Korean J Urol.  2006 Oct;47(10):1117-1123. 10.4111/kju.2006.47.10.1117.

Usefulness of the Mycofast Test (MYCOFAST(R) Evolution 2) for the Diagnosis of Nongonococcal Genitourinary Infections

• Park HR
• Kim YH
• Lee HJ
• Oh JS
• Kim HJ

• KMID: 2139816
• DOI: http://doi.org/10.4111/kju.2006.47.10.1117

Abstract

PURPOSE: We wanted to investigate the usefulness of Mycofast (MYCOFAST(R) Evolution 2, International Microbio, France) for Ureaplasma urealyticum (U. urealyticum) and Mycoplasma hominis (M. hominis) in association with nongonococcal genitourinary infections.
MATERIALS AND METHODS
530 patients visited our department for genitourinary infection symptoms or for the evaluation of sexually transmitted disease. The genital swabs were first vortexed in Mycofast transport broth. A volume of 100mul of liquid sample was innoculated to each well of the Mycofast broths and 0.5mul of liquid sample was innoculated to A7 agar culture media (International Microbio, France). The Mycofast broths were incubated at 35-37 degrees C for 36 hrs, and the A7 agar culture media was incubated for 4 days. We compaired Mycofast with A7 agar culture for the sensitivity, specificity, the positive and negative predictive values and the antibiotic susceptable profiles.
RESULTS
Of the 530 samples submitted, 165 samples were positive by the A7 agar culture and 162 samples were positive by Mycofast. 157 samples were positive by both methods. Of the 365 samples that were negative by the A7 agar culture, 360 samples were also negative by the Mycofast. In this study, Mycofast had a sensitivity and specificity of 95% and 98%, respectively, and a positive and negative predictive value of 96% and 97%, respectively. The Mycofast drug susceptibility tests indicate a high susceptibility to doxycyclin as follows: U. urealyticum: 86.3%; M. hominis: 85.0% and both organisms with simultaneous isolation: 75.8%.
CONCLUSIONS
Mycofast was an easy test to perform and it proved to be a practical and reliable method for isolating the Mycoplasma and Ureaplasma species for making the diagnosis of nongonococcal genitourinary infections, and it showed the added benefit of determining the limited susceptibilities of the isolated strains.

Keyword

Ureaplasma urealyticum; Mycoplasma hominis; Diagnosis

MeSH Terms

Agar
Culture Media
Diagnosis*
Humans
Mycoplasma
Mycoplasma hominis
Sensitivity and Specificity
Sexually Transmitted Diseases
Ureaplasma
Ureaplasma urealyticum
Agar
Culture Media

Figure

• 

  Fig. 1 Detection of Ureaplasma urealyticum and Ureaplasma urealyticum at 104 CCUs (color change units) mycofast/ml, as diagnosed by the color change of the enumeration and identification well on the MYCOFAST® Evolution 2 tray.

• 

  Fig. 2 MYCOFAST® Evolution 2 tray. The tray is consisted of 10 wells.

• 

  Fig. 3 (A) The microscopic finding of Ureaplasma urealyticum in the A7 agar culture medium. The colonies show a brown or black urchin-like appearance. (B) The microscopic finding of Mycoplasma hominis in the A7 agar culture medium. The colonies have a characteristic fried egg appearance. (C) The microscopic finding of Ureaplasma urealyticum and Mycoplasma hominis as cultured simultaneously in A7 agar culture medium.

Reference

1. Low N, FitzGerald MR. Success and failure in gonorrhea control. Dermatol Clin. 1998. 16:713–722.

2. Tompson SE, Washington AE. Epidemiology of sexually transmitted Chlamydia trachomatis infections. Epidemiol Rev. 1983. 5:96–123.

3. Munday PE, Thomson BJ, Johnson AP, Altman DG, Taylor-Robinson DT. Clinical and microbiological study of non-gonococcal urethritis with particular reference to non-chlamydial disease. Br J Vener Dis. 1981. 57:327–333.

4. Bowie WR. Holmes KK, Mardh PA, Sparling PF, Wiesner PJ, editors. Urethritis in male. Sexually transmitted disease. 1989. New York: McGraw-Hill;627–639.

5. Stamm WE, Hicks CB, Martin DH, Leone P, Hook EW III, Cooper RH, et al. Azithromycin for empirical treatment of the nongonococcal urethritis syndrome in men. A randomized double-blind study. JAMA. 1995. 274:545–549.

6. Hooton TM, Roberts MC, Kenny GE. Mycoplasma genitalium and non-gonococcal urethritis. Lancet. 1994. 343:69.

7. Ingham HR, MacFarlane WW, Hale JH, Selkon JB, Codd AA. Controlled study of the prevalence of T-strain mycoplasmata in male with non-gonococcal urethritis. Br J Vener Dis. 1966. 42:269–271.

