1
|
Pereyre S, Hénin N, Dolzy A, Guiraud J, Laurier-Nadalié C, Gardette M, Bébéar C. Evaluation of commercial, customized microdilution plates for Ureaplasma parvum, Ureaplasma urealyticum, and Mycoplasma hominis antimicrobial susceptibility testing and determination of antimicrobial resistance prevalence in France. J Clin Microbiol 2024:e0022624. [PMID: 38832769 DOI: 10.1128/jcm.00226-24] [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: 02/12/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024] Open
Abstract
Antimicrobial susceptibility testing (AST) of human mycoplasmas using microdilution is time-consuming. In this study, we compared the performance of MICRONAUT-S plates (Biocentric-Bruker) designed for AST of Ureaplasma parvum, Ureaplasma urealyticum, and Mycoplasma hominis with the results using the Clinical & Laboratory Standards Institute (CLSI) reference method. Then, we investigated the prevalence and mechanisms of resistance to tetracyclines, fluoroquinolones, and macrolides in France in 2020 and 2021. The two methods were compared using 60 strains. For the resistance prevalence study, U. parvum-, U. urealyticum-, and M. hominis-positive clinical specimens were collected for 1 month each year in 22 French diagnostic laboratories. MICs were determined using the MICRONAUT-S plates. The tet(M) gene was screened using PCR, and fluoroquinolone resistance-associated mutations were screened using PCR and Sanger sequencing. Comparing the methods, 99.5% (679/680) MICs obtained using the MICRONAUT-S plates concurred with those obtained using the CLSI reference method. For 90 M. hominis isolates, the tetracycline, levofloxacin, and moxifloxacin resistance rates were 11.1%, 2.2%, and 2.2%, respectively, with no clindamycin resistance. For 248 U. parvum isolates, the levofloxacin and moxifloxacin resistance rates were 5.2% and 0.8%, respectively; they were 2.9% and 1.5% in 68 U. urealyticum isolates. Tetracycline resistance in U. urealyticum (11.8%) was significantly (P < 0.001) higher than in U. parvum (1.2%). No macrolide resistance was observed. Overall, the customized MICRONAUT-S plates are a reliable, convenient tool for AST of human mycoplasmas. Tetracycline and fluoroquinolone resistance remain limited in France. However, the prevalence of levofloxacin and moxifloxacin resistance has increased significantly in Ureaplasma spp. from 2010 to 2015 and requires monitoring. IMPORTANCE Antimicrobial susceptibility testing of human urogenital mycoplasmas using the CLSI reference broth microdilution method is time-consuming and requires the laborious preparation of antimicrobial stock solutions. Here, we validated the use of reliable, convenient plates designed for antimicrobial susceptibility testing that allows the simultaneous determination of the MICs of eight antibiotics of interest. We then investigated the prevalence and mechanisms of resistance of each of these bacteria to tetracyclines, fluoroquinolones, and macrolides in France in 2020 and 2021. We showed that the prevalence of levofloxacin and moxifloxacin resistance has increased significantly in Ureaplasma spp. from 2010 to 2015 and requires ongoing monitoring.
Collapse
Affiliation(s)
- Sabine Pereyre
- UMR 5234 Fundamental Microbiology and Pathogenicity, CNRS, University of Bordeaux, Bordeaux, France
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Nadège Hénin
- UMR 5234 Fundamental Microbiology and Pathogenicity, CNRS, University of Bordeaux, Bordeaux, France
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Amandine Dolzy
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Jennifer Guiraud
- UMR 5234 Fundamental Microbiology and Pathogenicity, CNRS, University of Bordeaux, Bordeaux, France
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Laurier-Nadalié
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Marie Gardette
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| | - Cécile Bébéar
- UMR 5234 Fundamental Microbiology and Pathogenicity, CNRS, University of Bordeaux, Bordeaux, France
- Bacteriology Department, Bordeaux University Hospital, National Reference Centre for Bacterial Sexually Transmitted Infections, Bordeaux, France
| |
Collapse
|
2
|
Sabat AJ, Durfee T, Baldwin S, Akkerboom V, Voss A, Friedrich AW, Bathoorn E. The complete genome sequence of unculturable Mycoplasma faucium obtained through clinical metagenomic next-generation sequencing. Front Cell Infect Microbiol 2024; 14:1368923. [PMID: 38694516 PMCID: PMC11062135 DOI: 10.3389/fcimb.2024.1368923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/25/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction Diagnosing Mycoplasma faucium poses challenges, and it's unclear if its rare isolation is due to infrequent occurrence or its fastidious nutritional requirements. Methods This study analyzes the complete genome sequence of M. faucium, obtained directly from the pus of a sternum infection in a lung transplant patient using metagenomic sequencing. Results Genome analysis revealed limited therapeutic options for the M. faucium infection, primarily susceptibility to tetracyclines. Three classes of mobile genetic elements were identified: two new insertion sequences, a new prophage (phiUMCG-1), and a species-specific variant of a mycoplasma integrative and conjugative element (MICE). Additionally, a Type I Restriction-Modification system was identified, featuring 5'-terminally truncated hsdS pseudogenes with overlapping repeats, indicating the potential for forming alternative hsdS variants through recombination. Conclusion This study represents the first-ever acquisition of a complete circularized bacterial genome directly from a patient sample obtained from invasive infection of a primary sterile site using culture-independent, PCR-free clinical metagenomics.
