Ann Clin Microbiol.  2016 Mar;19(1):13-19. 10.5145/ACM.2016.19.1.13.

Prevalence and Antimicrobial Susceptibility of Genital Mycoplasmataceae in Korean Women: Correlation between Phenotypic Test and Resistance Genes

Affiliations
  • 1Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yjpk@catholic.ac.kr
  • 2Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

BACKGROUND
While 7.6% of cultured genital Mycoplasmataceae was identified as Ureaplasma urealyticum, most of them were Ureaplasma parvum (80.3%). This is the first study differentiating between these two species. We investigated the prevalence and antimicrobial resistance of genital Mycoplasmataceae in Korean women.
METHODS
A total of 150 specimens submitted to the laboratory for culture of M. hominis and Ureaplasma spp. were included. Detection and antimicrobial susceptibility tests were performed with the Mycoplasma IST2 kit (bioMérieux, France). The identification of Ureaplasma spp. was performed by PCR, and mutations in drug resistance genes were investigated by PCR and sequencing.
RESULTS
In total, 66 specimens (44.0%) were positive for genital Mycoplasmatacea: U. parvum, 53 (80.3%); U. urealyticum, 5 (7.6%); M. hominis, 2 (3.0%); mixed infection, 6 (9.1%). Susceptibilities of Ureaplasma spp. to erythromycin, azithromycin, clarithromycin, and doxycycline were 86.0%, 80.7%, 98.2%, and 94.7%, respectively. The susceptibility of Ureaplasma spp. to ofloxacin and ciprofloxacin was 47.4% and 17.5%, respectively. The S83L mutation was found in the ParC subunit of the ofloxacin-resistant (5/7, 71.4%) and the ciprofloxacin-resistant isolates (7/14, 50.0%). One M. hominis isolate showed resistance to erythromycin, azithromycin, and clarithromycin but susceptibility to josamycin, pristinamycin, fluoroquinolones, and tetracyclines.
CONCLUSION
The prevalence of genital Mycoplasmataceae in Korean women was 44.0%; most of them were identified as U. parvum. As more than 10% of Ureaplasma spp. showed non-susceptibility to erythromycin and azithromycin (15.5%, 20.7%), a susceptibility test is needed prior to use of these antibiotics. Further study is needed about the clinical features of infections caused by U. urealyticum vs. U. parvum and their associated resistance mechanisms.

Keyword

Antimicrobial susceptibility; Mycoplasma IST2 kit; Ureaplasma parvum; Ureaplasma urealyticum

MeSH Terms

Anti-Bacterial Agents
Azithromycin
Ciprofloxacin
Clarithromycin
Coinfection
Doxycycline
Drug Resistance
Erythromycin
Female
Fluoroquinolones
Humans
Josamycin
Mycoplasma
Mycoplasmataceae*
Ofloxacin
Polymerase Chain Reaction
Prevalence*
Pristinamycin
Tetracyclines
Ureaplasma
Ureaplasma urealyticum
Anti-Bacterial Agents
Azithromycin
Ciprofloxacin
Clarithromycin
Doxycycline
Erythromycin
Fluoroquinolones
Josamycin
Ofloxacin
Pristinamycin
Tetracyclines

Figure

  • Fig. 1. Clostridium difficile isolates from unformed stool (CDI or colonization): Number and proportion of isolates (total 251 unduplicated isolates). Abbreviations: CDI, Clostridium difficile infection; HCFA-HO, healthcare facility-associated hospital onset; HCFA-CO, healthcare facility-associated community onset; CA, community-associated community onset.


Reference

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