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Liu W, Yang T, Kong Y, Xie X, Ruan Z. Ureaplasma infections: update on epidemiology, antimicrobial resistance, and pathogenesis. Crit Rev Microbiol 2024:1-31. [PMID: 38794781 DOI: 10.1080/1040841x.2024.2349556] [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: 12/06/2023] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
Human Ureaplasma species are being increasingly recognized as opportunistic pathogens in human genitourinary tract infections, infertility, adverse pregnancy, neonatal morbidities, and other adult invasive infections. Although some general reviews have focused on the detection and clinical manifestations of Ureaplasma spp., the molecular epidemiology, antimicrobial resistance, and pathogenesis of Ureaplasma spp. have not been adequately explained. The purpose of this review is to offer valuable insights into the current understanding and future research perspectives of the molecular epidemiology, antimicrobial resistance, and pathogenesis of human Ureaplasma infections. This review summarizes the conventional culture and detection methods and the latest molecular identification technologies for Ureaplasma spp. We also reviewed the global prevalence and mechanisms of antibiotic resistance for Ureaplasma spp. Aside from regular antibiotics, novel antibiotics with outstanding in vitro antimicrobial activity against Ureaplasma spp. are described. Furthermore, we discussed the pathogenic mechanisms of Ureaplasma spp., including adhesion, proinflammatory effects, cytotoxicity, and immune escape effects, from the perspectives of pathology, related molecules, and genetics.
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Affiliation(s)
- Wenwen Liu
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Ting Yang
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yingying Kong
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Xinyou Xie
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Zhi Ruan
- Department of Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
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Farfour E, Vasse M, Vallée A. Mollicutes-related infections in thoracic surgery including lung and heart transplantation: A systematic review. J Heart Lung Transplant 2024; 43:169-180. [PMID: 37797819 DOI: 10.1016/j.healun.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Urogenital Mollicutes, that is, Mycoplasma hominis and Ureaplasma spp., can colonize the urogenital tract. While urogenital colonization is frequent, infections are rare but should not be missed. Furthermore, extragenital infections are even rarer. Over the past years, they have been increasingly documented as a cause of hyperammonemia syndrome (HS) and post-surgical infections. We review the literature on studies focused on post-surgical infections and HS involving urogenital Mollicutes after thoracic surgery including lung (LTR) and heart (HTR) transplantation. METHODS A systematic review was performed by searching PubMed/Medline case reports, case series, cohort studies, and clinical trials. Cases of infections and HS by urogenital Mollicutes after HTR and LTR transplantations were reported. RESULTS Overall, urogenital Mollicutes were associated with 15 HS, 31 infections in HTR and LTR, and 18 post-thoracic surgical infections in another context. Post-surgical infections were reported in all contexts. They were mainly due to M hominis, the only species that could cultivate on standard enriched agar forming pinpoint colonies after 3-5 days of incubation. Microbiologists should be prompted to pinpoint colonies even if the examination of Gram-staining is negative. The patients' management required surgical treatment and antimicrobials, almost always tetracyclines and/or fluoroquinolones. Conversely, HS occurred almost exclusively in bilateral LTR and is more likely due to Ureaplasma spp. As Ureaplasma spp. do not cultivate on standard media, the microbiological diagnosis was performed using molecular methods. CONCLUSIONS Infections involving urogenital Mollicute should be considered in LTR with HS. The overall rate of mortality is high and might be due in part to delay in etiologic diagnosis. Post-surgical infections were reported in all contexts. The route of contamination with Mollicutes remains unknown in HTR and non-transplant surgery, but evidence of transmission from donors has been documented for LTR.
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Affiliation(s)
- Eric Farfour
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France.