Collapse
Affiliation(s)
- Artur J. Sabat
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Tim Durfee
- DNASTAR, Inc., Madison, WI, United States
| | | | - Viktoria Akkerboom
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Andreas Voss
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Erik Bathoorn
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| |
Collapse
|
3
|
You C, Liao M, Wang M, Zhao L, Li L, Ye X, Yang T. The Effect of Amoxicillin Pre-Exposure on Treatment Outcomes and Antimicrobial Susceptibility in Patients with Urogenital Chlamydia trachomatis Infection. Infect Drug Resist 2023; 16:3575-3587. [PMID: 37305735 PMCID: PMC10257477 DOI: 10.2147/idr.s410410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/25/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose We investigated the influence of amoxicillin pre-exposure on treatment outcomes, Chlamydia trachomatis (CT) culture, the presence of drug-resistant genes, minimum inhibitory concentrations (MICs), and fractional inhibitory concentrations (FICs) in CT clinical strains. Additionally, we explored the effect of different antimicrobial combinations on CT. Patients and Methods Clinical data of 62 patients with CT infection were recorded. Of these, 33 had pre-exposure to amoxicillin and 29 did not. Among patients with pre-exposure, 17 received azithromycin and 16 received minocycline. Among the patients without pre-exposure, 15 received azithromycin and 14 received minocycline. All patients underwent microbiological cure follow-ups one month after completing the treatment. 23S rRNA gene mutations, acquisition of tet(M) and tet(C) were detected using reverse transcription PCR (RT-PCR) and PCR, respectively. The MICs and FICs of azithromycin, minocycline, and moxifloxacin, alone or in combination, were determined using the microdilution and checkerboard methods, respectively. Results More cases of treatment failure occurred in pre-exposed patients, in both treatment groups (P <0.05). No 23S rRNA gene mutations or tet(M) and tet(C) acquisitions were found. More inclusion bodies were cultured from patients without amoxicillin pre-exposure than from those with pre-exposure (P <0.0001). The MICs of all antibiotics were higher in pre-exposed patients than in those without pre-exposure (P <0.01). The FICs of azithromycin plus moxifloxacin were lower than those of the other antibiotic combinations (P <0.0001). The synergy rate of azithromycin plus moxifloxacin was significantly higher than those of azithromycin plus minocycline and minocycline plus moxifloxacin (P <0.001). The FICs of all antibiotic combinations were comparable between isolates from the two patient groups (all P >0.05). Conclusion Pre-exposure to amoxicillin in CT patients may inhibit CT growth and decrease sensitivity of CT strains to antibiotics. Azithromycin plus moxifloxacin may be a promising treatment regimen for genital CT infections with treatment failure.
Collapse
Affiliation(s)
- Cong You
- Department of Dermatology and Venereology; Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Mingyi Liao
- Department of Dermatology and Venereology; Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Mei Wang
- Department of Dermatology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, People’s Republic of China
| | - Leran Zhao
- Department of Dermatology and Venereology, the General Hospital of Tianjin Medical University, Tianjin, People’s Republic of China
| | - Longnian Li
- Department of Dermatology and Venereology; Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Xiaoying Ye
- Department of Dermatology and Venereology; Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China
| | - Tao Yang
- Department of Dermatology and Venereology; Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, the First Affiliated Hospital of Gannan Medical University, Ganzhou, People’s Republic of China
| |
Collapse
|
4
|
Wu J, He D, Yu F, Huang Y, Bian M, Yu C, Liu J, Cai Z, Zhao Y. Mycoplasma infection mimicking a malignancy in a waldenstrom macroglobulinemia patient. BMC Infect Dis 2023; 23:219. [PMID: 37029352 PMCID: PMC10080790 DOI: 10.1186/s12879-023-08163-6] [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: 12/10/2022] [Accepted: 03/15/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND Mycoplasma hominis infection is common in urinary tract. 18F-FDG-PET/CT is a valuable tool for tumor and infection diagnosis. Few studies have shown the 18F-FDG-PET/CT images after mycoplasma infection. CASE PRESENTATION Here we described a case of Waldenstrom macroglobulinemia with thickened bladder wall. The 18F-FDG-PET/CT showed the SUVmax up to 36.1 mimicking bladder cancer. The results of histopathological examination and metagenomic sequencing of the blood and urinary revealed the Mycoplasma hominis infection. CONCLUSION The full consideration should be given to the possibility of infection besides tumor in lesions with high SUV value in 18F-FDG-PET/CT, especially in immunodeficiency patients.
