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Ehrnström B, Haugan MS, Andreasen JB, Ellingsen A. Immunocompromised teenager with meningitis caused by Ureaplasma parvum. BMJ Case Rep 2024; 17:e257261. [PMID: 38453229 PMCID: PMC10921514 DOI: 10.1136/bcr-2023-257261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024] Open
Abstract
Infection in the immunocompromised patient is often challenging on multiple levels. It can be difficult to distinguish between manifestations of the underlying disease, infection or malignancy. Symptoms may be vague or even absent, deviations in the common inflammatory parameters discrete, imaging findings scarce and the causative microbe may be a true pathogen as well as opportunistic. Here, we report an immunosuppressed female in her late teens with a purulent meningitis due to Ureaplasma parvum-a very rare cause of infection in the central nervous system of adults. We wish to highlight the relevance of intracellular pathogens and the need to actively search for these microbes, especially when response to broad-spectrum antibiotic treatment is absent. Furthermore, we emphasise the need for adequate molecular microbial diagnostics in search of microbes that are difficult to identify by culture and where serology and antigen tests may be absent or unreliable due to immune suppression.
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Affiliation(s)
- Birgitta Ehrnström
- Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Maria Schei Haugan
- Department of Medical Microbiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jo Bønding Andreasen
- Clinic of Anaesthesia and Intensive Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- Thoracic Intensive Care Unit, Aalborg Universitetshospital, Aalborg, Denmark
| | - Asbjørn Ellingsen
- Department of Infectious Diseases, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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2
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Abe Y, Inoue M, Sekiguchi K, Nakano S, Tomaru Y, Maeda T, Shimizu N, Ihara K. Clinical characteristics of preterm and term infants with Ureaplasma in gastric fluid. Pediatr Neonatol 2024; 65:170-176. [PMID: 37741759 DOI: 10.1016/j.pedneo.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Ureaplasma spp. is an endemic microorganism that causes placental chorioamnionitis or preterm delivery in pregnant women, and the occurrence of bronchopulmonary dysplasia or intraventricular hemorrhaging in preterm infants after birth, although the pathogenicity of Ureaplasma remains controversial. The association between Ureaplasma exposure and the symptoms or outcomes of infected mothers or their infants born at term remains poorly understood. We investigated the clinical characteristics of preterm and term infants with or without Ureaplasma in their gastric fluid. METHODS Gastric fluid samples were collected from 47 newborns in the neonatal intensive-care unit immediately after birth and tested using multiplex polymerase chain reaction (PCR) assays targeting Ureaplasma spp., Ureaplasma parvum, and Ureaplasma urealyticum. The clinical findings and outcomes of the neonates and their mothers were retrospectively evaluated. RESULTS Ureaplasma spp. were detected in 9/47 samples (19%) by multiplex PCR assays. In all cases, the subspecies was U. parvum. The Ureaplasma-positive group had a significantly higher incidence of chorioamnionitis in utero than the Ureaplasma-negative group. Regarding preterm infants, the IgM levels in the Ureaplasma-positive group were significantly higher than in the Ureaplasma-negative group. In contrast, in term infants, the rates of a non-reassuring fetal status, a maternal fever, and maternal leukocyte counts and maternal C-reactive protein levels within five days before delivery in the Ureaplasma-positive group were significantly higher than those in the Ureaplasma-negative group. All three extremely-low-birth-weight infants with Ureaplasma developed bronchopulmonary dysplasia. The length of hospitalization in the Ureaplasma-positive group was almost same as that in the Ureaplasma-negative group for term infants. CONCLUSION Mothers or their fetuses with exposure to Ureaplasma expressed characteristic clinical features during pregnancy and after birth.
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Affiliation(s)
- Yoshiichi Abe
- Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan; Department of Pediatrics, Koseiren Tsurumi Hospital, Oita, Japan
| | - Masanori Inoue
- Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan.
| | - Kazuhito Sekiguchi
- Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan
| | - Satoko Nakano
- Department of Ophthalmology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yasuhiro Tomaru
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomoki Maeda
- Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan
| | - Norio Shimizu
- Center for Stem Cell and Regenerative Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Ihara
- Department of Pediatrics, Faculty of Medicine, Oita University, Oita, Japan
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3
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Chan JL, Cerón S, Horiuchi SM, Yap JP, Chihuahua EG, Tsan AT, Kamau E, Yang S. Development of a Rapid and High-Throughput Multiplex Real-Time PCR Assay for Mycoplasma hominis and Ureaplasma Species. J Mol Diagn 2023; 25:838-848. [PMID: 37683891 DOI: 10.1016/j.jmoldx.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/10/2023] [Accepted: 07/27/2023] [Indexed: 09/10/2023] Open
Abstract
Bacterial commensals of the human genitourinary tract, Mycoplasma hominis and Ureaplasma species (parvum and urealyticum) can be sexually transmitted, and may cause nongonococcal urethritis, pelvic inflammatory disease, and infertility. Mycoplasma hominis and Ureaplasma species may also cause severe invasive infections in immunocompromised patients. Current culture-based methods for Mycoplasma/Ureaplasma identification are costly and laborious, with a turnaround time between 1 and 2 weeks. We developed a high-throughput, real-time multiplex PCR assay for the rapid detection of M. hominis and Ureaplasma species in urine, genital swab, body fluid, and tissue. In total, 282 specimens were tested by PCR and compared with historic culture results; a molecular reference method was used to moderate discrepancies. Overall result agreement was 99% for M. hominis (97% positive percentage agreement and 100% negative percentage agreement) and 96% for Ureaplasma species (96% positive percentage agreement and 97% negative percentage agreement). Specimen stability was validated for up to 7 days at room temperature. This multiplex molecular assay was designed for implementation in a high-complexity clinical microbiology laboratory. With this method, >90 samples can be tested in one run, with a turnaround time of 4 to 5 hours from specimen extraction to reporting of results. This PCR test is also more labor effective and cheaper than the conventional culture-based test, thus improving laboratory efficiency and alleviating labor shortages.
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Affiliation(s)
- June L Chan
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Stacey Cerón
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Stephanie M Horiuchi
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Jewell P Yap
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Erika G Chihuahua
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Allison T Tsan
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Edwin Kamau
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California
| | - Shangxin Yang
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California.