| | - Marc Vasse
- Service de Biologie Clinique, Hôpital Foch, Suresnes, France; Université Paris-Saclay, INSERM Hémostase Inflammation Thrombose HITH U1176, Le Kremlin-Bicêtre, France
| | - Alexandre Vallée
- Département d'Epidémiologie et de Santé Publique, Hôpital Foch, Suresnes, France
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Yeoh K, Aikeremu D, Aw-Yeong B, Slavin MA, Williams E. An Unusual and Difficult to Detect Cause of Infection in Two Trauma Patients. Clin Infect Dis 2023; 77:154-157. [PMID: 36202767 PMCID: PMC10320131 DOI: 10.1093/cid/ciac748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Kim Yeoh
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
| | - Dilare Aikeremu
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Benjamin Aw-Yeong
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Monica A Slavin
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
- Department of Infectious Diseases, and National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Eloise Williams
- Department of Microbiology, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity . Melbourne, Victoria, Australia
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Tian M, Han D, Ma S, Liu T, Yang W, Zheng X. Fatal multiple organ dysfunction caused by commensal bacteria of urogenital tract infection in adult lung transplant recipients: two case reports. Virol J 2023; 20:24. [PMID: 36755309 PMCID: PMC9906855 DOI: 10.1186/s12985-022-01958-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/22/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Infection following lung transplantation has been the focus of clinical concerns. The colonization rate of commensal bacteria of the urogenital tract, including Mycoplasma hominis, Ureaplasma urealyticum (UU), and herpes simplex virus type-2 (HSV-2), is high, which may cause secondary infection after transplantation. CASE PRESENTATION Twenty-three-year-old and 67-year-old women underwent lung transplantation for different causes. Shortly after the operation, they developed perineal skin ulcers, hypoxia, and intractable epilepsy. Subsequent computed tomography (CT) of the chest showed lung consolidation, and cranial CT showed shallowing sulci and gyri. UU and HSV-2 were detected in bronchoalveolar lavage fluid by next-generation sequencing, and HSV-2 was shown in the cerebrospinal fluid of both patients. Despite active treatment, both suffered irreversible brain function damage within 72 h of the seizure. CONCLUSIONS Clinicians should know that commensal bacteria of urogenital tract infections can lead to fatal multiple organ dysfunction after lung transplantation.
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Affiliation(s)
- Manman Tian
- grid.13402.340000 0004 1759 700XDepartment of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003 China
| | - Dongsheng Han
- grid.13402.340000 0004 1759 700XDepartment of Laboratory Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province and Institute of Laboratory Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003 China
| | - Subo Ma
- grid.13402.340000 0004 1759 700XDepartment of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003 China
| | - Tingting Liu
- grid.13402.340000 0004 1759 700XDepartment of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003 China
| | - Wu Yang
- grid.13402.340000 0004 1759 700XDepartment of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003 China
| | - Xia Zheng
- Department of Critical Care Units, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.
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Madlener M, Breuninger M, Meißner A, Stetefeld H, Telentschak S, Wille T, van Eimeren T, Jung N. Brain abscess with Ureaplasma parvum in a patient with granulomatosis with polyangiitis. Infection 2022; 51:779-782. [PMID: 36580229 DOI: 10.1007/s15010-022-01966-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE Ureaplasma species are associated with urogenital infections, infertility and adverse pregnancy outcomes as well as neonatal infections. Involvement of the central nervous system in adults is extremely rare. We report an unusual case of a brain abscess secondary to otitis media with Ureaplasma parvum in a patient with granulomatosis with polyangiitis (GPA). METHODS Imaging and laboratory findings, treatment decisions, and outcome of this case are explicated. RESULTS A young adult with GPA presented with progredient earache after ambulant diagnosis of otitis media. Despite different courses of broad-spectrum antibiotic therapy, she developed meningoencephalitis due to mastoiditis following temporal abscess formation. Mastoidectomy and neurosurgical abscess removal were performed. Standard cultures of cerebrospinal fluid, blood and intracranial abscess material, as well as polymerase chain reaction (PCR) for common bacterial and viral meningitis pathogens remained negative. Only eubacterial PCR of intracranial abscess material returned positive for Ureaplasma parvum. The patient finally improved under antibiotic therapy with moxifloxacin and doxycycline. CONCLUSION Ureaplasma species are rare causative pathogens in immunocompromised patients. They should be considered in patients with humoral immunodeficiencies with culture-negative infections failing standard therapy. Eubacterial PCR should be performed in early states of infection in these patients for immediate diagnosis and initiation of appropriate treatment to prevent adverse outcomes.
