An antigenic analysis for membranes of Mycoplasma hominis by cross-absorption

Antigenic components at the outer surface membranes of seven serotypes of Mycoplasma hominis were analysed by the mycoplasmacidal reaction and the agglutination during growth reaction. Antibody absorbing capacities of the mycoplasma cells were compared with absorbing capacities of membranes. It was shown that serologically active membrane antigens were mainly heat-labile proteins. No major antigens common to all seven serotypes were detected and each strain had its own specific antigens at the cell surface. Results of analysis indicate that there is a complex antigenic structure exposed in M. hominis and that 7 to 14 cross-reacting antigens may be present at the outer surface in the different serotypes examined. Additional cross-reacting antigens, presumably inner membrane in origin and not exposed at the cell surface, were also demonstrable.

Serologic studies of human genital mycoplasmas: distribution of titers of mycoplasmacidal antibody to Ureaplasma urealyticum and Mycoplasma hominis in pregnant women

Titers of mycoplasmacidal antibody to the human genital mycoplasmas Ureaplasma urealyticum and Mycoplasma hominis were determined using genital isolates from pregnant patients as antigens and comparing these isolates with the 11 prototypic reference strains for U. urealyticum and the seven reference strains for M. hominis. Virtually all titers that were detected with use of the patient's own isolates were detected by the 11 reference strains of U. urealyticum and by the seven reference strains of M. hominis. Serologic surveys of pregnant women who harbored either or both mycoplasmas in vaginal cultures indicated that antibody to M. hominis was found more commonly than antibody to U. urealyticum. It was demonstrated that significant postpartum rises in titers of antibody to M. hominis were correlated with the presence of these mycoplasmas in genital cultures. Postpartum rises in titer of antibody were particularly likely to occur in women with low titers of mycoplasmacidal antibody in serum at the time of delivery. Approximately 88% of the women who were colonized with M. hominis showed significant changes in titer of antibody to M. hominis throughout an apparently normal pregnancy; only 40% of the women who were colonized with U. urealyticum showed such changes in titers to U. urealyticum. Statistical analysis showed that mean log titers of antibody to both mycoplasmas at the first prenatal visit were significantly associated with the number of pregnancies experienced by these women.

Isolation of Mycoplasma hominis from blood cultures in patients with postpartum fever

Eight women with postpartum fever are presented in whom Mycoplasma hominis was isolated from cultures of their blood. Clinical disease consisted of a mild although often prolonged febrile illness, and all but one recovered without appropriate antimicrobial therapy. Five patients demonstrated elevated convalescent titers of mycoplasmacidal antibodies. The isolates of M. hominis were recovered from routine blood cultures in the diagnostic bacteriology laboratory using blind subcultures to blood agar plates. These cases lend support to the concept that endometritis with M. hominis is a cause of postpartum fever and suggest that these organisms may be recovered with increased frequency if minor changes in standard bacteriologic technique are introduced.

Etiology of nongonococcal urethritis. Evidence for Chlamydia trachomatis and Ureaplasma urealyticum

Chlamydia trachomatis, Ureaplasma urealyticum (T-mycoplasma), and Hemophilus vaginalis have previously been considered possible etiological agents in nongonococcal urethritis (NGU). In this study, current C. trachomatis infection was confirmed by culture and (or) micro-immunofluorescence serology in 26 of 69 men experiencing afirst episode of NGU, and 1 of 39 with no urethritis. Serum IgM immunofluorescent antibody to chlamydia was demonstrated in 16 of 20 men with chlamydia culture positive NGU, and 3 of 39 with chlamydia culture negative NG, and none of 34 with no urethritis. 9 of 10 culture positive men with less than or equal to 10 days symptoms developed immunofluorescent antibody seroconversion in paired sera. U. realyticum was isolated significantly more often and in significantly higher concentration from first voided urine from chlamydia-negative cases of NGU than from chlamydia-positive NGU. Ureaplasmacidal antibody titers increased fourfold in six men, four of whom had negative cultures for for unreaplasma. H. vaginalis was isolated from c9 of 33 men with no urethritis and 2 of 69 with NGU. C. trachomatis is susceptible, and U. urealyticum is resistant to sulfonamides. A 10-day course of sulfisoxazole therapy produced improvement in 13 of 13 chlamydia-positive, unreaplasma-negative, and only 14 of 29 chlamydia-negative, unreaplasma-positive NGU cases (P less than 0.002). Thus, culture, serology, and response to therapy support the etiologic role of chlamydia in NGU. Quantitative culture and response to therapy suggest U. unrealyticum may cause many cases of chlamydia-netative NGU.

Oxidation of N-methyl-gamma-tocopheramine to a nitroxide

An unstable nitroxide identified by electron paramagnetic resonance spectra was obtained by oxidation of N-methyl-gamma-tocopheramine with peroxide and also by ultraviolet photooxidation.

Complement-dependent and complement-independent interactions between Mycoplasma hominis and antibodies in vitro

Several in vitro reactions between a strain of M. hominis (no. 4195) and homologous antiserum have been delineated and compared. One complement-dependent and four complement-independent activities of antibody have been studied. The complement-dependent activity was mycoplasmacidal and was inhibited by the presence of arginine in the test medium. The complement-independent antibody-mediated reactions were not mycoplasmacidal and were four in number: (a) agglutination, which was manifested in buffered saline after incubation for 24-48 h at 36 degrees C, and in which the end-points were dependent upon the concentration of antigen; (b) metabolic inhibition, in which antiserum added to liquid growth medium produced slowing of the rate at which the pH rises during growth; (c) agglutination during growth, which occurred in liquid growth medium after the addition of antiserum and coincided with, but generally preceded, metabolic inhibition; and (d) inhibition of multiplication in which high concentrations of antiserum led to inhibition of multiplication or metabolic activity, with persistence of viable mycoplasmas, under otherwise favourable conditions of growth. The end-points for each of the above methods of detecting antibody are not identical.