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4
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Kojima K, Morimoto K, Juma KM, Takita T, Saito K, Yanagihara I, Fujiwara S, Yasukawa K. Application of recombinant human pyruvate kinase in recombinase polymerase amplification. J Biosci Bioeng 2023; 136:341-346. [PMID: 37718149 DOI: 10.1016/j.jbiosc.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/01/2023] [Accepted: 08/26/2023] [Indexed: 09/19/2023]
Abstract
Recombinase polymerase amplification (RPA) is an isothermal DNA amplification reaction at around 41°C using recombinase (Rec), single-stranded DNA-binding protein (SSB), strand-displacing DNA polymerase (Pol), and an ATP-regenerating enzyme. In this study, we attempted to use pyruvate kinase instead of creatine kinase (CK) that has been consistently used as an ATP-regenerating enzyme in RPA. Human pyruvate kinase M1 (PKM) was expressed in Escherichia coli and purified from the cells. RPA with PKM was performed at 41°C with the in vitro synthesized urease subunit β (ureB) DNA from Ureaplasma parvum serovar 3 as a standard DNA. The optimal concentrations of PKM and phosphoenolpyruvate were 20 ng/μL and 10 mM, respectively. The RPA reaction with PKM was more sensitive than that with CK. PKM exhibited higher thermostability than CK, suggesting that the RPA reagents with PKM are preferable to those with CK for onsite use.
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Affiliation(s)
- Kenji Kojima
- Division of Bioanalytical Chemistry, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, Himeji, Hyogo 670-8524, Japan
| | - Kenta Morimoto
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Sakyo-ku, Kyoto 606-8502, Japan
| | - Kevin Maafu Juma
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Sakyo-ku, Kyoto 606-8502, Japan
| | - Teisuke Takita
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Sakyo-ku, Kyoto 606-8502, Japan
| | - Kazuki Saito
- Division of Bioanalytical Chemistry, Faculty of Pharmaceutical Sciences, Himeji Dokkyo University, Himeji, Hyogo 670-8524, Japan
| | - Itaru Yanagihara
- Department of Developmental Medicine, Research Institute, Osaka Women's and Children's Hospital, Izumi-shi, Osaka 594-1101, Japan
| | - Shinsuke Fujiwara
- Department of Biosciences, School of Biological and Environmental Sciences, Kwansei-Gakuin University, Sanda, Hyogo 669-1330, Japan
| | - Kiyoshi Yasukawa
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Sakyo-ku, Kyoto 606-8502, Japan.
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5
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Pella-Saavedra P, Ramos-Vallejos F, del Valle-Mendoza J, Becerra-Goicochea L, Silva-Caso W, Pinillos-Vilca L, Cornejo-Tapia A, Martins-Luna J, Aquino-Ortega R, Carrillo-Ng H, Aguilar-Luis MA. Prevalence of coinfections in a cross-sectional cohort of women screened for multiple pathogens in Peru. Heliyon 2023; 9:e14257. [PMID: 36950601 PMCID: PMC10025105 DOI: 10.1016/j.heliyon.2023.e14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Objective To determine the prevalence and risk factors of sexually transmitted infections (STIs) including Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium among asymptomatic women with human papillomavirus (HPV) infection. Methods A cross-sectional study was performed in 842 asymptomatic women from Cajamarca, Peru. The pathogens were detected using polymerase chain reaction (PCR) and the results were analyzed according to the HPV status: high-risk HPV, low-risk HPV and negative for HPV. Demographical and gyneco-obstetric data was analyzed to identify risk factors. Results We found that 23.99% (202/842) women were positive for HPV, of whom 79.21% (160/202) were infected with a high-risk genotype. Co-infections were evaluated and 14.38% (23/160) were positive for Ureaplasma urealyticum, 9.38% (15/160) for Chlamydia trachomatis and 1.25% (2/160) for Mycoplasma genitalium. We found a significant association between HPV genotype and the number of children, partners, and history of sexual abuse. The co-infection between high-risk HPV and Chlamydia trachomatis was associated with number of abortions, number of sexual partners and no use of condom. Finally, co-infection between high-risk HPV and Ureaplasma urealyticum was associated with no use of condom and history of STIs. Conclusion HPV infection continues to be a highly relevant problem in Peru, particularly due to the high prevalence of high-risk genotypes. In addition, we report high rates of co-infections with other STIs, such as U. urealyticum and C. trachomatis. We highlight the importance of active surveillance to promptly diagnose these infections, since they may lead to persistent HPV infections.
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Affiliation(s)
- Priscilla Pella-Saavedra
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Fatima Ramos-Vallejos
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Juana del Valle-Mendoza
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
- Corresponding authors. School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
| | - Lorena Becerra-Goicochea
- Hospital Regional Docente de Cajamarca, Cajamarca, Peru
- Facultad de Ciencias de la Salud. Universidad Nacional de Cajamarca, Cajamarca, Peru
| | - Wilmer Silva-Caso
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Luis Pinillos-Vilca
- Hospital Regional Docente de Cajamarca, Cajamarca, Peru
- Facultad de Medicina. Universidad Nacional de Cajamarca, Cajamarca, Peru
| | - Angela Cornejo-Tapia
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Johanna Martins-Luna
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Ronald Aquino-Ortega
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Hugo Carrillo-Ng
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
- Corresponding authors. School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
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6
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Darvishi F, Ganji A, Khansarinejad B, Sadoogh Abbasian S, Abtahi H. Cloning, expression and purification of antigenic fragments of the Ureaplasma urealyticum UreD protein and its value in serology. IRANIAN JOURNAL OF MICROBIOLOGY 2022; 14:813-819. [PMID: 36721453 PMCID: PMC9867610 DOI: 10.18502/ijm.v14i6.11255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background and Objectives The detection of Ureaplasma urealyticum is usually done through culture. With the change of the smallest effective factor in culture, we face the lack of growth of these bacteria, which is one of the important reasons to find a suitable alternative for the diagnosis of this bacterium. UreD is a protected gene in this bacterium. The aim of this was to evaluate the ability of antigenic regions of UreD protein to bind to patients' serum antibodies. Materials and Methods Antigenic regions of UreD protein were predicted using IEDB software with five different methods: Emini Surface Accessibility Prediction, Kolaskar and Tongaonkar Antigenicity, Chou and Fasman beta turn prediction, Karplus and Schulz flexibility scale, Ellipro-Epitope prediction based upon structural protrusion. Antigenic regions of UreD gene was clonned, expressed and purified. The antigenicity of this recombinant protein against the antibodies in the serum of people infected with U. urealyticum infections was checked in western blotting. Results The results showed that the antigenic regions of the UreD protein was producted and its antigenicity was demonstrated in western blotting. Moreover, all sera from patients infected with U. urealyticum reacted to the recombinant antigen. Conclusion Specimens from people infected with U. urealyticum infection was positive in Western blotting suggesting that UreD protein has antigenic properties. Therefore, it can be used as a suitable candidate for the design of diagnostic kits and U. urealyticum vaccine.
