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Tam PCK, Alexander BD, Lee MJ, Hardie RG, Reynolds JM, Haney JC, Waites KB, Perfect JR, Baker AW. Donor-derived Mycoplasma and Ureaplasma infections in lung transplant recipients: A prospective study of donor and recipient respiratory tract screening and recipient outcomes. Am J Transplant 2024:S1600-6135(24)00436-2. [PMID: 39025302 DOI: 10.1016/j.ajt.2024.07.013] [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: 12/13/2023] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 07/20/2024]
Abstract
Mycoplasma hominis and Ureaplasma species are urogenital mollicutes that can cause serious donor-derived infections in lung transplant recipients. Best practices for mollicute screening remain unknown. We conducted a single-center prospective study analyzing lung transplants performed from October 5, 2020, to September 25, 2021, whereby donor and recipient bronchoalveolar lavage (BAL) samples obtained at time of transplant underwent mollicute screening via culture and polymerase chain reaction (PCR). Of 115 total lung transplants performed, 99 (86%) donors underwent combined mollicute BAL culture and PCR testing. The study cohort included these 99 donors and their matched recipients. In total, 18 (18%) of 99 donors screened positive via culture or PCR. Among recipients, 92 (93%) of 99 had perioperative BAL screening performed, and only 3 (3%) had positive results. After transplant, 9 (9%) recipients developed mollicute infection. Sensitivity of donor screening in predicting recipient mollicute infection was 67% (6/9) via culture and 56% (5/9) via PCR. Positive predictive value for donor culture was 75% (6/8), compared with 33% (5/15) for PCR. Donor screening via culture predicted all serious recipient mollicute infections and had better positive predictive value than PCR; however, neither screening test predicted all mollicute infections. Independent of screening results, clinicians should remain suspicious for posttransplant mollicute infection.
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Affiliation(s)
- Patrick C K Tam
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Mark J Lee
- Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Rochelle G Hardie
- Division of Infectious Diseases, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - John M Reynolds
- Department of Medicine, Transplant Pulmonology, Duke University School of Medicine, Durham, North Carolina, USA
| | - John C Haney
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Ken B Waites
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - John R Perfect
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arthur W Baker
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA.
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Tam PCK, Hardie R, Alexander BD, Yarrington ME, Lee MJ, Polage CR, Messina JA, Maziarz EK, Saullo JL, Miller R, Wolfe CR, Arif S, Reynolds JM, Haney JC, Perfect JR, Baker AW. Risk factors, management, and clinical outcomes of invasive Mycoplasma and Ureaplasma infections after lung transplantation. Am J Transplant 2024; 24:641-652. [PMID: 37657654 PMCID: PMC10902193 DOI: 10.1016/j.ajt.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 09/03/2023]
Abstract
Mollicute infections, caused by Mycoplasma and Ureaplasma species, are serious complications after lung transplantation; however, understanding of the epidemiology and outcomes of these infections remains limited. We conducted a single-center retrospective study of 1156 consecutive lung transplants performed from 2010-2019. We used log-binomial regression to identify risk factors for infection and analyzed clinical management and outcomes. In total, 27 (2.3%) recipients developed mollicute infection. Donor characteristics independently associated with recipient infection were age ≤40 years (prevalence rate ratio [PRR] 2.6, 95% CI 1.0-6.9), White race (PRR 3.1, 95% CI 1.1-8.8), and purulent secretions on donor bronchoscopy (PRR 2.3, 95% CI 1.1-5.0). Median time to diagnosis was 16 days posttransplant (IQR: 11-26 days). Mollicute-infected recipients were significantly more likely to require prolonged ventilatory support (66.7% vs 21.4%), undergo dialysis (44.4% vs 6.3%), and remain hospitalized ≥30 days (70.4% vs 27.4%) after transplant. One-year posttransplant mortality in mollicute-infected recipients was 12/27 (44%), compared to 148/1129 (13%) in those without infection (P <.0001). Hyperammonemia syndrome occurred in 5/27 (19%) mollicute-infected recipients, of whom 3 (60%) died within 10 weeks posttransplant. This study highlights the morbidity and mortality associated with mollicute infection after lung transplantation and the need for better screening and management protocols.
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Affiliation(s)
- Patrick C K Tam
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.
| | - Rochelle Hardie
- Division of Infectious Diseases, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Barbara D Alexander
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Michael E Yarrington
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA
| | - Mark J Lee
- Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Chris R Polage
- Duke University Clinical Microbiology Laboratory, Durham, North Carolina, USA
| | - Julia A Messina
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Eileen K Maziarz
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer L Saullo
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rachel Miller
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Cameron R Wolfe
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Sana Arif
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - John M Reynolds
- Department of Medicine, Transplant Pulmonology, Duke University School of Medicine, Durham, North Carolina, USA
| | - John C Haney
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - John R Perfect
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA
| | - Arthur W Baker
- Division of Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA; Duke Center for Antimicrobial Stewardship and Infection Prevention, Durham, North Carolina, USA.
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Hoxha I, Lesiak-Markowicz I, Walochnik J, Stary A, Fürnkranz U. The Prevalence of Genital Mycoplasmas and Coinfection with Trichomonas vaginalis in Female Patients in Vienna, Austria. Microorganisms 2023; 11:933. [PMID: 37110356 PMCID: PMC10146908 DOI: 10.3390/microorganisms11040933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Trichomonas vaginalis causes trichomoniasis, the most recurrent sexually transmitted infection (STI) worldwide. Genital mycoplasmas, not considered STI agents, are frequently isolated from the female genital tract. A symbiosis between Mycoplasma species and T. vaginalis has been described. The aim of this study was to conduct molecular-based analyses of vaginal specimens, thus assessing the prevalence of non-STI Mycoplasma infections. In total, 582 samples from female patients and an additional 20 T. vaginalis isolates were analyzed by PCR using Mycoplasma specific 16S rRNA primers, and the obtained PCR products were sequenced. Mycoplasma species were detected in 28.2% of the collected vaginal samples. Mycoplasma hominis was found in 21.5% of the specimens, Ureaplasma species were found in 7.5% of the samples. The molecular data of the newly described species, CandidatusMycoplasma girerdii, were obtained for the first time in Austria, in a sample also positive for T. vaginalis. Analyses of the cultivated T. vaginalis strains confirmed the presence of M. hominis in two out of 20 samples. A comparably high prevalence of genital mycoplasmas was revealed through advanced diagnostic assays, with M. hominis and U. parvum being the most prevalent species. The previously described symbiotic relationship between M. hominis and T. vaginalis was confirmed.
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Affiliation(s)
- Ina Hoxha
- Institute for Specific Prophylaxis and Tropical Medicine (ISPTM), Centre for Pathophysiology, Infectiology and Immunology Medical University of Vienna, 1090 Vienna, Austria
| | - Iwona Lesiak-Markowicz
- Institute for Specific Prophylaxis and Tropical Medicine (ISPTM), Centre for Pathophysiology, Infectiology and Immunology Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Walochnik
- Institute for Specific Prophylaxis and Tropical Medicine (ISPTM), Centre for Pathophysiology, Infectiology and Immunology Medical University of Vienna, 1090 Vienna, Austria
| | - Angelika Stary
- Pilzambulatorium Schlösselgasse, Outpatients Centre for the Diagnosis of Venero-Dermatological Diseases, 1210 Vienna, Austria
| | - Ursula Fürnkranz
- Institute for Specific Prophylaxis and Tropical Medicine (ISPTM), Centre for Pathophysiology, Infectiology and Immunology Medical University of Vienna, 1090 Vienna, Austria
- Pilzambulatorium Schlösselgasse, Outpatients Centre for the Diagnosis of Venero-Dermatological Diseases, 1210 Vienna, Austria
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Jensen JS. To Test or Not to Test for Mycoplasma hominis and Ureaplasmas: That's (Not) the Question. Clin Infect Dis 2021; 73:669-671. [PMID: 33493329 DOI: 10.1093/cid/ciab065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- Jørgen Skov Jensen
- Unit for Reproductive Microbiology, Division of Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark
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Are Urogenital Symptoms Caused by Sexually Transmitted Infections and Colonizing Bacteria? J Low Genit Tract Dis 2021; 25:232-235. [PMID: 33883524 DOI: 10.1097/lgt.0000000000000608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of sexually transmitted infections (STIs) and colonizing bacteria in relation to urogenital symptoms. MATERIALS AND METHODS In this cross-sectional study, patients visiting the STI clinic at Umeå University Hospital were asked for symptoms and condom use. Samples from 759 patients (465 male and 294 female) were analyzed for 4 STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium) and 3 colonizing bacteria (Mycoplasma hominis, Ureaplasma parvum, and Ureaplasma urealyticum). RESULTS Chlamydia trachomatis prevalence was 11% among women and 9.5% among men. Neisseria gonorrhoeae prevalence was 0.7% among women and 0.9% among men. Mycoplasma genitalium was found in 11% and 5.6% of women and men, respectively. Asymptomatic men and women had similar distribution patterns of microorganisms as those with urogenital symptoms, with the exceptions of Neisseria gonorrhoeae- and Mycoplasma genitalium-infected men who declared symptoms more frequently. Of 158 men with urogenital symptoms, 55% were test-negative. Of 129 women with urogenital symptoms, 12% were test-negative. CONCLUSIONS This study reveals a complex picture, where a large number of multi-positive tests made it complicated to correlate urogenital symptoms with microorganisms. A high number of test-negative but symptomatic patients indicate a need of searching for additional pathogens.
