Comparison between Cervical Ureaplasma spp. Colonization and the Intensity of Inflammatory Mediators in the Amniotic Fluid Retrieved during Cesarean Delivery in Preterm Birth

We investigated whether cervical Ureaplasma spp. colonization affects the intensity of inflammatory mediators in amniotic fluid retrieved during cesarean delivery in singleton preterm birth. One hundred fifty-three cases in singleton preterm birth with 24–34 weeks’ gestation were enrolled. The intensities of seven inflammatory mediators (interleukin (IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor-α, and matrix metalloproteins (MMP)-8, MMP-9) of amniotic fluid were measured. We tested cervical swab specimens using real-time polymerase chain reaction assays to detect Ureaplasma spp. colonization. Histologic chorioamnionitis (HCA) was diagnosed when acute inflammation was observed in any of the placental tissues. Mean gestational age at delivery and birth weight were 30.9 ± 2.4 weeks and 1567 ± 524 g, respectively. Cervical Ureaplasma spp. colonization was detected 78 cases. The incidence of HCA was 32.3% (43/133). Although the intensities of all inflammatory mediators were significantly different according to presence or absence of HCA, there were no significant differences according to cervical Ureaplasma spp. colonization. In all 43 cases with HCA and 90 cases without HCA, there were no significant differences between cervical Ureaplasma spp. colonization and the intensity of inflammatory mediators. Cervical Ureaplasma spp. colonization did not affect the intensity of inflammatory mediators in the amniotic fluid retrieved during cesarean delivery.

Monitoring Sexually Transmitted Infections in Cervicovaginal Exfoliative Samples in Mexican Women

Background. Globally, Sexually Transmitted Infections (STIs) are a major cause of morbidity in sexually active individuals, having complications in reproduction health and quality of life. In concordance with the Sustainable Development Goals (SDG), the study aimed to investigate the prevalence of Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, HSV, and Mycoplasma spp. from cervicovaginal samples and to correlate them with the gynecological history of the patients. Methods. Our analytical, prospective, and cross-sectional study included 377 women who participated in a reproductive health campaign during 2015–2016. Anthropometric and gynecological variables were obtained. Cervicovaginal specimens were collected and analyzed with a multiplex in-house PCR to detect Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, HSV, Mycoplasma spp., and Chlamydia trachomatis. Results. The positive cases were 175/377 (46.4%) to at least one of the microorganisms. The most frequent pathogen detected in this population was Ureaplasma spp. (n = 111, 29.4%), followed by Mycoplasma spp. (n = 56, 14.9%) and Candida spp. (n = 47, 12.5%); 33.7% of the positive cases were single infections, whereas 12.7% had coinfection. The multiplex PCR assay was designed targeting nucleotide sequences. Conclusions. Our data demonstrated that monitoring STIs among asymptomatic patients will encourage target programs to be more precisely and effectively implemented, as well as make these programs more affordable, to benefit society by decreasing the prevalence of STIs.

The Frequency Detection of Opportunistic Sexually Transmitted Infections among HIV-Infected Women Planning Pregnancy

The purpose of our study was to determine the frequency of detection of opportunistic sexually transmitted infections (Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma spp, Human papillomavirus) in HIV-infected women planning pregnancy. Methods and Results: We examined 31 HIV-positive Caucasian women. They sought pregnancy planning advice at the Scientific Center for Family Health and Human Reproduction Problems in Irkutsk during 2014-2015. The average age of the women was 30.9±4.5 years (20-39 years). A clinical diagnosis of HIV was made at Irkutsk Regional AIDS Center. All HIV-infected women were tested for the presence of DNA of pathogens of bacterial and viral sexually transmitted infections in the epithelium of the cervical canal. Chlamydia trachomatis was detected in 1(3.2%) participant, Trichomonas vaginalis in 1(3.2%), Ureaplasma spp. in 14(45.2%), and HPV in 22(71%). Co-infection of HPV and Ureaplasma spp. was observed in 35.5% of HIV-positive women. Conclusion: the prevention and detection of sexually transmitted infections in HIV-infected individuals remain a public health priority and an integral component of HIV primary care.

Determination of In Vitro Antimicrobial Susceptibility for Lefamulin (Pleuromutilin) for Ureaplasma Spp. and Mycoplasma hominis

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.

Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma spp. Coinfection in an HIV-Positive Homosexual Man

A 21-year-old human immunodeficiency virus-positive male patient presented with complaints of multiple hyperpigmented verrucous papules over his perianal area. He reported having unprotected anal and oral sex with multiple male partners. On examination, superficial ill-defined perianal erosions were present. A first void urine sample and clinician-collected rectal and oropharyngeal swabs were sent for the detection of Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis, and Ureaplasma spp. Rectal swab tested positive for all the four pathogens. Oropharyngeal swab and urine samples tested positive for C. trachomatis. The patient was treated with doxycycline and moxifloxacin. This case underscores the importance of screening of men who have sex with men for possible coinfections with multiple sexually transmitted pathogens.

Infektionsmanagement bei drohender Frühgeburt – eine Umfrage an deutschen Perinatalzentren

Zusammenfassung Einleitung Internationalen und nationalen Leitlinien fehlt es an detaillierten Empfehlungen zur Infektionsdiagnostik und -therapie bei drohender Frühgeburt. Ziel der Studie war es, Daten zur Versorgungssituation an deutschen Perinatalzentren zu erheben. Methoden Onlineumfrage zum Infektionsmanagement bei drohender Frühgeburt an allen 212 deutschen Perinatalzentren der Versorgungsstufen Level I und II. Ergebnisse Die Rücklaufquote betrug 31,6% (n=67). Bei drohender Frühgeburt unter 34 vollendeten SSW ohne Blasensprung verzichten 78,8% auf eine kalkulierte Antibiotikagabe. Von den verbleibenden vierzehn Zentren (21,2%) würde die Hälfte generell bei klinischen Zeichen einer drohenden Frühgeburt antibiotisch behandeln. Fast alle Zentren (94%) führen eine vaginale Erregerdiagnostik durch. Eine mikroskopische Abstrichbeurteilung mittels Nugent- oder Amsel-Score erfolgt in 37,3%. Abweichungen von der physiologischen vaginalen Mikrobiota werden mehrheitlich antibiotisch behandelt (bakterielle Vaginose 79,1%, n=53, Candida spp. 77,6%, n=52, Ureaplasma spp. 49,3%, n=33). Kontrollabstriche erfolgen in 70,1%. Konsens besteht hinsichtlich einer Antibiotikagabe bei frühem vorzeitigem Blasensprung. 72,6% bevorzugen eine Monotherapie mit einem β-Laktam-Antibiotikum. Uneinheitlich waren hier die Angaben zur Dauer der Therapie, wobei 58% der Zentren länger als sieben Tage behandeln. Schlussfolgerung An deutschen Perinatalzentren besteht eine hohe Bereitschaft zur Infektionsdiagnostik und -therapie bei drohender Frühgeburt. Das Infektionsmanagement ist jedoch uneinheitlich und partiell widersprüchlich zu den vorliegenden Leitlinien. Es besteht ein Bedarf an qualitativ hochwertigen Studien zu diesem Thema.