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Affiliation(s)
- Marie Madlener
- Department of Neurology, Faculty of Medicine, University of Cologne, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Marianne Breuninger
- Department I of Internal Medicine, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Arne Meißner
- Department of Hospital Hygiene and Infection Control, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Henning Stetefeld
- Department of Neurology, Faculty of Medicine, University of Cologne, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Sergej Telentschak
- Center for Neurosurgery, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Thorsten Wille
- Institute for Medical Microbiology, Immunology and Hygiene, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Department of Neurology, Faculty of Medicine, University of Cologne, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Norma Jung
- Department I of Internal Medicine, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany
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Xing N, Zhao Z, Li Q, Dong Y, Li J, Zhang S. Ureaplasma parvum meningitis following atypical choroid plexus papilloma resection in an adult patient: a case report and literature review. BMC Infect Dis 2021; 21:1276. [PMID: 34930148 PMCID: PMC8690907 DOI: 10.1186/s12879-021-06975-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background While Ureaplasma parvum has previously been linked to the incidence of chorioamnionitis, abortion, premature birth, and perinatal complications, there have only been rare reports of invasive infections of the central nervous system (CNS) in adults. Owing to its atypical presentation and the fact that it will yield sterile cultures using conventional techniques, diagnosing U. parvum meningitis can be challenging. Case presentation We describe a case of U. parvum meningitis detected in an adult patient following surgical brain tumor ablation. After operation, the patient experienced epilepsy, meningeal irritation, and fever with unconsciousness. Cerebrospinal fluid (CSF) analysis showed leukocytosis (484 * 106 /L), elevated protein levels (1.92 g/L), and decreased glucose concentrations (0.02 mmol/L). Evidence suggested that the patient was suffering from bacterial meningitis. However, no bacterial pathogens in either CSF or blood were detected by routine culture or serology. The symptoms did not improve with empirical antibiotics. Therefore, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the meningitis. Ureaplasma parvum was detected by mNGS in CSF samples. To the best of our knowledge, this case is the first reported instance of U. parvum meningitis in an adult patient in Asian. After diagnosis, the patient underwent successful moxifloxacin treatment and recovered without complications. Conclusions As mNGS strategies can enable the simultaneous detection of a diverse array of microbes in a single analysis, they may represent a valuable means of diagnosing the pathogens responsible for CNS infections and other clinical conditions with atypical presentations.
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Affiliation(s)
- Na Xing
- Department of Endocrinology, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Zhenxiang Zhao
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China.
| | - Qingjing Li
- Clinical Laboratory, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Yalan Dong
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Jianfeng Li
- Department of Neurosurgery, The Fourth Hospital of Hebei Medical University, No. 12, Jiankang Road, Shijiazhuang, 050000, Hebei, People's Republic of China
| | - Shuping Zhang
- Department of Oncology, The Seventh People's Hospital of Hebei Province, No. 389, Jungong Road, Dingzhou, 073000, Hebei, People's Republic of China
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Gómez Rufo D, García Sánchez E, García Sánchez JE, García Moro M. [Clinical implications of the genus Mycoplasma]. REVISTA ESPANOLA DE QUIMIOTERAPIA 2021; 34:169-184. [PMID: 33735544 PMCID: PMC8179937 DOI: 10.37201/req/014.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dentro del género Mycoplasma, las especies que tradicionalmente se han relacionado con cuadros infecciosos han sido principalmente M. pneumoniae, M. genitalium, M. hominis o U. urealyticum. Sin embargo, existen otras muchas que están implicadas y, que muchas veces, son desconocidas para los profesionales sanitarios. El objetivo de esta revisión es identificar todas las especies del género Mycoplasma que se han aislado en el hombre y determinar su participación en la patología infecciosa humana.
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Affiliation(s)
| | - E García Sánchez
- Enrique García Sánchez, Departamento de Ciencias Biomédicas. Facultad de Medicina. Universidad de Salamanca. Spain.