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Adams M, Bouzigard R, Al-Obaidi M, Zangeneh TT. Perinephric abscess in a renal transplant recipient due to Mycoplasma hominis: Case report and review of the literature. Transpl Infect Dis 2020; 22:e13308. [PMID: 32378787 DOI: 10.1111/tid.13308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/06/2020] [Accepted: 04/25/2020] [Indexed: 11/26/2022]
Abstract
A 42-year-old man presented with nausea, malaise, and pain at his renal graft site 4 months following deceased donor renal transplant. His transplantation had been complicated by urinary leak with delayed wound closure requiring ureteral revision with biologic mesh placement. The initial evaluation in the hospital revealed urinalysis with significant pyuria as well as abdominal CT imaging concerning for abscess formation anterior to the grafted kidney. Interventional radiology (IR) guided drainage of this abscess yielded growth of Enterococcus faecalis treated with intravenous ampicillin/sulbactam. He continued to have pain at his graft site and repeat imaging revealed a persistent abscess despite prolonged antimicrobial therapy. Urine cultures isolated Mycoplasma species. A repeat aspirate of abscess fluid collected and Mycoplasma hominis was identified by molecular test. Patient's symptoms abated and his abscess completely resolved on repeat imaging after completing a course of oral moxifloxacin and doxycycline. His immunosuppression did not require adjustment and the renal graft continued to function well following this therapy. Mycoplasma and Ureaplasma should be considered as a potential etiology for perinephric abscess in renal transplant recipients.
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Affiliation(s)
- Matthew Adams
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Rory Bouzigard
- Department of Medicine, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Mohanad Al-Obaidi
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
| | - Tirdad T Zangeneh
- Division of Infectious Diseases, Banner University Medical Center, University of Arizona, Tucson, Arizona, USA
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Betschart C, Dedes I, Scheiner D. [Recurrent Urogynecological Infections]. PRAXIS 2020; 109:79-85. [PMID: 32019451 DOI: 10.1024/1661-8157/a003368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Recurrent Urogynecological Infections Abstract. Changes in the urogenital microbiome of the bladder, urethra, vagina and cervix can cause recurrent infections. We distinguish between obligate and facultative pathogens. In the case of facultative pathogens, treatment with antibiotic, antiviral or antifungal drugs should only be considered in cases with attributable symptoms. Sexually transmitted diseases (STD) manifest either urogenitally alone or in association with an ascending infection of the adnexa as a pelvic inflammatory disease. STD may be asymptomatic, as in cases of chlamydia, or may cause a high burden of symptoms, impairment of quality of life or infertility. The aim of this minireview is to give an overview of the pathogenicity of the different germs and their treatment.
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Diaz Pallares C, Griener T, Vaughan S. Ureaplasma urealyticum disseminated multifocal abscesses in an immunocompromised adult patient: a case report. BMC Infect Dis 2020; 20:47. [PMID: 31941460 PMCID: PMC6964043 DOI: 10.1186/s12879-020-4771-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/07/2020] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Ureaplasma urealyticum is a fastidious bacteria which lacks a cell wall. Extragenital infections are rare in immunocompetent adults. There are few literature reports of perinephric abscess. We present a case of non-resolving multifocal "culture-negative" abscesses in a hypogammaglobulinemic adult female due to U. urealyticum. CASE PRESENTATION 66-year-old female with a one-week history of fever, malaise and new right hip and leg pain. Past medical history was notable for chronic pancytopenia secondary to in remission B cell follicular lymphoma, ESRD on intermittent hemodialysis with bilateral nephrostomy tubes and Crohn's. CT abdomen/pelvis revealed a small left perinephric hematoma and proximal right femur fluid collection. Persistent right thigh pain led to additional ultrasound with anterior thigh collection and CT revealed an irregular rim-enhancing fluid collection in the left posterior pararenal space. Antimicrobial therapy included ertapenem and vancomycin followed by meropenem, trimethoprim-sulfamethoxazole, daptomycin and metronidazole in setting of persistent culture-negative results and clinical deterioration. Following detection of U. urealyticum by 16S rDNA PCR in both left pararenal and right trochanteric bursa abscesses doxycycline was started. Despite this, the patient died four days later. CONCLUSIONS Disseminated infection by U. urealyticum has been documented in immunocompromised adult patients with few reports of perinephric abscess. We propose that ascending genitourinary route led to perinephric abscess. The multiple disseminated fluid collections make it highly suspicious for hematogenous spread given the lack of radiographic enhancement to suggest contiguous spread. Diagnosis and treatment of U. urealyticum-disseminated infection is extremely challenging as culture is laborious and not routinely performed. Furthermore, the lack of cell wall renders beta-lactams and vancomycin ineffective and therefore requirement for "atypical" coverage. Early diagnosis and treatment are key to prevent further complications and death.
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Affiliation(s)
- Carolina Diaz Pallares
- University of Calgary Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada.
| | - Thomas Griener
- University of Calgary Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Stephen Vaughan
- University of Calgary Cumming School of Medicine, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
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Bondy L, Hynes B, Christner R. An unusual cervical mass. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2019; 4:113-115. [PMID: 36337738 PMCID: PMC9602954 DOI: 10.3138/jammi.2018-0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 01/03/2019] [Indexed: 06/16/2023]
Abstract
Head and neck masses are usually indicative of infectious, neoplastic, or congenital entities. Most head and neck masses are related to local or regional disease, although systemic neoplastic disease can present in the cervical area. We present an interesting case report of a young woman with a neck mass caused by an organism most commonly associated with sexually transmitted infections, and not with the more common causes of cervical head and neck masses.
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Affiliation(s)
- Lise Bondy
- Division of Infectious Diseases, St. Joseph’s Hospital, London, Ontario, Canada
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Silva J, Cerqueira F, Teixeira AL, Bicho MC, Campainha R, Amorim J, Medeiros R. Genital mycoplasmas and ureaplasmas in cervicovaginal self-collected samples of reproductive-age women: prevalence and risk factors. Int J STD AIDS 2018; 29:999-1006. [DOI: 10.1177/0956462418774209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to characterise the prevalence and risk factors associated with genital mycoplasmas ( Mycoplasma hominis [MH], M. genitalium [MG]) and ureaplasmas ( Ureaplasma urealyticum [UU], U. parvum [UP]) in Portuguese women of reproductive age. The cross-sectional study included 612 cervicovaginal self-collected samples from women aged 15–44 years, tested for MH, MG, UU, UP by polymerase chain reaction. Y chromosome (Yc) DNA was detected as a biomarker of recent unprotected sexual intercourse. The prevalences of UU, UP, MH and MG were 28.4% (95% confidence interval [CI] 25.0–32.1), 22.4% (95% CI 19.3–25.9), 8.5% (95% CI 6.5–11.0) and 0.8% (95% CI 0.4–1.9), respectively. Overall, women aged 20–29 years (odds ratio [OR] 1.78; P = 0.010) and the presence of Yc-DNA (OR 2.33; P = 0.038) were associated with an increased risk of UU. Lifetime number of sexual partners was a predictor of UU, UP and MH (OR 2.46; P < 0.001, OR 2.78; P < 0.001 and OR 1.55; P < 0.001, respectively, for more than one versus one partner). The prevalence of MG was low, while UU, UP and MH were common in Portuguese women of reproductive age. The presence of UU, UP and MH was associated with sexual activity (number of sexual partners), although the consequences of its prevalence are not fully understood and should be further investigated.
