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Frontiers in Microbiology 2020is an important etiologic agent of non-gonococcal urethritis (NGU), known for chronicity and multidrug resistance, in which biofilms may play an integral role. In some...
is an important etiologic agent of non-gonococcal urethritis (NGU), known for chronicity and multidrug resistance, in which biofilms may play an integral role. In some bacterial species capable of forming biofilms, extracellular polymeric substances (EPS) composed of poly--acetylglucosamine (PNAG) are a crucial component of the matrix. Monosaccharide analysis of strains revealed high abundance of GlcNAc, suggesting a biofilm-specific EPS. Chromatograms also showed high concentrations of galactose and glucose as observed in other mycoplasma species. Fluorescence microscopy of biofilms utilizing fluor-coupled lectins revealed differential staining of biofilm structures. Scanning electron microscopy (SEM) showed increasing maturation over time of bacterial "towers" seen in biofilm development. As seen with , organisms within fully mature biofilms exhibited loss of cell polarization. Bacteria associated with disrupted biofilms exhibited decreased dose-dependent viability after treatment with antibiotics compared to bacteria with intact biofilms. In addition, growth index analysis demonstrated decreases in metabolism in cultures with disrupted biofilms with antibiotic treatment. Taken together, these data suggest that biofilms are a contributing factor in antibiotic resistance.
PubMed: 33193233
DOI: 10.3389/fmicb.2020.585524 -
Andrology Sep 2015The relationship between mycoplasma and ureaplasma infection and male infertility has been studied widely; however, results remain controversial. This meta-analysis... (Meta-Analysis)
Meta-Analysis Review
The relationship between mycoplasma and ureaplasma infection and male infertility has been studied widely; however, results remain controversial. This meta-analysis investigated the association between genital ureaplasmas (Ureaplasma urealyticum, Ureaplasma parvum) and mycoplasmas (Mycoplasma hominis, Mycoplasma genitalium), and risk of male infertility. Differences in prevalence of ureaplasma and mycoplasma infection between China and the rest of the world were also compared. Study data were collected from PubMed, Embase and the China National Knowledge Infrastructure. Summary odds ratio (OR) with 95% confidence interval (CI) was applied to assess the relationship. Heterogeneity testing and publication bias testing were also performed. A total of 14 studies were used: five case-control studies with 611 infertile cases and 506 controls featuring U. urealyticum infection, and nine case-control studies with 2410 cases and 1223 controls concerning M. hominis infection. Two other infection (U. parvum and M. genitalium) were featured in five and three studies, respectively. The meta-analysis results indicated that U. parvum and M. genitalium are not associated with male infertility. However, a significant relationship existed between U. urealyticum and M. hominis and male infertility. Comparing the global average with China, a significantly higher positive rate of U. urealyticum, but a significantly lower positive rate of M. hominis, was observed in both the infertile and control groups in China.
Topics: China; Genital Diseases, Male; Humans; Infertility, Male; Male; Mycoplasma Infections; Mycoplasma genitalium; Mycoplasma hominis; Ureaplasma; Ureaplasma Infections; Ureaplasma urealyticum
PubMed: 26311339
DOI: 10.1111/andr.12078 -
Clinical Infectious Diseases : An... Jul 2014
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Mycoplasma Infections; Mycoplasma genitalium
PubMed: 24729505
DOI: 10.1093/cid/ciu224 -
Clinical Infectious Diseases : An... Nov 2023Mycoplasma genitalium (MG) is on the CDC Watch List of Antimicrobial Resistance Threats, yet there is no systematic surveillance to monitor change.
BACKGROUND
Mycoplasma genitalium (MG) is on the CDC Watch List of Antimicrobial Resistance Threats, yet there is no systematic surveillance to monitor change.
METHODS
We initiated surveillance in sexual health clinics in 6 cities, selecting a quota sample of urogenital specimens tested for gonorrhea and/or chlamydia. We abstracted patient data from medical records and detected MG and macrolide-resistance mutations (MRMs) by nucleic acid amplification testing. We used Poisson regression to estimate adjusted prevalence ratios (aPRs) and 95% CIs, adjusting for sampling criteria (site, birth sex, symptom status).