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Paparoupa M, Barten MJ, de Heer J, Giessen HS, Frings D, Kluge S. Hyperammonemia by Ureaplasma urealyticum Pneumonia after Lung Transplantation. Respir Med Case Rep 2020; 30:101080. [PMID: 32420020 PMCID: PMC7218208 DOI: 10.1016/j.rmcr.2020.101080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/05/2020] [Indexed: 11/18/2022] Open
Abstract
Ureaplasma urealyticum is a commensal of the female genital tract and can be detected as a pathogen in urethritis and vaginitis. Its importance as a respiratory pathogen beyond the field of neonatology remains controversial. We report a case of Ureaplasma-pneumonia in a recently lung-transplanted patient, with hyperammonemic syndrome. The 51-year-old lung-transplanted female was admitted to the intensive care unit with new-onset reduction of her mental state due to hyperammonemia. A diagnostic bronchoscopy showed purulent bronchitis and multiple superficial ulcerations of the bronchial mucosa. The DNA-PCR from bronchoalveolar lavage confirmed the presence of Ureaplasma urealyticum in low concentration (about 5 * 104 copies/ml), which was interpreted as evidence of infection and treated with Doxycycline intravenously. Ureaplasma was also identified by DNA-PCR in the biopsy specimens of the inflammatory enlarged mediastinal lymph nodes. Bilateral pleural effusions were found to be transudative and culturally sterile. Ureaplasma-pneumonia can cause fatal hyperammonemia in lung-transplant patients and should be considered in the differential diagnosis of every unclear hyperammonemia with normal liver function. The early identification and treatment of the infection leads to clinical and biochemical resolution.
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Affiliation(s)
- Maria Paparoupa
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
| | - Markus Johannes Barten
- University Heart & Vascular Center Hamburg, Department of Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
| | - Jocelyn de Heer
- Department of Internal Medicine, Gastroenterology, Infectiology and Tropical Diseases, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
| | - Hanna Sophie Giessen
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
| | - Daniel Frings
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
| | - Stefan Kluge
- Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistr.52, D-20246, Hamburg, Germany
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Saje A, Velnar T, Smrke B, Spazzapan P, Keše D, Kobal B, Beović B. Ureaplasma parvum ventriculitis related to surgery and ventricular peritoneal drainage. J Infect Chemother 2020; 26:513-515. [PMID: 32007385 DOI: 10.1016/j.jiac.2019.12.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 11/29/2022]
Abstract
Ureaplasma spp. usually causes genitourinary infections; few reports in the literature describe extragenital infections, usually in immunocompromised patients. We present a case of Ureaplasma parvum ventriculitis in an immunocompetent patient related to ventriculoperitoneal drainage and surgery. Ureaplasma parvum was detected with broad range 16S rRNA PCR and cultured on A8 agar.
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Affiliation(s)
- Andreja Saje
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia.
| | - Tomaž Velnar
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Barbara Smrke
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Peter Spazzapan
- Department of Neurosurgery, University Medical Centre Ljubljana, Slovenia
| | - Darja Keše
- Institute of Microbiology and Immunology Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
| | - Borut Kobal
- Department of Gynaecology, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
| | - Bojana Beović
- Department of Infectious Diseases, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
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A case of Ureaplasma parvum meningitis in an adult after transphenoidal ablation of craniopharyngioma. Int J Infect Dis 2019; 84:5-7. [DOI: 10.1016/j.ijid.2019.04.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/19/2019] [Accepted: 04/24/2019] [Indexed: 10/26/2022] Open
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Canouï E, Blanc K, Loubinoux J, Valade S, Hamard C, Lefebvre A, Amorim S, Bébéar C, Rodriguez-Nava V, Lebeaux D, Launay O, Alifano M, Rabbat A, Kernéis S. The value of molecular techniques to diagnose Ureaplasma urealyticum and Nocardia farcinica pleuropneumonia in a patient with diffuse large B-cell lymphoma. Int J Infect Dis 2017; 64:93-95. [DOI: 10.1016/j.ijid.2017.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/12/2017] [Accepted: 09/15/2017] [Indexed: 12/24/2022] Open
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Posse T, Prieto M, Cipolla L, Kaufman S. [Mycoplasma hominis bacteremia. An underestimated etiological agent]. Rev Argent Microbiol 2017; 50:45-47. [PMID: 29054551 DOI: 10.1016/j.ram.2017.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 02/06/2017] [Accepted: 02/20/2017] [Indexed: 10/18/2022] Open
Abstract
Mycoplasma hominis is a fastidious bacterium, which usually colonizes the lower urogenital tract and may cause systemic infections in neonates and genital infections in adults. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects. CASE PRESENTATION We describe a case of bacteremia caused by M. hominis in a previously healthy woman after uterine curettage due to incomplete abortion. M. hominis could be an underestimated cause of bacteremia in immunocompetent patients. Mycoplasma organisms have fastidious growth requirements, are often difficult to culture on a cell-free medium and have no cell wall. The conventional method for detection may fail. This is the first report of M. hominis isolation from a positive automated blood culture (BD BACTEC, USA).