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Affiliation(s)
- Jani Silva
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centre, Portuguese Institute of Oncology of Porto (IPO-Porto), Porto, Portugal
- FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal
- LPCC, Research Department – Portuguese League Against Cancer (LPPC – NRN), Porto, Portugal
| | - Fátima Cerqueira
- FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal
| | - Ana Luísa Teixeira
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centre, Portuguese Institute of Oncology of Porto (IPO-Porto), Porto, Portugal
| | - Maria Clara Bicho
- IMM, Instituto de Medicina Molecular, Faculty of Medicine of Lisboa, Lisboa, Portugal
- British Hospital Lisboa, Lisboa, Portugal
| | | | | | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, IPO-Porto Research Centre, Portuguese Institute of Oncology of Porto (IPO-Porto), Porto, Portugal
- FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal
- LPCC, Research Department – Portuguese League Against Cancer (LPPC – NRN), Porto, Portugal
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Choi JB, Lee SJ, Lee MK, Lee SJ, Park DC, Kim HY, Lee DS, Choe HS. Prevalence and Antimicrobial Susceptibility of Ureaplasma spp. and Mycoplasma hominis in Asymptomatic Individuals in Korea. Microb Drug Resist 2018; 24:1391-1396. [PMID: 29708840 DOI: 10.1089/mdr.2017.0431] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study investigated the prevalence and antibiotic resistance of Ureaplasma spp. and Mycoplasma hominis isolated from asymptomatic individuals in Korea. Endocervical swabs from women and urine from men, from a total of 5,781 asymptomatic individuals, were analyzed using a Mycoplasma IST2 Kit. Of the 4,825 specimens tested from females, 486 (10.1%) were positive culture. In these positive specimens, 437 (9.1%) were positive only for Ureaplasma spp., 17 (0.4%) were positive only for M. hominis, and 32 (0.7%) were positive for both Ureaplasma spp. and M. hominis. In males, of the 956 tested specimens, only 4 (0.42%) were positive for Ureaplasma spp. and no M. hominis colonization was identified. In antimicrobial susceptibility tests, more than 93.2% of both M. hominis and Ureaplasma spp. was susceptible to tetracycline, doxycycline, josamycin, and pristinamycin. However, M. hominis isolates were found to be highly resistant to erythromycin, azithromycin, and clarithromycin (82.4%, 70.6%, and 76.5%, respectively). Ofloxacin and ciprofloxacin, which have recently exhibited increasing resistance rates, showed rates of 17.7% and 35.3%, respectively, in M. hominis, and 50.6% and 27.4%, respectively, in Ureaplasma spp. In conclusion, accurate antimicrobial susceptibility tests of the genital mycoplasmas should be conducted for each case to select the appropriate antibiotics. Fluoroquinolone-based drugs should be avoided in the initial treatment of urogenital mycoplasmas because of the increasing rate of resistance to quinolones, although the susceptibility to tetracycline remains high in Korea.
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Affiliation(s)
- Jin Bong Choi
- 1 Department of Urology, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea , Bucheon, Republic of Korea
| | - Seung-Ju Lee
- 2 Department of Urology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
| | - Mi-Kyung Lee
- 3 Department of Laboratory Medicine, Chung-Ang University College of Medicine , Seoul, Republic of Korea
| | - Sung-Jong Lee
- 4 Department of Obstetrics and Gynecology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
| | - Dong Choon Park
- 4 Department of Obstetrics and Gynecology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
| | - Hee Youn Kim
- 2 Department of Urology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
| | - Dong Sup Lee
- 2 Department of Urology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
| | - Hyun-Sop Choe
- 2 Department of Urology, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea , Suwon, Republic of Korea
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12
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Maraki S, Mavromanolaki VE, Nioti E, Stafylaki D, Minadakis G. Prevalence and antimicrobial susceptibility of Ureaplasma species and Mycoplasma hominis in Greek female outpatients, 2012-2016. J Chemother 2017; 30:140-144. [PMID: 29182058 DOI: 10.1080/1120009x.2017.1404287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mycoplasma hominis and Ureaplasma species are opportunistic pathogens associated with urogenital infections, complications during pregnancy and postpartum infections. Appropriate empirical antimicrobial treatment is necessary to achieve an optimal therapeutic outcome. This study evaluated the prevalence and the antimicrobial susceptibility of Mycoplasma hominis and Ureaplasma spp. isolated from 1,008 endocervical samples of outpatients in Crete, Greece, during a five-year period (2012-2016), using the commercially available Mycoview kit (Zeakon diagnostics, France). Ureaplasma spp. was isolated from 116 patients (11.5%), M. hominis from 6 (0.6%), while coinfection with both mycoplasmas was demonstrated in 17 (1.7%). All Ureaplasma strains were susceptible to josamycin and doxycycline. Doxycycline, minocycline and ofloxacin were the most potent antibiotics against M. hominis. Docycycline was proved the most active and is still the drug of choice for the treatment of genital mycoplasma infections. Local surveillance to monitor changes in antimicrobial susceptibilities is necessary to guide treatment strategies.
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Affiliation(s)
- Sofia Maraki
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | | | - Eleni Nioti
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | - Dimitra Stafylaki
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
| | - George Minadakis
- a Department of Clinical Microbiology and Microbial Pathogenesis , University Hospital of Heraklion , Heraklion , Greece
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13
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Affiliation(s)
- Søren A Ladefoged
- Department of Medical Microbiology and Immunology University of Aarhus, Denmark.,Department of Clinical Biochemistry University Hospital of Aarhus, Denmark
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14
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Taylor-Robinson D. Mollicutes in vaginal microbiology: Mycoplasma hominis, Ureaplasma urealyticum, Ureaplasma parvum and Mycoplasma genitalium. Res Microbiol 2017; 168:875-881. [PMID: 28263902 DOI: 10.1016/j.resmic.2017.02.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 11/19/2022]
Abstract
Mycoplasma hominis was isolated in 1937 from the human genital tract, followed 17 years later by Ureaplasma urealyticum and 27 years after that by Mycoplasma genitalium. The first two proved relatively easy to culture but the latter required a polymerase chain reaction assay for further studies. In sexually mature women, M. hominis may be found in the vagina/cervix of about 20-50%, ureaplasmas in 40-80% and M. genitalium in 0-5%. Some heterogeneity has been found among strains of all these species, sufficient to divide ureaplasmas into two species, namely U. urealyticum and Ureaplasma parvum. Studies in female mice show that sex hormones have a profound influence on colonization, multiplication and persistence of mycoplasmas/ureaplasmas in the genital tract and provoke the question, unanswered, of whether there is such an effect in the human tract. In women, there is no evidence that any of the mycoplasmal species stimulate an inflammatory vaginitis. M. hominis organisms increase hugely in number in the case of bacterial vaginosis (BV), and to a lesser extent so do ureaplasmas. Despite this, they have not been incriminated as a sole cause of BV. Evidence for the involvement of M. genitalium remains controversial. The strong association of BV with preterm birth raises the possibility that the genital mycoplasmas might play a part, but assurance that any do will be difficult to obtain. Detailed examination of the vaginal microbiome has not yet provided an answer.
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Affiliation(s)
- David Taylor-Robinson
- Section of Infectious Diseases, Wright-Fleming Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
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Nishiumi F, Ogawa M, Nakura Y, Hamada Y, Nakayama M, Mitobe J, Hiraide A, Sakai N, Takeuchi M, Yoshimori T, Yanagihara I. Intracellular fate of Ureaplasma parvum entrapped by host cellular autophagy. Microbiologyopen 2017; 6. [PMID: 28088841 PMCID: PMC5458467 DOI: 10.1002/mbo3.441] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 11/29/2016] [Accepted: 12/12/2016] [Indexed: 12/22/2022] Open
Abstract
Genital mycoplasmas, including Ureaplasma spp., are among the smallest human pathogenic bacteria and are associated with preterm birth. Electron microscopic observation of U. parvum showed that these prokaryotes have a regular, spherical shape with a mean diameter of 146 nm. U. parvum was internalized into HeLa cells by clathrin‐mediated endocytosis and survived for at least 14 days around the perinuclear region. Intracellular U. parvum reached endosomes in HeLa cells labeled with EEA1, Rab7, and LAMP‐1 within 1 to 3 hr. After 3 hr of infection, U. parvum induced the cytosolic accumulation of galectin‐3 and was subsequently entrapped by the autophagy marker LC3. However, when using atg7−/−MEF cells, autophagy was inadequate for the complete elimination of U. parvum in HeLa cells. U. parvum also colocalized with the recycling endosome marker Rab11. Furthermore, the exosomes purified from infected HeLa cell culture medium included U. parvum. In these purified exosomes ureaplasma lipoprotein multiple banded antigen, host cellular annexin A2, CD9, and CD63 were detected. This research has successfully shown that Ureaplasma spp. utilize the host cellular membrane compartments possibly to evade the host immune system.
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Affiliation(s)
- Fumiko Nishiumi
- Department of Developmental Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Michinaga Ogawa
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yukiko Nakura
- Department of Developmental Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Yusuke Hamada
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Nakayama
- Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Jiro Mitobe
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Atsushi Hiraide
- Critical Care Medical Center, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Norio Sakai
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.,Division of Health Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Makoto Takeuchi
- Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Tamotsu Yoshimori
- Department of Genetics, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Itaru Yanagihara
- Department of Developmental Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
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16
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Xu C, Zhang N, Huo Q, Chen M, Wang R, Liu Z, Li X, Liu Y, Bao H. Polymerase chain reaction-hybridization method using urease gene sequences for high-throughput Ureaplasma urealyticum and Ureaplasma parvum detection and differentiation. Anal Biochem 2016; 499:57-62. [PMID: 26853743 DOI: 10.1016/j.ab.2016.01.018] [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: 10/21/2015] [Revised: 01/24/2016] [Accepted: 01/25/2016] [Indexed: 12/09/2022]
Abstract
In this article, we discuss the polymerase chain reaction (PCR)-hybridization assay that we developed for high-throughput simultaneous detection and differentiation of Ureaplasma urealyticum and Ureaplasma parvum using one set of primers and two specific DNA probes based on urease gene nucleotide sequence differences. First, U. urealyticum and U. parvum DNA samples were specifically amplified using one set of biotin-labeled primers. Furthermore, amine-modified DNA probes, which can specifically react with U. urealyticum or U. parvum DNA, were covalently immobilized to a DNA-BIND plate surface. The plate was then incubated with the PCR products to facilitate sequence-specific DNA binding. Horseradish peroxidase-streptavidin conjugation and a colorimetric assay were used. Based on the results, the PCR-hybridization assay we developed can specifically differentiate U. urealyticum and U. parvum with high sensitivity (95%) compared with cultivation (72.5%). Hence, this study demonstrates a new method for high-throughput simultaneous differentiation and detection of U. urealyticum and U. parvum with high sensitivity. Based on these observations, the PCR-hybridization assay developed in this study is ideal for detecting and discriminating U. urealyticum and U. parvum in clinical applications.
