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PloS One 2014Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU.
AIMS
The goals of this study were to evaluate the association of Ureaplasmas spp. with NGU, and to compare the prevalence of Ureaplasmas spp. infection in China relative to the world average.
METHODS
A systematic review and meta-analysis was conducted following standard guidelines for meta-analysis. The quality of included studies was assessed by Newcastle-Ottawa scale.
RESULTS
A total of seven studies involving 1,507 NGU patients and 1,223 controls were eligible for meta-analysis. There was no significant difference in the Ureaplasma spp. positive rate between the NGU and control groups. However, the U. urealyticum positive rate was significantly higher in NGU patients compared to controls; the U. parvum positive rate was significantly higher in controls compared to NGU patients. Furthermore, within the NGU patient group, the positive rate of U. urealyticum was significantly higher than that of U. parvum, whereas within the control group, the opposite trend was observed. Compared to the world average, a significantly higher positive rate of Ureaplasma spp. was observed in both the NGU and control groups in China.
CONCLUSIONS
Our analysis supports that U. urealyticum, but not U. parvum, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU.
Topics: Adolescent; Adult; Aged; Case-Control Studies; China; Humans; Middle Aged; Neisseria gonorrhoeae; Prevalence; Publication Bias; Ureaplasma; Ureaplasma Infections; Urethritis; Young Adult
PubMed: 25463970
DOI: 10.1371/journal.pone.0113771 -
The Journal of Antimicrobial... Mar 2021Resistance to tetracyclines, the first-line treatment for urogenital infections caused by Mycoplasma hominis and Ureaplasma species, is increasing worldwide. The aim of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Resistance to tetracyclines, the first-line treatment for urogenital infections caused by Mycoplasma hominis and Ureaplasma species, is increasing worldwide. The aim of the present study was to determine the global status of resistance to this class of antibiotics.
METHODS
Electronic databases were searched using keywords including 'Mycoplasma', 'Mycoplasma hominis', 'M. hominis', 'Ureaplasma', 'Ureaplasma urealyticum', 'Ureaplasma parvum', 'U. urealyticum', 'U. parvum', 'Ureaplasma species', 'resistance', 'antibiotic resistance', 'antibiotic susceptibility', 'antimicrobial resistance', 'antimicrobial susceptibility', 'tetracycline', 'doxycycline' and 'minocycline'. Finally, after some exclusions, 37 studies from different countries were included in the study and meta-analysis was performed on the data collected.
RESULTS
The midrange resistance rates for M. hominis and U. urealyticum/parvum to tetracycline, doxycycline and minocycline were 50.0%, 9.0% and 16.7% and 43.3%, 28.6% and 9.0%, respectively. A high level of heterogeneity was observed in all studies (I2 > 50%, P value < 0.05), except those representing doxycycline resistance in M. hominis isolates (I2 = 39.1%, P = 0.02). No evidence of publication bias was observed in the studies and neither Egger's test nor Begg's test showed significant publication bias.
CONCLUSIONS
The results of the present study show that the overall resistance to tetracyclines is relatively high and prevalent among M. hominis and Ureaplasma species throughout the world. This highlights the importance of and necessity for regional and local antibiotic susceptibility testing before treatment choice as well as development of newer generations of tetracyclines to prevent antibiotic misuse, emergence and spread of resistant strains and, finally, the failure of treatment.
Topics: Anti-Bacterial Agents; Humans; Microbial Sensitivity Tests; Mycoplasma Infections; Mycoplasma hominis; Ureaplasma; Ureaplasma Infections; Ureaplasma urealyticum
PubMed: 33367765
DOI: 10.1093/jac/dkaa538 -
The Lancet. Infectious Diseases Nov 2020Mycoplasma genitalium is now recognised as an important bacterial sexually transmitted infection. We summarised data from studies of mutations associated with macrolide... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mycoplasma genitalium is now recognised as an important bacterial sexually transmitted infection. We summarised data from studies of mutations associated with macrolide and fluoroquinolone resistance in M genitalium to establish the prevalence of resistance. We also investigated temporal trends in resistance and aimed to establish the association between resistance and geographical location.