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Affiliation(s)
- Faleh Darvishi
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Ali Ganji
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran,Department of Microbiology and Immunology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Behzad Khansarinejad
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | | | - Hamid Abtahi
- Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran,Corresponding author: Hamid Abtahi, Ph.D, Molecular and Medicine Research Center, Arak University of Medical Sciences, Arak, Iran. Tel: +98-8614173526 Fax: +98-8614173526
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7
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Tang Y, Guo F, Lei A, Xiang J, Liu P, Ten W, Dai G, Li R. GrpE Immunization Protects Against Ureaplasma urealyticum Infection in BALB/C Mice. Front Immunol 2020; 11:1495. [PMID: 32849509 PMCID: PMC7411329 DOI: 10.3389/fimmu.2020.01495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/08/2020] [Indexed: 12/28/2022] Open
Abstract
Nucleotide exchange factor (GrpE), a highly conserved antigen, is rapidly expressed and upregulated when Ureaplasma urealyticum infects a host, which could act as a candidative vaccine if it can induce an anti-U. urealyticum immune reaction. Here, we evaluated the vaccine potential of recombinant GrpE protein adjuvanted by Freund's adjuvant (FA), to protect against U. urealyticum genital tract infection in a mouse model. After booster immunization in mice with FA, the GrpE can induced both humoral and cellular immune response after intramuscular injection into BALB/c mice. A strong humoral immune response was detected in the GrpE-immunized mice characterized by production of high titers of antigen-specific serum IgG (IgG1, IgG2a, and IgG3) antibodies. At the same time, the GrpE also induced a Th1-biased cytokine spectrum with high levels of IFN-γ and TNF-α after re-stimulation with immunogen GrpE in vitro, suggesting that GrpE could trigger the Th1 response when used for vaccination in the presence of FA. Although GrpE vaccination in the presence of a Th1-type adjuvant-induced had readily detectable Th1 responses, there wasn't increase inflammation in response to the infection. More importantly, the robust immune responses in mice after immunization with GrpE showed a significantly reduced U. urealyticum burden in cervical tissues. Histopathological analysis confirmed that tissues of GrpE-immunized BALB/c mice were protected against the pathological effects of U. urealyticum infection. In conclusion, this study preliminarily reveals GrpE protein as a promising new candidate vaccine for preventing U. urealyticum reproductive tract infection.
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Affiliation(s)
- Yanhong Tang
- Chenzhou Hospital Affiliated to University of South China, Hunan, China.,Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, Pathogenic Biology Institute, Medical College, University of South China, Hunan, China.,The First People's Hospital of Chenzhou, Hunan, China
| | - Fangyi Guo
- Chenzhou Hospital Affiliated to University of South China, Hunan, China.,Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, Pathogenic Biology Institute, Medical College, University of South China, Hunan, China.,The First People's Hospital of Chenzhou, Hunan, China
| | - Aihua Lei
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, Pathogenic Biology Institute, Medical College, University of South China, Hunan, China
| | - Jing Xiang
- The First People's Hospital of Chenzhou, Hunan, China
| | - Pengqin Liu
- The First People's Hospital of Huaihua, Hunan, China
| | - Wenyou Ten
- The First People's Hospital of Chenzhou, Hunan, China
| | - Guozhi Dai
- Chenzhou Hospital Affiliated to University of South China, Hunan, China.,Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, Pathogenic Biology Institute, Medical College, University of South China, Hunan, China.,The First People's Hospital of Chenzhou, Hunan, China
| | - Ranhui Li
- Hunan Provincial Key Laboratory for Special Pathogens Prevention and Control, Institute of Pathogenic Biology, Pathogenic Biology Institute, Medical College, University of South China, Hunan, China
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8
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Srinivasan S, Chambers LC, Tapia KA, Hoffman NG, Munch MM, Morgan JL, Domogala D, Sylvan Lowens M, Proll S, Huang ML, Soge OO, Jerome KR, Golden MR, Hughes JP, Fredricks DN, Manhart LE. Urethral Microbiota in Men: Association of Haemophilus influenzae and Mycoplasma penetrans With Nongonococcal Urethritis. Clin Infect Dis 2020; 73:e1684-e1693. [PMID: 32750107 DOI: 10.1093/cid/ciaa1123] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 07/30/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Nongonococcal urethritis (NGU) is a common syndrome with no known etiology in ≤50% of cases. We estimated associations between urethral bacteria and NGU in men who have sex with men (MSM) and men who have sex with women (MSW). METHODS Urine was collected from NGU cases (129 MSM, 121 MSW) and controls (70 MSM, 114 MSW) attending a Seattle STD clinic. Cases had ≥5 polymorphonuclear leukocytes on Gram stain plus symptoms or discharge; controls had <5 PMNs, no symptoms, no discharge. NGU was considered idiopathic when Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Trichomonas vaginalis, adenovirus, and herpes simplex virus were absent. The urethral microbiota was characterized using 16S rRNA gene sequencing. Compositional lasso analysis was conducted to identify associations between bacterial taxa and NGU and to select bacteria for targeted qPCR. RESULTS Among NGU cases, 45.2% were idiopathic. Based on compositional lasso analysis, we selected Haemophilus influenzae (HI) and Mycoplasma penetrans (MP) for targeted qPCR. Compared with 182 men without NGU, the 249 men with NGU were more likely to have HI (14% vs 2%) and MP (21% vs 1%) (both P ≤ .001). In stratified analyses, detection of HI was associated with NGU among MSM (12% vs 3%, P = .036) and MSW (17% vs 1%, P < .001), but MP was associated with NGU only among MSM (13% vs 1%, P = .004). Associations were stronger in men with idiopathic NGU. CONCLUSIONS HI and MP are potential causes of male urethritis. MP was more often detected among MSM than MSW with urethritis.