Collapse
Affiliation(s)
- Junqing Wu
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 310000, China
| | - Donghua He
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 310000, China
| | - Fang Yu
- Department of Pathology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Yue Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
| | - Meiru Bian
- Department of Hematology, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huaian, 223001, China
| | - Chengxuan Yu
- Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, The Second Affiliated Hospital, Ministry of Education, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China
| | - Jiao Liu
- Hangzhou Xixi Hospital, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310000, Zhejiang, China
| | - Zhen Cai
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 310000, China
- Institute of Hematology, Zhejiang University, Hangzhou, 310000, Zhejiang, China
- Zhejiang Laboratory for Systems & Precision Medicine, Zhejiang University Medical Center, Hangzhou, 310000, China
| | - Yi Zhao
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 310000, China.
| |
Collapse
|
5
|
Chen Y, Li R, Yang L, Wang R, Li Z, Li T, Liu M, Ramakrishna S, Long Y. Synergistic Effects of Magnetic Z-Scheme g-C 3N 4/CoFe 2O 4 Nanofibres with Controllable Morphology on Photocatalytic Activity. NANOMATERIALS (BASEL, SWITZERLAND) 2023; 13:1142. [PMID: 37049235 PMCID: PMC10096916 DOI: 10.3390/nano13071142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
The rational design of interfacial contacts plays a decisive role in improving interfacial carrier transfer and separation in heterojunction photocatalysts. In Z-scheme photocatalysts, the recombination of photogenerated electron-hole pairs is prevented so that the redox capacity is maintained. Here, one-dimensional graphitic carbon nitride (g-C3N4)/CoFe2O4 fibres were synthesised as a new type of magnetic Z-scheme visible-light photocatalyst. Compared with pure g-C3N4 and CoFe2O4, the prepared composite photocatalysts showed considerably improved performance for the photooxidative degradation of tetracycline and methylene blue. In particular, the photodegradation efficiency of the g-C3N4/CoFe2O4 fibres for methylene blue was approximately two and seven times those of g-C3N4 and CoFe2O4, respectively. The formation mechanism of the Z-scheme heterojunctions in the g-C3N4/CoFe2O4 fibres was investigated using photocurrent spectroscopy and electrochemical impedance spectroscopy. We proposed that one of the reasons for the improved photodegradation performance is that the charge transport path in one-dimensional materials enables efficient photoelectron and hole transfer. Furthermore, the internal electric field of the prepared Z-scheme photocatalyst enhanced visible-light absorption, which provided a barrier for photoelectron-hole pair recombination.
Collapse
Affiliation(s)
- Yelin Chen
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
| | - Ru Li
- Instrumental Analysis Center of Qingdao University, Qingdao 266071, China
| | - Lei Yang
- Research Center for Intelligent & Wearable Technology, College of Textiles & Clothing, Qingdao University, Qingdao 266071, China
| | - Rongxu Wang
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
| | - Zhi Li
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
| | - Tong Li
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
| | - Meijie Liu
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
| | - Seeram Ramakrishna
- Center for Nanofibers & Nanotechnology, Faculty of Engineering, National University of Singapore, Singapore 119077, Singapore
| | - Yunze Long
- Collaborative Innovation Center for Nanomaterials & Devices, College of Physics, Qingdao University, Qingdao 266071, China
- State Key Laboratory of Bio-Fibers & Eco-Textiles, Qingdao University, Qingdao 266071, China
| |
Collapse
|
6
|
Huang SM, Tang YR, Wang JL, Wang XZ, Zhang YY, Pan SF. Case Report: Double trouble: a rare case of successfully treated Mycoplasma hominis and Pseudomonas aeruginosa co-infection. Front Cell Infect Microbiol 2023; 13:1159891. [PMID: 37197207 PMCID: PMC10183579 DOI: 10.3389/fcimb.2023.1159891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
Background Extra-urogenital infections due to Mycoplasma hominis (M. hominis) are rare, particularly co-infection with Pseudomonas aeruginosa (P. aeruginosa). Herein, we report on a patient who was co-infected and successfully treated despite delayed treatment. Case presentation We reported the case of a 43-year-old man with M. hominis and P. aeruginosa co-infection after a traffic accident. The patient developed a fever and severe infection despite postoperative antimicrobial therapies. The blood culture of wound tissues was positive for P. aeruginosa. Meanwhile, culturing of blood and wound samples showed pinpoint-sized colonies on blood agar plates and fried-egg-type colonies on mycoplasma medium, which were identified as M. hominis by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA sequencing. Based on antibiotic susceptibility and symptoms, ceftazidime-avibactam and moxifloxacin were administered for P. aeruginosa infection. Meanwhile, after the failure of a series of anti-infective agents, M. hominis and P. aeruginosa co-infection was successfully treated with a minocycline-based regimen and polymyxin B. Conclusion The co-infection with M. hominis and P. aeruginosa was successfully treated with anti-infective agents despite delayed treatment, providing information for the management of double infection.
