Evaluation of Mycotrim-GU for isolation of Mycoplasma species and Ureaplasma urealyticum

A Randomized, Double-Blind Study Comparing Single-Dose Rifalazil With Single-Dose Azithromycin for the Empirical Treatment of Nongonococcal Urethritis in Men

OBJECTIVES

To determine the safety and effectiveness of single-dose rifalazil, a new rifamycin, for the treatment of nongonococcal urethritis (NGU).

STUDY DESIGN

Randomized, double-blind trial comparing rifalazil, 2.5, 12.5 or 25 mg, with 1.0 g azithromycin for the treatment of NGU. One hundred and seventy men were evaluated for Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma genitalium infection before therapy and 2- and 5-weeks posttreatment.

RESULTS

C. trachomatis, M. genitalium, and U. urealyticum were present in 42%, 24%, and 28% of subjects, respectively. Microbiologic eradication of C. trachomatis with rifalazil 25 mg at 2- and 5- weeks was 85% and 83%, respectively. Rifalazil was ineffective in eradicating M. genitalium and U. urealyticum. Overall clinical cure rates at 2- and 5-weeks were 86% (95% CI 67-96) and 59% (39-78) in the rifalazil-treated 25 mg group, and 77% (56-91) and 63% (41-81) in the azithromycin-treated group.

CONCLUSIONS

Rifalazil was well tolerated and eradicates C. trachomatis but not M. genitalium and U. ureaplasma in men with NGU.

Sperm motility, morphology, hyperactivation, and ionophore-induced acrosome reactions after overnight incubation with mycoplasmas

OBJECTIVE

To evaluate the effect on the function on human sperm of overnight incubation with mycoplasma species.

DESIGN

Prospective controlled in vitro study.

SETTING

Community-based sperm bank and andrology laboratory.

INTERVENTIONS

Percoll-separated sperm were incubated overnight with a low densities of Myco-plasma hominis and Ureaplasma urealyticum serotypes.

MAIN OUTCOME MEASURES

Motility, midpiece and tail morphology, hyperactivation after overnight capacitation, and acrosome status after incubation with calcium ionophore.

RESULTS

Overnight incubation with mycoplasma species resulted in small but highly statistically significant differences in motility, morphology, hyperactivation after overnight capacitation, and proportion acrosome reacted after incubation with calcium ionophore compared with controls.

CONCLUSIONS

Incubation with mycoplasma species impairs sperm physiology. Identification and treatment of mycoplasma may augment a physiology-based infertility evaluation.

Comparison of commercially available media for detection and isolation of Ureaplasma urealyticum and Mycoplasma hominis

The Mycotrim Triphasic flask system (Irvine Scientific, Irvine, Calif.) was compared with a system composed of Mycotrim GU broth (Irvine Scientific) and A7 or A8 agar (Remel, Lenexa, Kans.) for the ability to detect Ureaplasma urealyticum and Mycoplasma hominis from 129 genital specimens. Of the 64 specimens positive for U. urealyticum, 25, 98, and 100% were detected on Mycotrim Triphasic agar and A7 and A8 agars, respectively. All 18 specimens that grew M. hominis were detected by A7 and A8 agars, and 94% grew on Mycotrim Triphasic agar. Mycotrim GU broth detected all of the positive specimens, and Mycotrim Triphasic broth detected all but one. Mycotrim GU broth inoculated simultaneously with either A7 or A8 agar was found to be more sensitive and cost-effective than the Mycotrim Triphasic flask system.

Isolation of Mycoplasma species and Ureaplasma urealyticum from obstetrical and gynecological patients by using commercially available medium formulations

One hundred duplicate endocervical specimens from obstetrical and gynecological patients were cultured for Mycoplasma spp. and Ureaplasma urealyticum. Rates of recovery of these organisms from commercially prepared A7 medium and the Mycotrim-GU system were compared. We detected 14 (93%) of the total 15 isolates of Mycoplasma spp. on A7 plates and 11 (73%) in the Mycotrim-GU system. We detected 34 (89%) of the total 38 isolates of U. urealyticum on A7 plates and 32 (84%) in the Mycotrim-GU system. The times of detection for both types of organism were similar in the two systems. We conclude that cultivation on A7 medium as described is a more cost-effective method of recovery of Mycoplasma spp. and U. urealyticum than the Mycotrim-GU system.