METHODS
In this systematic review and meta-analysis, we searched PubMed, Embase, and MEDLINE for studies that included data for the prevalence of mutations associated with macrolide and fluoroquinolone resistance in M genitalium published in any language up to Jan 7, 2019. We defined prevalence as the proportion of M genitalium samples positive for key mutations associated with azithromycin resistance (23S rRNA gene, position 2058 or 2059) or moxifloxacin resistance (S83R, S83I, D87N, or D87Y in parC), or both, among all M genitalium samples that were successfully characterised. We used random-effects meta-analyses to calculate summary estimates of prevalence. Subgroup and meta-regression analyses by WHO region and time period were done. This study was registered with PROSPERO, number CRD42016050370.
RESULTS
Overall, 59 studies from 21 countries met the inclusion criteria for our study: 57 studies of macrolide resistance (8966 samples), 25 of fluoroquinolone resistance (4003 samples), and 22 of dual resistance to macrolides and fluoroquinolones (3280 samples). The summary prevalence of mutations associated with macrolide resistance among M genitalium samples was 35·5% (95% CI 28·8-42·5); prevalence increased from 10·0% (95% CI 2·6-20·1%) before 2010, to 51·4% (40·3-62·4%) in 2016-17 (p<0·0001). Prevalence of mutations associated with macrolide resistance was significantly greater in samples in the WHO Western Pacific and Americas regions than in those from the WHO European region. The overall prevalence of mutations associated with fluoroquinolone resistance in M genitalium samples was 7·7% (95% CI 4·5-11·4%). Prevalence did not change significantly over time, but was significantly higher in the Western Pacific region than in the European region. Overall, the prevalence of both mutations associated with macrolide resistance and those associated with fluoroquinolone resistance among M genitalium samples was 2·8% (1·3-4·7%). The prevalence of dual resistance did not change significantly over time, and did not vary significantly by geographical region.
INTERPRETATION
Global surveillance and measures to optimise the efficacy of treatments-including resistance-guided strategies, new antimicrobials, and antimicrobial combination approaches-are urgently needed to ensure cure in a high proportion of M genitalium infections and to prevent further spread of resistant strains.
FUNDING
Australian National Health and Medical Research Council.
Topics: Anti-Bacterial Agents; Azithromycin; Carrier Proteins; Drug Resistance, Bacterial; Female; Humans; Male; Moxifloxacin; Mutation; Mycoplasma Infections; Mycoplasma genitalium; Polymorphism, Single Nucleotide; Prevalence; RNA, Ribosomal, 23S; Sexually Transmitted Diseases, Bacterial; Transferases
PubMed: 32622378
DOI: 10.1016/S1473-3099(20)30154-7 -
Sexually Transmitted Infections Aug 2019is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to , but its natural history is poorly understood. The objectives of this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to , but its natural history is poorly understood. The objectives of this systematic review were to determine incidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID).
METHODS
We searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.
RESULTS
We screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I 0%). Median persistence of was estimated from one to three months in four studies but 15 months in one study. In 10 studies measuring infection status in couples, 39%-50% of male or female sexual partners of infected participants also had detected. In prospective studies, PID incidence was higher in women with than those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I 0%, two studies).
DISCUSSION
Incidence of in very highly developed countries is similar to that for , but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections, is not the new chlamydia. Synthesised data about prevalence, incidence and persistence of infection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics of .
REGISTRATION NUMBERS
CRD42015020420, CRD42015020405.