Collapse
|
7
|
Song J, Wu X, Kong Y, Jin H, Yang T, Xie X, Zhang J. Prevalence and antibiotics resistance of Ureaplasma species and Mycoplasma hominis in Hangzhou, China, from 2013 to 2019. Front Microbiol 2022; 13:982429. [PMID: 36187990 PMCID: PMC9520197 DOI: 10.3389/fmicb.2022.982429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022] Open
Abstract
Ureaplasma spp. and Mycoplasma hominis, frequent colonizers in the lower urogenital tract, have been implicated in various infections, with antibiotic resistance growing and varying regionally. This study aims to investigate the prevalence and antibiotic resistance profiles of Ureaplasma spp. and M. hominis in outpatients in Hangzhou, China, from 2013 to 2019. A total of 135,263 outpatients were examined to determine the prevalence of Ureaplasma spp. and M. hominis, including 48,638 males and 86,625 females. Furthermore, trends in antibiotic susceptibility of Ureaplasma spp. and M. hominis during 1999–2019 were analyzed. The cultivation, identification, and antibiotic susceptibility of the bacteria (ofloxacin, ciprofloxacin, erythromycin, clarithromycin, azithromycin, josamycin, tetracycline, doxycycline, and pristinamycin) were determined using the Mycoplasma IST2 kit. Our study indicated that the overall prevalence of total Ureaplasma spp./M. hominis was 38.1% from 2013 to 2019. Ureaplasma spp. were the most frequently isolated species (overall prevalence, 31.3%), followed by Ureaplasma spp./M. hominis coinfection (6.0%) and single M. hominis infection (0.8%). The prevalence of Ureaplasma spp. and M. hominis was significantly higher in females than in males, and the highest positive rates of total Ureaplasma spp./M. hominis were observed in both female and male outpatients aged 14–20 years. During 2013–2019, josamycin, tetracycline, doxycycline, and pristinamycin maintained exceptionally high activity (overall resistance rates, <5%) against both Ureaplasma spp. and M. hominis, but ofloxacin and ciprofloxacin showed limited activity (overall resistance rates, >70%). During 1999–2019, the rates of resistance to ofloxacin and ciprofloxacin increased against both Ureaplasma spp. and M. hominis but decreased to erythromycin, clarithromycin, azithromycin, tetracycline, and doxycycline against Ureaplasma spp. In conclusion, our study demonstrates a high prevalence of Ureaplasma spp. compared to M. hominis and Ureaplasma spp./M. hominis, and their distribution was associated with sex and age. Josamycin, doxycycline, and tetracycline are promising antibiotics that have remarkable activity against Ureaplasma species and M. hominis.