RESULTS
From October-December 2020 we tested 1743 urogenital specimens: 57.0% from males, 46.1% from non-Hispanic Black persons, and 43.8% from symptomatic patients. MG prevalence was 16.6% (95% CI: 14.9-18.5%; site-specific range: 9.9-23.5%) and higher in St Louis (aPR: 1.9; 1.27-2.85), Greensboro (aPR: 1.8; 1.18-2.79), and Denver (aPR: 1.7; 1.12-2.44) than Seattle. Prevalence was highest in persons <18 years (30.4%) and declined 3% per each additional year of age (aPR: .97; .955-.982). MG was detected in 26.8%, 21.1%, 11.8%, and 15.4% of urethritis, vaginitis, cervicitis, and pelvic inflammatory disease (PID), respectively. It was present in 9% of asymptomatic males and 15.4% of asymptomatic females, and associated with male urethritis (aPR: 1.7; 1.22-2.50) and chlamydia (aPR: 1.7; 1.13-2.53). MRM prevalence was 59.1% (95% CI: 53.1-64.8%; site-specific range: 51.3-70.6%). MRMs were associated with vaginitis (aPR: 1.8; 1.14-2.85), cervicitis (aPR: 3.5; 1.69-7.30), and PID cervicitis (aPR: 1.8; 1.09-3.08).
CONCLUSIONS
MG infection is common in persons at high risk of sexually transmitted infections; testing symptomatic patients would facilitate appropriate therapy. Macrolide resistance is high and azithromycin should not be used without resistance testing.
Topics: Female; Humans; Male; Anti-Bacterial Agents; Urethritis; Mycoplasma genitalium; Uterine Cervicitis; Sexual Health; Macrolides; Drug Resistance, Bacterial; Pelvic Inflammatory Disease; Vaginitis; Mycoplasma Infections; Prevalence
PubMed: 37402645
DOI: 10.1093/cid/ciad405 -
Clinical Infectious Diseases : An... Dec 2011Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M....
Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M. genitalium is associated with urethritis, cervicitis, pelvic inflammatory disease, and possibly female infertility. Data are inconclusive regarding the role of M. genitalium in adverse pregnancy outcomes and ectopic pregnancy. Available data suggest that azithromycin is superior to doxycycline in treating M. genitalium infection. However, azithromycin-resistant infections have been reported in 3 continents, and the proportion of azithromycin-resistant M. genitalium infection is unknown. Moxifloxacin is the only drug that currently seems to uniformly eradicate M. genitalium. Detection of M. genitalium is hampered by the absence of a commercially available diagnostic test. Persons with persistent pelvic inflammatory disease or clinically significant persistent urethritis or cervicitis should be tested for M. genitalium, if possible. Infected persons who have not previously received azithromycin should receive that drug. Persons in whom azithromycin therapy fails should be treated with moxifloxicin.
Topics: Anti-Bacterial Agents; Aza Compounds; Azithromycin; Doxycycline; Drug Resistance, Bacterial; Female; Fluoroquinolones; Humans; Infertility, Female; Male; Moxifloxacin; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; Pregnancy; Pregnancy, Ectopic; Quinolines; Treatment Outcome; Urethritis; Uterine Cervicitis
PubMed: 22080266
DOI: 10.1093/cid/cir702 -
Sexually Transmitted Diseases Sep 2018Mycoplasma genitalium is an important cause of bacterial sexually transmitted diseases. Diagnosis and susceptibility testing of M. genitalium are limited by the...
BACKGROUND
Mycoplasma genitalium is an important cause of bacterial sexually transmitted diseases. Diagnosis and susceptibility testing of M. genitalium are limited by the fastidious nature of the organism. Therefore, the prevalence of infection and azithromycin resistance are poorly studied.
METHODS
We conducted an exploratory study on remnant clinical specimens. We collected remnant DNA from consecutive urine samples and clinical swabs (cervical/vaginal, rectal, and pharyngeal) previously tested for Neisseria gonorrhoeae and Chlamydia trachomatis using the Cobas 4800 CT/NG assay (Roche Molecular Systems, Pleasanton, CA) between March-April 2017 from across the University of California, Los Angeles Health System. We then retrospectively tested all specimens with the ResistancePlus MG (550) kit, a molecular assay for the detection of M. genitalium and genetic mutations associated with azithromycin resistance.
RESULTS
Among 500 specimens, the prevalence of M. genitalium was 1.1% (95% confidence interval [CI], 0.04%-3.0%) in urine samples (n = 362), 17.4% (95% CI, 5.7%-39.6%) in rectal swabs (n = 23), and 1.9% (95% CI, 0.3%-7.3%) in cervical/vaginal swabs (n = 106). The prevalence of N. gonorrhoeae was 0.6% in urine samples and 4.3% in rectal swabs, whereas the prevalence of C. trachomatis was 2.2% in urine samples, 4.3% in rectal swabs and 3.8% in cervical/vaginal swabs. Of the 10 M. genitalium positive specimens, 8 (80.0%) had a mutation associated with azithromycin resistance.
CONCLUSIONS
The prevalence of M. genitalium infection in our population varied by anatomic site of infection. Most M. genitalium infections had at least 1 mutation associated with azithromycin resistance.