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Affiliation(s)
- Chen Xu
- Fourth Central Hospital, Tianjin 300203, China
| | - Nan Zhang
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Qianyu Huo
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Minghui Chen
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Rengfeng Wang
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Zhili Liu
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Xue Li
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Yunde Liu
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China
| | - Huijing Bao
- School of Laboratory Science, Tianjin Medical University, Tianjin 300203, China.
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Complete Genome Sequence of Mycoplasma hominis Strain Sprott (ATCC 33131), Isolated from a Patient with Nongonococcal Urethritis. GENOME ANNOUNCEMENTS 2015; 3:3/4/e00771-15. [PMID: 26159538 PMCID: PMC4498124 DOI: 10.1128/genomea.00771-15] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Presented here is the complete and annotated genome sequence of Mycoplasma hominis Sprott (ATCC 33131). The chromosome comprises 695,214 bp, which is approximately 30 kb larger than the syntenic genome of M. hominis PG21(T). Tetracycline resistance of strain Sprott is most probably conferred by the tetM determinant, harbored on a mosaic transposon-like structure.
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Analysis of the Complete Mycoplasma hominis LBD-4 Genome Sequence Reveals Strain-Variable Prophage Insertion and Distinctive Repeat-Containing Surface Protein Arrangements. GENOME ANNOUNCEMENTS 2015; 3:3/1/e01582-14. [PMID: 25720686 PMCID: PMC4342427 DOI: 10.1128/genomea.01582-14] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The complete genome sequence of Mycoplasma hominis LBD-4 has been determined and the gene content ascribed. The 715,165-bp chromosome contains 620 genes, including 14 carried by a strain-variable prophage genome related to Mycoplasma fermentans MFV-1 and Mycoplasma arthritidis MAV-1. Comparative analysis with the genome of M. hominis PG21(T) reveals distinctive arrangements of repeat-containing surface proteins.
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In vitro activity of five quinolones and analysis of the quinolone resistance-determining regions of gyrA, gyrB, parC, and parE in Ureaplasma parvum and Ureaplasma urealyticum clinical isolates from perinatal patients in Japan. Antimicrob Agents Chemother 2015; 59:2358-64. [PMID: 25645833 DOI: 10.1128/aac.04262-14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Ureaplasma spp. cause several disorders, such as nongonococcal urethritis, miscarriage, and preterm delivery with lung infections in neonates, characterized by pathological chorioamnionitis in the placenta. Although reports on antibiotic resistance in Ureaplasma are on the rise, reports on quinolone-resistant Ureaplasma infections in Japan are limited. The purpose of this study was to determine susceptibilities to five quinolones of Ureaplasma urealyticum and Ureaplasma parvum isolated from perinatal samples in Japan and to characterize the quinolone resistance-determining regions in the gyrA, gyrB, parC, and parE genes. Out of 28 clinical Ureaplasma strains, we isolated 9 with high MICs of quinolones and found a single parC gene mutation, resulting in the change S83L. Among 158 samples, the ParC S83L mutation was found in 37 samples (23.4%), including 1 sample harboring a ParC S83L-GyrB P462S double mutant. Novel mutations of ureaplasmal ParC (S83W and S84P) were independently found in one of the samples. Homology modeling of the ParC S83W mutant suggested steric hindrance of the quinolone-binding pocket (QBP), and de novo prediction of peptide structures revealed that the ParC S84P may break/kink the formation of the α4 helix in the QBP. Further investigations are required to unravel the extent and mechanism of antibiotic resistance of Ureaplasma spp. in Japan.
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Hasebe A, Mu HH, Cole BC. A potential pathogenic factor from Mycoplasma hominis is a TLR2-dependent, macrophage-activating, P50-related adhesin. Am J Reprod Immunol 2014; 72:285-95. [PMID: 24938999 DOI: 10.1111/aji.12279] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/21/2014] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Mycoplasma hominis has been implicated in many inflammatory conditions of the human urogenital tract in particular amniotic infections that lead to fetal and neonatal disease and pre-term labor. The mechanisms responsible are poorly defined. METHOD OF STUDY Biochemical and immunological methods were used to extract, purify, and characterize an inflammatory component present in M. hominis. RESULTS We isolated and purified to homogeneity a 40-kDa bioactive lipoprotein from M. hominis that was a potent TLR2-dependent, CD14-independent activator of the human THP-1 macrophage cell line. Homology searches of the N-terminal sequence revealed that 22 of the first 23 residues were identical to those seen for the phase-variable M. hominis p50 adhesin. The truncated P50t lipoprotein importantly retained its adhesive properties for human macrophages. CONCLUSION The unique adhesin/macrophage activator may play a key role in M. hominis infections by triggering an inflammatory cytokine cascade.
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Affiliation(s)
- Akira Hasebe
- Division of Rheumatology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA; Department of Oral Pathobiological Science, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan
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Simultaneous direct identification of genital microorganisms in voided urine using multiplex PCR-based reverse line blot assays. Methods Mol Biol 2013; 943:229-45. [PMID: 23104293 DOI: 10.1007/978-1-60327-353-4_15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Our aim was to develop and evaluate sensitive methods that would allow simultaneous direct identification of multiple potential pathogens in clinical specimens for diagnosis and epidemiological studies, using a multiplex PCR-based reverse line blot assay. We have previously developed assays suitable for detection of bacterial respiratory and systemic pathogens. In this chapter we describe, in detail, a method developed to identify 14 genital microorganisms, for use in epidemiological studies of genital infection or colonization, using first voided urine specimens. The 14 urogenital pathogens or putative pathogens studied were Trichomonas vaginalis, Streptococcus pneumoniae, Neisseria gonorrhoeae, N. meningitidis, Chlamydia trachomatis, Ureaplasma parvum, U. urealyticum, Mycoplasma hominis, M. genitalium, Gardnerella vaginalis, Haemophilus influenzae, herpes simplex virus 1 and 2, and adenovirus. Two species-specific primer pairs and probes were designed for each target. The method was validated using a reference strain or a well-characterized clinical isolate of each target organism. In a clinical study among men attending sexual health clinics in Sydney, we used the assay to compare rates of detection of the 14 organisms in men with urethritis with those in asymptomatic controls and found the method to be sensitive, specific, convenient, and relatively inexpensive.
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VALVO JOHNR, CALDAMONE ANTHONYA, HIPP SALLY, DUNCAN DAVID, COCKETT ABRAHAMTK. Elevated SeminalpH and Ureaplasma Urealyticum. ACTA ACUST UNITED AC 2013. [DOI: 10.1002/j.1939-4640.1982.tb00659.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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23
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Prevalence of sexually transmitted diseases in juvenile prostitutes and street youth. Can J Infect Dis 2012; 5:21-7. [PMID: 22346477 DOI: 10.1155/1994/146514] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/1992] [Indexed: 11/17/2022] Open
Abstract
Four groups of adolescents - 35 juvenile prostitutes, 36 street youth, 31 monogamous sexually active adolescents and 35 non-sexually active adolescents - were studied between January 1, 1988 and December 31, 1988 for the presence of sexually transmitted diseases and other genital pathogens. The high prevalence of sexually transmitted diseases found in the juvenile prostitutes (Neisseria gonorrhoeae, 49%; Chlamydia trachomatis, 83%) is in contrast to other studies, which document much lower rates of infection. This could be due to the fact that there are few studies done on juvenile prostitutes as a well defined group. Despite high risk sexual behaviour, the consistent use of contraception was low. No contraceptives were used by 57% of the juvenile prostitutes and 85% of the street youth. None of the adolescents sought medical attention although 48% of the juvenile prostitutes and 53% of the street youth had genital symptoms. It appears that the present public health education and health care delivery do not reach this high risk population.
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24
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Association of genitalMycoplasmasinfection in women who had preterm delivery and outcomes in premature infants. ACTA ACUST UNITED AC 2012. [DOI: 10.5468/kjog.2012.55.3.158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Namba F, Hasegawa T, Nakayama M, Hamanaka T, Yamashita T, Nakahira K, Kimoto A, Nozaki M, Nishihara M, Mimura K, Yamada M, Kitajima H, Suehara N, Yanagihara I. Placental features of chorioamnionitis colonized with Ureaplasma species in preterm delivery. Pediatr Res 2010; 67:166-72. [PMID: 19858776 DOI: 10.1203/pdr.0b013e3181c6e58e] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Ureaplasma spp. is detected in the urogenital tract, including the vagina, cervix, chorioamnion, and placenta. Their colonization is associated with histologic chorioamnionitis (CAM), often observed in placentas from preterm delivery. We isolated Ureaplasma spp. from 63 preterm placentas among 151 specimens, which were delivered at <32 wk of gestation. Of the 63 placentas, 52 (83%) revealed CAM in cultures positive for Ureaplasma spp., however, CAM was observed only in 30% (26/88) of cultures negative for Ureaplasma spp. (p < 0.01). Colonization by Ureaplasma spp. was an independent risk factor for CAM (OR, 11.27; 95% CI, 5.09-24.98). Characteristic neutrophil infiltration was observed in the amnion and subchorion (bistratified pattern) in cultures positive for Ureaplasma spp. FISH analysis of CAM placenta with male infant pregnancy indicated that bistratified infiltrated neutrophils showed the XX karyotype and umbilical vein infiltrated neutrophils showed XY karyotype. The distribution of sulfoglycolipid, the receptor of Ureaplasma spp., was mainly detected in the amnion. Ureaplasmal urease D protein and ureB gene were both detected in the amnion, indicating direct colonization by Ureaplasma spp.
