Mycoplasma genitalium and Mycoplasma hominis infection in south Korea during 2018-2020

Background and Objectives: Sexually transmitted infections (STIs) can remain undetected and untreated; therefore, rapid diagnosis and treatment of STIs are important. Mycoplasma genitalium (MG), Mycoplasma hominis (MH), and Ureaplasma urealyticum are sexually transmitted pathogens that cause asymptomatic, organ-specific, and chronic infections, thereby pos- ing a threat to community health. Therefore, we investigated the epidemiological trends of MG and MH infections in South Korea for rapid diagnosis and treatment. Materials and Methods: From September 2018 to December 2020, samples (catheter, pus, tissue, swab, and urine) were collected from outpatients of hospitals in South Korea for molecular biological venereal disease testing. DNA was extracted and analyzed using real-time polymerase chain reaction. Results: Of the 59,381 samples analyzed, 8.78% (n=5,215) were positive for MG and MH. The MH positivity rate (5.51%, n=3,273) was higher than the MG positivity rate (3.27%, n=1,942). MG and MH positivity rates were the highest in patients aged <19 years. Men had higher MG positivity rate, whereas women had higher MH positivity rates. Furthermore, the MG- positivity rate was the highest in the swab samples of both men and women, whereas that of MH was the highest in the urine samples of men and swab samples of women. Conclusion: We identified the differences between MG and MH positivity rates based on sex, specimen, and age. Our findings can provide information for strategies that protect public health and reduce STI incidence and transmission.

Case Report: First Report of Disseminated Trachipleistophora hominis Infection in an AIDS Patient from Thailand

Microsporidial myositis caused by Trachipleistophora hominis is a life-threatening and emerging microsporidiosis among immunocompromised hosts. This article reports a case of disseminated microsporidiosis caused by T. hominis in southern Thailand. The patient had HIV and presented at the clinic with incapacitating muscle pain. She was diagnosed with disseminated microsporidiosis. Molecular identification revealed the sequence of 16S ribosomal RNA gene involving sequences sharing 99% nucleotide identity with T. hominis from an Australian patient. To our knowledge, this is the first study to report the detection of T. hominis microsporidia in an HIV patient in Thailand.

Profil dan Prevalensi Blastocystis hominis di Laboratorium Parasitologi Fakultas Kedokteran Universitas Kristen Indonesia

Abstrak Blastocystis hominis merupakan emerging disease yang terdistribusi luas di dunia, dengan prevalensi 10% di negara maju hingga 60% di negara berkembang. Perannya sebagai mikroorganisme patogen masih kontroversial. Diduga angka kejadian B. hominis lebih banyak didapatkan pada curah hujan yang rendah dan daerah tropis/ sub-tropis. Penelitian dilakukan untuk mengetahui prevalensi, profil B. hominis di Laboratorium Parasitologi Fakultas Kedokteran Universitas Kristen Indonesia, serta hubungan antara angka kejadian infeksi B. hominis dengan curah hujan dan kelembaban pada musim penghujan dan kemarau. Penelitian potong lintang deksriptif berdasarkan data pemeriksaan feses di Laboratorium Parasitologi Fakultas Kedokteran Universitas Kristen Indonesia selama 20 tahun sejak Januari 2000 sampai dengan Desember 2019. Sampel feses diperiksa dari sediaan basah dengan pewarnaan eosin dan lugol, dan hasilnya dilaporkan dengan sistem skoring semi kuantitatif. Data curah hujan dan kelembaban didapatkan dari Badan Meteorologi Klimatologi dan Geofisika Stasiun Meteorologi Kemayoran Jakarta.Didapatkan 3270 sampel, dengan hasil sampel positif B. hominissebanyak 440 sampel (14%), Prevalensi pada perempuan lebih tinggi dibandingkan laki-laki dan terbanyak pada kelompok usia 21-60 tahun (67,4%). Persentase tertinggi ditemukan pada feses dengan konsistensi cair. Tidak ditemukan hubungan antara prevalensi infeksi B. hominis dengan curah hujan (P=0,285) dan kelembaban (P=0,204). Kata kunci: prevalensi, konsistensi, curah hujan, kelembaban, musim Profile and Prevalence of Blastocystis hominis at Parasitology Laboratory, Medical Faculty Universitas Kristen Indonesia Abstract Blastocystis hominis is an emerging disease that is widely distributed in the world, with a prevalence of 10% in developed countries to 60% in developing countries. Its role as a pathogen is still controversial. It is suspected that the incidence of B. hominis is mostly found in low rainfall and tropical/ sub-tropical areas. The study was conducted to determine the prevalence and profile of B. hominis in the Laboratory of Parasitology, Faculty of Medicine, Universitas Kristen Indonesia.and the relationship between incidence of B. hominisinfection with rainfall and humidity in the rainy and dry seasons.This descriptive cross-sectional study was based on fecal examination data at the FK UKI Parasitology Laboratory for 20 years. from January 2000 to December 2019. Stool examination was carried out by making eosin and lugol wet preparations to examine intestinal protozoa, and the results were reported using a semi-quantitative scoring system.Rainfall and humidity data are obtained from the Meteorology, Climatology and Geophysics Agency of the Stasiun MeteorologiKemayoran, Jakarta. As many as3270 samples were obtained, feses with B. hominis positive results was 440 samples (14%). Based on gender, 53.1% of B. hominisinfected were women and most patients were found in the age range from 21 to 60 years (67.4%). The highest percentage was found in watery stool. There was no statistically significant between the prevalence of B. hominis infection with rainfall (p= 0.285) and humidity (p= 0.204). Key words: prevalence, consistency, rainfall, humidity, season