Topics: Anti-Bacterial Agents; Azithromycin; Cervix Uteri; DNA, Bacterial; Drug Resistance, Bacterial; Female; Humans; Los Angeles; Mutation; Mycoplasma Infections; Mycoplasma genitalium; Pharynx; Prevalence; Rectum; Retrospective Studies; Sexually Transmitted Diseases, Bacterial
PubMed: 29509566
DOI: 10.1097/OLQ.0000000000000829 -
Journal of Reproductive Immunology Nov 2018Sexually transmitted infections (STI) can have major consequences for the reproductive health of women. Mycoplasma genitalium is a STI that is not as well studied but... (Review)
Review
Sexually transmitted infections (STI) can have major consequences for the reproductive health of women. Mycoplasma genitalium is a STI that is not as well studied but causes pelvic inflammatory disease (PID) among other complications. Another well-known STI is Chlamydia trachomatis, notorious for its capability to cause infertility. Both C. trachomatis and M. genitalium share some of the same clinical aspects. Parts of the pathogenesis of C. trachomatis and M. genitalium infections are unclear but potential factors are the microbiome and other STIs. The healthy vaginal microbiome is dominated by Lactobacillus spp; these bacteria protect the host against invading bacteria like C. trachomatis and M. genitalium by producing antibacterial compounds and providing a mechanical barrier. A dysbiosis of the vaginal microbiome is characterized by a non-Lactobacillus spp. dominated microbiome, also known as bacterial vaginosis (BV). BV and BV associated bacteria play a role in the pathogenesis of STIs such as C. trachomatis and M. genitalium. The different species of BV associated bacteria have distinct characteristics that could play a role in C. trachomatis and M. genitalium infections. Host factors should also be considered when analysing the interaction of C. trachomatis and M. genitalium and the microbiome. One important factor is the hormonal homeostasis. Oral hormonal contraception influences the vaginal milieu and could influence the infection process of STIs. Overall, this review attempts to give an overview of the pathogenesisof C. trachomatis and M. genitalium infections and the relationship between M. genitalium, C. trachomatis, and the vaginal microbiome.
Topics: Chlamydia Infections; Chlamydia trachomatis; Contraceptives, Oral, Hormonal; Dysbiosis; Female; Humans; Lactobacillus; Microbiota; Mycoplasma Infections; Mycoplasma genitalium; Sexually Transmitted Diseases; Vagina; Vaginosis, Bacterial
PubMed: 30149363
DOI: 10.1016/j.jri.2018.08.006 -
Clinical Infectious Diseases : An... Jul 2014Mycoplasma genitalium is a common cause of nongonococcal urethritis (NGU) and cervicitis. The aim of the study was to analyze the M. genitalium testing pattern and...
BACKGROUND
Mycoplasma genitalium is a common cause of nongonococcal urethritis (NGU) and cervicitis. The aim of the study was to analyze the M. genitalium testing pattern and distribution of positive results according to sex and age in a 5-year period where all diagnostic M. genitalium testing in Denmark was centralized at the Statens Serum Institut. A secondary aim was to estimate the occurrence of macrolide resistance in a 3-year period.
METHODS
The study was performed as a nationwide retrospective survey of specimens submitted from general practice, private specialists, and hospitals to Statens Serum Institut for detection of M. genitalium by polymerase chain reaction between 1 January 2006 and 31 December 2010. Macrolide resistance screening was introduced December 2007.
RESULTS
A total of 31 600 specimens from 28 958 patients were tested for M. genitalium, with an increasing trend from 3858 per year in 2006 to 7361 in 2010. The majority (54%) of the patients were tested in general practice. For both sexes, the positive rate increased significantly, from 2.4% to 3.8% for women and from 7.9% to 10.3% for men (P < .0005). Macrolide resistance was detected in 38% (385/1008) of the M. genitalium-positive patients, and the highest rate was found in patients tested at sexually transmitted disease clinics (43%).
CONCLUSIONS
Testing for M. genitalium has become important for clinicians treating sexually transmitted infections. In this nationwide survey, macrolide resistance was found in almost 40% of the specimens, raising concern about single-dose azithromycin treatment of NGU, and emphasizing that NGU treatment should be guided by etiologic diagnosis.
Topics: Adolescent; Adult; Anti-Bacterial Agents; DNA, Bacterial; Denmark; Drug Resistance, Bacterial; Female; Genotype; Genotyping Techniques; Humans; Macrolides; Male; Middle Aged; Mycoplasma Infections; Mycoplasma genitalium; Polymerase Chain Reaction; Prevalence; RNA, Ribosomal, 16S; RNA, Ribosomal, 23S; Retrospective Studies; Sequence Analysis, DNA; Young Adult
PubMed: 24729494
DOI: 10.1093/cid/ciu217 -
Emerging Infectious Diseases Mar 2021Much about the range of pathogens, frequency of coinfection, and clinical effects of reproductive tract infections (RTIs) among pregnant women remains unknown. We report...
