Gardnerella vaginalis
plays an important role in bacterial vaginosis (BV,) while the role of genital Mollicutes is less obvious. The diagnosis of BV by use of the current Gram stain Nugent score is ...also suboptimal for defining the role of Mollicutes that lack a cell wall. Since bacterial load and diversity is an important prerequisite for BV, real-time quantitative polymerase chain reaction (qPCR) assays enable these to be assessed. The purpose of this study was to define the role of genital Mollicutes and potential patterns of synergy with
G. vaginalis
in women with BV. Vaginal swabs from 130 women categorised by Nugent score as BV (
n
= 28), intermediate (
n
= 22) and non-BV (
n
= 80) were tested against four qPCR TaqMan assays targeting
G. vaginalis
,
Mycoplasma hominis
,
M. genitalium
,
Ureaplasma urealyticum
and
U. parvum
. Statistical analyses were used to compare bacterial prevalence and load between the three groups of women.
Mycoplasma hominis
and
G. vaginalis
co-infection was significantly more common in BV (60.7 %) compared to intermediate (36.4 %) and non-BV (8.8 %) Nugent scores (
p
< 0.001). Significantly higher loads of
M. hominis
(
p
= 0.001) and
G. vaginalis
(
p
< 0.001) were detected in women with BV and the respective loads in
M. hominis
and
G. vaginalis
co-infections displayed a significant positive correlation (
p
< 0.001;
r
= 0.60). No significant associations were seen with the other Mollicutes. The findings strengthen the evidence of a role for
M. hominis
in BV and a potential synergy with
G. vaginalis
. This synergy could be an important trigger of the condition and sexual contact the conduit for the transmission of an otherwise commensal bacterium that could initiate it.
The aim of this study was to estimate the prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in a comprehensive teaching hospital Shenyang, China over the ...past 4 years.
A total of 1448 individuals with urogenital symptoms underwent mycoplasma testing between April 2016 and March 2020. Detection, identification and antimicrobial susceptibility testing were carried out using Mycoplasma ID/AST kits.
The total infection rate of genital mycoplasmas was 37.5% (543/1448 cases) with an observed increase over the past 4 years. The positive rates of all three detected infections, as well as overall infection rate, were significantly higher in females than in males (P < 0.05). A higher positive rate of infection was observed in females aged 25–29 (60.5%), and in the 15–19 years age group (57.7%). The changes observed among all age groups of females were statistically significantly different (P < 0.001). The positive rates of U. urealyticum and M. hominis co-infection among the four seasons during which the survey was carried out were also observed to be statistically different (P = 0.01). More than 70% of U. urealyticum isolates were found to be resistant to ciprofloxacin, and more than 80% of M. hominis isolates were resistant to erythromycin, roxithromycin, azithromycin and clarithromycin. Josamycin, doxycycline and minocycline were most effective against U. urealyticum and M. hominis.
Results of this study found increasing rates of U. urealyticum and M. hominis infection over the past 4 years, particularly among younger age groups. U. urealyticum/Mycoplasma hominis screening among younger age cohorts are therefore strongly recommend to preventing the spread of pathogens. Monitoring antimicrobial resistance is important for preventing transmission of resistant strains of infection and for the management of antibiotics.
Objective This study was undertaken to evaluate the frequency of umbilical cord blood infections with Ureaplasma urealyticum and Mycoplasma hominis in preterm 23- to 32-week births and to determine ...their association with various obstetric conditions, markers of placental inflammation, and newborn outcomes. Study Design 351 mother/infant dyads with deliveries between 23 and 32 weeks’ gestational age who had cord blood cultures for U urealyticum and M hominis had their medical records abstracted, other placental cultures performed, cord interleukin-6 levels determined, placentas evaluated histologically, and infant outcomes determined. Results U urealyticum and/or M hominis were present in 23% of cord blood cultures. Positive cultures were more common in infants of nonwhite women (27.9% vs 16.8%; P = .016), in women less than 20 years of age, in those undergoing a spontaneous compared to an indicated preterm delivery (34.7% vs 3.2%; P = .0001), and in those delivering at earlier gestational ages. Intrauterine infection and inflammation were more common among infants with a positive U urealyticum and M hominis culture as evidenced by placental cultures for these and other bacteria, elevated cord blood interleukin-6 levels, and placental histology. Infants with positive cord blood U urealyticum and M hominis cultures were more likely to have neonatal systemic inflammatory response syndrome (41.3% vs 25.7%; P = .007; adjusted odds ratio, 1.86; 1.08-3.21) and probably bronchopulmonary dysplasia (26.8% vs 10.1%; P = .0001; adjusted odds ratio 1.99; 0.91-4.37), but were not significantly different for other neonatal outcomes, including respiratory distress syndrome, intraventricular hemorrhage, or death. Conclusion U urealyticum and M hominis cord blood infections are far more common in spontaneous vs indicated preterm deliveries and are strongly associated with markers of acute placental inflammation. Positive cultures are associated with neonatal systemic inflammatory response syndrome and probably bronchopulmonary dysplasia.
