Abstract
Objective
Genital mycoplasmas are opportunistic pathogens that have been associated with urogenital
infections in humans. Only a few groups of antimicrobials are available for treatment
of urogenital tract infections caused by genital mycoplasmas. However, emerging resistance
of mycoplasmas to antimicrobial agents has been reported worldwide. The aim of the
study was a retrospective analysis of the prevalence and antimicrobial susceptibility
patterns of M. hominis and Ureaplasma spp. in patients with urogenital tract infections during a twelve-year period between
2003 and 2015.
Study design
Mycoplasma IST2 test was used for the detection, enumeration, identification and antimicrobial
susceptibility testing of genital mycoplasmas in 1182 samples from 778 women and 404
men with genitourinary tract infection. Indicative enumeration in the test determines
whether the mycoplasma count in the sample is equal or higher than the threshold set
at 104 colony forming units.
Results
A total of 152 (12.8%) samples were found to be positive for genital mycoplasmas.
M. hominis was detected only in three samples and Ureaplasma spp. in 141 samples. Both, M. hominis and Ureaplasma spp. were detected in the remaining eight samples. In the analyzed period between
2003 and 2015, a gradually increasing resistance of ureaplasmas to ciprofloxacin and
clarithromycin and decreasing resistance to ofloxacin, erythromycin and tetracycline
were observed. Pristinamycin, josamycin and doxycycline were most active against Ureaplasma spp. In contrast, fluoroquinolones had the lowest efficacy against Ureaplasma spp. and as many as 116 (82.3%) and 77 (54.6%) of Ureaplasma spp. isolates were resistant to ciprofloxacin and ofloxacin, respectively. M. hominis isolates were uniformly resistant to azithromycin, clarithromycin and erythromycin
but susceptible to josamycin, ofloxacin, doxycycline and pristinamycin. One-third
of these isolates were resistant to ciprofloxacin and tetracycline.
Conclusion
In the study Ureaplasma spp. and M. hominis were detected with relatively low frequency in comparison with other studies however,
most of these isolates were resistant to ciprofloxacin indicating the need for better
management of ciprofloxacin prescription. Important limitations of Mycoplasma IST2
assay concerning antimicrobial susceptibility testing and divergences between breakpoints
in the test and EUCAST guidelines point the need to introduce new methodologies to
improve evaluation of resistant strains at our region.
Keywords
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Article info
Publication history
Published online: November 14, 2017
Accepted:
November 10,
2017
Received in revised form:
August 21,
2017
Received:
October 17,
2016
Identification
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