8. Dunlop EM, Hare MJ, Jones BR, Taylor-Robinson D. Mycoplasma and "non-specific" genital infections. II. Clinical aspects. Br J Vener Dis. 1969. 45:274–281.

9. Weidner W, Krause W, Schiefer HG, Brunner H, Friedrich HJ. Ureaplasmal infections of the male urogenital tract, in particular prostatitis, and semen quality. Urol Int. 1985. 40:5–9.

10. Yoon YR, Yoon NS. A study of the effect on sperm motility by Mycoplasma. Korean J Urol. 1983. 24:255–259.

11. Lee YT, Lee MS. A study of the isolation of Ureaplasma urealyticum in nongonococcal urethritis. Korean J Urol. 1982. 23:1067–1073.

12. Brunner H, Weidner W, Schiefer HG. Studies of the role of Ureaplasma urealyticum and Mycoplasma hominis in prostatitis. J Infect Dis. 1983. 147:807–813.

13. Jalil N, Doble A, Gilchrist C, Taylor-Robinson D. Infection of the epididymis by Ureaplasma urealyticum. Genitourin Med. 1988. 64:367–368.

14. Furr PM, Taylor-Robinson D. Microimmunofluorescence technique for detection of antibody to Mycoplasma genitalium. J Clin Pathol. 1984. 37:1072–1074.

15. Hyman HC, Yogev D, Razin S. DNA probes for detection and identification of Mycoplasma pneumoniae and Mycoplasma genitalium. J Clin Microbiol. 1987. 25:726–728.

16. Hooton TM, Roberts MC, Robert PL, Holmes KK, Stamm WE, Kenny GE. Prevalence of Mycoplasma genitalium determined by DNA probe in men with urethritis. Lancet. 1988. 1:266–268.

17. Able Horn M, Wolff C, Dressel P, Zimmermann A, Vahlensieck W, Pfaff F, et al. Polymerase chain reaction versus culture for detection of Ureaplasma urealyticum and Mycoplasma hominis in the urogenital tract of adults and the respiratory tract of newborns. Eur J Clin Microbiol Infect Dis. 1996. 15:595–598.

18. Stellrecht KA, Woron AM, Mishrik NG, Venezia RA. Comparison of multiplex PCR assay with culture for detection of genital Mycoplasmas. J Clin Microbiol. 2004. 42:1528–1533.

19. Dienes L, Edsall G. Observation on the L-orgarnism of Klineberger. Proc Soc Exp Biol Med. 1937. 36:740–744.

20. Shepard MC. Recovery of pleuropneumonia-like organisms from Negro men with and without nongonococcal urethritis. Am J Syph Gonorrhea Vener Dis. 1954. 38:113–124.

21. Purcell RH, Taylor-Robinson D, Wong DC, Chanock RM. Color test for the measurement of antibody to T-strain mycoplasmas. J Bacteriol. 1966. 92:6–12.

22. Shepard MC. Cultivation and properties of T-strain of mycoplasma associated with nongonococcal urethritis. Ann N Y Acad Sci. 1967. 143:505–514.

23. Shepard MC, Ford DK, Purcell RH, Taylor-Robinson D, Razin S, Black FT. Ureaplasma urealyticum gen. nov., sp. nov.: Proposed nomenclature for the human T Mycoplasma. Int J Syst Bacteriol. 1974. 24:160–171.

24. Taylor-Robinson D. Genital Mycoplasma infections. Clin Lab Med. 1989. 9:501–523.

25. Taylor-Robinson D, Csonka GW. Harris JR, editor. Laboratory and clinical aspects of Mycoplasmal infections of the human genitourinary tract. Recent advences in sexually transmitted diseases. 1981. London: Churchill Livingstone;151.

26. Furr PM, Taylor-Robinson D. Prevalence and significance of Mycoplasma hominis and Ureaplasma urealyticum in the urines of a non-venereal disease population. Epidemiol Infect. 1987. 98:353–359.

27. McCormack WM, Almeida PC, Bailey PE, Grady EM, LEE YH. Sexual activity and vaginal colonization with genital mycoplasmas. JAMA. 1972. 221:1375–1377.

28. Bae HG, Heo WB, Lee NY, Lee WK, Koo TB. Detection of Ureaplasma urealyticum and Mycoplasma hominis in pregnant women using MYCOFAST® Evolution 2 and PCR. Korean J Clin Microbiol. 2003. 6:74–80.

29. Taylor-Robinson D, Furr PM. Clinical antibiotic resistance of Ureaplasma urealyticum. Pediatr Infect Dis. 1986. 5:6 Suppl. S335–S337.

30. Chang JH, Choi JG, Rhew HY. Isolation of Ureaplasma urealyticum from patient with genitourinary tract infection attending urologic clinic. Korean J Urol. 1991. 32:744–749.