Collapse
Affiliation(s)
- Jingjuan Song
- 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
| | - Xuanlan Wu
- 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
| | - Hong Jin
- 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
| | - 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
- *Correspondence: Xinyou Xie,
| | - Jun Zhang
- 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
- Jun Zhang,
| |
Collapse
|
8
|
Delafoy M, Goutines J, Fourmont AM, Birgy A, Chomton M, Levy M, Naudin J, Zafrani L, Le Mouel L, Yakouben K, Cointe A, Caseris M, Lafaurie M, Bonacorsi S, Mechinaud F, Pereyre S, Boissel N, Baruchel A. Case Report: Hyperammonemic Encephalopathy Linked to Ureaplasma spp. and/or Mycoplasma hominis Systemic Infection in Patients Treated for Leukemia, an Emergency Not to Be Missed. Front Oncol 2022; 12:912695. [PMID: 35875088 PMCID: PMC9304698 DOI: 10.3389/fonc.2022.912695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
Background Hyperammonemic encephalopathy caused by Ureaplasma spp. and Mycoplasma hominis infection has been reported in immunocompromised patients undergoing lung transplant, but data are scarce in patients with hematological malignancies. Case Presentation We describe the cases of 3 female patients aged 11–16 years old, developing initially mild neurologic symptoms, rapidly evolving to coma and associated with very high ammonia levels, while undergoing intensive treatment for acute leukemia (chemotherapy: 2 and hematopoietic stem cell transplant: 1). Brain imaging displayed cerebral edema and/or microbleeding. Electroencephalograms showed diffuse slowing patterns. One patient had moderate renal failure. Extensive liver and metabolic functions were all normal. Ureaplasma spp. and M. hominis were detected by PCR and specific culture in two patients, resulting in prompt initiation of combined antibiotics therapy by fluoroquinolones and macrolides. For these 2 patients, the improvement of the neurological status and ammonia levels were observed within 96 h, without any long-term sequelae. M. hominis was detected post-mortem in vagina, using 16S rRNA PCR for the third patient who died of cerebral edema. Conclusion Hyperammonemic encephalopathy linked to Ureaplasma spp. and M. hominis is a rare complication encountered in immunocompromised patients treated for acute leukemia, which can lead to death if unrecognized. Combining our experience with the few published cases (n=4), we observed a strong trend among female patients and very high levels of ammonia, consistently uncontrolled by classical measures (ammonia-scavenging agents and/or continuous kidney replacement therapy). The reversibility of the encephalopathy without sequelae is possible with prompt diagnosis and adequate combined specific antibiotherapy. Any neurological symptoms in an immunocompromised host should lead to the measurement of ammonia levels. If increased, and in the absence of an obvious cause, it should prompt to perform a search for Ureaplasma spp. and M. hominis by PCR as well as an immediate empirical initiation of combined specific antibiotherapy.
Collapse
Affiliation(s)
- Manon Delafoy
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- *Correspondence: Manon Delafoy,
| | - Juliette Goutines
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Aude-Marie Fourmont
- Department of Hematology, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - André Birgy
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Maryline Chomton
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Michaël Levy
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Jérôme Naudin
- Paediatric Intensive Care Unit, Robert-Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Lara Zafrani
- Medical Intensive Care Unit, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Unité Mixte de Recherche 976, Institut National de la Santé Et de la Recherche Médicale, Paris, France
| | - Lou Le Mouel
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Karima Yakouben
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Aurélie Cointe
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Marion Caseris
- Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Matthieu Lafaurie
- Department of Infectious Diseases, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Stéphane Bonacorsi
- Department of Microbiology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Infection, Antimicrobiens, Modélisation, Evolution, Unité Mixte de Recherche 1137, Institut National de la Santé Et de la Recherche Médicale, Université Paris Cité, Paris, France
| | - Françoise Mechinaud
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Sabine Pereyre
- Department of Bacteriology, National Reference Center for Bacterial Sexually Transmitted Infections, Bordeaux University Hospital, Bordeaux, France
- Unité Mixte de Recherche 5234, Fundamental Microbiology and Pathogenicity, Université de Bordeaux, Centre National de la Recherche Scientifique, Bordeaux, France
| | - Nicolas Boissel
- Department of Hematology, Saint-Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Research Unit EA-3518, Université Paris Cité, Paris, France
| | - André Baruchel
- Department of Hematology, Robert Debré University Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
- Research Unit EA-3518, Université Paris Cité, Paris, France
| |
Collapse
|
9
|
Clinical and Microbiological Characterization of Bloodstream Infections Caused by Mycoplasma hominis: An Overlooked Pathogen. Infect Dis Ther 2022; 11:1003-1017. [PMID: 35286659 PMCID: PMC9124272 DOI: 10.1007/s40121-022-00616-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/23/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction Methods Results Conclusions Supplementary Information
Collapse
|
10
|
Chang SY, Price TK, Beaird OE, Gaynor PT, Schaenman JM, Carlson ME, Kubak BM, Yang S, Multani A. Mycoplasma hominis
