In-Vitro activities of tetracyclines, macrolides, fluoroquinolones and clindamycin against Mycoplasma hominis and Ureaplasma ssp. isolated in Germany over 20 years

Abstract

Antimicrobial resistance in genital mycoplasmas is increasing and shows global variation. We determined the susceptibilities of 469 mycoplamas, comprising 290 Mycoplasma hominis and 179 ureaplasma isolates collected during 1983 and 1989-2004, to eleven antibacterials by agar dilution. Additionally, we analyzed the results of routine E-testing during 2005-2008. Doxycycline was the most active tetracycline with (MIC₉₀ of 1 and 8 mg/L for ureaplasmas and M. hominis, respectively. Significantly more M. hominis isolates (approximately 10-13%) than ureaplasmas (approximately 1-3%) were resistant to tetracyclines. Ofloxacin was effective against both species (>95% susceptibility). Ciprofloxacin was moderately active against M. hominis and less active against ureaplasmas (70.3% and 35.2% susceptibility, respectively). Clarithromycin and josamycin were the most potent macrolides (MIC₉₀ of 0.5 mg/L) against ureaplasmas. Erythromycin had the lowest activity (MIC₉₀ of 8 mg/L) against ureaplasmas like clindamycin which was the most potent agent against M. hominis. Cross-resistance was found between tetracyclines (53-93%), macrolides and erythromycin (70-100%), and between erythromycin and ciprofloxacin (43-55%). M. hominis became more resistant to tetracyclines and fluoroquinolones between 1989 and 2004, although there was little change during 2005-2008. Ureaplasmas became more resistant to cipfloxacin during 1997 – 2004 and showed high resistance rates to erythromycin during 1989-2008. Doxycycline is still the drug of first-choice for the treatment of ureaplasmal infections and may be used for co-infection with M. hominis.

Evidence for the predominance of a single tet(M) gene sequence type in tetracycline-resistant Ureaplasma parvum and Mycoplasma hominis isolates from Tunisian patients

“…In Hungary, in isolates collected between May 2008 and July 2010, 6.07 % (15/247) and 11.54 % (3/26) of U. urealyticum and M. hominis isolates were resistant to tetracycline, respectively (Farkas et al, 2011). Similar rates of tetracycline resistance were obtained in Germany according to a study involving 469 mycoplasma isolates (179 ureaplasmas and 290 M. hominis) collected over a 20-year period (Krausse & Schubert, 2010), with observed tetracycline resistance rates of 1-3 and 10-13 %, respectively. However, higher tetracycline resistance rates of U. urealyticum isolates (17 %) were reported in China (Zhou et al, 2011), and the 45 % (45/100) prevalence of tet(M) in ureaplasma isolates collected from a broad geographical area of the USA between 2000 and 2004 (Waites et al, 2005) suggests resistance rates even higher than those reported in Tunisia.…”

Urogenital Mycoplasmosis and Pregnancy

“…Other two macrolides that were studied-azithromycin and erythromycin -were only moderately effective [32]. Resistance to erythromycin has been reported additionally by Ponyai et al [31] and Krausse et al [33] who determined that the resistance of ureaplasmas to erythromycin is 81% and 21%, respectively. Pignanelly et al [5] studied M. hominis and found that the isolates were sensitive to tetracycline and doxycycline but resistant to fluoroquinolones and macrolides except jocamycin.…”

“…Nevertheless, doxycycline is still the drug of choice for the treatment of urogenital mycoplasma infections and may also be used for coinfection with M. hominis [33]. However, resistant strains are increasingly prevalent.…”

“…Pignanelly et al [5] studied M. hominis and found that the isolates were sensitive to tetracycline and doxycycline but resistant to fluoroquinolones and macrolides except jocamycin. Krausse et al [33] found that doxycycline was the most active tetracycline against ureaplasmas and M. hominis. However, 10-13% of M. hominis was resistant to tetracyclines [33].…”

“…Krausse et al [33] found that doxycycline was the most active tetracycline against ureaplasmas and M. hominis. However, 10-13% of M. hominis was resistant to tetracyclines [33].…”