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Affiliation(s)
- Sujatha Srinivasan
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Laura C Chambers
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Kenneth A Tapia
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Noah G Hoffman
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Matthew M Munch
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Jennifer L Morgan
- Public Health-Seattle & King County HIV/STD Program, Seattle, Washington, USA
| | - Daniel Domogala
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - M Sylvan Lowens
- Public Health-Seattle & King County HIV/STD Program, Seattle, Washington, USA
| | - Sean Proll
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Meei-Li Huang
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Olusegun O Soge
- Department of Global Health, University of Washington, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Keith R Jerome
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Matthew R Golden
- Public Health-Seattle & King County HIV/STD Program, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, Washington, USA
| | - James P Hughes
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - David N Fredricks
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.,Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Lisa E Manhart
- Department of Epidemiology, University of Washington, Seattle, Washington, USA.,Department of Global Health, University of Washington, Seattle, Washington, USA
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9
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Buder S, Schöfer H, Meyer T, Bremer V, Kohl PK, Skaletz-Rorowski A, Brockmeyer N. Bacterial sexually transmitted infections. J Dtsch Dermatol Ges 2020; 17:287-315. [PMID: 30920748 DOI: 10.1111/ddg.13804] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/15/2019] [Indexed: 12/14/2022]
Abstract
Worldwide, the incidence of bacterial sexually transmitted infections (STIs) has shown a significant increase in recent years. In Germany, this circumstance is reflected by a rise in the number of reported syphilis cases. There has also been an uptick in the incidence of non-notifiable STIs such as gonorrhea and infections caused by Chlamydia trachomatis and Mycoplasma genitalium. A key factor in the spread of these infections is their varied clinical presentation, which includes urogenital, pharyngeal and rectal involvement as well as a large number of asymptomatic cases. New real-time multiplex PCR methods allow for rapid and targeted detection of STI pathogens. The most common bacterial STI is urogenital chlamydial infection caused by serovars D-K, which affects young adults in particular. Lymphogranuloma venereum (LGV) caused by L serovars often presents as chlamydial proctitis. In recent years, Neisseria (N.) gonorrhoeae has shown a significant development of resistance, with high-level monoresistance and multiresistance to antibiotics commonly used for treatment. It is therefore imperative that sensitivity testing of N. gonorrhoeae be performed in addition to nucleic acid amplification tests (NAATs). Increased drug resistance has also been observed for Mycoplasma genitalium, a fact that complicates treatment.
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Affiliation(s)
- Susanne Buder
- German Reference Laboratory for Gonococci, Department of Dermatology and Venerology, Vivantes Hospital, Berlin, Germany
| | - Helmut Schöfer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Frankfurt am Main, Germany
| | - Thomas Meyer
- Department of Dermatology, Venereology and Allergology, St. Josef Hospital, Ruhr University, Bochum, Germany
| | - Viviane Bremer
- Division of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Peter K Kohl
- German Reference Laboratory for Gonococci, Department of Dermatology and Venerology, Vivantes Hospital, Berlin, Germany
| | - Adriane Skaletz-Rorowski
- WIR "Walk In Ruhr", competence network HIV/AIDS, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
| | - Norbert Brockmeyer
- WIR "Walk In Ruhr", competence network HIV/AIDS, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr University, Bochum, Germany
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10
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Zhao F, Feng X, Lv P, Xu X, Zhao Z. Real-time PCR assay may be used to verify suspicious test results of Ureaplasmas spp. from the liquid culture method. J Microbiol Methods 2020; 169:105831. [PMID: 31904441 DOI: 10.1016/j.mimet.2020.105831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/01/2020] [Accepted: 01/01/2020] [Indexed: 11/16/2022]
Abstract
Ureaplasma spp. are associated with female genital tract infections and are mainly tested by liquid culture in developing countries. To evaluate the accuracy of liquid culture, 686 vaginal swabs were collected and tested by using the Mycoplasma Culturing, Identification, Enumeration, and Susceptibility (IES) Kit. Then these culture broths were verified using real-time PCR. Among 368 Ureaplasma positive broths, 263 contained Ureaplasma parvum, 30 contained Ureaplasma urealyticum, 57 contained both, and 18 were negative by real-time PCR. In 318 Ureaplasmas negative broths, 78 were found to be Ureaplasma positive by real-time PCR. Using real-time PCR as the reference, the false positive rate of the liquid culture was 7.0%. It has been suggested that the liquid culture positive broth should be inoculated onto solid agar to eliminate false-positives. However, solid culture is rarely used due to low sensitivity and being time consuming. Real-time PCR may be performed to replace solid culture to verify suspicious liquid culture results.
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Affiliation(s)
- Fang Zhao
- Clinical Laboratory, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Xiaojing Feng
- Clinical Laboratory, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Panpan Lv
- Clinical Laboratory, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Xiaoqin Xu
- Clinical Laboratory, Minhang Hospital, Fudan University, Shanghai 201199, China
| | - Zhen Zhao
- Clinical Laboratory, Minhang Hospital, Fudan University, Shanghai 201199, China.
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11
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Buder S, Schöfer H, Meyer T, Bremer V, Kohl PK, Skaletz-Rorowski A, Brockmeyer N. Bakterielle sexuell übertragbare Infektionen. J Dtsch Dermatol Ges 2019; 17:287-317. [PMID: 30920739 DOI: 10.1111/ddg.13804_g] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/15/2019] [Indexed: 01/08/2023]
Abstract
Bakterielle sexuell übertragbare Infektionen (STI) zeigen seit Jahren weltweit eine deutliche Zunahme. In Deutschland wird diese Tatsache durch steigende Meldezahlen für Syphilis bestätigt. Auch für die nicht meldepflichtigen STI Gonorrhoe, Chlamydia-trachomatis- und Mycoplasma-genitalium-Infektionen wird eine zunehmende Inzidenz beobachtet. Entscheidend für die Weiterverbreitung ist, dass das breite klinische Spektrum, welches neben Urogenitalsitus auch Pharynx und Rektum einbezieht, durch eine hohe Zahl asymptomatischer Verläufe ergänzt wird. Neue Real-Time-Multiplex-Diagnostikverfahren ermöglichen einen schnellen und gezielten Nachweis von STI-Erregern. Die häufigste bakterielle STI ist die urogenitale Chlamydieninfektion mit den Serovaren D-K, die besonders bei jungen Erwachsenen auftritt. Einer Chlamydien-Proktitis kann eine Infektion mit L-Serovaren und damit eine Lymphogranuloma-venereum (LGV)-Infektion zugrunde liegen. Neisseria (N.) gonorrhoeae zeigte in den letzten Jahren eine starke Resistenzentwicklung mit Ausbildung von Einzel- und Multiresistenzen gegenüber bisher gängigen Antibiotika. Daher ist für N. gonorrhoeae zusätzlich zum nucleic acid amplification test (NAAT) eine kulturelle Empfindlichkeitstestung durchzuführen. Auch für Mycoplasma genitalium sind Resistenzentwicklungen bekannt, die eine Therapie erschweren können.