infections in solid organ transplant recipients: clinical characteristics, treatment outcomes, and comparison of phenotypic and genotypic susceptibility profiles. Transpl Infect Dis 2022; 24:e13822. [DOI: 10.1111/tid.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/25/2022] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Sandy Y. Chang
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
- Division of Infectious Diseases Department of Medicine Loma Linda University Loma Linda CA USA
| | - Travis K. Price
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Omer E. Beaird
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Pryce T. Gaynor
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Joanna M. Schaenman
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Margrit E. Carlson
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Bernard M. Kubak
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Shangxin Yang
- Department of Pathology and Laboratory Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Ashrit Multani
- Division of Infectious Diseases Department of Medicine David Geffen School of Medicine at UCLA Los Angeles CA USA
| |
Collapse
|
11
|
Sharratt M, Sands K, Portal EAR, Boostrom I, Mondeja BA, Rodríguez NM, Jones LC, Spiller OB. Defining Fluoroquinolone Resistance-Mediating Mutations from Non-Resistance Polymorphisms in Mycoplasma hominis Topoisomerases. Antibiotics (Basel) 2021; 10:antibiotics10111379. [PMID: 34827317 PMCID: PMC8614649 DOI: 10.3390/antibiotics10111379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 12/02/2022] Open
Abstract
Often dismissed as a commensal, Mycoplasma hominis is an increasingly prominent target of research due to its role in septic arthritis and organ transplant failure in immunosuppressed patients, particularly lung transplantation. As a mollicute, its highly reductive genome and structure render it refractile to most forms of treatment and growing levels of resistance to the few sources of treatment left, such as fluoroquinolones. We examined antimicrobial susceptibility (AST) to fluoroquinolones on 72 isolates and observed resistance in three (4.1%), with corresponding mutations in the quinolone resistance-determining region (QRDR) of S83L or E87G in gyrA and S81I or E85V in parC. However, there were high levels of polymorphism identified between all isolates outside of the QRDR, indicating caution for a genomics-led approach for resistance screening, particularly as we observed a further two quinolone-susceptible isolates solely containing gyrA mutation S83L. However, both isolates spontaneously developed a second spontaneous E85K parC mutation and resistance following prolonged incubation in 4 mg/L levofloxacin for an extra 24–48 h. Continued AST surveillance and investigation is required to understand how gyrA QRDR mutations predispose M. hominis to rapid spontaneous mutation and fluoroquinolone resistance, absent from other susceptible isolates. The unusually high prevalence of polymorphisms in M. hominis also warrants increased genomics’ surveillance.
Collapse
Affiliation(s)
- Martin Sharratt
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (M.S.); (K.S.); (E.A.R.P.); (I.B.)
| | - Kirsty Sands
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (M.S.); (K.S.); (E.A.R.P.); (I.B.)
- Department of Zoology, Oxford University, Oxford OX1 3RE, UK
| | - Edward A. R. Portal
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (M.S.); (K.S.); (E.A.R.P.); (I.B.)
- Bacteriology Reference Department, UK Health Security Agency, London NW9 5EQ, UK
| | - Ian Boostrom
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (M.S.); (K.S.); (E.A.R.P.); (I.B.)
| | - Brian A. Mondeja
- Pedro Kourí Tropical Medicine Institute, Havana 11400, Cuba; (B.A.M.); (N.M.R.)
- Center for Advance Research of Cuba, Havana CP17100, Cuba
| | - Nadia M. Rodríguez
- Pedro Kourí Tropical Medicine Institute, Havana 11400, Cuba; (B.A.M.); (N.M.R.)
| | - Lucy C. Jones
- Department of Integrated Sexual Health, Cwm Taf Morgannwg University Health Board, Pontypridd CF37 1LB, UK;
| | - Owen B. Spiller
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK; (M.S.); (K.S.); (E.A.R.P.); (I.B.)
- Bacteriology Reference Department, UK Health Security Agency, London NW9 5EQ, UK
- Correspondence:
| |
Collapse
|
12
|
Spiller-Boulter O, Paukner S, Boostrom I, Sands K, Portal EAR, Spiller OB. Determination of In Vitro Antimicrobial Susceptibility for Lefamulin (Pleuromutilin) for Ureaplasma Spp. and Mycoplasma hominis. Antibiotics (Basel) 2021; 10:antibiotics10111370. [PMID: 34827308 PMCID: PMC8614837 DOI: 10.3390/antibiotics10111370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/30/2022] Open
Abstract
Lefamulin is the first of the pleuromutilin class of antimicrobials to be available for therapeutic use in humans. Minimum inhibitory concentrations of lefamulin were determined by microbroth dilution for 90 characterised clinical isolates (25 Ureaplasma parvum, 25 Ureaplasma urealyticum, and 40 Mycoplasma hominis). All Mycoplasma hominis isolates possessed lefamulin MICs of ≤0.25 mg/L after 48 h (MIC50/90 of 0.06/0.12 mg/L), despite an inherent resistance to macrolides; while Ureaplasma isolates had MICs of ≤2 mg/L after 24 h (MIC50/90 of 0.25/1 mg/L), despite inherent resistance to clindamycin. Two U. urealyticum isolates with additional A2058G mutations of 23S rRNA, and one U. parvum isolate with a R66Q67 deletion (all of which had a combined resistance to macrolides and clindamycin) only showed a 2-fold increase in lefamulin MIC (1–2 mg/L) relative to macrolide-susceptible strains. Lefamulin could be an effective alternative antimicrobial for treating Ureaplasma spp. and Mycoplasma hominis infections irrespective of intrinsic or acquired resistance to macrolides, lincosamides, and ketolides. Based on this potent in vitro activity and the known good, rapid, and homogenous tissue penetration of female and male urogenital tissues and glands, further exploration of clinical efficacy of lefamulin for the treatment of Mycoplasma and Ureaplasma urogenital infections is warranted.