Stroke associated with Mycoplasma hominis infection: a case report

Background Mycoplasmas are the smallest prokaryotic microorganisms in nature. Many cases of stroke post-Mycoplasma pneumoniae infection have been reported, particularly in the pediatric population. However, Mycoplasma hominis infection has not previously been associated with stroke. Case presentation We report the case of a 36-year-old Greek woman who presented with an extensive stroke with an unspecified cause. She had a concurrent genital infection with Mycoplasma hominis for an unknown duration. Conclusion An association may exist between stroke and the immune response to Mycoplasma hominis infection.

Ramification of TNF-α-associated apoptosis on lactase enzyme activity due to Blastocystis hominis infection

Blastocystis hominis is a cosmopolitan protozoan that has been associated with several gastrointestinal disturbances involving lactose intolerance. However, the underlying pathogenic factors remain indistinct. 20 Swiss albino mice were utilized and assembled into four groups, each of five mice: group-I: received neither infection nor lactose (healthy control), group-II: received a single dose of 10000 cysts of Blastocystis and lactose diets in a dose of 12.5 g/ day/mouse for 7 consecutive ‎days starting from day 14 p.i, group-III: non-infected mice with oral doses of lactose (12.5 g/day/mouse) for 7 consecutive ‎days (positive control), group-IV: infected mice on lactose free diet (negative control). We investigated the histopathological changes using H&E stain. Also, lactase enzyme activity was measured using spectrophotometry and the production of TNF-α and apoptotic events were explored via immunohistochemistry and compared in the small intestine of all groups. The active inflammatory changes in the infected animals were moderate in the form of loss of villous architecture, increased ILC (P- value > 0.001) besides scattered forms of the parasite as compared to non-infected mice. There was a reduction in lactase enzyme activity p.i... The TNF-α levels were induced p.i. as compared to non-infected mice (P-value > 0.001). The expression of Bax protein was upgraded, while Bcl-2 expression decreased significantly with a reverse in Bax/Bcl2 ratio in infected animals. Blastocystis infection appears to humble lactase enzyme activity via the induction of apoptosis in the epithelial cells of the small intestinal brush border in a TNF-α associative pathway.

670. Rapid, Non-invasive Detection of Invasive Mycoplasma hominis Infection using the Karius Test, A Next-Generation Sequencing Test for Microbial Cell-free DNA in Plasma

Background Mycoplasma hominis is typically associated with genital infections in women and is a rare cause of musculoskeletal infections often in immunocompromised hosts. Diagnosis of invasive Mycoplasma hominis infections are difficult due to challenges in culturing these organisms. Molecular diagnostics require an index of suspicion which may not be present at the time of tissue sampling. Accurate, rapid diagnosis of Mycoplasma hominis infections are important for antibiotic management. Methods Two cases of invasive Mycoplasma hominis infections are presented in which the Karius test (KT) was used to make the diagnosis. The KT is a CLIA certified/CAP-accredited next-generation sequencing (NGS) plasma test that detects microbial cell-free DNA (mcfDNA). After mcfDNA is extracted and NGS performed, human reads are removed and remaining sequences are aligned to a curated database of &gt; 1400 organisms. Organisms present above a statistical threshold are reported. Case review was performed for clinical correlation. Results A young woman with lupus nephritis status post renal transplant developed persistent fever with progressive multifocal culture-negative osteoarticular infection despite empiric ceftriaxone. An adolescent female presented with an ascending pelvic infection progressing to purulent polymicrobial peritonitis (see table) requiring surgical debridement and cefipime, metronidazole and micafungin therapy; her course was complicated by progressive peritonitis/abscesses. Karius testing detected high-levels of Mycoplasma hominis mcfDNA in both cases – at 3251 molecules/microliter (MPM) in the first case and 3914 MPM in the second case. The normal range of Mycoplasma hominis mcfDNA in a cohort of 684 normal adults is 0 MPM. The patients rapidly improved with atypical coverage with doxycycline and levofloxaxin. Clinical findings in 2 patients with M. hominis infection detected by the Karius Test Conclusion Open-ended, plasma-based NGS for mcfDNA provides a rapid, non-invasive method to diagnose invasive Mycoplasma hominis infection. This case series highlights the potential to diagnose infections caused by fastidious pathogens to better inform antimicrobial therapy and achieve favorable outcomes. Disclosures William V. La Via, MD, Karius (Employee)

Mucosa-Associated Lymphoid-Tissue Lymphoma of the Descending Colon in a Patient with Blastocystis hominis Infection: A Case Report and Review of Literature

Mucosa-associated lymphoid tissue (MALT) lymphoma is an extra nodal marginal zone B-cell lymphoma that has been associated with chronic infections. It affects especially stomach, but other organs of gastrointestinal tract can be also involved. Colon MALT lymphoma is a very rare disease. We report a case of large bowel MALT lymphoma diagnosed as a result of weight loss and positive occult fecal blood test. Blastocystis hominis infection was detected in fecal analysis. We hypothesize chronic parasitic infection could be related with the development of the lymphoma.