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Affiliation(s)
- Tamara Posse
- Sección Microbiología Clínica, Hospital Juan A. Fernández, Buenos Aires, Argentina
| | - Monica Prieto
- Sección Bacteriología Especial, ANLIS Malbrán, Buenos Aires, Argentina
| | - Lucia Cipolla
- Sección Bacteriología Especial, ANLIS Malbrán, Buenos Aires, Argentina
| | - Sara Kaufman
- Sección Microbiología Clínica, Hospital Juan A. Fernández, Buenos Aires, Argentina.
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Barie PS. Atypical Wound Pathogens. Surg Infect (Larchmt) 2017; 18:455-460. [PMID: 28541806 DOI: 10.1089/sur.2017.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Atypical wound pathogens may be so described because they are uncommon pathogens of soft tissue among human beings, or because they may be fastidious and difficult to recover/isolate in the laboratory. METHODS A review of pertinent English-language literature was performed. RESULTS These wound pathogens are a diverse lot, including aerobic and anaerobic gram-positive and gram-negative bacilli, non-tuberculous mycobacteria, and bacteria that cannot be characterized conventionally because they lack a cell wall (the Mycoplasmataceae). They are diverse with respect to their virulence, but many are opportunistic pathogens. CONCLUSIONS Among these atypical pathogens, clinical reports are most common of wound infections caused by Mycoplasma/Ureaplasma (sometimes as co-infecting agents), and the so-called rapidly growing non-tuberculous mycobacteria (Runyon Type IV; e.g., M. chelonae).
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Affiliation(s)
- Philip S Barie
- Departments of Surgery and Medicine, Weill Cornell Medicine , New York, New York
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Hagiya H, Yoshida H, Yamamoto N, Kimura K, Ueda A, Nishi I, Akeda Y, Tomono K. Mycoplasma hominisperiaortic abscess following heart-lung transplantation. Transpl Infect Dis 2017; 19. [DOI: 10.1111/tid.12697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/20/2016] [Accepted: 12/31/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Hideharu Hagiya
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Hisao Yoshida
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Norihisa Yamamoto
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Keigo Kimura
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Akiko Ueda
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Isao Nishi
- Laboratory for Clinical Investigation; Osaka University Hospital; Osaka Japan
| | - Yukihiro Akeda
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
| | - Kazunori Tomono
- Department of Infection Control and Prevention; Osaka University Graduate School of Medicine; Osaka Japan
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Mycoplasma hominis Induces Mediastinitis after a Tonsillar Abscess. Case Rep Infect Dis 2016; 2016:9531715. [PMID: 27957362 PMCID: PMC5121441 DOI: 10.1155/2016/9531715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 11/18/2022] Open
Abstract
Mycoplasma hominis is commonly involved in genitourinary tract infections. We report a 59-year-old man who developed a M. hominis-associated mediastinitis following acute tonsillar infection.
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16
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Mycoplasma hominis, a Rare but True Cause of Infective Endocarditis. J Clin Microbiol 2015; 53:3068-71. [PMID: 26135868 DOI: 10.1128/jcm.00827-15] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/18/2015] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma spp. are rarely recognized agents of infective endocarditis. We report a case of Mycoplasma hominis prosthetic valve endocarditis diagnosed by 16S ribosomal DNA (rDNA) PCR and culture of valves in a 74-year-old man. We reviewed the literature and found only 8 other cases reported.
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17
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Le Guern R, Loïez C, Loobuyck V, Rousse N, Courcol R, Wallet F. A new case of Mycoplasma hominis mediastinitis and sternal osteitis after cardiac surgery. Int J Infect Dis 2014; 31:53-5. [PMID: 25532483 DOI: 10.1016/j.ijid.2014.12.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 11/16/2022] Open
Abstract
We report a case of nosocomial mediastinitis and sternal osteitis due to M. hominis after open-heart surgery in an immuno-competent patient. This infection has been diagnosed by incubating the culture media for an extended period of time, and sequencing 16S rDNA directly from the clinical samples.