Topics: Adolescent; Adult; Anti-Bacterial Agents; Female; Humans; Incidence; Male; Mycoplasma Infections; Mycoplasma genitalium; Sexual Behavior; Sexual Partners; Young Adult
PubMed: 31055469
DOI: 10.1136/sextrans-2018-053823 -
AIDS Reviews 2023Several studies have reported the occurrence of genital mycoplasmas (Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Mycoplasma fermentans) among... (Meta-Analysis)
Meta-Analysis
Several studies have reported the occurrence of genital mycoplasmas (Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, and Mycoplasma fermentans) among human immunodeficiency virus (HIV)-infected patients, but findings are conflicting. The aim of this systematic review and meta-analysis was to assess the association of U. urealyticum and M. hominis with HIV infection. We searched seven databases to retrieve articles reporting the prevalence of genital mycoplasmas among HIV-infected patients. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated and displayed by forest plots. Cochran Q and I statistics were applied to assess heterogeneity. In addition, a funnel plot with an Egger's test was performed to evaluate potential publication bias. Of the 1123 articles identified, 12 studies met the inclusion criteria and were included in this meta-analysis. Our results revealed that HIV-infected patients had higher colonization rates by U. urealyticum and M. hominis (single infection) than the control group (OR = 1.526; 95% CI: 1.202-1.937; p = 0.001 and OR = 2.610; 95% CI: 1.890-3.604; p = 0,000, respectively). However, coinfection seemed to be not associated with HIV infection (OR = 1.311; 95% CI: 0.744-2.311; p = 0.348). A subgroup analysis showed that study design and geographical origin were a source of heterogeneity in the studies that reported coinfection among HIV-infected patients. However, there was no statistical evidence of publication bias. Our study revealed that genital mycoplasmas were more frequent in HIV-infected patients than healthy individuals, resulting from a decline of natural immunity due to HIV. More effort should be dedicated to the screening, prevention, and treatment of genital mycoplasmas, to curb the spread of HIV.
Topics: Humans; Ureaplasma urealyticum; Mycoplasma hominis; HIV Infections; Coinfection; Mycoplasma Infections; Genitalia
PubMed: 37585358
DOI: 10.24875/AIDSRev.22000024 -
Journal of the European Academy of... Mar 2015Mycoplasma pneumoniae, a bacterium known to be a common cause of pneumonia, has been documented to cause complications such as debilitating mucositis previously... (Review)
Review
BACKGROUND
Mycoplasma pneumoniae, a bacterium known to be a common cause of pneumonia, has been documented to cause complications such as debilitating mucositis previously described as an atypical Stevens-Johnson syndrome without skin lesions. However, in the spectrum of epidermal dermatopathies, the condition is increasingly recognized as a separate entity, now termed M. pneumoniae-associated mucositis (MPAM).
OBJECTIVES
We present a case of MPAM and systemically review the literature to discuss diagnostic and therapeutic options.
METHODS
A systematic literature search was performed to find studies reporting MPAM in adults. We extracted and analysed patient demographics, disease symptomatology, diagnostic testing and treatment.
RESULTS
Eleven articles, describing 12 patients and our own patient met the predefined criteria and were analysed. Respiratory, ocular and oral symptoms were present in all patients. Therapies predominantly included antibiotics (10 of 13) and immunosuppressive treatment (9 of 13) leading to complete resolution of symptoms in all patients.
CONCLUSION
Our findings highlight that MPAM should be recognized as a distinct disease entity within the spectrum of epidermal dermatopathies. We discuss and show in our patient why M. pneumoniae IgA serum levels could prove to be more reliable diagnostic tools in the MPAM diagnosis than the widely used IgG and IgM titre levels.
Topics: Adolescent; Adult; Humans; Mucositis; Mycoplasma pneumoniae; Young Adult
PubMed: 24665876
DOI: 10.1111/jdv.12392 -
The Journal of Antimicrobial... Jul 2022Limited antimicrobial resistance (AMR) surveillance coupled with syndromic management of sexually transmitted infections (STIs) in sub-Saharan Africa (SSA) could be...
