In a recent study published in The Journal of Antibiotics, a group of researchers analyzed the trends in antimicrobial resistance among urogenital Mycoplasma hominis (M. hominis) and Ureaplasma species in Greece, utilizing 2,992 Ureaplasma spp. and 371 M. hominis isolates from 2014 to 2022, assessing their sensitivity to various antibiotics.
Background
M. hominis and Ureaplasma species, part of the Mollicutes group, are notable for their lack of a cell wall, making them undetectable by Gram staining and nesessitating polymerase chain reaction (PCR) for diagnosis.
They include many species of organisms commonly inhabiting the genital track and believed to contribute to certain urological infections and pregnancy complications. Nevertheless, it is difficult to differentiate between colonization and infection.
These pathogens have a unique cell structure that makes them resistant to penicillin or other drugs targeting cell wall synthesis, relying instead on agents that interfere with protein synthesis or topoisomerases.
Of recent interest is the rising resistance to these therapies, generating great apprehension among clinicians. The mechanisms of antibiotic resistance in Ureaplasma spp. and M. hominis are not fully understood, and further studies are necessary to assess the impact of antibiotic overuse and the efficacy of current treatment regimens.
About the study
The present study’s methods involved a retrospective descriptive analysis of medical laboratory records from the ‘Bioiatriki’ Healthcare Center and Leto General Maternity and Gynecology Clinic S.A. in Athens, Greece.
The data spanned from 2014 to 2022 for Ureaplasma spp. and from 2016 to mid-2022 for M. hominis. The subjects included symptomatic patients with genito-urethral complaints and asymptomatic individuals undergoing regular genital healthcare screening.
Universal flexible cotton swabs were utilized to collect clinical samples from different sites of males, such as urethra, urine, semen, expressed prostatic secretions; female samples were obtained from the cervix, urethra, and urine.
After four hours, these samples were cultured aerobically for a period of 48 hours in an incubator set at 37 degrees Celsius using a Mycoplasma DUO kit. Red discoloration from yellow, without disrupting a medium cloud development, indicated mycoplasma species. The SIR Mycoplasma kit tested Antibiotic sensitivity in U9 or arginine broth for U. urealyticum or M. hominis.
Tested antibiotics included azithromycin, josamycin, doxycycline, tetracycline, erythromycin, clindamycin, pristinamycin, and ofloxacin. Mycoplasma grew, generating ammonia that changed the medium to alkaline which caused discoloration of the medium. When the microorganisms were sensitive to the tested antibiotics, metabolism was inhibited, and the medium remained yellow.
Descriptive statistics were used in data analysis, with results expressed as frequencies and percentages of resistance for given age categories and annual resistance per antimicrobial agent. Graphic representation of trends in antimicrobial resistance from 2014 to 2022 showed changes within the stipulated period.
Susceptibility, intermediate resistance, and resistance proportions for M. hominis and Ureaplasma spp. were included in the sensitivity analysis across the various antibiotics.