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Affiliation(s)
- Rémi Le Guern
- Institute of Microbiology, University Hospital Center, Lille, France.
| | - Caroline Loïez
- Institute of Microbiology, University Hospital Center, Lille, France
| | - Valentin Loobuyck
- Department of Cardiovascular Surgery, University Hospital Center, Lille, France
| | - Natacha Rousse
- Department of Cardiovascular Surgery, University Hospital Center, Lille, France
| | - René Courcol
- Institute of Microbiology, University Hospital Center, Lille, France
| | - Frédéric Wallet
- Institute of Microbiology, University Hospital Center, Lille, France
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Meng DY, Sun CJ, Yu JB, Ma J, Xue WC. Molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis clinical isolates. Braz J Microbiol 2014; 45:239-42. [PMID: 24948939 PMCID: PMC4059304 DOI: 10.1590/s1517-83822014000100034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 09/09/2013] [Indexed: 11/22/2022] Open
Abstract
To evaluate the molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis (MH) clinical strains isolated from urogenital specimens. 15 MH clinical isolates with different phenotypes of resistance to fluoroquinolones antibiotics were screened for mutations in the quinolone resistance-determining regions (QRDRs) of DNA gyrase (gyrA and gyrB) and topoisomerase IV (parC and parE) in comparison with the reference strain PG21, which is susceptible to fluoroquinolones antibiotics. 15 MH isolates with three kinds of quinolone resistance phenotypes were obtained. Thirteen out of these quinolone-resistant isolates were found to carry nucleotide substitutions in either gyrA or parC. There were no alterations in gyrB and no mutations were found in the isolates with a phenotype of resistance to Ofloxacin (OFX), intermediate resistant to Levofloxacin (LVX) and Sparfloxacin (SFX), and those susceptible to all three tested antibiotics. The molecular mechanism of fluoroquinolone resistance in clinical isolates of MH was reported in this study. The single amino acid mutation in ParC of MH may relate to the resistance to OFX and LVX and the high-level resistance to fluoroquinolones for MH is likely associated with mutations in both DNA gyrase and the ParC subunit of topoisomerase IV.
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Affiliation(s)
- Dong-Ya Meng
- Department of Clinical Laboratory General Hospital of Shenyang Military Area Command Shenyang P.R. China
| | - Chang-Jian Sun
- Department of Clinical Laboratory No. 463 Hospital of Shenyang Military Area Command Shenyang P.R. China
| | - Jing-Bo Yu
- Department of Clinical Laboratory General Hospital of Shenyang Military Area Command Shenyang P.R. China
| | - Jun Ma
- Department of Clinical Laboratory General Hospital of Shenyang Military Area Command Shenyang P.R. China
| | - Wen-Cheng Xue
- Department of Clinical Laboratory General Hospital of Shenyang Military Area Command Shenyang P.R. China
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Karaca S, Kalangos A. Vacuum-assisted closure (VAC)-Instill(®) with continuous irrigation for the treatment of Mycoplasma hominis mediastinitis. Int Wound J 2014; 12:595-7. [PMID: 24684727 DOI: 10.1111/iwj.12234] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 01/08/2014] [Accepted: 01/12/2014] [Indexed: 11/29/2022] Open
Abstract
A 56-year-old patient who underwent ascending aorta replacement postoperatively developed mediastinitis with atypical Mycoplasma hominis. We present the first successful treatment of M. hominis mediastinitis after cardiac surgery with vacuum-assisted closure (VAC)-Instill(®) therapy combined with dilute antiseptic irrigation for bacterial eradication.
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Affiliation(s)
- Saziye Karaca
- Department of Cardiovascular Surgery, University Hospital Geneva, Geneva, Switzerland
| | - Afksendiyos Kalangos
- Department of Cardiovascular Surgery, University Hospital Geneva, Geneva, Switzerland
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Abstract
Ureaplasma urealyticum is a fastidious bacterium usually residing in the female genitourinary tract. We present an exceedingly complicated case of a brain abscess secondary to mastoiditis by U. urealyticum in an adult hypogammaglobulinemic patient after rituximab treatment 3 years earlier.
