Susceptibilities of Mycoplasma Hominis and Ureaplasma Urealyticum to Fluoroquinolones

Objectives: To determine the susceptibilities of M.hominis and U. urealyticum to fluoroquinolones forthe instruction of reasonable clinical application ofantibiotics.Method: The susceptibilities of M. hominis and U.urealyticum to six fluoroquinolones were determinedby the broth dilution method.Results: Sparfloxacin and gatifloxacin were veryactive with MIC50S of 0.03125 and 0.25 μg/ml againstM. hominis, 0.25 and 0.5 μg/ml against U. urealyticum,respectively. Levofloxacin and ofloxacin had MIC50S of1 μg/ml and 2 μg/ml, respectively against both species.Norfloxacin was less effective against both species at16 and 32 μg/ml. Ciprofloxacin was unusual in thatthe MIC50S varied fourfold between species, with 2 μg/ml against M. hominis and 8 μg/ml against U.urealyticum.Conclusions: The results can provide useful infor-mation for selecting fluoroquinolones for treatmentof urogenital mycoplasma infections.

Presence of an Active Effiux System in the Fluoroquinolones Resistance of Mycoplasma Hominis

Objective: To investigate the possible presence ofan active efflux system in resistance tofluoroquinolones in Mycoplasma hominis. Methods: The resistant strains of M. hominis wereselected from one hundred and three clinical strainsof M. hominis by broth microdilution method. The ac-cumulation of ciprofloxacin in M. hominis and the in-fluence of carbonyl cyanide m-chlorophenyl-hydrazone(CCCP) and reserpine were measured by a fluores-cence method. Results: Two resistant strains and two susceptiblestrains of M. hominis were selected in vitro. The accu-mulation of ciprofloxacin for resistant strains is lowerthan that of susceptible strains. CCCP and reserpinehad different influence on clinical strains of M.hominis. Reserpine could dramatically increase theaccumulation of ciprofloxacin, however CCCP had alittle effect on it. Conclusion: These results suggest that the pres-ence of an active efflux system implicated in thefluoroquinolones-resistant in M. hominis.

Susceptibility of Mixed Infection of Ureaplasma Urealyticum and Mycoplasma Hominis to Seven Antimicrobial Agents and Comparison with that of Ureaplasma Urealyticum Infection

In order to investigate the susceptibility of mixed infection of Ureaplasma Urealyticum (UU) and Mycoplasma Hominis (MH) to 7 kinds of antimicrobial agents and comparison with that of UU infection in NGU patients, the in vitro susceptibility was determined by using microdilution method. The positive results were analyzed. The results showed that the sequence of susceptibility to 7 kinds of antimicrobial agents for both UU infection group and UU-MH mixed infection group was almost the same from the highest susceptibility to the lowest accordingly: Josamycin, Doxycycline, Minocycline, Sparfloxacin, Roxithromycin, Ofloxacin and Azithromycin. The total drug resistance rate for UU-MH mixed infection group (97. 67 %) was significantly higher than that for UU infection group (44. 67 %, P<.0. 01). The highest drug resistance rate in UU group and UU-MH mixed infection group was 31. 33 % (Ofloxacin) and 90. 48 % (Azithromycin) respectively. UU-MH mixed infection showed an increased drug resistance and changes of drug resistance spectrum.

Ureaplasma Urealyticum or Mycoplasma Hominis Infections and Semen Quality of Infertile Men in Abidjan

