ma Z, James G, Gordon S, Gilbert GL. Species identification and subtyping of Ureaplasma parvum and Ureaplasma urealyticum using PCR-based assays. J Clin Microbiol. 2000; 38:1175–9.
27. McIver CJ, Rismanto N, Smith C, Naing ZW, Rayner B, Lusk MJ, et al. Multiplex PCR testing detection of higher-than-expected rates of cervical mycoplasma, ureaplasma, and trichomonas and viral agent infections in sexually active australian women. J Clin Microbiol. 2009; 47:1358–63.
28. Cassell GH, Waites KB, Watson HL, Crouse DT, Harasawa R. Ureaplasma urealyticum intrauterine infection: role in prematurity and disease in newborns. Clin Microbiol Rev. 1993; 6:69–87.
Article
29. Zeighami H, Peerayeh SN, Yazdi RS, Sorouri R. Prevalence of Ureaplasma urealyticum and Ureaplasma parvum in semen of infertile and healthy men. Int J STD AIDS. 2009; 20:387–90.
Article
30. Bayraktar MR, Ozerol IH, Gucluer N, Celik O. Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women. Int J Inf Dis. 2010; 14:e90–5.
Article
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