OBJECTIVES
Limited antimicrobial resistance (AMR) surveillance coupled with syndromic management of sexually transmitted infections (STIs) in sub-Saharan Africa (SSA) could be contributing to an increase in AMR in the region. This systematic review aimed to synthesize data on the prevalence of AMR in common STIs in SSA and identify some research gaps that exist.
METHODS
We searched three electronic databases for studies published between 1 January 2000 and 26 May 2020. We screened the titles and abstracts for studies that potentially contained data on AMR in SSA. Then we reviewed the full text of these studies to identify articles that reported data on the prevalence of AMR in Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium in SSA. We summarized the data using a narrative synthesis.
RESULTS
The 40 included studies reported on AMR data from 7961 N. gonorrhoeae isolates from 15 countries in SSA and 350 M. genitalium specimens from South Africa. All four SSA regions reported very high rates of ciprofloxacin, tetracycline and penicillin resistance in N. gonorrhoeae. Resistance to cefixime or ceftriaxone was observed in all regions except West Africa. Azithromycin resistance, recommended as part of dual therapy with an extended-spectrum cephalosporin for gonorrhoea, was reported in all the regions. Both macrolide and fluoroquinolone-associated resistance were reported in M. genitalium in South Africa. Studies investigating AMR in C. trachomatis and T. vaginalis were not identified.
CONCLUSIONS
There is a need to strengthen AMR surveillance in SSA for prompt investigation and notification of drug resistance in STIs.
Topics: Anti-Bacterial Agents; Chlamydia trachomatis; Drug Resistance, Bacterial; Gonorrhea; Humans; Mycoplasma Infections; Mycoplasma genitalium; Neisseria gonorrhoeae; Prevalence; Sexually Transmitted Diseases; South Africa
PubMed: 35578892
DOI: 10.1093/jac/dkac159 -
Clinical Infectious Diseases : An... Nov 2015Mycoplasma genitalium (MG) is associated with nongonococcal urethritis in men and cervicitis in women. Current guidelines recommend treatment with 1 gram of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mycoplasma genitalium (MG) is associated with nongonococcal urethritis in men and cervicitis in women. Current guidelines recommend treatment with 1 gram of azithromycin; however, treatment failure has increasingly been reported. This meta-analysis estimates treatment efficacy following treatment with 1 gram of azithromycin.
METHODS
Electronic databases were searched for articles published to the end of February 2015 using the following search terms: (Mycoplasma genitalium) AND (azithromycin OR zithromax OR [treatment efficacy]). Studies were included if they were English language, had participants aged ≥12 years diagnosed with urogenital MG, and had microbial cure measured within 12 months of treatment. Treatment efficacy was measured as microbial cure at last follow-up after treatment.
RESULTS
A total of 21 studies, including 1490 participants, fulfilled the inclusion criteria. Most studies were observational, with only 5 controlled trials identified. The random-effects pooled microbial cure was 77.2% (95% confidence interval [CI], 71.1%-83.4%; I(2) = 80.8%, P < .01). For the 12 studies conducted prior to 2009, pooled microbial cure was 85.3% (CI, 82.3%-88.3%; I(2) = 19.7%, P = .25); for the 9 studies conducted since the beginning of 2009, pooled microbial cure was 67.0% (CI, 57.0%-76.9%; I(2) = 80.9%, P < .01).
CONCLUSIONS
The efficacy of a single dose of 1 gram of azithromycin for the treatment of urogenital MG has decreased to approach 60%. Even though most of the available evidence is based on observational studies that have considerable variability in sample size and timing of microbial cure, this low efficacy is of considerable concern. It is vital that new treatment options for MG are investigated.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Azithromycin; Child; Female; Humans; Male; Middle Aged; Mycoplasma Infections; Mycoplasma genitalium; Reproductive Tract Infections; Treatment Outcome; Young Adult
PubMed: 26240201
DOI: 10.1093/cid/civ644 -
Journal of Reproductive Immunology Feb 2022To assess the available scientific evidence regarding the placental microbial composition of a healthy pregnancy, the quality of this evidence, and the potential...