Collapse
Affiliation(s)
| | | | - Ian Boostrom
- Division of Infection and Immunity, Department of Medical Microbiology, Cardiff University, 6th Floor University Hospital of Wales, Cardiff CF14 4XN, UK; (I.B.); (K.S.); (E.A.R.P.)
| | - Kirsty Sands
- Division of Infection and Immunity, Department of Medical Microbiology, Cardiff University, 6th Floor University Hospital of Wales, Cardiff CF14 4XN, UK; (I.B.); (K.S.); (E.A.R.P.)
- Department of Zoology, University of Oxford, Oxford OX1 3RE, UK
| | - Edward A. R. Portal
- Division of Infection and Immunity, Department of Medical Microbiology, Cardiff University, 6th Floor University Hospital of Wales, Cardiff CF14 4XN, UK; (I.B.); (K.S.); (E.A.R.P.)
- Bacterial Reference Department, UK Health Security Agency, London NW9 5DF, UK
| | - Owen B. Spiller
- Division of Infection and Immunity, Department of Medical Microbiology, Cardiff University, 6th Floor University Hospital of Wales, Cardiff CF14 4XN, UK; (I.B.); (K.S.); (E.A.R.P.)
- Bacterial Reference Department, UK Health Security Agency, London NW9 5DF, UK
- Correspondence:
| |
Collapse
|
13
|
Wang Z, Li H, Zhang J, Wang X, Zhang Y, Wang H. Identification of a novel plasmid-mediated tigecycline resistance-related gene, tet(Y), in Acinetobacter baumannii. J Antimicrob Chemother 2021; 77:58-68. [PMID: 34634801 DOI: 10.1093/jac/dkab375] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/20/2021] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To characterize a novel plasmid-mediated tigecycline resistance-related gene, tet(Y), in a clinical Acinetobacter baumannii isolate from China. METHODS The tet(Y)-encoded tigecycline-resistant A. baumannii 2016GDAB1 was screened through antimicrobial susceptibility testing and WGS. The function of tet(Y) was verified by complementation of tet(Y). The plasmid transferability and stability were detected via plasmid conjugation and in vitro bacterial passaging. The 3D structure of Tet(Y) was predicted and docked using tFold and AutoDock Vina. RESULTS The tigecycline-resistant A. baumannii 2016GDAB1 was isolated from bronchoalveolar lavage fluid of a patient with hospital-acquired pneumonia. However, this strain did not harbour any common tigecycline resistance genes, determinants or mutations. 2016GDAB1 belongs to the non-epidemic clone ST355 (Oxford scheme), which has been mainly reported in animals. The tet(Y) gene was located on a 72 156 bp plasmid and genomic environment analysis revealed that Tn5393 may play a role in tet(Y) transmission, whereas phylogenetic analysis indicated the origin of tet(Y) as from Aeromonas. Overexpression of tet(Y) resulted in a 2- to 4-fold increase in tigecycline MIC. Introduction of the tet(Y)-harbouring plasmid p2016GDAB1 via electroporation resulted in a 16-fold increase in tigecycline MIC but failed to transfer into the tigecycline-susceptible A. baumannii recipient via conjugation. Isolates carrying the tet(Y) gene were vulnerable to tigecycline pressure and exhibited decreased susceptibility to tigecycline. A tet(Y)-carrying plasmid was stably maintained in the host strains. CONCLUSIONS This study identified the tigecycline resistance-related gene tet(Y) in A. baumannii. This gene conferred an increased tigecycline MIC and the transposable element Tn5393 may play a role in its transmission across isolates.