Objective To determine the prevalence of U. urealyticum and M. hominis in semen samples collected from men admitted in clinic for infertility, and to compare the quality of these semen samples.Methods A total of 1 058 semen samples collected were investigated. Sperm semiological assays were performed according to the guidelines of the World Health Organisation （WHO）. Semen were examined by Mycoplasma IST for the detection of mycoplasma. Semen culture on agar media was used to detect other microorganisms. Chlamydia was detected using direct fluorescent assay （DFA） of Clamydia Trachomatis.Results Among 1 058 semen samples, microorganisms were detected in 638 （60.3%）. The infected sperms consisted of mycoplasma alone in 507 cases （47.9%）, mycoplasma and other microorganisms in 98 （9.3%）, giving in all 605 （57.2%） samples infected with mycoplasma. The last 33 （3.1%） consisted of other microorganisms alone. The frequency of U. urealyticum, M. hominis and mixed genital infections detected in semen samples of infertile men were 39%, 23.8% and 5.6%, respectively. The rates of abnormal semen parameters recorded among patients infected with mycoplasma were for volume （22.2%-25%）, viscosity （29.6%-43.5%）, pH （64.7%-72.9%）, motility （80.8%-93.8%）, morphology （36.3%-47.9%）, sperm concentration （53.3%-58.3%） and leukocyte count （51.4%-58.3%）.Conclusion Frequency of U. urealyticum infection was higher than that of M. hominis. Mycoplasma infections were associated with disorders of pH, motility and sperm concentration. In addition M. hominis infection affected spermatozoa morphology. Therefore, screening of U. urealyticum clinically relevant in Abidjan. and M. hominis for routine semen analysis is

Mycoplasma hominis meningitis after operative neurosurgery:A case report and review of literature

BACKGROUND Mycoplasma hominis(M.hominis),which causes central nervous system infections in adults,is very rare.It is also relatively difficult to culture mycoplasma and culturing requires special media,resulting in a high rate of clinical underdiagnosis.Therefore,clinicians often treat patients based on their own experience before obtaining pathogenic results and may ignore infections with atypical pathogens,thus delaying the diagnosis and treatment of patients and increasing the length of hospital stay and costs.CASE SUMMARY A 44-year-old man presented to the hospital complaining of recurrent dizziness for 1 year,which had worsened in the last week.After admission,brain magnetic resonance imaging(MRI)revealed a 7.0 cm×6.0 cm×6.1 cm lesion at the skull base,which was irregular in shape and had a midline shift to the left.Based on imaging findings,meningioma was our primary consideration.After lesion resection,the patient had persistent fever and a diagnosis of suppurative meningitis based on cerebrospinal fluid(CSF)examination.The patient was treated with the highest level of antibiotics(meropenem and linezolid),but the response was ineffective.Finally,M.hominis was detected by next-generation metagenomic sequencing(mNGS)in the CSF.Therefore,we changed the antibiotics to moxifloxacin 0.4 g daily combined with doxycycline 0.1 g twice a day for 2 wk,and the patient had a normal temperature the next day.CONCLUSION Mycoplasma meningitis after neurosurgery is rare.We can use mNGS to detect M.hominis in the CSF and then provide targeted treatment.

<i>Mycoplasma hominis</i>Variable Adherence-Associated Antigen: A Major Adhesin and Highly Variable Surface Membrane Protein

Mycoplasma hominis is a member of the genus mycoplasma and has only been isolated from humans. It is most frequently isolated from the urogenital tract in the absence of symptoms, but has been isolated from wounds, brain abscess, inflamed joints, blood and placenta from pregnancy with adverse outcomes (especially preterm birth and occasionally term stillbirth). Controversy surrounds whether this organism is a commensal or a pathogen;however, Mycoplasma hominis has been shown to induce preterm birth and foetal lung injury in an experimental primate model as a sole pathogen. These bacteria are known to exist as a parasitic infection, due to a number of missing synthetic and metabolism pathway enzymes from their minimal genome;therefore, the ability to adhere to host cells is important. Here we provide a review that clarifies the different nomenclature (variable adherence-associated antigen and P50) that has been used to investigate the major surface adhesin for this organism, as well as reported mechanisms responsible for turning off its expression. Variation in the structure of this protein can be used to separate strains into six categories, a method that we were able to use to distinguish and characterise 12 UK strains isolated from between 1983 and 2012. We propose that the Vaa should be used in further investigations to determine if commensal populations and those that are associated with disease utilise different forms of this adhesin, as this is under-studied and identification of pathogenic determinants is overdue for this organism.