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Affiliation(s)
- Fumihiko Namba
- Department of Developmental Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka 594-1101, Japan
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Raz R. Mycoplasma and Ureaplasma. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00175-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Rae DO, Chenoweth PJ, Brown MB, Genho PC, Moore SA, Jacobsen KE. Reproductive performance of beef heifers: effects of vulvo-vaginitis, Ureaplasma diversum and prebreeding antibiotic administration. Theriogenology 2009; 40:497-508. [PMID: 16727333 DOI: 10.1016/0093-691x(93)90403-r] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/1993] [Accepted: 05/19/1993] [Indexed: 11/22/2022]
Abstract
A group of 450 heifers, 13 to 15 mo of age, were individually identified, vaccinated (IBR, PI(3), Leptospira, Campylobacter fetus), examined (body condition score, reproductive tract evaluation, assessment of vaginal lesions), and cultured for U. diversum . Heifers were randomly allocated to either a treated group given chlortetracycline (approximately 350 mg/hd/d for 30 d in a grain crumble) or a nontreated control group. Prebreeding, most heifers showed signs of vulvovaginitis, 44% cultured positive for U. diversum . Significant associations were found between the severity of vaginal lesions and ovarian activity (P < 0.05), and between BCS and ovarian activity (P < 0.02). The U. diversum vaginal culture (positive or negative) showed no significant association with BCS, severity of vaginal lesions, or ovarian activity (all were P > 0.5). At pregnancy examination (35 d following conclusion of a 61-d breeding season), treated compared with nontreated heifers showed 1) a slight but not significant (P > 0.25) decrease in vaginal colonization by U. diversum (46 to 34% and 41 to 37%, respectively); 2) an association between increased severity of vaginal lesions and increasing pregnancy rate, especially in treated heifers; and 3) an increased pregnancy rate (72 and 57%, respectively; P < 0.01). Prebreeding treatment with chlortetracycline appeared to improve pregnancy rates in beef heifers with endemic U. diversum infections, although the role of U. diversum in heifer fertility is still not clear.
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Affiliation(s)
- D O Rae
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Miller RB, Ruhnke HL, Doig PA, Poitras BJ, Palmer NC. The effects of Ureplasma diversum inoculated into the amniotic cavity in cows. Theriogenology 2009; 20:367-74. [PMID: 16725853 DOI: 10.1016/0093-691x(83)90071-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/1983] [Accepted: 07/14/1983] [Indexed: 10/26/2022]
Abstract
Ureaplasma diversum was inoculated into the amniotic cavity in four cows. Two calves were aborted and two were born alive. One of the latter died shortly after birth and the other was killed. The cows remained clinically normal except that three retained their placenta. On microscopic examination there was a severe placentitis and an alveolitis was present in the lungs of all calves. Ureaplasma was recovered from four placentas and three lungs. Cows remained infected for a maximum of 132 days following inoculation and the organism was recovered in urine and vulvar swabs for a maximum of 17 and 60 days respectively following expulsion of the calf. Ureaplasma diversum has been isolated from natural cases of abortion with similar lesions. This experiment strongly supports a causal relationship between abortion, birth of calves with pneumonia and U. diversum infection.
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Affiliation(s)
- R B Miller
- Department of Pathology, Ontario Veterinary College, Guelph, Ontario, Canada N1G 2W1
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MEHL M, PETZOLDT R, ENGEL S, BOLLMANN R, KÖHLER W. Die Veränderung der Natrium- und Kaliumkonzentration in einer Humanspermasuspension nach artifizieller Infektion mit Ureaplasma urealyticum. Andrologia 2009. [DOI: 10.1111/j.1439-0272.1986.tb01767.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Simultaneous identification of 14 genital microorganisms in urine by use of a multiplex PCR-based reverse line blot assay. J Clin Microbiol 2009; 47:1871-7. [PMID: 19357202 DOI: 10.1128/jcm.00120-09] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to develop and evaluate a sensitive method for the simultaneous identification of 14 urogenital potential pathogens. A multiplex PCR-based reverse line blot (mPCR/RLB) assay was developed to detect 14 urogenital pathogens or putative pathogens, namely Trichomonas vaginalis, Streptococcus pneumoniae, Neisseria gonorrhoeae, Chlamydia trachomatis, Ureaplasma parvum, U. urealyticum, Gardnerella vaginalis, Haemophilus influenzae, herpes simplex virus type 1 (HSV1) and HSV2, N. meningitidis, Mycoplasma hominis, M. genitalium, and adenovirus, using two species-specific primer pairs and probes for each. The method was validated using a reference strain or a well-characterized clinical isolate of each target organism and was found to be both sensitive and specific. The limits of detection for the mPCR/RLB assay varied among the 14 target organisms from 4.2 x 10(-1) to 7.0 x 10(-11) ng/microl of genomic DNA. There were no cross-reactions among any of the probes. This method was used to test 529 first-voided urine specimens from male patients with and without urethritis attending two Sydney sexual health clinics. One or more target species were detected in 193 (36%) subjects. Of 233 positive results, overall 216 (93%) were concordant between mPCR/RLB and a comparator method (culture and/or species-specific PCR), 9 were positive only by mPCR/RLB, and 8 were positive only by the comparator method. The mPCR/RLB method was an accurate, convenient, and inexpensive method for the detection of multiple potential pathogens in first-voided urine specimens from men.
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Detection of Chlamydia trachomatis and Mycoplasma hominis, genitalium and Ureaplasma urealyticum by polymerase chain reaction in patients with sterile pyuria. Adv Med Sci 2008; 53:80-6. [PMID: 18614434 DOI: 10.2478/v10039-008-0020-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Chlamydia trachomatis and Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum are associated with various diseases of the urogenital tract, but they are usually not detected by routine microbiological diagnosis. To determine the occurrence of Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum in patients with sterile pyuria. MATERIAL/METHODS Sterile pyuria urine samples collected during the period from February 2006 to April 2007 were tested by polymerase chain reaction (PCR) for the presence of C. trachomatis, M. hominis, M. genitalium, and U. urealyticum using specific primers for each species. A total of 200 sterile pyuria samples selected from about 2400 urine samples attending the genitourinary clinic at Al-Shifa hospital, Gaza, during the period February 2006 to April 2007 and were analyzed for routine urine examination and cultured on MacConkey agar, blood agar, and sabouraud agar to detect the presence of bacteria and Candida. The 200 samples (96 male, 104 female; aged >or=18 years) containing more than 10 leukocytes / HPF and negative for culture (showing no significant growth after 24 hr) were tested by PCR for C. trachomatis and M. hominis, M. genitalium, and U. urealyticum. RESULTS C. trachomatis was detected in 20 samples (10%), U. urealyticum in 10 samples (5%), M. hominis in 6 samples (3%) and M. genitalium in 2 samples (1%). The difference in occurrence of C. trachomatis was statistically insignificant between males and females (P=0.509), but it was significant (P=0.008) for U. urealyticum. M. hominis was detected only in samples collected from female patients. On the other hand, M. genitalium was detected only in men. CONCLUSION PCR testing of sterile pyuria showed a significant number of C. trachomatis, Mycoplasma, and Ureaplasma infections. Consequently, PCR is recommended for the detection of those microorganisms in the urine samples of sterile pyuria patients.
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Imudia AN, Detti L, Puscheck EE, Yelian FD, Diamond MP. The prevalence of ureaplasma urealyticum, mycoplasma hominis, chlamydia trachomatis and neisseria gonorrhoeae infections, and the rubella status of patients undergoing an initial infertility evaluation. J Assist Reprod Genet 2008; 25:43-6. [PMID: 18202910 DOI: 10.1007/s10815-007-9192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2007] [Accepted: 11/22/2007] [Indexed: 10/22/2022] Open
Abstract
PURPOSE To determine the prevalence of positive test for Ureaplasma urealyticum (UU), Mycoplasma hominis (MH), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) infections, and their corresponding Rubella status when undergoing workup for infertility. METHODS Retrospective chart review to determine infection status for UU, MH, CT, and NG as determined by cervical swab, as well as the serum Rubella antibody titer. RESULTS A total of 46 patients of the patients reviewed were positive for UU (20.1%), three patients were positive for MH (1.3%), five patients were positive for CT (2.2%) and one patient was positive for NG (0.4%). Rubella immunity was confirmed in 90.3% of patients. CONCLUSION Approximately one quarter of women presenting to an infertility clinic seeking to conceive were found to have a positive test for UU, MH, CT or NG infection. Additionally, almost 10% of the patients were Rubella non-immune at the time of presentation for infertility evaluation.