The objective of the study was to determine the frequency of microbial invasion of the amniotic cavity in the midtrimester of pregnancy in patients undergoing amniocentesis for clinical indications.
...This was a prospective investigation of the amniotic fluid of 344 asymptomatic women recruited in midpregnancy for the presence of microbial DNA. Amniotic samples obtained at the time of amniocentesis for genetic testing on women between 15 and 22 weeks of gestation were tested specifically for the presence of Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, and Mycoplasma genitalium as well as for other bacteria and fungi using broad-range polymerase chain reaction only. Pregnancy outcomes were reviewed independent of all molecular test results.
Using broad-range polymerase chain reaction, the prevalence of microbial invasion of the amniotic cavity in women between 15 and 22 weeks of gestation was 0% (0 vs 344). Early preterm delivery occurred in only 4 women (1%); 1 delivered electively and 3 spontaneously. None were associated with Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, or Mycoplasma genitalium. In addition, broad range polymerase chain reaction did not reveal the presence of other bacterial or fungal microbes.
Microbial invasion of the amniotic cavity in midtrimester gestations of low-risk pregnant women was not detected using molecular methods in 344 patients.
In Mongolia, diagnostic tests for the detection of the sexually transmitted mycoplasmas, ureaplasmas, Herpes simplex virus (HSV), and cytomegalovirus (CMV) are currently not routinely used in ...clinical settings and the frequency of these STIs are enigmatic. The prevalence of these STI pathogens were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome. TaqMan PCRs were used to detect bacterial and viral STI pathogens in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and linear regression analysis was used to correlate pathogen detection with pregnancy outcome. Ureaplasmas were the most prevalent of the tested pathogens (positive in 90.5% positive women and 47.5% newborns), followed by mycoplasmas (32.5% and 7.5%), chlamydia (14.5% and 7.5%), trichomonas (8.5% and 4.0%) and gonococcus (0.5% and 0%). CMV was found in 46.5% of the pregnant women and in 10.5% of their newborns, whereas HSV-2 was detected in only two mothers. Multiple regression analyses indicate that colonization of the mothers with U. urealyticum, M. hominis, T. vaginalis or CMV is associated with transmission to newborns and that transmission of M. hominis or CMV from Mongolian pregnant women to offspring is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.
Preconcentrating particulate and cellular matter for their isolation or detection is often a necessary and critical sample preparation or purification step in many lab-on-a-chip diagnostic devices. ...While surface acoustic wave (SAW) microcentrifugation has been demonstrated as a powerful means to drive efficient particle concentration, this has primarily been limited to micron dimension particles. When the particle size is around 1 μm or below, studies on SAW microcentrifugation to date have shown that particle ring-like aggregates can only be obtained in contrast to the localized concentrated clusters that are obtained with larger particles. Considering the importance of submicron particles and bioparticles that are common in many real-world samples, we elucidate why previous studies have not been able to achieve the concentration of these smaller particles to completion, and we present a practical solution involving a novel closed chamber configuration that minimizes sample heating and eliminates evaporation to show that it is indeed possible to drive submicron particle and cell concentration down to 200 nm diameters with SAW microcentrifugation over longer durations.