Charcterization of Type Ⅱ Topoisomerase Gene Mutations in Clinical Isolates of Mycoplasma Hominis Resistant to Fluoroquinolones

Objective: To analyze type II topoisomerase genes in clinical isolates of fluoroquinolone-resistant Mycoplasmahominis. Methods: Eight isolates of M.hominis cross resistant to 6fluoroquinolones were selected from 103 clinical strains ofM.hominis using a broth microdilution method. Type IItopoisomerase genes were amplified by PCR and directlysequenced. Nucleotide sequences were compared to sequencesfrom a susceptible strain (M.hominis PG2I). Results: MICs of resistant Mh isolates were 4- to 512-foldhigher than MICs from the susceptible reference strain.Sequence comparison revealed a C to T change at 113nt ingyrA QRDR led to the substitution of Ser83 by Leucine and noamino acid change in gyrB. A change of G to T at 134nt inparC QRDR led to the substitution of Ser80 by Isoleucine anda G to A change at 70nt in ParE QRDR led to the substitutionof Aspartic acid by Asparagine.Conclusion: These results suggest that a C to T change at113nt in gyrA, a G to T change at 134nt in parC and a G to Achange at 70nt i atrE are associated with fluoroquinolone resistance of M.hominis.

A Study on Diagnosis of Mycoplasma Hominis in The Urogenital Tract By Nested Polymerase Chain Reaction with First Void Urine in Men

Objectives: To evaluate thc efficacy of nested polymerasechain reaction (PCR) with first void urine (FVU) for thediagnosis of Mycoplasma hominis in male patients. Methods: Matched FVU specimens and urethral swabs werecollected from 194 male patients with NongonococcalUrethritis and tested by nested PCR and cell culture. Cellculture was used as a gold standard for evaluating other assaytechniques. Results: For FVU nested PCR assay and FVU cell culture,our results showed that the sensitivity was 100% and 93.3%;specificity was 97.0% and 98.2%; positive predictive value(PPV) was 85.7% and 90.3%, negative predictive value (NPV)was 100% and 98.8%, respectively. The total consistencybetween the two techniques was 97.4%. Conclusions: For the diagnosis of Mycoplasma hominis inmen, nested PCR detecting FVU is a highly sensitive andspecific method. First void urine can replace swab culture orPCR in terms of acceptability and feasibility.

A Study on Infertility of Males Infected with <i>Mycoplasma hominis</i>with Reference to Sperm Morphology

Objectives: The main objective of this study was to investigate the effect of Mycoplasma hominis infection on the morphology of sperms and its association with the infertility of men. The patients were referred to the Urology Departments of Mosul General Hospital and Soran Hospital in Mosul and Erbil respectively. Methods: The present study was carried out from April 2019 to March 2020 and the number of the patients group was 108. The patients aged 20 to 60 years. Semen was collected from infertile men of a couple that female failed to become pregnant after one year of regular and unprotected intercourse of marriage and submitted for seminal fluid analysis as well as for bacteriological investigations Results: M. hominis was detected in 14 semen specimens (12.9%) from the infertile men. The teratozoospermia, normozoospermia, asthenoteratozoospermia, oligoasthenoteratozoospermia, asthenozoospermia, oligozoospermia, oligoasthenozoospermia and leukospermia were seen among patients examined. Statistically, there were no significant differences between these forms of infected infertile men and non-infected infertile men (P > 0.05). Conclusions: The results of present study demonstrated that the genital Mycoplasma hominis seems to be widespread among male partners of infertile couples in Iraq. The present data did not show any significant differences between forms of the sperm concentration and sperm morphology related to the infection by M. hominis.