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21
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Pignanelli S, Pulcrano G, Iula VD, Zaccherini P, Testa A, Catania MR. In vitro antimicrobial profile of Ureaplasma urealyticum from genital tract of childbearing-aged women in Northern and Southern Italy. APMIS 2013; 122:552-5. [PMID: 24106832 DOI: 10.1111/apm.12184] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 08/18/2013] [Indexed: 11/28/2022]
Abstract
Ureaplasma urealyticum is an opportunistic pathogen during pregnancy and in newborns. Other clinical problems related to U. urealyticum infections are: no susceptibility to cell wall-active drugs, limits of antibiotic treatment in pregnancy, and spread of antimicrobial resistance. In addition, the results of antimicrobial susceptibility against U. urealyticum from various countries are few and controversial. The antimicrobial susceptibility of U. urealyticum, isolated from cervical swabs and collected from outpatient childbearing-aged women in Italy from 2009 to 2012, was performed against fluoroquinolones, macrolides, streptogramin and tetracyclines, using an available biochemical commercial kit and a specific solid culture medium, to improve the therapeutic management of these pathogenic agents. Ureaplasma urealyticum was detected in 49.4% of samples, but significant bacterial load was revealed in 29.8%. In vitro tetracyclines showed the best activity against U. urealyticum, followed by streptogramin, macrolides, and fluoroquinolones.
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Affiliation(s)
- Salvatore Pignanelli
- Department of Diagnostic Services, O.U. Laboratory Analysis of Clinical Chemistry and Microbiology, S. Maria della Scaletta Hospital, Imola, Bologna, Italy
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22
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Young H, Henao-Martínez AF, Miller A, Wilson M, Price CS. Cluster or coincidence? An unusual cause of surgical site infections in adult trauma patients. Am J Infect Control 2012. [PMID: 23199728 DOI: 10.1016/j.ajic.2012.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Mycoplasma hominis is a bacteria that colonizes and infects the genitourinary tract; extragenital infections are not common. Three surgical site infections because of M hominis in immunocompetent adult trauma patients were detected at our facility in a 6-month time period. We investigated this case series and hypothesize transmission based on common exposures.
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Pascual A, Perez MH, Jaton K, Hafen G, Di Bernardo S, Cotting J, Greub G, Vaudaux B. Mycoplasma hominis necrotizing pleuropneumonia in a previously healthy adolescent. BMC Infect Dis 2010; 10:335. [PMID: 21106079 PMCID: PMC3006422 DOI: 10.1186/1471-2334-10-335] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Accepted: 11/24/2010] [Indexed: 11/10/2022] Open
Abstract
Background Mycoplasma hominis is a fastidious micro-organism causing systemic infections in the neonate and genital infections in the adult. It can also be the cause of serious extra-genital infections, mainly in immunosuppressed or predisposed subjects. Case Presentation We describe a case of severe pneumonia and pericarditis due to Mycoplasma hominis in a previously healthy adolescent who did not respond to initial therapy. Conclusions Mycoplasma hominis could be an underestimated cause of severe pneumonia in immunocompetent patients and should be particularly suspected in those not responding to standard therapy.
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Affiliation(s)
- Andres Pascual
- Infectious Diseases Service, Department of Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland.
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24
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Lucke K, Kuster SP, Bertea M, Ruef C, Bloemberg GV. A deep sternal wound infection caused by Ureaplasma urealyticum. J Med Microbiol 2010; 59:1254-1256. [PMID: 20616189 DOI: 10.1099/jmm.0.022814-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Ureaplasma species are usually associated with infection of the urogenital tract. An unusual case of a sternal wound infection caused by Ureaplasma urealyticum in a 41-year-old male after aortic valve replacement is described.
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Affiliation(s)
- Katja Lucke
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Mihai Bertea
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Christian Ruef
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Guido V Bloemberg
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
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25
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MacKenzie CR, Nischik N, Kram R, Krauspe R, Jäger M, Henrich B. Fatal outcome of a disseminated dual infection with drug-resistant Mycoplasma hominis and Ureaplasma parvum originating from a septic arthritis in an immunocompromised patient. Int J Infect Dis 2010; 14 Suppl 3:e307-9. [PMID: 20554466 DOI: 10.1016/j.ijid.2010.02.2253] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 12/19/2009] [Accepted: 02/24/2010] [Indexed: 12/31/2022] Open
Abstract
Mycoplasma hominis and Ureaplasma parvum are rare causes of severe and fatal infections. The diagnosis of infection with mycoplasma is dependent on clinical suspicion and microbiological diagnosis, and often relies on molecular methods that do not readily detect antibiotic resistance. This may be of increasing importance as illustrated in the case below.