Citation Marconi C, Ramos BRA, Peraçoli JC, Donders GGG, Silva MG. Amniotic fluid interleukin‐1 betaand interleukin‐6, but not interleukin‐8 correlate with microbial invasion of the amniotic cavity ...in preterm labor. Am J Reprod Immunol 2011; 65: 549–556
Problem We compared the frequency of intra‐amniotic infection in preterm labor (PL) with women not in labor, and correlated infection with amniotic fluid (AF) cytokines. Detailed identification of species, especially mycoplasmata, was tried to improve our understanding of the pathogenesis of PL.
Method of study AF from 20 women with PL and 20 controls were evaluated. Infection was detected by PCR for Mycoplasma hominis, Ureaplasma urealyticum and 16S rRNA bacterial gene, which was cloned and sequenced for bacterial identification. Interleukin (IL)‐1β, IL‐6, IL‐8 and tumor necrosis factor (TNF)‐α levels were measured by ELISA.
Results Frequency of intra‐amniotic infection is higher in PL (40.0%). Sequencing‐based method identified Bacteroides fragilis, Prevotella bivia and Leptotrichia amnionii, in addition to Mycoplasma species detected by PCR. AF infection correlated with increased IL‐1β and IL‐6 levels.
Conclusion The frequency of intra‐amniotic infection, especially M. hominis, in PL women who delivered with 7 days, is high and correlates with high IL‐1β and IL‐6 levels, but not IL‐8.
At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonizations/infections. ...Consequently, routine testing and treatment of asymptomatic or symptomatic men and women for M. hominis, U. urealyticum and U. parvum are not recommended. Asymptomatic carriage of these bacteria is common, and the majority of individuals do not develop any disease. Although U. urealyticum has been associated with urethritis in men, it is probably not causal unless a high load is present (likely carriage in 40–80% of detected cases). The extensive testing, detection and subsequent antimicrobial treatment of these bacteria performed in some settings may result in the selection of antimicrobial resistance, in these bacteria, ‘true’ STI agents, as well as in the general microbiota, and substantial economic cost for society and individuals, particularly women. The commercialization of many particularly multiplex PCR assays detecting traditional non‐viral STIs together with M. hominis, U. parvum and/or U. urealyticum has worsened this situation. Thus, routine screening of asymptomatic men and women or routine testing of symptomatic individuals for M. hominis, U. urealyticum and U. parvum is not recommended. If testing of men with symptomatic urethritis is undertaken, traditional STI urethritis agents such as Neisseria gonorrhoeae, Chlamydia trachomatis, M. genitalium and, in settings where relevant, Trichomonas vaginalis should be excluded prior to U. urealyticum testing and quantitative species‐specific molecular diagnostic tests should be used. Only men with high U. urealyticum load should be considered for treatment; however, appropriate evidence for effective treatment regimens is lacking. In symptomatic women, bacterial vaginosis (BV) should always be tested for and treated if detected.
Abstract
Female and male infertility have been associated to
Chlamydia trachomatis
,
Ureaplasma
spp. and
Mycoplasma hominis
urogenital infections. However, evidence from large studies assessing their ...prevalence and putative associations in patients with infertility is still scarce. The study design was a cross-sectional study including 5464 patients with a recent diagnosis of couple’s primary infertility and 404 healthy control individuals from Cordoba, Argentina. Overall, the prevalence of
C. trachomatis
,
Ureaplasma
spp. and
M. hominis
urogenital infection was significantly higher in patients than in control individuals (5.3%, 22.8% and 7.4% vs. 2.0%, 17.8% and 1.7%, respectively).
C. trachomatis
and
M. hominis
infections were significantly more prevalent in male patients whereas
Ureaplasma
spp. and
M. hominis
infections were more prevalent in female patients. Of clinical importance,
C. trachomatis
and
Ureaplasma
spp. infections were significantly higher in patients younger than 25 years. Moreover,
Ureaplasma
spp. and
M. hominis
infections were associated to each other in either female or male patients being reciprocal risk factors of their co-infection. Our data revealed that
C. trachomatis
,
Ureaplasma
spp. and
M. hominis
are prevalent uropathogens in patients with couple’s primary infertility. These results highlight the importance of including the screening of urogenital infections in the diagnostic workup of infertility.
PDF