Detection and evaluation of different morphological forms of Mycoplasma hominis in human semen

Recently discovered microcolonial forms of Mycoplasma hominis(M.hominis)and their impact on human spermatogenesis are studied.The spermatozoa of 125 fertile men(sperm donors;from Reprobank[Reproductive Tissue Bank,Moscow,Russial)and of 93 patients with fertility problems(from the Federal State Budgetary Institution"Research Centre for Medical Genetics[RCMG]",Moscow,Russia)were used.Classical colonies of M.hominis and microcolonies were detected by molecular biological methods,culture of bacteria,and transmission electron microscopy.The unique structure of microcolonial cells,in which the cytoplasmic cylinder is surrounded by concentric electron-dense and electron-light layers with a periodicity of 12-14 nm,and the ability of microcolonial cells to attach to spermatozoa are shown.In patients with lower sperm quality,microcolonies of M.hominis were detected 2.5 times more frequently than classical colonies.The detection of microcolonies in the ejaculate and the frequent isolation of microcolonies from sperm samples of patients with fertility problems suggest that microcolonial cells may be one cause of infertility.

2例人型支原体导致骨折术后手术部位感染的病例报告

人型支原体可定植于人体泌尿生殖系统,为机会性致病菌,其引起的骨折术后手术部位感染较为罕见。由于人型支原体缺乏细胞壁,革兰染色阴性,常规细菌培养易漏检,感染后诊断和治疗较为困难。该文分析2例骨折术后人型支原体伤口感染患者的临床资料、治疗经过、检验确诊及微生物药敏结果,以提高临床医生与检验人员对生殖道以外部位人型支原体感染的认识,减少误诊和漏诊。

1例人型支原体感染超早产儿的药学监护实践

目的:探讨超早产儿人型支原体感染的抗菌药物选择及药学监护。方法:临床药师参与1例人型支原体感染超早产儿的治疗过程,通过查阅大量文献,协助医师选择适宜患儿的抗菌药物,并给出用药监护方案。结果:患儿经抗人型支原体药物治疗后,枕部疖肿消退;经联合其他抗菌药物治疗,体温、感染指标逐渐降至正常,未观察到药物不良反应。结论:临床药师参与特殊患儿个体化给药方案的制定与实施,可保障药物治疗安全、有效。

生殖道Uu、Ct及Mh感染在不孕不育妇女中的检测结果分析及相关性研究

目的探讨生殖道Uu、Ct及Mh感染在不孕不育妇女中的检测结果分析及相关性。方法选取2016年1月至2017年1月期间,于我院妇产科进行诊治的126例女性不孕患者为研究对象,作为不孕组,选取同期进行体检的健康妇女100例作为对照组。比较不孕组与健康对照组、原发性不孕组与继发性不孕组生殖道Uu、Ct与Mh单一及混合感染阳性率,以及不同年龄段不孕妇女生殖道Uu、Ct与Mh单一及混合感染阳性率。对生殖道Uu、Ct与Mh感染与妇女不孕进行Logistic多元回归分析。结果不孕组患者生殖道Uu、Ct与Mh单一及混合感染阳性率均显著高于对照组,有统计学差异(P<0.05)。继发性不孕组患者生殖道Uu、Ct与Mh单一及混合感染阳性率均显著高于原发性不孕组,均有统计学差异(P<0.05)。在126例不孕患者中,<25岁有8例,25~35岁有81例,35~40岁有37例,以25~35岁不孕妇女Uu、Mh和Ct感染阳性率最高,与其他两组比较,差异有统计学意义(P<0.05)。经过Logistic多元回归分析,生殖道Uu、Ct及Mh感染均与妇女的不孕存在相关性。结论生殖道Uu、Ct及Mh感染与妇女不孕有明显相关性,临床上对不孕妇女应重视对Uu、Ct及Mh感染的检查。

白细胞酯酶和CD15阳性细胞同步检测在女性UU、Mh感染者中诊断价值的研究

目的研究白细胞酯酶和CD15阳性细胞同步检测在非淋菌性尿道炎中的诊断价值。方法对经UU和Mh培养进行筛选的60例的非淋菌性尿道炎女性患者分别检测阴道深部分泌物中的白细胞酯酶和CD15阳性中性粒细胞。结果60例标本中白细胞酯酶阳性者37例,白细胞酯酶的阳性率明显增高(P<0.05)。在37例白细胞酯酶阳性者中CD15阳性细胞百分率大于50%者为17例,小于50%者为20例;结论白细胞酯酶的检测对UU和Mh泌尿生殖系感染有较高诊断价值;CD15阳性细胞检测有助于病情判断和估测预后。

