Incidence and antibiotic susceptibility of genital mycoplasmas in sexually active individuals in Hungary

Abstract

The aim of this study was to examine the incidence and antibiotic sensitivity of Ureaplasma urealyticum and Mycoplasma hominis strains cultured from the genital discharges of sexually active individuals who attended our STD outpatient service. Samples were taken with universal swab (Biolab®, Budapest, Hungary) into the Urea-Myco DUO kit (Bio-Rad®, Budapest, Hungary) and incubated in ambient air for 48 h at 37 °C. The determination of antibiotic sensitivity was performed in U9 and arginin broth using the SIR Mycoplasma kit (Bio-Rad®, Budapest, Hungary) under the same conditions. Between 01.05.2008 and 31.12.2011, 373/4,466 (8.35 %) genito-urethral samples with U. urealyticum and 41/4,466 (0.91 %) genito-urethral samples with M. hominis infection were diagnosed in sexually active individuals in the National STD Center, Semmelweis University. U. urealyticum was isolated in 12.54 % in the cervix and 4.1 % in the male urethra, while M. hominis was isolated in 1.33 % in the cervix and 0.51 % in the male urethra. The affected age group was between 21 and 60 years old. U. urealyticum strains were sensitive to tetracycline (95.9 %), doxycycline (97.32 %), and azithromycin (85.79 %), and resistant to erythromycin (81.23 %), clindamycin (75.06 %), and ofloxacin (25.2 %). Cross-resistance occurred in 38.71 % of patients to erythromycin and clindamycin. M. hominis strains were sensitive to clindamycin, ofloxacin, and doxycycline in more than 95 %, to tetracycline in 82.92 %, and no cross-resistance was detected among the antibiotics. Our study confirms that the continuously changing antibiotic resistance of ureaplasmas and mycoplasmas should be followed at least in a few centers in every country, so as to determine the best local therapy options for sexually transmitted infection (STI) patients.

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.…”

“…Additionally, ureaplasma species have natural resistance to lincosamides (e.g. clindamycin) and M. hominis possesses inherent resistance to macrolides, except josamycin [31].…”

In vitro antimicrobial susceptibility of Mycoplasma hominis genital isolates

“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Only 10 (58.8%) of these focused their attention on antimicrobial susceptibility. [3][4][5][6][7][8][9][10]13,15] Moreover, 9 (52.9%) articles studied female patients, [2][3][4][5][6]9,11,15,18] 4 (23.5%) male, [7,14,16,17] and 4 (23.5%) both; [8,10,12,13] the populations showed genital disorder in 15 (88.2%) cases. [2,[4][5][6][7][8][9][10]…”

“…[3][4][5][6][7][8][9][10]13,15] Moreover, 9 (52.9%) articles studied female patients, [2][3][4][5][6]9,11,15,18] 4 (23.5%) male, [7,14,16,17] and 4 (23.5%) both; [8,10,12,13] the populations showed genital disorder in 15 (88.2%) cases. [2,[4][5][6][7][8][9][10][11][12][13][14][15][16]18] In these works, the prevalence of M. hominis ranged from 0.5% to 39.7% (male 0.5-28.3% and female 0.9-39.7%). [2][3][4][5][6][7][8][9][10]…”

“…[2,[4][5][6][7][8][9][10][11][12][13][14][15][16]18] In these works, the prevalence of M. hominis ranged from 0.5% to 39.7% (male 0.5-28.3% and female 0.9-39.7%). [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Studies from South Africa showed high prevalence (39.7%), [5] followed by Paraguay (30.9%), [2] Cuba (31%), [4] Russia (28.3%), [14] Romania (21.9%), [18] China (15.6%), [15] Japan (6.0%), [16] Italy (1.1-6.9%), [7][8][9][10] Poland (4.0%), [11] Burkina Faso (2.7%), [6] and Hungary (0.9-1.2%). [12,13] In addition, two studies on asymptomatic patients displayed a prevalence of 7.5% in Romania and 6.3% in Japan.…”