Antimicrobial susceptibility pattern of genital Mycoplasmas among a group of pregnant women

Abstract

Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) are important members of genital Mycoplasmas. They are implicated in urogenital infections and complicated pregnancy (chorioamnionitis, preterm delivery, abortion, and preterm birth) as well as bacterial vaginosis and cervicitis. The administration of antimicrobial agents to pregnant women with preterm rupture of the membranes (PROM) may extend the gestation period and decrease the risks of associated complications and neonatal infections. Despite empirical therapy is the rule in cases suspected to have genital infection in Egypt, the surveillance of the susceptibilities of used antibiotics is mandatory to ensure treatment efficacy and good prevention of any possible complications. This study aimed to assess the infection rate of genital Mycoplasmas (MH and UU) among pregnant females and their antimicrobial susceptibility pattern to provide a provisional idea about the effectiveness of antibiotics used empirically to treat cases of genital infections in pregnant women. High vaginal swabs of 50 pregnant females were examined using Mycoplasma IES kit, for identification of UU and MH. The kit also provides the antimicrobial susceptibility results for 12 antimicrobials of five different classes. UU and MH were detected in 26/50 (52%), and 7/50 (14%) of cases respectively, of which 5 cases showed mixed infection with both organisms. UU was most sensitive to quinolones (90-95%), followed by tetracyclines (80-85%). The least sensitivity was detected with chloramphenicol and clindamycin (40% and 30% respectively). The two MH isolates (100%) were sensitive to the three tested quinolones in addition to clindamycin and thiamphenicol. MH showed 100% sensitivity to clindamycin and 75% of UU isolates were sensitive to azithromycin. Further studies are needed to detect any future changes in the susceptibility pattern for these drugs or other antibiotics.

Current understanding and treatment of intra‐amniotic infection with Ureaplasma spp.

“…Clarithromycin is another macrolide with good antibacterial activity against Ureaplasma spp. isolated from pregnant women who showed high susceptability (82.9–86.0%) to clarithromycin . A report showed that 3.7% of pregnant patients with U. parvum colonization who were not treated with antibiotics, such as clarithromycin, had preterm birth at less than 34 weeks of gestation and late abortion.…”

“…Among the macrolides, clarithromycin has the optimal placental passage if administered after the first trimester of pregnancy, making it a potential treatment option for genital ureaplasma infections during pregnancy . Based on antibiotic resistance studies, U. urealyticum isolated from pregnant women showed low resistance (0.9–25%) against clarithromycin …”

Rapid Detection of Urinary Ureaplasma urealyticum and Mycoplasma hominis Isolated from Pregnant Women and Their Antibiotic Susceptibility Profile

“…The current results seem to be concordant with other studies reporting the infection rate of mycoplasmas in the genital tract of pregnant women. In a previous study carried out in our country Egypt, U. urealyticum infection was detected in 21 vaginal swabs (42%) of 50 obtained from pregnant women, whereas M. hominis was detected in 14% (7/50) 26 . In addition, in the study of Bayraktar et al, 27 infection rates of vaginitis among symptomatic pregnant women were 44% (22/50) by U. urealyticum , 4% (2/50) by M. hominis , and 6% (3/50) by both organisms.…”

“…In a previous study carried out in our country Egypt, U. urealyticum infection was detected in 21 vaginal swabs (42%) of 50 obtained from pregnant women, whereas M. hominis was detected in 14% (7/50). 26 In addition, in the study of Bayraktar et al, 27 infection rates of vaginitis among symptomatic pregnant women were 44% (22/50) by U. urealyticum, 4% (2/50) by M. hominis, and 6% (3/50) by both organisms. This emphasizes that pregnancy is a risk factor for developing infection rather than just colonization.…”

“…Their 2 M. hominis isolates were absolutely sensitive to quinolones and clindamycin (100%, for each). 26 Therefore, the only agreement between the 2 studies is the susceptibility of U. urealyticum to doxycycline and minocycline and M. hominis to clindamycin. The discrepancy between the 2 studies can be ascribed to various factors, including the difference in the tested antimicrobial drugs due to different commercial kits, the small number of specimens tested in their studies, and the variability in the site of infection and the antibiotic regimen that was used in each hospital.…”