莫西沙星治疗超早产儿人型支原体脑膜炎1例

患儿男,生后2 h,因早产(胎龄27+5周)、生后气促2 h入院。患儿入院后出现发热,血C反应蛋白升高,生后第4天脑脊液宏基因组二代测序示人型支原体阳性(序列数9898);生后第8天复查脑脊液宏基因组二代测序示人型支原体阳性(序列数56806)阳性。患儿人型支原体化脓性脑膜炎诊断明确,抗生素调整为莫西沙星静脉滴注[5 mg/(kg·d)],总疗程4周。治疗后患儿脑脊液检查恢复正常,于生后第76天治愈出院。该文对新生儿人型支原体化脓性脑膜炎的诊断和治疗进行重点描述,介绍超早产儿人型支原体化脓性脑膜炎的多学科诊疗.

4694例宫颈分泌物Uu、Mh检出率及药敏探析

目的探讨4 694例宫颈分泌物解脲支原体(Uu)与人型支原体(Mh)检出率及药敏情况。方法采用法国生物梅里埃IST2支原体鉴定及药敏试剂盒对2010年1月至2012年12月在玉环县人民医院妇科门诊就诊的4 694例疑似支原体感染患者宫颈分泌物进行Uu、Mh鉴定及药敏试验,统计其检出率及药敏情况。结果支原体阳性2 755例,总检出率为58.69%;其中Uu阳性2 163例,检出率为46.08%;Mh阳性53例,检出率为1.13%;Uu合并Mh阳性539例,检出率为11.48%。Uu检出率高于Mh或Uu合并Mh。药敏结果显示:Uu敏感率最高的抗菌药为原始霉素,耐药率最高的抗菌药为环丙沙星;Mh敏感率最高的抗菌药为原始霉素、交沙霉素、强力霉素,耐药率最高的抗菌药为克拉霉素;Uu合并Mh敏感率最高的抗菌药为强力霉素,耐药率最高的抗菌药为环丙沙星。结论支原体检出率较高,主要以Uu为主;Uu和Mh对多种抗菌药的耐药现象已普遍存在,药敏试验能为临床治疗宫颈分泌物Uu和Mh感染合理用药提供理论依据。

生殖道支原体感染与不孕不育、妇科疾病的相关性

目的:分析门诊女性患者支原体感染情况以及与不孕不育、妇科疾病的相关性。方法:回顾性分析6943例门诊女性患者的支原体感染情况,并分析临床诊断为HPV感染、阴道炎及不孕、不良孕史等患者的支原体感染相关性。结果:共检测6943例女性泌尿生殖道样本,支原体阳性2507例,总阳性率为36.1%,≤20岁女性的阳性率高达56.0%。其中微小脲原体3型阳性率最高达12.5%,解脲脲原体阳性率为8.4%,人型支原体和生殖支原体的阳性率分别是7.9%和0.4%;不孕组、HPV感染组和阴道炎组的阳性率分别为44.8%、44.7%和42.9%,与对照组相比χ~2值分别为15.871、12.500、25.337,P<0.001,与正常组相比具有显著差异。结论:支原体感染在不同年龄段分布不同,且与不孕、HPV感染和阴道炎相关,临床应加强支原体筛查,早诊断、早治疗。