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Affiliation(s)
- Anthony N Imudia
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Wayne State University, 3750 Woodward Avenue, Suite 200-D, Detroit, MI, 48201, USA
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Gdoura R, Kchaou W, Chaari C, Znazen A, Keskes L, Rebai T, Hammami A. Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis and Mycoplasma genitalium infections and semen quality of infertile men. BMC Infect Dis 2007; 7:129. [PMID: 17988404 PMCID: PMC2194714 DOI: 10.1186/1471-2334-7-129] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Accepted: 11/08/2007] [Indexed: 11/17/2022] Open
Abstract
Background Genital ureaplasmas (Ureaplasma urealyticum and Ureaplasma parvum) and mycoplasmas (Mycoplasma genitalium and Mycoplasma hominis) are potentially pathogenic species playing an etiologic role in both genital infections and male infertility. Reports are, however, controversial regarding the effects of these microorganisms infections in the sperm seminological variables. This study aimed at determining the frequency of genital ureplasmas and mycoplasmas in semen specimens collected from infertile men, and at comparing the seminological variables of semen from infected and non-infected men with these microorganisms. Methods A total of 120 semen samples collected from infertile men were investigated. Semen specimens were examined by in-house PCR-microtiter plate hybridization assay for the presence of genital ureaplasmas and mycoplasmas DNA. Semen analysis was assessed according to the guidelines of the World Health Organization. Standard parametric techniques (t-tests) and nonparametric techniques (Wilcoxon tests) were used for statistical analysis. Results The frequency of genital ureaplasmas and mycoplasmas detected in semen samples of infertile men was respectively 19.2% (23/120) and 15.8% (19/120). The frequency of Ureaplasma urealyticum (15%) was higher than that of Mycoplasma hominis (10.8%), Ureaplasma parvum (4.2%) and Mycoplasma genitalium (5%). Mixed species of mycoplasmas and ureaplasmas were detected in 6.7% of semen samples. Comparison of the parameters of the standard semen analysis between the male partners of the infertile couples with and without genital ureaplasmas and mycoplasmas infection showed that the presence of Mycoplasma hominis DNA in semen samples is associated with low sperm concentration (p = 0.007) and abnormal sperm morphology (p = 0.03) and a negative correlation between sperm concentration and the detection of Mycoplasma genitalium in semen samples of infertile men (p = 0.05). The mean values of seminal volume, pH, vitality, motility and leukocyte count were not significantly related either to the detection of genital mycoplasmas DNA or to the detection of ureaplasmas DNA in semen specimens. Conclusion Our results demonstrate that genital mycoplasmas and ureaplasmas seem to be widespread among the male partners of infertile couples in Tunisia. Genital mycoplasmas infections of the male genital tract could negatively influence semen quality. Our results also indicate that PCR-microtiter plate hybridization assay method provides a rapid and effective technique to detect human genital mycoplasmas and ureaplasmas which is useful for etiological and epidemiological studies of these pathogens.
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Affiliation(s)
- Radhouane Gdoura
- Department of Microbiology and research Laboratory Microorganismes et Pathologie Humaine, Habib BOURGUIBA Hospital-Sfax-TUNISIA.
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Grandics P. The cancer stem cell: evidence for its origin as an injured autoreactive T cell. Mol Cancer 2006; 5:6. [PMID: 16478542 PMCID: PMC1386699 DOI: 10.1186/1476-4598-5-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Accepted: 02/14/2006] [Indexed: 02/06/2023] Open
Abstract
This review explores similarities between lymphocytes and cancer cells, and proposes a new model for the genesis of human cancer. We suggest that the development of cancer requires infection(s) during which antigenic determinants from pathogens mimicking self-antigens are co-presented to the immune system, leading to breaking T cell tolerance. Some level of autoimmunity is normal and necessary for effective pathogen eradication. However, autoreactive T cells must be eliminated by apoptosis when the immune response is terminated. Apoptosis can be deficient in the event of a weakened immune system, the causes of which are multifactorial. Some autoreactive T cells suffer genomic damage in this process, but manage to survive. The resulting cancer stem cell still retains some functions of an inflammatory T cell, so it seeks out sites of inflammation inside the body. Due to its defective constitutive production of inflammatory cytokines and other growth factors, a stroma is built at the site of inflammation similar to the temporary stroma built during wound healing. The cancer cells grow inside this stroma, forming a tumor that provides their vascular supply and protects them from cellular immune response. As cancer stem cells have plasticity comparable to normal stem cells, interactions with surrounding normal tissues cause them to give rise to all the various types of cancers, resembling differentiated tissue types. Metastases form at an advanced stage of the disease, with the proliferation of sites of inflammation inside the body following a similar mechanism. Immunosuppressive cancer therapies inadvertently re-invigorate pathogenic microorganisms and parasitic infections common to cancer, leading to a vicious circle of infection, autoimmunity and malignancy that ultimately dooms cancer patients. Based on this new understanding, we recommend a systemic approach to the development of cancer therapies that supports rather than antagonizes the immune system.
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Abstract
The genital mycoplasmas represent a complex and unique group of microorganisms that have been associated with a wide array of infectious diseases in adults and infants. The lack of conclusive knowledge regarding the pathogenic potential of Mycoplasma and Ureaplasma spp. in many conditions is due to a general unfamiliarity of physicians and microbiology laboratories with their fastidious growth requirements, leading to difficulty in their detection; their high prevalence in healthy persons; the poor design of research studies attempting to base association with disease on the mere presence of the organisms in the lower urogenital tract; the failure to consider multifactorial aspects of diseases; and considering these genital mycoplasmas only as a last resort. The situation is now changing because of a greater appreciation of the genital mycoplasmas as perinatal pathogens and improvements in laboratory detection, particularly with regard to the development of powerful molecular nucleic acid amplification tests. This review summarizes the epidemiology of genital mycoplasmas as causes of neonatal infections and premature birth; evidence linking ureaplasmas with bronchopulmonary dysplasia; recent changes in the taxonomy of the genus Ureaplasma; the neonatal host response to mycoplasma and ureaplasma infections; advances in laboratory detection, including molecular methods; and therapeutic considerations for treatment of systemic diseases.
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Affiliation(s)
- Ken B Waites
- Department of Pathology, University of Alabama, Birmingham, Alabama 35249, USA.
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Dessì D, Delogu G, Emonte E, Catania MR, Fiori PL, Rappelli P. Long-term survival and intracellular replication of Mycoplasma hominis in Trichomonas vaginalis cells: potential role of the protozoon in transmitting bacterial infection. Infect Immun 2005; 73:1180-6. [PMID: 15664961 PMCID: PMC546971 DOI: 10.1128/iai.73.2.1180-1186.2005] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The existence of a symbiotic relationship between Trichomonas vaginalis and Mycoplasma hominis, which is the first reported example of symbiosis between two obligate human pathogens, has been recently reported by our research group. In this work, we examined the cellular location of M. hominis in respect to T. vaginalis. By using gentamicin protection assays, double immunofluorescence, and confocal microscopy, we obtained strong evidence that M. hominis is located within protozoan cells. 5-Bromodeoxyuridine incorporation assays showed that intracellularly located mycoplasmas actively synthesize DNA. Our results demonstrate that M. hominis has the capability of entering trichomonad cells and of replicating inside the protozoon. These findings suggest that symbiosis might provide the bacteria, during human infection, with the capability to resist to environmental stresses, such as host defense mechanisms and pharmacological therapies.
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Affiliation(s)
- Daniele Dessì
- Department of Biomedical Sciences, Division of Experimental and Clinical Microbiology, University of Sassari, Viale S. Pietro 43/B, 07100 Sassari, Italy
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Sturm PDJ, Moodley P, Khan N, Ebrahim S, Govender K, Connolly C, Sturm AW. Aetiology of male urethritis in patients recruited from a population with a high HIV prevalence. Int J Antimicrob Agents 2005; 24 Suppl 1:S8-14. [PMID: 15364299 DOI: 10.1016/j.ijantimicag.2004.02.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aetiology of urethritis, the significance of potential pathogens and the relation of urethritis to HIV infection were determined in 335 men (cases) with and 100 men (controls) without urethral symptoms. Urethral swab specimens were tested for different organisms by PCR or by culture for Neisseria gonorrhoeae. The prevalence of N. gonorrhoeae and Chlamydia trachomatis was 52 and 16%, respectively. The potential pathogens: Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis and herpes simplex virus (HSV), were present in 5, 36, 6 and 6% of the cases respectively. M. genitalium was the only potential pathogen associated with microscopic urethritis. After excluding gonococcal infections, U. urealyticum was more frequent in symptomatic patients, while the prevalence of T. vaginalis was similar among cases and controls. These results strongly suggest an a etiological role for M. genitalium in male urethritis, a possible role for U. urealyticum, but not for T. vaginalis. The control group, with 97% genital ulcer disease patients, was not suitable for the investigation of the role of HSV. The sero-prevalence of HIV was 45%. Current infections were not associated with HIV. However, a history of previous urethral discharge was associated with HIV in a multivariate analysis and supported the hypothesis that non-ulcerative sexually transmitted diseases facilitate HIV transmission.