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Affiliation(s)
- Susanne Buder
- Konsiliarlabor für Gonokokken, Klinik für Dermatologie und Venerologie, Vivantes-Klinikum Region Süd, Berlin
| | - Helmut Schöfer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Frankfurt, Frankfurt am Main
| | - Thomas Meyer
- Klinik für Dermatologie, Venerologie und Allergologie, St. Josef Hospital, Ruhr-Universität Bochum
| | - Viviane Bremer
- Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin
| | - Peter K Kohl
- Konsiliarlabor für Gonokokken, Klinik für Dermatologie und Venerologie, Vivantes-Klinikum Region Süd, Berlin
| | - Adriane Skaletz-Rorowski
- WIR "Walk In Ruhr", Kompetenznetz HIV/AIDS, Zentrum für Sexuelle Gesundheit und Medizin, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum
| | - Norbert Brockmeyer
- WIR "Walk In Ruhr", Kompetenznetz HIV/AIDS, Zentrum für Sexuelle Gesundheit und Medizin, Klinik für Dermatologie, Venerologie und Allergologie, Ruhr-Universität Bochum
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12
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Otgonjargal B, Batbaatar G, Pfeffer K, Bruhn T, Battogtokh C, Henrich B. A novel mba-based Real time PCR approach for genotyping of Ureaplasma parvum validated in a cohort of Mongolian mothers and offspring. Int J Med Microbiol 2018; 308:865-871. [PMID: 30100523 DOI: 10.1016/j.ijmm.2018.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/03/2018] [Accepted: 08/03/2018] [Indexed: 12/19/2022] Open
Abstract
The role of Ureaplasma parvum in abnormal outcomes of human pregnancy has been discussed controversially in the past. Of the 14 known ureaplasma serovars, the Ureaplasma parvum serovars 1, 3, 6 and 14, have been found to derive from smaller genomes. Serovars 3 and 6 have been described more often to cause complications in pregnancy. To elucidate the serovar distribution in U. parvum positive specimens of 200 Mongolian mothers and their offspring, a new set of mba-targeting PCRs was developed enabling a fast and reliable serovar differentiation by melting peak analysis in a Real time PCR approach or by conventional agarose gel electrophoresis. 92% maternal and 55% neonatal samples were retrospectively genotyped and a dominance of serovars 3 and 6 was detected while serovar 14 was almost absent. Transmission from mothers to newborns was detected in 83% of U. parvum positive neonates exhibiting serovar patterns identical to their mothers. No statistically significant correlation between a distinct serovar and pregnancy outcome could be detected. However, neonatal colonization with serovar 1 declined with progressing pregnancy suggesting that a higher ureaplasma load shortened pregnancy and thereby had a potential negative effect on offspring health. Our novel mba-based Real time PCR approach, which can also be used in conventional PCR and gel electrophoretic analysis, provides the proof of principle that the four U. parvum serovars 1, 3, 6 and 14 can be differentially detected and quantified. A larger scale study outside the scope of this work should be conducted to clarify the impact of serovar 1 on pregnancy outcome.
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Affiliation(s)
- B Otgonjargal
- Department of Microbiology and Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia.
| | - G Batbaatar
- Department of Microbiology and Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia.
| | - K Pfeffer
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University Düsseldorf, University Street, Düsseldorf, 40225, Germany.
| | - T Bruhn
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University Düsseldorf, University Street, Düsseldorf, 40225, Germany.
| | - C Battogtokh
- Department of Microbiology and Immunology, School of Biomedicine, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar, 14210, Mongolia.
| | - B Henrich
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University Düsseldorf, University Street, Düsseldorf, 40225, Germany.
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13
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Chen Y, Wang Z, Liu Y, Wang X, Li Y, Ma P, Gu B, Li H. Recent advances in rapid pathogen detection method based on biosensors. Eur J Clin Microbiol Infect Dis 2018; 37:1021-1037. [DOI: 10.1007/s10096-018-3230-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 03/12/2018] [Indexed: 12/28/2022]
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14
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Effect of Genital Sampling Site on the Detection and Quantification of Ureaplasma Species with Quantitative Polymerase Chain Reaction during Pregnancy. Infect Dis Obstet Gynecol 2017; 2017:6725168. [PMID: 28260847 PMCID: PMC5316449 DOI: 10.1155/2017/6725168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 01/05/2017] [Indexed: 11/18/2022] Open
Abstract
Objective. This study aimed to compare the qualitative and quantitative reproducibility of quantitative PCR (qPCR) for Ureaplasma species (Ureaplasma spp.) throughout pregnancy and according to the genital sampling site. Study Design. Between 5 and 14 weeks of gestation (T1), vaginal, fornix, and two cervical samples were taken. Sampling was repeated during the 2nd (T2) and 3rd (T3) trimester in randomly selected T1 positive and negative women. Qualitative and quantitative reproducibility were evaluated using, respectively, Cohen's kappa (κ) and interclass correlation coefficients (ICC) and repeated measures ANOVA on the log-transformed mean number of DNA copies for each sampling site. Results. During T1, 51/127 women were positive for U. parvum and 8 for U. urealyticum (4 patients for both). Sampling was repeated for 44/55 women at T2 and/or T3; 43 (97.7%) remained positive at the three timepoints. κ ranged between 0.83 and 0.95 and the ICC for cervical samples was 0.86. Conclusions. Colonization by Ureaplasma spp. seems to be very constant during pregnancy and vaginal samples have the highest detection rate.