Much about the range of pathogens, frequency of coinfection, and clinical effects of reproductive tract infections (RTIs) among pregnant women remains unknown. We report on RTIs (Mycoplasma genitalium, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Treponema pallidum subspecies pallidum, bacterial vaginosis, and vulvovaginal candidiasis) and other reproductive health indicators in 699 pregnant women in Papua New Guinea during 2015-2017. We found M. genitalium, an emerging pathogen in Papua New Guinea, in 12.5% of participants. These infections showed no evidence of macrolide resistance. In total, 74.1% of pregnant women had >1 RTI; most of these infections were treatable. We detected sexually transmitted infections (excluding syphilis) in 37.7% of women. Our findings showed that syndromic management of infections is greatly inadequate. In total, 98.4% of women had never used barrier contraception. These findings will inform efforts to improve reproductive healthcare in Papua New Guinea.
Topics: Anti-Bacterial Agents; Chlamydia Infections; Chlamydia trachomatis; Drug Resistance, Bacterial; Female; Gonorrhea; Humans; Macrolides; Mycoplasma Infections; Mycoplasma genitalium; Neisseria gonorrhoeae; Papua New Guinea; Pregnancy; Pregnant Women; Reproductive Tract Infections; Sexually Transmitted Diseases
PubMed: 33622474
DOI: 10.3201/eid2703.201783 -
BMC Infectious Diseases Jan 2023Chlamydia trachomatis and Mycoplasma infections have been regarded as severe challenges to public health worldwide because their potential risk of leading to serious...
BACKGROUND
Chlamydia trachomatis and Mycoplasma infections have been regarded as severe challenges to public health worldwide because their potential risk of leading to serious reproductive complications. C. trachomatis is the most common sexually transmitted bacterial infections and the prevalence has been increasing in recent years. As a newly discovered pathogen, Mycoplasma genitalium has gradually been recognized as important sexually transmitted infection and even been called a "new chlamydia". There are no official epidemiological data of M. genitalium in China especially in women with lower reproductive tract infection. This work aims to understand the prevalence and risk factors of M. genitalium and C. trachomatis in women with lower reproductive tract infections and to provide reference for the formulation of health policy in China.
METHODS
This study was conducted in the gynecological clinics of 12 hospitals geographically located in different regions in China. Women with purulent cervical secretions or abnormal vaginal microecology were included as the research group, and those with normal vaginal microecology and cervical secretions were included as the control group. A total of 2190 participants were recruited in this project including 1357 of research group and 833 of control group. All participants were required to complete questionnaires, whose vaginal discharge were collected for vaginal microecology test and cervical discharge for detection of M. genitalium and C. trachomatis.
RESULTS
The prevalence of C. trachomatis and M. genitalium were 7.1% (96/1357) and 3.8% (51/1357), respectively in research group. The prevalence of C. trachomatis and M. genitalium varied in different regions. Infection rates of C. trachomatis and M. genitalium were higher in women with abnormal vaginal microecology (C.t P = 0.038, M.g P = 0.043), especially in women with bacterial vaginosis and mixed vaginitis, of which C. trachomatis showed statistical differences (bacterial vaginosis, P = 0.035; mixed vaginitis, P = 0.0001) and M. genitalium was close to statistical differences (bacterial vaginosis, P = 0.057; mixed vaginitis, P = 0.081). Alcoholism and abnormal vaginal microecology were positively correlated with both C. trachomatis and M. genitalium infection. Increasing age, being married and multi-parity were negatively correlated with C. trachomatis infection. There is a positive correlation between multiple sexual partners, diversed styles of sex and C. trachomatis infection.
CONCLUSIONS
Women with lower genital dysbiosis have an increased risk of C. trachomatis and M. genitalium. The overall prevalence of M. genitalium is lower than that of C. trachomatis, while they have similarities in the characteristics of infection. Although M. genitalium is not routinely screened as C. trachomatis in young women, attention should be paid to M. genitalium infection in young women with abnormal vaginal microecology or having childbearing needs.
Topics: Pregnancy; Female; Humans; Chlamydia trachomatis; Vaginosis, Bacterial; Reproductive Tract Infections; Mycoplasma genitalium; Chlamydia Infections; Prevalence; East Asian People; Surveys and Questionnaires; Mycoplasma Infections
PubMed: 36604611
DOI: 10.1186/s12879-022-07975-2