OBJECTIVE
To assess the available scientific evidence regarding the placental microbial composition of a healthy pregnancy, the quality of this evidence, and the potential relation between placental and oral microbiome.
MATERIALS AND METHODS
Data sources: MEDLINE and EMBASE up to August 1, 2019.
STUDY ELIGIBILITY CRITERIA
Human subjects; healthy women; term deliveries; healthy normal birth weight; assessment of microorganisms (bacteria) in placental tissue; full research papers in English. The quality of the included studies was assessed by a modified Joanna Briggs Institute checklist for analytical cross-sectional studies.
RESULTS
57 studies passed the inclusion criteria. Of these, 33 had a high risk of quality bias (e.g., insufficient infection control, lack of negative controls, poor description of the healthy cases). The remaining 24 studies had a low (N = 12) to moderate (N = 12) risk of bias and were selected for in-depth analysis. Of these 24 studies, 22 reported microorganisms in placental tissues, where Lactobacillus (11 studies), Ureaplasma (7), Fusobacterium (7), Staphylococcus (7), Prevotella (6) and Streptococcus (6) were among the most frequently identified genera. Methylobacterium (4), Propionibacterium (3), Pseudomonas (3) and Escherichia (2), among others, although frequently reported in placental samples, were often reported as contaminants in studies that used negative controls.
CONCLUSIONS
The results support the existence of a low biomass placental microbiota in healthy pregnancies. Some of the microbial taxa found in the placenta might have an oral origin. The high risk of quality bias for the majority of the included studies indicates that the results of individual papers should be interpreted with caution.
Topics: Adult; Animals; Female; Fusobacterium; Healthy Volunteers; Humans; Lactobacillus; Microbiota; Placenta; Pregnancy; RNA, Ribosomal, 16S; Ureaplasma
PubMed: 34883392
DOI: 10.1016/j.jri.2021.103455 -
Transboundary and Emerging Diseases May 2021Contagious caprine pleuropneumonia (CCPP) is a highly contagious respiratory disease of small ruminants that is caused by the bacterium Mycoplasma capricolum subsp.... (Meta-Analysis)
Meta-Analysis
Contagious caprine pleuropneumonia (CCPP) is a highly contagious respiratory disease of small ruminants that is caused by the bacterium Mycoplasma capricolum subsp. capripneumoniae. Sheep and goats are two of the species of small ruminants most at risk of CCPP. Outbreaks of CCPP cause significant economic and trade disturbances in several parts of the world. However, the extent and magnitude of CCPP in a particular geographical region is still not well known due to lack of comprehensive data on its occurrence. The present study aimed to investigate the prevalence of CCPP in sheep and goats raised in different geographical regions as well as the factors contributing to the spread of the disease. Searches were done in five online repositories: PubMed, Web of Science, Scopus, CAB Direct and Google Scholar using pre-selected key terms. Data were retrieved from the 41 articles that met the study's inclusion criteria. The pooled prevalences were determined using a random effect meta-analysis model. Prevalence of CCPP was 23.19% (95% CI: 11.90-34.47%) in sheep and 24.91% (95% CI: 20.99-28.84%) in goats. Overall, the regional level pooled prevalence estimates ranged from 8.0% (95% CI: 6.91-9.09%) to 28.70% (22.02-35.38%), depending on species and world region. Substantial heterogeneity (I > 75%) was observed in most pooled prevalence estimates. The results indicate high prevalences of CCPP in sheep and goats across the regions, particularly in Africa and Asia, and highlights the need to institute appropriate control measures. Active surveillance and research on risk factors are recommended.
Topics: Animals; Goat Diseases; Goats; Mycoplasma; Pleuropneumonia, Contagious; Prevalence; Sheep; Sheep Diseases; Sheep, Domestic
PubMed: 33448706
DOI: 10.1111/tbed.13794