Collapse
Affiliation(s)
- Zhiren Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Henan Li
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Jiangang Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Xiaojuan Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Yawei Zhang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| | - Hui Wang
- Department of Clinical Laboratory, Peking University People's Hospital, Beijing, China
| |
Collapse
|
14
|
Pereyre S, Tardy F. Integrating the Human and Animal Sides of Mycoplasmas Resistance to Antimicrobials. Antibiotics (Basel) 2021; 10:1216. [PMID: 34680797 PMCID: PMC8532757 DOI: 10.3390/antibiotics10101216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 01/17/2023] Open
Abstract
Mycoplasma infections are frequent in humans, as well as in a broad range of animals. However, antimicrobial treatment options are limited, partly due to the lack of a cell wall in these peculiar bacteria. Both veterinary and human medicines are facing increasing resistance prevalence for the most commonly used drugs, despite different usage practices. To date, very few reviews have integrated knowledge on resistance to antimicrobials in humans and animals, the latest dating back to 2014. To fill this gap, we examined, in parallel, antimicrobial usage, resistance mechanisms and either phenotype or genotype-based methods for antimicrobial susceptibility testing, as well as epidemiology of resistance of the most clinically relevant human and animal mycoplasma species. This review unveiled common features and differences that need to be taken into consideration in a "One Health" perspective. Lastly, two examples of critical cases of multiple drug resistance are highlighted, namely, the human M. genitalium and the animal M. bovis species, both of which can lead to the threat of untreatable infections.
Collapse
Affiliation(s)
- Sabine Pereyre
- USC EA 3671, Mycoplasmal and Chlamydial Infections in Humans, Univ. Bordeaux, INRAE, F-33000 Bordeaux, France
- Bacteriology Department, National Reference Center for Bacterial Sexually Transmitted Infections, CHU Bordeaux, F-33000 Bordeaux, France
| | - Florence Tardy
- UMR Mycoplasmoses Animales, Anses, VetAgro Sup, Université de Lyon, F-69007 Lyon, France
| |
Collapse
|
15
|
Boostrom I, Bala Y, Vasic JM, Gluvakov J, Chanard E, Barratt AH, Sands K, Portal E, Devigne L, Jones LC, Spiller OB. Evaluation of the MYCOPLASMA IST3 urogenital mycoplasma assay in an international multicentre trial. J Antimicrob Chemother 2021; 76:3175-3182. [PMID: 34477840 PMCID: PMC8678932 DOI: 10.1093/jac/dkab320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 08/04/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To evaluate the accuracy, susceptibility and specificity of MYCOPLASMA IST3, the next generation of the most popular culture-based in vitro diagnostic device designed to detect, identify and test the susceptibility of urogenital mycoplasma infections. METHODS MYCOPLASMA IST3 was evaluated against culture- and molecular-based gold standard methodologies to detect, identify, enumerate and determine antimicrobial resistance for Mycoplasma hominis and Ureaplasma species in 516 clinical samples collected across France, Serbia and the UK. Sample types included vulvovaginal/endocervical or urethral swabs (dry swab or eSwab®), semen and urine samples, which included blinded analysis following addition of a panel of 80 characterized control strains. RESULTS Overall species identification was excellent for both Ureaplasma spp. (98.4% sensitivity, 99.7% specificity) and M. hominis (95.7% sensitivity, 100% specificity) relative to combined colony morphology on agar and quantitative PCR standards. Non-dilution-based bacterial load estimation by the assay was accurate between 83.7% (M. hominis) and 86.3% (Ureaplasma spp.) of the time (increased to 94.2% and 100%, respectively, if ±10-fold variance was allowed) relative to colonies counted on agar. Resistance accuracy for Ureaplasma spp. varied from gold standards for only 11/605 of individual tests (major error rate = 1.8%) and for 14/917 individual tests for M. hominis (major error rate = 1.5%). CONCLUSIONS The redesigned MYCOPLASMA IST3 assay eliminated previous shortcomings by providing independent accurate resistance screening of M. hominis and Ureaplasma species, even in mixed infections, with CLSI-compliant thresholds. Specificity, sensitivity and enumeration estimates correlated closely with the confirmatory methods.
Collapse
Affiliation(s)
- Ian Boostrom
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK
| | - Yohan Bala
- bioMérieux Global Clinical Affairs, Marcy, L'Étoile, France
| | | | | | | | - Andrew H Barratt
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK
| | - Kirsty Sands
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK.,Department of Zoology, University of Oxford, Oxford, UK
| | - Edward Portal
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK
| | | | - Lucy C Jones
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK.,Department of Integrated Sexual Health, Dewi Sant Hospital Cwm Taf Morgannwg University Health Board, Pontypridd, UK.,HealthFirst Consulting, Research Division, Blackwood, UK
| | - Owen B Spiller
- Cardiff University, Division of Infection and Immunity, Department of Medical Microbiology, University Hospital of Wales, Cardiff, UK.,Public Heath England, Bacterial Reference Department, London, UK
| |
Collapse
|