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Affiliation(s)
- P D J Sturm
- Department of Medical Microbiology, Nelson R. Mandela School of Medicine, University of Natal, Durban, South Africa.
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Ngan CCL, Lim T, Choo CM, Toh GLX, Lim YS. Susceptibility testing of Singapore strains of Mycoplasma hominis to tetracycline, gatifloxacin, moxifloxacin, ciprofloxacin, clindamycin, and azithromycin by the Etest method. Diagn Microbiol Infect Dis 2004; 48:207-10. [PMID: 15023431 DOI: 10.1016/j.diagmicrobio.2003.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2003] [Accepted: 10/26/2003] [Indexed: 10/26/2022]
Abstract
The minimal inhibitory concentrations of tetracycline, gatifloxacin, moxifloxacin, ciprofloxacin, clindamycin and azithromycin for 28 Singapore clinical Mycoplasma hominis strains were studied using the Etest method. Different incubation conditions did not affect susceptibility categories, except for tetracycline intermediate-susceptibility strains. Tetracycline-susceptibility was only 35.7%. All strains were susceptible to the fluoroquinolones and clindamycin but resistant to azithromycin.
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Affiliation(s)
- Cecilia C L Ngan
- Department of Pathology, Singapore General Hospital, Singapore 169608, Singapore.
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Colaizy TT, Kuforiji T, Sklar RS, Pillers DAM. PCR methods in clinical investigations of human ureaplasmas: a minireview. Mol Genet Metab 2003; 80:389-97. [PMID: 14654351 DOI: 10.1016/j.ymgme.2003.08.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Human ureaplasmas are small, cell-wall-deficient organisms that are implicated in many human infections. Due to their small size and fastidious growth requirements, ureaplasmal infections are hard to diagnose clinically, and ureaplasmal disease is difficult to study in clinical samples. Standard culture methods for ureaplasmas are technically challenging, and 3 to 5 days are required to identify this pathogen. PCR methods have been increasingly used in the diagnosis of these infections and in the study of this pathogen in human specimens from multiple sites. These methods have theoretical advantages over traditional culture methods. Organism identification can occur in the presence of low numbers of bacteria, and viability is not necessary. Rapid identification of organisms within 24 h is also possible. In addition, subtyping of isolates can be performed faster with PCR methods than with culture methods. The use of PCR methods in translational research in multiple human ureaplasmal diseases will be reviewed in this paper, and their usefulness will be compared to culture methods.
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Affiliation(s)
- Tarah T Colaizy
- Department of Pediatrics, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, OR 97239, USA
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House P, Dunn J, Carroll K, MacDonald J. Seeding of a cavernous angioma with Mycoplasma hominis: case report. Neurosurgery 2003; 53:749-52; discussion 752-3. [PMID: 12943591 DOI: 10.1227/01.neu.0000080064.21806.28] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2002] [Accepted: 04/22/2003] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE AND IMPORTANCE To describe a unique case of hematogenous seeding of a cavernous angioma with the commensal organism Mycoplasma hominis. CLINICAL PRESENTATION A 40-year-old female patient presented with a severe headache and acute left facial nerve palsy. Imaging studies revealed a right frontal mass lesion with characteristics of a cavernous angioma. INTERVENTION The patient underwent a craniotomy for cavernous angioma resection. Purulent material was noted at the time of resection, and no hemorrhage was observed. Despite antibiotic therapy, the patient required repeat craniotomies for subsequent abscess treatment. M. hominis was identified as the pathogen. CONCLUSION M. hominis is a rare cause of brain abscesses and can be difficult to eradicate. Cavernous angiomas can be seeded hematogenously.
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Affiliation(s)
- Paul House
- Department of Neurological Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA
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Samra Z, Rosenberg S, Soffer Y. In vitro susceptibility of Mycoplasma hominis clinical isolates to tetracyclines, quinolones and macrolides. Diagn Microbiol Infect Dis 2002; 44:359-61. [PMID: 12543541 DOI: 10.1016/s0732-8893(02)00459-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We tested the in vitro activity of levofloxacin, ciprofloxacin, doxycycline, tetracycline, erythromycin, roxithromycin, clarithromycin and azithromycin against 110 clinical isolates of Mycoplasma hominis. The minimal inhibitory concentrations (MICs) were determined with the Etest. The minimal concentrations at which 90% of the isolates were inhibited (MIC(90)) were 0.064 microg/ml doxycycline and 0.19 microg/ml tetracycline. In 9 isolates (8.1%), the MIC for doxycycline was 4-12 microg/ml. These isolates were also resistant to tetracycline with a MIC of 32-128 microg/ml. No significant difference was found between doxycycline and tetracycline (p = 0.076). Comparison of the two quinolones revealed that the MIC(90) for levofloxacin was 0.19 microg/ml and for ciprofloxacin, 0.5 microg/ml. A significant difference was found between doxycycline/tetracycline and levofloxacin or ciprofloxacin (p = 0.0001), and between levofloxacin and ciprofloxacin (p = 0.001). All the isolates were highly resistant to the macrolides with MIC > or = 256 microg/ml. This finding has important implications for cases in which Mycoplasma infection is suspected and culture and/or in vitro susceptibility tests are not available.
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Affiliation(s)
- Zmira Samra
- Chlamydia and Mycoplasma National Center, Department of Microbiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.
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Machado AA, Zorzi AR, Gléria AE, Donadi EA. Frequency of Mycoplasma hominis and Ureaplasma urealyticum infections in women with systemic lupus erythematosus. Rev Soc Bras Med Trop 2001; 34:243-7. [PMID: 11460209 DOI: 10.1590/s0037-86822001000300003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) have been detected in the urine of women with systemic lupus erythematosus (SLE). We evaluated the presence of these mycoplasma in the endocervix of women presenting SLE. A total of 40 SLE patients (mean age 40.2 years), and 51 healthy women (mean age 30.9 years), were studied. Endocervical swabs were cultured in specific liquid media for MH or UU, detected by a quantitative color assay, and considered positive at >10(3) dilutions. Statistical analysis was performed using the two-tailed Fisher test. UU was detected in 52.5 % of patients and in 11.8% of controls (p= 0.000059). MH was detected in 20% of patients and 2% controls (p=0.003905). Both mycoplasmas were detected in 7.3% patients and 0% controls (p<0.000001). The results reported here corroborate the association of the mycoplasma infection and SLE. Thus, these agents may stimulate the production of autoreactive clones.
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Affiliation(s)
- A A Machado
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil.
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Abstract
AIM: To explore relationships between human carcinomas and mycoplasma infection.
METHODS: Monoclonal antibody PD4, which specifically recognizes a distinct protein from mycoplasma hyorhinis, was used to detect mycoplasma infection in different paraffin embedded carcinoma tissues with immunohistochemistry. PCR was applied to amplify the mycoplasma DNA from the positive samples for confirming immunohistochemistry.
RESULTS: Fifty of 90 cases (56%) of gastric carcinoma were positive for mycoplasma hyorhinis. In other gastric diseases, the mycoplasma infection ratio was 28% (18/49) in chronic superficial gastritis, 30% (14/46) in gastric ulcer and 37% (18/49) in intestinal metaplasia. The difference is significant with gastric cancer (χ2 = 12.06, P < 0.05). In colon carcinoma, the mycoplasma infection ratio was 55.1% (32/58),but it was 20.9% (10/ 49) in adenomarous polyp (χ2 = 13.46, P < 0.005). Gastric and colon cancers with high differentiation had a higher mycoplasma infection ratio than those with low differentiation (P < 0.05). Mycoplasma infection in esophageal cancer, lung cancer, breast cancer and glioma was 50.9% (27/53), 52.6% (31/ 59), 39.7% (25/63)and 41% (38/91), respectively. The mycoplasma DNA was successfully amplified with the DNA extracted from the cancer tissues that were positive for mycoplasma infection (detected with antibody PD4).
CONCLUSION: There was high correlation between mycoplasma infection and different cancers, which suggests the possibility of an association between the two. The mechanism involved in oncogenesis by mycoplasma remains unknown.
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Affiliation(s)
- S Huang
- Department of Biochemistry and Molecular Biology, Beijing Institute for Cancer Research and Peking University School of Oncology.No.1 Da Hong Luo Chang Street, Western District, Beijing 100034, China.