Polymicrobial etiology of acute pelvic inflammatory disease

We studied 204 women with acute pelvic inflammatory disease to delineate further the causes of that illness. Gonococci were recovered from 91. Gonococcal pili antibody rose or fell significantly in 12 of 18 patients with positive cultures and only two of 19 who had negative cultures and smears for Neisseria gonorrhaoea(P smaller than 0.005). N. gonorrhoeae was found in peritoneal exudate from eight of 21 patients with, and none of 33 without, cervical gonococcal infection. Among patients with severe disease, other bacteria were recovered from peritoneal exudates from five of 16 with, and 19 of 22 without, cervical gonococcal infection (P smaller than 0.025). Mixed anaerobic and aerobic bacterial peritoneal infection was common in nongonococcal pelvic disease. The most common species recovered were Bacteroides fragilis, peptostreptococci, and peptococci. Tuboperitoneal gonococcal infection probably causes pelvic inflammatory disease in most patients with cervical gonococcal infection, whereas polymicrobial tuboperitoneal infection probably causes most nongonococcal cases.

Combined type-specific antisera in the identification of Mycoplasma hominis

In the usual serologic test for Mycoplasma hominis, disks containing antibody to a prototype strain are applied to an agar plate that has been inoculated with the microorganism to be tested, and inhibition of growth is studied. The recent demonstration that M. hominis is not serologically homogeneous but consists of at least seven serotypes suggested the need for reexamination of the specificity of the disk test. The inhibition of growth of M. hominis on solid medium by disks containing seven antisera to the seven prototype strains was studied. Antisera to strains 1, 2, and 3 significantly inhibited all seven prototype strains, but the other four antisera did not inhibit the growth of all heterologous strains. The individual antisera 1, 2, and 3 did not inhibit all of a group of 19 recent genital isolates of M. hominis. However, when the three antisera were combined, they inhibited all 19 isolates as much as or more than any of the three alone. The growth of the prototype strain 5 (PG 21) and of some recent clinical isolates was not completely prevented by the homologous or reference antisera, but the growth of all was partially inhibited.

The genital mycoplasmas: serological inquiries

Serological studies on the genital mycoplasmas (U. urealyticum and M. hominis) are briefly reviewed. Newly developed serological tests from our laboratory have been applied to the studies of mycoplasma strains and antibody responses in patients. The data indicate that genital mycoplasmas are serologically diverse, with at least 11 serotypes of U. urealyticum and 7 of M. hominis. No one serotype predominates in relation to any known association with illness. However, serological and cultural data indicate a strong link between genital mycoplasmas and perinatal morbidity and mortality.

Isolation of genital mycoplasmas from blood obtained shortly after vaginal delivery

Blood obtained from three hundred and twenty-seven women within a few minutes of vaginal delivery was cultured for genital mycoplasmas (Mycoplasma hominis and T mycoplasmas). Twenty-six (8%) of the women had genital mycoplasmas isolated from their blood. Ten women had blood-cultures which contained M. hominis. Fifteen women had blood-cultures which contained T mycoplasmas. Both M. hominis and T mycoplasmas were isolated from the blood of one woman. Only one of two hundred and seventy-three blood-cultures obtained 1 or more days after delivery contained mycoplasmas. The isolation of M. hominis, but not of T mycoplasmas, from the blood was associated with vaginal colonisation and a serological response to the homologous isolate. Two of ten women whose blood contained M. hominis gave birth to stillborn infants. In contrast, there were only four (1.3%) stillbirths among the infants born to the three hundred and one women whose blood did not contain mycoplasmas. This difference is statistically significant.

Serological reactions of Mycoplasma hominis: differences among mycoplasmacidal, metabolic inhibition, and growth agglutination tests

Seven strains of Mycoplasma hominis from human genital tracts were selected to produce antisera. The complement-dependent mycoplasmacidal (MC) activity and two complement-independent activities, metabolic inhibition (MI) and agglutination during growth (GA), of these sera were compared. The GA and MI tests were equivalent in titer and generally not affected by concentration of antigen; they revealed specific cross-reacting patterns among the seven strains. There was little if any cross-reactivity with antisera to other human mycoplasmas or to Mycoplasma arthritidis. Control sera from unimmunized rabbits and sera against concentrated uninoculated culture media were also nonreactive. On the other hand, the sensitivity and specificity of the MC test were affected by the concentration of antigen: at about 10(2) color-changing units (CCU) of antigen, all strains were equivalently cross-reactive against the seven antisera, but at 10(2) to 10(4) CCU the individual strain specificity appeared, whereas at about 10(5) CCU little or no antibody was detectable by MC. The MC tests with the lowest concentrations of antigen gave the highest titers of antibody, but at such low concentrations of antigen there was not only loss of individual strain specificity but also some cross-reactivity against other human mycoplasmas, M. arthritidis, or control rabbit sera. Studies with paired human sera also indicate that the MC test with small amounts of antigen is more sensitive than GA-MI.

Serotypic heterogeneity in isolates of human genital T-mycoplasmas

Serological typing of human genital T-mycoplasmas by a complement-dependent mycoplasmacidal test showed that some recent isolates had different serotypic behavior before and after purification, and that the widely distributed prototype strain T960 was composed of at least two different serotypes. These results indicate that T-mycoplasma isolates from human genital tracts are not serologically homogeneous.