Μοριακή επιδημιολογία και μικροβιολογία σεξουαλικώς μεταδιδόμενων νοσημάτων

Αντικείμενο Σκοπός: Η διερεύνηση και η διάγνωση των σεξουαλικώς μεταδιδόμενων νοσημάτων (ΣΜΝ) συμπεριλαμβανομένου και του HPV και η παρουσία κυτταρολογικών αλλαγών στον τράχηλο σε μια κοόρτη μελέτη με σεξουαλικώς ενεργές γυναίκες στον ελλαδικό χώρο.Υλικό και μέθοδοι: Πραγματοποιήθηκε κυτταρολογία τραχήλου μήτρας και μοριακή τυποποίηση HPV και άλλων ΣΜΝ για 345 ενεργά σεξουαλικά γυναίκες ηλικίας μεταξύ 18 και 45 ετών (μέσος όρος 33.2±7.2 έτη) που προσήλθαν σε γυναικολογική κλινική για έλεγχο διαλογής ρουτίνας. Μελετήθηκε η συσχέτιση του HPV και άλλων ΣΜΝ με την κυτταρολογική εικόνα.Αποτελέσματα: HPV εντοπίστηκε σε 61 γυναίκες (17.7%) και άλλα ΣΜΝ σε 82 (23.8%). Το Ureaplasma spp ήταν το πιο συχνά εντοπιζόμενο παθογόνο, το οποίο βρέθηκε σε 63 (18.2%) γυναίκες και ακολούθησαν το Mycoplasma spp (21 γυναίκες, 25.6%) και το Chlamydia trachomatis (πέντε γυναίκες, 6.1%). Η HPV θετικότητα μόνο (χωρίς τη συνύπαρξη άλλων ΣΜΝ) συσχετίσθηκε με μη φυσιολογική κυτταρολογία (odds ratio 6.9, p<0.001), ενώ γυναίκες που ήταν αρνητικές τόσο για HPV όσο και για τα άλλα ΣΜΝ είχαν μεγαλύτερη πιθανότητα να εμφανίσουν φυσιολογική κυτταρολογία τραχήλου μήτρας (odds ratio 0.36, p<0.01). Δεκαέξι από τις 63 (25.4%) γυναίκες οι οποίες ελέγχθηκαν θετικές για Ureaplasma spp, είχαν υψηλού ρίσκου HPV τύπο (odds ratio 2.3, p=0.02).Συμπεράσματα: Σε έναν πληθυσμό με αυξημένη εμφάνιση του Ureaplasma spp, υπήρχε συσχέτιση αυτού του συγκεκριμένου παθογόνου με υψηλού κινδύνου (υψηλού ρίσκου) HPV λοίμωξη, εύρημα που χρειάζεται περαιτέρω διερεύνηση και μελέτη.

Have the same pathogenicity of Ureaplasma Parvum and Ureaplasma Urealyticum in non-specific cervicitis? -based on digital droplet PCR assay

Background: Ureaplasma spp. are association with a various of infectious diseases in female, but it still limited evidence for the pathogenicity in nonspecific cervicitis. The aim of this study was to develop and evaluate a digital droplet PCR (ddPCR) assay for quantified the load of Ureaplasma spp in cervical swabs. Methods: A total of 293 non-specific cervicitis (NSC) patients and 211 asymptomatic female fulfilled the inclusion criteria. Cervical swabs were identified by qPCR and further absolutely quantified by ddPCR. Results: The prevalence of U.parvum were 51.9% (152/293) and 46.9% (99/211); while U.urealyticum were 8.2% (24/293) and 8.1% (17/211) in the NSC and Control group, respectively. In addition, the average Ct value and median copy number per microliter of U.parvum were 31.33 (n=152) and 599 (n=48) in the NSC group and 33.68 (n=99) and 17.4 (n=33) in control group, respectively, suggest that the load of U.parvum of NSC group were significantly higher than the asymptomatic individual (P<0.001). But, the median load number of U.urealyticum were 1.26 (n=22) and 5.35 (n=14) copies per microliter two groups, the difference was no statistical significance (P>0.05). Conclusions: our study suggests that often carrying U.parvum at a high load but not U.urealyticum may have an important implications on the development and progression of cervicitis among female.

DISTRIBUTION OF MYCOPLASMA SPP. AND UREAPLASMA SPP. AMONG PREGNANT WOMEN

The purpose of the present study is to determine the prevalence of genital mycoplasmas (M. genitalium, M. hominis, U. parvum, U. urealyticum) in pregnant women by molecular biological methods. Material/Methods: A prospective epidemiological study of 107 pregnant women hospitalized in the Clinic of Obstetrics and Gynecology, University Hospital-Pleven, Bulgaria, was conducted. Vaginal secretion samples were taken from all 107 pregnant women. A Polymerase chain reaction (PCR) assay was used to detect the genomic DNA of the bacteria in pregnant women. Results: The highest is the relative share of women in the age group from 20 to 35 years - 66 (64.68%), followed by women under 20 years - 27 (25.23%) and women over 35 years - 14 (13.08%). Detection of bacterial DNA was found in 85 (79.44%) of the cases, with present Ureaplasma spp. Colonization in 42 women (39.25%). Although no statistical dependence was found on open bacteria and age groups (p-value = 0.4688), it is noteworthy that the prevalence of Mycoplasma spp. and Ureaplasma spp. as a whole in the age group from 20 to 35 years, which has the highest birth rate, is more than twice higher than the group of up to 20 years and more than five times higher compared to the group over 35 years. Conclusions: Studies on the incidence of Mycoplasma spp. and Ureaplasma spp. in pregnant women is important for controlling the pregnancy, predicting the risk of developing maternal-fetal infection and discussing the options for timely treatment.