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15
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Cox C, Watt AP, McKenna JP, Coyle PV. Gardnerella vaginalis and Mollicute detection in rectal swabs from men who have sex with men. Int J STD AIDS 2016; 28:708-714. [PMID: 27542698 DOI: 10.1177/0956462416665060] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The numbers of rectal sexually transmitted infections are on the rise especially among men who have sex with men. Males from men who have sex with men population are encouraged to send a rectal swab to the laboratory for sexually transmitted infection screening at their visit to the Genitourinary Medicine Clinic. In healthy asymptomatic males, the range of pathogens tested is limited therefore other pathogens may be left untreated allowing infections to persist among sexual partners. Molecular techniques have revolutionarised sexually transmitted infection testing enabling the detection of previously difficult-to-culture pathogens in extra-genital sites and have increased the evidence base for their clinical significance. The present study tests 107 rectal swabs from men who have sex with men negative for Chlamydia trachomatis and Neisseria gonorrhoeae against quantitative polymerase chain reaction (qPCR) assays targeting five common sexually transmitted bacteria which include Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum and Gardnerella vaginalis. The pathogenic role of these five bacteria in men who have sex with men is currently unknown. Amongst the 107 patients, a positive qPCR was obtained respectively for G. vaginalis 89 (83.2%); U. urealyticum 26 (24.3%); M. hominis 26 (24.3%); M. genitalium 10 (9.3%) and U. parvum 5 (4.7%). Bacterial loads in single and co-infections were compared for each organism. G. vaginalis and M. hominis loads were significantly ( p = 0.007 and p = 0.005, respectively) higher when co-infecting with at least one other organism. Amongst co-infections, the loads of each organism were assessed to determine possible synergies. G. vaginalis and M. hominis displayed a synergistic pattern ( r = 0.51; p = 0.02) which is in keeping with a similar synergy detected previously in the vagina of women with bacterial vaginosis. This study outlines that potential significant infections are being missed in men who have sex with men population; however, further research is warranted to confirm a pathogenesis in the rectal mucosa before routine screening can be introduced to clinical settings.
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Affiliation(s)
- Ciara Cox
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Northern Ireland and Centre for Infection and Immunity, Queens University Belfast, Belfast, Northern Ireland
| | - Alison P Watt
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Northern Ireland and Centre for Infection and Immunity, Queens University Belfast, Belfast, Northern Ireland
| | - James P McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Northern Ireland and Centre for Infection and Immunity, Queens University Belfast, Belfast, Northern Ireland
| | - Peter V Coyle
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Northern Ireland and Centre for Infection and Immunity, Queens University Belfast, Belfast, Northern Ireland
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16
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Cox C, Saxena N, Watt AP, Gannon C, McKenna JP, Fairley DJ, Sweet D, Shields MD, L Cosby S, Coyle PV. The common vaginal commensal bacterium Ureaplasma parvum is associated with chorioamnionitis in extreme preterm labor. J Matern Fetal Neonatal Med 2016; 29:3646-51. [PMID: 26795404 DOI: 10.3109/14767058.2016.1140734] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the association of vaginal commensal and low-grade pathogenic bacteria including Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, Group B streptococcus (GBS), and Gardnerella vaginalis, in women who delivered preterm at less than 37-week gestation in the presence or absence of inflammation of the chorioamnionitic membranes. METHODS A case control study involving women who delivered before 37-week gestation with and without inflammation of chorioamnionitic membranes. A total of 57 placental samples were histologically examined for polymorphonuclear leukocyte infiltration of placental tissue for evidence of chorioamnionitis, and by type-specific nucleic acid amplification for evidence of infection with one or more of the target bacteria. Demographic data were collected for each mother. RESULTS Among the 57 placental samples, 42.1% had chorioamnionitis and 24.6% delivered in the second trimester of pregnancy; U. parvum, U. urealyticum, G. vaginalis, and GBS were all detected in the study with respective prevalence of 19.3%, 3.5%, 17.5%, and 15.8%; M. genitalium and M. hominis were not detected. U. parvum was significantly associated with chorioamnionitis (p = 0.02; OR 5.0; (95% CI 1.2-21.5) and was more common in women who delivered in the second (35.7%) compared to the third trimester of pregnancy (13.9%). None of the other bacteria were associated with chorioamnionitis or earlier delivery, and all G. vaginalis-positive women delivered in the third trimester of pregnancy (p = 0.04). CONCLUSIONS The detection of U. parvum in placental tissue was significantly associated with acute chorioamnionitis in women presenting in extreme preterm labor.
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Affiliation(s)
- Ciara Cox
- a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .,b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK
| | - Nita Saxena
- c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and
| | - Alison P Watt
- a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK
| | - Caroline Gannon
- d Department of Pathology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK
| | - James P McKenna
- a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK
| | - Derek J Fairley
- a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .,b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK
| | - David Sweet
- c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and
| | - Michael D Shields
- b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .,c Royal Belfast Hospital for Sick Children, Royal Hospitals Group , Belfast , UK , and
| | - Sara L Cosby
- b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK
| | - Peter V Coyle
- a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK
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17
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Cox C, Watt AP, McKenna JP, Coyle PV. Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis. Eur J Clin Microbiol Infect Dis 2016; 35:481-7. [PMID: 26796553 DOI: 10.1007/s10096-015-2564-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 12/21/2015] [Indexed: 11/24/2022]
Abstract
Gardnerella vaginalis plays an important role in bacterial vaginosis (BV,) while the role of genital Mollicutes is less obvious. The diagnosis of BV by use of the current Gram stain Nugent score is also suboptimal for defining the role of Mollicutes that lack a cell wall. Since bacterial load and diversity is an important prerequisite for BV, real-time quantitative polymerase chain reaction (qPCR) assays enable these to be assessed. The purpose of this study was to define the role of genital Mollicutes and potential patterns of synergy with G. vaginalis in women with BV. Vaginal swabs from 130 women categorised by Nugent score as BV (n = 28), intermediate (n = 22) and non-BV (n = 80) were tested against four qPCR TaqMan assays targeting G. vaginalis, Mycoplasma hominis, M. genitalium, Ureaplasma urealyticum and U. parvum. Statistical analyses were used to compare bacterial prevalence and load between the three groups of women. Mycoplasma hominis and G. vaginalis co-infection was significantly more common in BV (60.7 %) compared to intermediate (36.4 %) and non-BV (8.8 %) Nugent scores (p < 0.001). Significantly higher loads of M. hominis (p = 0.001) and G. vaginalis (p < 0.001) were detected in women with BV and the respective loads in M. hominis and G. vaginalis co-infections displayed a significant positive correlation (p < 0.001; r = 0.60). No significant associations were seen with the other Mollicutes. The findings strengthen the evidence of a role for M. hominis in BV and a potential synergy with G. vaginalis. This synergy could be an important trigger of the condition and sexual contact the conduit for the transmission of an otherwise commensal bacterium that could initiate it.