宏基因组测序技术辅助诊断人型支原体及解脲支原体共同感染的成人脑膜炎的临床研究

目的通过1例由人型支原体和解脲支原体合并感染的成人脑膜炎诊治情况以及相关文献回顾,探讨宏基因组二代测序技术(mNGS)在人型支原体和解脲支原体合并中枢神经感染诊断中的应用,以提高临床医生对此类罕见感染性疾病的诊疗水平。方法总结2021年6月该院收治的1例成年人型支原体及解脲支原体合并感染脑膜炎患者的临床诊疗过程,以“Mycoplasma hominis”“Ureaplasma urealyticum”“meningitis”和“CSF”为英文关键词,通过PubMed数据库进行文献复习,检索时间为2000年1月至2021年6月。结果患者因严重的头部创伤就诊,术后出现间歇性发热,脑脊液生化检测提示急性脑膜炎。临床经验性使用美罗培南、利奈唑胺等抗菌药物抗感染治疗后,效果不佳,患者仍反复发热,原发感染灶不明确,后将脑脊液进行mNGS检测,报告结果为人型支原体和解脲支原体序列数较高,随即给予多西环素治疗,3 d后患者全身情况得到改善,症状减轻,治疗7 d后,蛛网膜下腔出血明显吸收,双侧额颞部硬膜下积液较之前逐渐减少、消失,患者身体恢复顺利,无复发征象。通过文献检索共纳入23篇病例报道,在这些报道中,有20例由人型支原体感染引起脑膜炎,3例由解脲支原体感染引起脑膜炎。结论mNGS的发展和临床应用使易被临床误诊的该类罕见病原体感染性疾病的诊疗效率有所提高。

The Association between Mycoplasma Species Infection and Tubal Obstruction

Objectives: Numerous factors can cause infertility. Tubal factor accounts for approximately 30% of infertility in females. This study was conducted to evaluate the rate of asymptomatic Mycoplasma hominis and Ureaplasma urealyticum infection in females diagnosed with tubal obstruction. Methods: This is a retrospective case-control study conducted at New Life Fertility Centre. We have identified and reviewed the health records of 167 subfertile women that had HSG and an endocervical swab for Mycoplasma hominis and Ureaplasma urealyticum done. Results: We compared the endocervical swab results of ureaplasma and mycoplasma in the patients with tubal obstruction (group 1) to the patients with normal patent tubes (group 2). Diagnosis of tubal patency was based on the HSG results. Our results show that there is a significantly higher rate of Ureaplasma urealyticum/Mycoplasma hominis infection in group 1 compared to group 2. Conclusion: Our data shows that there is a high rate of U. urealyticum and M. hominis infection in patients diagnosed with tubal factor of infertility and it can be a marker in the prediction of the tubal pathology.

2015—2022年连云港地区生殖道支原体感染情况及耐药变迁分析

目的 调查连云港地区泌尿生殖系统支原体感染情况和耐药性变迁,为临床合理用药提供依据。方法 收集2015—2022年连云港市妇幼保健院疑似泌尿生殖道支原体感染的病例22 889例,回顾性分析临床资料,统计生殖道支原体感染情况和药敏结果。结果 生殖道支原体阳性标本8 943例,其中解脲脲原体(Uu)感染率最高,为33.64%(7 700/22 889),明显高于人型支原体(Mh)感染率3.91%(894/22 889)和混合(Uu+Mh)型感染率1.52%(349/22 889),差异具有统计学意义(P<0.05)。2015—2022年总体感染率和Uu感染率呈增长趋势。女性泌尿生殖道支原体感染率为42.42%,显著高于男性的22.47%(χ^(2)=534.21,P<0.05);与小于20岁以及40岁以上年龄段人群相比,20~40岁人群感染率最高,达到40.84%(6 108/14 955)。泌尿生殖道支原体对强力霉素、美满霉素及交沙霉素敏感性较高,耐药率均未超过5.00%;Uu感染者对红霉素、氧氟沙星和环丙沙星的耐药率有增长趋势(P<0.05),Mh感染者对红霉素、罗红霉素、阿奇霉素和氧氟沙星的耐药率有增长趋势(P<0.05)。结论连云港地区泌尿生殖道支原体感染率呈逐年增长趋势,需加强相应的监控;强力霉素、美满霉素和交沙霉素适合作为本地区泌尿生殖道支原体感染治疗的首选临床用药,大部分喹诺酮类药物的耐药率较高,提示存在该类药物滥用情况,需加强临床监管。