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Affiliation(s)
- Colin R MacKenzie
- Institute of Medical Microbiology and Hospital Hygiene, University Hospital, Heinrich-Heine-University, Universitätsstraße 1, Düsseldorf, Germany.
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Mitsani D, Nguyen M, Silveira F, Bermudez C, Toyoda Y, Pasculle A, Clancy C. Mycoplasma hominispericarditis in a lung transplant recipient: review of the literature about an uncommon but important cardiothoracic pathogen. Transpl Infect Dis 2010; 12:146-50. [DOI: 10.1111/j.1399-3062.2009.00457.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Evaluation of Mycoplasma inactivation during production of biologics: egg-based viral vaccines as a model. Appl Environ Microbiol 2010; 76:2718-28. [PMID: 20228111 DOI: 10.1128/aem.02776-09] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Although mycoplasmas are generally considered to be harmless commensals, some mycoplasma species are able to cause infections in pediatric, geriatric, or immunocompromised patients. Thus, accidental contamination of biologics with mycoplasmas represents a potential risk for the health of individuals who receive cell-derived biological and pharmaceutical products. To assess the efficiency of inactivation of mycoplasmas by the agents used in the manufacture of egg-derived influenza vaccines, we carried out a series of experiments aimed at monitoring the viability of mycoplasmas spiked into both chicken allantoic fluid and protein-rich microbiological media and then treated with beta-propiolactone, formalin, cetyltrimethylammonium bromide, Triton X-100, and sodium deoxycholate, which are agents that are commonly used for virus inactivation and disruption of viral particles during influenza vaccine production. Twenty-two mycoplasma species (with one to four strains of each species) were exposed to these inactivating agents at different concentrations. The most efficient inactivation of the mycoplasmas evaluated was observed with either 0.5% Triton X-100 or 0.5% sodium deoxycholate. Cetyltrimethylammonium bromide at concentrations of >or=0.08% was also able to rapidly inactivate (in less than 30 min) all mycoplasmas tested. In contrast, negligible reductions in mycoplasma titers were observed with 0.0125 to 0.025% formaldehyde. However, increasing the concentration of formaldehyde to 0.1 to 0.2% improved the mycoplasmacidal effect. Incubation of mycoplasmas with 0.1% beta-propiolactone for 1 to 24 h had a marked mycoplasmacidal effect. A comparison of the mycoplasma inactivation profiles showed that strains of selected species (Mycoplasma synoviae, Mycoplasma gallisepticum, Mycoplasma orale, Mycoplasma pneumoniae, and Acholeplasma laidlawii) represent a set of strains that can be utilized to validate the effectiveness of mycoplasma clearance obtained by inactivation and viral purification processes used for the manufacture of an inactivated egg-based vaccine.
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Mycoplasma hominis-associated parapharyngeal abscess following acute Epstein-Barr virus infection in a previously immunocompetent adult. J Clin Microbiol 2009; 47:3050-2. [PMID: 19641070 DOI: 10.1128/jcm.02203-08] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycoplasma hominis most frequently causes diseases of the genitourinary tract. Extragenital infections are uncommon, with almost all occurring in immunosuppressed persons or those predisposed due to trauma or surgery. We present the case of a previously well man who developed an M. hominis-associated parapharyngeal abscess following acute Epstein-Barr virus infection.
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Abstract
Infectious pericardial effusion with tamponade is an uncommon but life-threatening disease. We report an unusual case of spontaneous Ureaplasma pericardial effusion with tamponade associated with pneumonia, pleural effusion, and urinary tract infection. All published cases of clinically invasive Ureaplasma infections in the adult population are also reviewed.
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Abstract
Few reports in the literature have documented the isolation of Ureaplasma species from sternal wounds. A case of sternal wound infection likely due to Ureaplasma parvum is described. When routine bacterial cultures from a sternal wound infection fail to yield a pathogen, diagnostic testing for mycoplasmas and ureaplasmas should be considered.
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