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Affiliation(s)
- C Cox
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK. .,Centre for Infection and Immunity, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - A P Watt
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - J P McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - P V Coyle
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
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18
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EKIEL ALICJA, APTEKORZ MAŁGORZATA, KŁUCIŃSKI PIOTR, SMOLEC DOMINIKA, WIECHUŁA BARBARA, JÓŹWIAK JAROSŁAW, MARTIROSIAN GAYANE. Prevalence of Urogenital Mycoplasmas Among Men with NGU in Upper Silesia, Poland. Preliminary Study. Pol J Microbiol 2016; 65:93-5. [DOI: 10.5604/17331331.1197326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The prevalence of urogenital mycoplasmas in men with NGU in Upper Silesia (Poland) was studied. Mycoplasmas were detected in 36.7% men (Ureaplasma parvum and Mycoplasma genitalium were found in 30% and 16.7% respectively). Urealyticum urealyticum was not detected. We suggest including M. genitalium in the diagnostic scheme for nongonococcal urethritis (NGU).
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Affiliation(s)
- ALICJA EKIEL
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - MAŁGORZATA APTEKORZ
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - PIOTR KŁUCIŃSKI
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - DOMINIKA SMOLEC
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - BARBARA WIECHUŁA
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
| | - JAROSŁAW JÓŹWIAK
- Department of Histology and Embryology Warsaw Medical University , Warsaw , Poland
| | - GAYANE MARTIROSIAN
- Department of Medical Microbiology, School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
- Department of Histology and Embryology Warsaw Medical University , Warsaw , Poland
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19
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Cox C, McKenna JP, Watt AP, Coyle PV. Ureaplasma parvum and Mycoplasma genitalium are found to be significantly associated with microscopy-confirmed urethritis in a routine genitourinary medicine setting. Int J STD AIDS 2015; 27:861-7. [PMID: 26378187 DOI: 10.1177/0956462415597620] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 06/29/2015] [Indexed: 11/17/2022]
Abstract
Inflammation of the urethra defined by an excess of polymorphonuclear leukocytes in the absence of sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae is called non-chlamydial non-gonococcal urethritis (NCNGU). Although Mycoplasma genitalium is now recognised as causing a sexually transmitted infection, the clinical significance of the other Mollicute species is less clear. This study used specific real-time quantitative polymerase chain reaction assays to detect and quantify four Mollicute species, M. genitalium, M. hominis, Ureaplasma urealyticum and U. parvum, in urine specimens from men with and without NCNGU. A total of 165 urine specimens from male patients attending a genitourinary medicine clinic were eligible for the study, with microscopy-confirmed (≥5 polymorphonuclear leukocytes in urethral swab) NCNGU in 75 (45.5%) and non-confirmed NCNGU in 90 (54.5%). Chi-squared statistical analysis indicated a significantly higher prevalence of U. parvum (17.3% vs. 5.6%; p = 0.03) and M. genitalium (12% vs. 0%; p < 0.001) in NCNGU. In a subset analysis, M. genitalium was also significantly (p = 0.03) higher in men who have sex with men (MSM; 13.5%) compared to non-MSM (3.1%). No significant associations were reported for U. urealyticum and M. hominis In conclusion, this study supports a clinically significant role in NGNCU for both U. parvum and M. genitalium.
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Affiliation(s)
- Ciara Cox
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - James P McKenna
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - Alison P Watt
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, UK
| | - Peter V Coyle
- Regional Virus Laboratory, Belfast Health and Social Care Trust, Belfast, UK
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20
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Vancutsem E, Faron G, Foulon W, Naessens A. Genital tract colonization with Ureaplasma spp. and its association with abnormal vaginal flora. J Med Microbiol 2015; 64:654-656. [PMID: 25878169 DOI: 10.1099/jmm.0.000071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ellen Vancutsem
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Gilles Faron
- Department of Obstetrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Walter Foulon
- Department of Obstetrics, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Anne Naessens
- Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Brussels, Belgium
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21
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Sellami H, Znazen A, Sellami A, Mnif H, Louati N, Zarrouk SB, Keskes L, Rebai T, Gdoura R, Hammami A. Molecular detection of Chlamydia trachomatis and other sexually transmitted bacteria in semen of male partners of infertile couples in Tunisia: the effect on semen parameters and spermatozoa apoptosis markers. PLoS One 2014; 9:e98903. [PMID: 25019616 PMCID: PMC4096407 DOI: 10.1371/journal.pone.0098903] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 05/08/2014] [Indexed: 11/19/2022] Open
Abstract
This study was undertaken to determine the prevalence of Chlamydia trachomatis, Mycoplasmas, and Ureaplasmas in semen samples of the male partners of infertile couples and to investigate whether Chlamydia trachomatis could initiate apoptosis in human spermatozoa. A total of 85 males partners of infertile couples undergoing routine semen analysis according to World Health Organization guidelines were included. Specimens were examined for the presence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum and Ureaplasma parvum by Real time PCR (qPCR). Semen specimens were analysed for the appearance of apoptotic markers (sperm DNA fragmentation, activated caspase 3 levels, mitochondrial membrane potential (ΔΨm)) using flow cytometry. C. trachomatis, N. gonorrhoeae, U. urealyticum, M genitalium were detected in semen samples of 13 (15.2%), 5 (5.8%), 5 (5.8%) and 3 (3.5%) male partners of infertile couples, respectively. M. hominis and U. parvum were detected in semen sample of only one patient (1.1%). The semen of infertile men positive for C. trachomatis showed lower mean of semen count and lower rapid progressive motility (category [a]) of spermatozoa compared to uninfected men with statistically significances (p = 0.02 and p = 0.04, respectively). Flow cytometry analyses demonstrated a significant increase of the mean rate of semen with low ΔΨm and caspase 3 activation of infertile men positive for C. trachomatis compared to uninfected men (p = 0.006 and p = 0.001, respectively). DNA fragmentation was also increased in sperm of infertile men positive for C. trachomatis compared to uninfected men but without statistical significances (p = 0.62). Chlamydial infection was associated to loss of ΔΨm and caspase 3activation. Thus, C. trachomatis infection could be incriminated in apoptosis induction of spermatozoa. These effects may explain the negative direct impact of C. trachomatis infection on sperm fertilizing ability.