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Arya OP, Tong CY, Hart CA, Pratt BC, Hughes S, Roberts P, Kirby P, Howel J, McCormick A, Goddard AD. Is Mycoplasma hominis a vaginal pathogen? Sex Transm Infect 2001; 77:58-62. [PMID: 11158693 PMCID: PMC1758313 DOI: 10.1136/sti.77.1.58] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the role of Mycoplasma hominis as a vaginal pathogen. DESIGN Prospective study comprising detailed history, clinical examination, sexually transmitted infection (STI) and bacterial vaginosis screen, vaginal swabs for mycoplasmas and other organisms, follow up of bacterial vaginosis patients, and analysis of results using SPSS package. SETTING Genitourinary medicine clinic, Royal Liverpool University Hospital. PARTICIPANTS 1200 consecutive unselected new patients who had not received an antimicrobial in the preceding 3 weeks, and seen by the principal author, between June 1987 and May 1995. MAIN OUTCOME MEASURES Relation of M. hominis isolation rate and colony count to: (a) vaginal symptoms and with the number of polymorphonuclear leucocytes (PMN) per high power field in the Gram stained vaginal smear in patients with a single condition--that is, candidiasis, bacterial vaginosis, genital warts, chlamydial infection, or trichomoniasis, as well as in patients with no genital infection; (b) epidemiological characteristics of bacterial vaginosis. RESULTS 1568 diagnoses were made (the numbers with single condition are in parenthesis). These included 291 (154) cases of candidiasis, 208 (123) cases of bacterial vaginosis, 240 (93) with genital warts, 140 (42) chlamydial infections, 54 (29) cases of trichomoniasis, and 249 women with no condition requiring treatment. M. hominis was found in the vagina in 341 women, but its isolation rates and colony counts among those with symptoms were not significantly different from those without symptoms in the single condition categories. There was no association between M. hominis and the number of PMN in Gram stained vaginal smears whether M. hominis was present alone or in combination with another single condition. M. hominis had no impact on epidemiological characteristics of bacterial vaginosis. CONCLUSION This study shows no evidence that M. hominis is a vaginal pathogen in adults.
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Affiliation(s)
- O P Arya
- University Department of Medical Microbiology and Genitourinary Medicine, Liverpool, UK.
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45
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Moodley P, Sturm AW. Sexually transmitted infections, adverse pregnancy outcome and neonatal infection. SEMINARS IN NEONATOLOGY : SN 2000; 5:255-69. [PMID: 10956450 DOI: 10.1053/siny.2000.0026] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Prevention and treatment of sexually transmitted infections (STIs) in the sexually active population are the main steps to prevent perinatal infection. However, the spread of STIs continues at an astronomical pace despite various attempts at controlling the epidemic. An important reason for this lack of STI control is that a large percentage of infected people go untreated because they have asymptomatic or unrecognized infections. The microbial differential diagnosis of STIs implicated in adverse pregnancy outcome is broad and includes viral, bacterial and protozoal infections. Infertility, ectopic pregnancy, pelvic inflammatory disease, chorioamnionitis, premature rupture of membranes, preterm birth and puerperal sepsis are some of complications seen in women as a result of infection with sexually transmitted pathogens. In addition, STIs may facilitate the acquisition and transmission of HIV. In the fetus or neonate, complications include abnormalities of the major organ systems. Infections in the form of pneumonia or conjunctivitis may also occur. Due to the lack of simple, inexpensive and sensitive point-of-care tests, screening for STIs in pregnancy is not performed routinely.
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Affiliation(s)
- P Moodley
- Department of Medical Microbiology and Africa Centre for Population Studies and Reproductive Health, School of Infection, Medical School, University of Natal, Durban, South Africa.
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46
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Abstract
There is a paucity of information about sperm-mediated transmission of exogenous DNA to implanting embryos and cells of the reproductive tract. Preliminary experiments established that sperm has the capacity to actively take in exogenous DNA derived from HPV. In addition, blastocysts also take up exogenous HPV DNA, but in contrast to sperm, the process appears passive. DNA-carrying sperm migrating in an artificial glass tube or excised mouse bicornuate uteri transfected the blastocysts at the remote position using a flip-flop mechanism. There were preferential transmission of the types of HPV DNA but this was not attributed to the gene sequence or the size of the DNA fragments. The internalized DNA became undetectable unless continuous sperm bombardment or pricking took place. Mycoplasma vectors offer a novel way to enhance the transfection of blastocyst with exogenous DNA.
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Affiliation(s)
- P J Chan
- Center for Fertility and In Vitro Fertilization, Department of Gynecology and Obstetrics, Loma Linda University, California, USA
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Krieger JN, Jacobs R, Ross SO. Detecting urethral and prostatic inflammation in patients with chronic prostatitis. Urology 2000; 55:186-91; discussion 191-2. [PMID: 10688076 DOI: 10.1016/s0090-4295(99)00437-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Diagnosis of urethral and prostatic inflammation can represent a challenge. We compare the accuracy of diagnostic methods for detecting inflammation in lower urinary specimens/samples. METHODS A standardized protocol was used to evaluate urethral smear, first-void urine (VB1), midstream urine (VB2), expressed prostatic secretions (EPS), and postmassage urine (VB3) in urologic patients with no symptoms or signs of urethritis who were attending our prostatitis clinic. RESULTS Of 235 subjects, 60 (26%) had leukocytes detected by the Gram-stained urethral smear, 44 (18%) by the VB1, and only 14 (6%) by the VB2. Compared with the urethral swab, VB1 had 0% to 22% sensitivity and 81% to 98% specificity, and VB2 had 8% to 11% sensitivity. Of 83 subjects with prostatic inflammation, the EPS detected 63 (76%) and the VB3 detected 68 (82%). CONCLUSIONS VB1 or VB2 examinations had low sensitivity for detecting urethral inflammation. Examining both the EPS and VB3 proved best for detecting prostatic fluid inflammation. Combining the urethral smear with lower urinary tract localization ("four-glass test") represents an optimal approach for detecting urethral and prostatic inflammation.
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Affiliation(s)
- J N Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, USA
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48
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Chan PJ, Brossfield JE, Patton WC, King A. Mycoplasma-mediated uptake of the exogenous human BRCA1 gene by hatching blastocysts. J Assist Reprod Genet 1999; 16:546-50. [PMID: 10575584 PMCID: PMC3455373 DOI: 10.1023/a:1020553322073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Biological vectors for cell transfection are mainly viral in origin, with inherent shortcomings. Mycoplasmas are ubiquitous organisms that traverse cells easily. The objective was to determine if Ureaplasma urealyticum (T-mycoplasma) would vector exogenous BRCA1 DNA into blastocysts. METHODS Hatching mouse blastocysts (N = 70) were incubated in the presence of either viable or dead Ureaplasma urealyticum at 37 degrees C for 1 hr. The blastocysts were exposed to human BRCA1 DNA lacking homology in the mouse genome for 2 hr, followed by DNase-1 treatment and wash. Polymerase chain reaction and agarose gel electrophoresis analysis of amplified products were performed. RESULTS The BRCA1 gene was detected in the blastocysts only when viable Ureaplasma was present. PCR analyses of control Ureaplasma and untreated blastocysts were negative. CONCLUSION Viable Ureaplasma organisms were shown to mediate the uptake of DNA fragments into blastocysts, resulting in transgenic mouse blastocysts with a normal human BRCA1 exon 11 gene.
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Affiliation(s)
- P J Chan
- Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, California 92350, USA
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49
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Fernández Guerrero ML, Manuel Ramos J, Soriano F. Mycoplasma hominis bacteraemia not associated with genital infections. J Infect 1999; 39:91-4. [PMID: 10468136 DOI: 10.1016/s0163-4453(99)90109-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We describe two cases of systemic infection with M. hominis without prior genital infection and review the previous literature on this condition.
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50
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Kidder M, Chan PJ, Seraj IM, Patton WC, King A. Assessment of archived paraffin-embedded cervical condyloma tissues for mycoplasma-conserved DNA using sensitive PCR-ELISA. Gynecol Oncol 1998; 71:254-7. [PMID: 9826468 DOI: 10.1006/gyno.1998.5177] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Clinically, it is important to detect mycoplasmas because these organisms have been implicated in gastric and ovarian cancer, pneumonia, postabortal fever, pelvic inflammatory disease, pyelonephritis, endometritis, urethritis, perinatal mortality, arthritis, spontaneous abortion, infertility and interference with sperm development and they act as cofactors catalyzing the HIV disease state. Recently, the combined polymerase chain reaction and enzyme-linked immunosorbent assay method targeting the consensus DNA of over 15 species of mycoplasmas was shown to be superior for the detection of mycoplasmas. The objective was to determine if there was an association between mycoplasmas and cervical neoplasia. Cervical tissues, histopathologically categorized by cervical intraepithelial neoplasia (CIN) grade, flat or exophytic, and acanthosis or koilocytotic, were used. The results showed that mycoplasmas DNA were present in 21.4% of the condyloma tissues and in 33.3% of condyloma tissues with CIN. In contrast, mycoplasmas DNA were not detected when there were no CIN. The presence or absence of human papillomavirus (HPV) did not make a difference. Mycoplasmas DNA were present in 40.0 and 12.5% of the exophytic and flat condylomas, respectively. A higher percentage of cervical tissues graded with slight koilocytosis had (P = 0.05) mycoplasmas DNA compared with tissues graded with moderate koilocytosis. The detection of mycoplasmas DNA in archived cervical condyloma tissues with CIN corroborated previous reports of an association between mycoplasmas and CIN. However, the association between mycoplasmas and the presence of HPV could not be made in this study.
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Affiliation(s)
- M Kidder
- Department of Gynecology and Obstetrics, Loma Linda University School of Medicine, Loma Linda, California, 92350, USA
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