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Affiliation(s)
- Hanen Sellami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Abir Znazen
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
| | - Afifa Sellami
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hela Mnif
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Nour Louati
- Sfax Regional Center of Blood Transfusion, Sfax, Tunisia
| | - Soumaya Ben Zarrouk
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Leila Keskes
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarek Rebai
- Histology Embryology Research Unit, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Radhouane Gdoura
- Unit Research of Toxicology-Microbiology Environmental and Health, Sciences Faculty of Sfax, University of Sfax, Sfax, Tunisia
| | - Adnene Hammami
- Department of Microbiology and research laboratory “Microorganismes et Pathologies Humaines”, Habib Bourguiba University Hospital of Sfax, Sfax, Tunisia
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Liu L, Cao G, Zhao Z, Zhao F, Huang Y. High bacterial loads of Ureaplasma may be associated with non-specific cervicitis. ACTA ACUST UNITED AC 2014; 46:637-41. [PMID: 25017795 DOI: 10.3109/00365548.2014.922696] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Ureaplasma parvum and Ureaplasma urealyticum are commonly found in the cervix of women with non-chlamydial and non-gonococcal cervicitis or non-specific cervicitis (NSC). However their contribution to the aetiology of NSC is controversial. METHODS U. parvum and U. urealyticum were identified and quantified in cervical swabs collected from 155 women with NSC and 312 controls without NSC, using real-time PCR. The relative bacterial quantification was then calculated using the Ureaplasma copy number divided by the number of host cells; this is important for the correction of bias linked to the number of cells harvested in different swabs. RESULTS Ureaplasma was detected in 58.7% (91/155) of NSC patients: U. parvum in 30.3%, U. urealyticum in 16.1%, and mixed infection in 12.3%. It was also detected in 54.5% (170/312) of controls: U. parvum in 33.0%, U. urealyticum in 11.5%, and mixed infection in 9.9%. There were no significant differences for U. parvum, U. urealyticum, or mixed infection between the 2 groups (p > 0.05). However, both biovars were present at higher concentrations in NSC patients than in controls (p < 0.05). Using >10 copies/1000 cells as a reference, the positive rate of U. parvum in NSC patients was 16.1%, significantly higher than that in controls at 5.1% (relative risk 3.145, p < 0.05); positive rates of U. urealyticum in NSC patients and controls were 28.4% and 8.7%, respectively, with a statistically significant difference (relative risk 3.131, p < 0.05). CONCLUSIONS Ureaplasma can adhere to host cells, colonize, internalize, and subsequently produce pathological lesions. A high density of Ureaplasma in the cervix may be associated with the aetiology of NSC.
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Affiliation(s)
- Lu Liu
- From the Department of Laboratory Medicine, Obstetrics and Gynaecology Hospital of Fudan University , Shanghai , China
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23
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Urogenital mycoplasmas and human papilloma virus in hemodialysed women. ScientificWorldJournal 2013; 2013:659204. [PMID: 24363622 PMCID: PMC3865691 DOI: 10.1155/2013/659204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 10/28/2013] [Indexed: 11/18/2022] Open
Abstract
Bacterial infections, especially endogenous, are the frequent complications among hemodialyzed and renal transplant patients. In this study we assumed the prevalence of urogenital mycoplasmas and HPV among hemodialysed women. We examined 32 hemodialysed women aged 20–48 (mean 35.6 ± 8.23) and 100 healthy controls of the same ages. Two swabs were collected for detection of mycoplasmas and HPV. Culture of Ureaplasma spp. and M. hominis was performed using Mycoplasma IST2 (bioMérieux, France), Identificaton of U. parvum and U. urealyticum was performed by Kong. Primers described by Jensen were used for M. genitalium. For detection of high-risk HPV types Amplicor HPV (Roche Molecular System, CA) was used. Prevalence of urogenital mycoplasmas in the hemodialysed women (53.1%) was significantly higher (P = 0.0059), compared with controls (25%). In both groups, U. parvum was the most frequently isolated. Cooccurrence of urogenital mycoplasmas was shown in 75% of the HPV-positive hemodialysed women and in 30.4% of HPV-positive controls (P = 0.0461). Cooccurrence of urogenital mycoplasmas with HPV was significantly higher in hemodialysed women. The need to take into account these microorganisms in routine diagnostic, especially for hemodialysed patients, was demonstrated. Further studies to demonstrate the role of this cooccurrence in etiopathogenesis of infection in hemodialysed patients are required.
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Abstract
In recent years, quantitative real-time PCR tests have been extensively developed in clinical microbiology laboratories for routine diagnosis of infectious diseases, particularly bacterial diseases. This molecular tool is well-suited for the rapid detection of bacteria directly in clinical specimens, allowing early, sensitive and specific laboratory confirmation of related diseases. It is particularly suitable for the diagnosis of infections caused by fastidious growth species, and the number of these pathogens has increased recently. This method also allows a rapid assessment of the presence of antibiotic resistance genes or gene mutations. Although this genetic approach is not always predictive of phenotypic resistances, in specific situations it may help to optimize the therapeutic management of patients. Finally, an approach combining the detection of pathogens, their mechanisms of antibiotic resistance, their virulence factors and bacterial load in clinical samples could lead to profound changes in the care of these infected patients.
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Affiliation(s)
- Max Maurin
- Laboratoire de Bactériologie, Département des Agents Infectieux, Institut de Biologie et Pathologie, CHU de Grenoble, Université Joseph Fourier Grenoble 1, France.
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Rapid PCR Detection of Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. INTERNATIONAL JOURNAL OF BACTERIOLOGY 2013; 2013:168742. [PMID: 26904723 PMCID: PMC4745450 DOI: 10.1155/2013/168742] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 01/30/2013] [Indexed: 12/02/2022]
Abstract
Objective. We compared laboratory developed real-time PCR assays for detection of Mycoplasma hominis and for detection and differentiation of Ureaplasma urealyticum and parvum to culture using genitourinary specimens submitted for M. hominis and Ureaplasma culture. Methods. 283 genitourinary specimens received in the clinical bacteriology laboratory for M. hominis and Ureaplasma species culture were evaluated. Nucleic acids were extracted using the Total Nucleic Acid Kit on the MagNA Pure 2.0. 5 μL of the extracts were combined with 15 μL of each of the two master mixes. Assays were performed on the LightCycler 480 II system. Culture was performed using routine methods. Results.
M. hominis PCR detected 38/42 M. hominis culture-positive specimens, as well as 2 that were culture negative (sensitivity, 90.5%; specificity, 99.2%). Ureaplasma PCR detected 139/144 Ureaplasma culture-positive specimens, as well as 9 that were culture negative (sensitivity, 96.5%; specificity, 93.6%). Of the specimens that tested positive for Ureaplasma species, U. urealyticum alone was detected in 33, U. parvum alone in 109, and both in 6. Conclusion. The described PCR assays are rapid alternatives to culture for detection of M. hominis and Ureaplasma species, and, unlike culture, the Ureaplasma assay easily distinguishes U. urealyticum from parvum.
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