IMR Press / CEOG / Volume 50 / Issue 2 / DOI: 10.31083/j.ceog5002029
Open Access Original Research
Identification and Characteristics of Multidrug-Resistant Ureaplasm urealyticum and Mycoplasma hominis Isolates among Female Patients with Recurrent Non-Gonococcal Urethritis in a Tertiary Hospital, China
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1 Department of Clinical Laboratory, Associated Hospital, Beihua University, 132013 Jilin, Jilin, China
2 Department of Renal Medicine, People’s Hospital of Jilin, 132012 Jilin, Jilin, China
3 Department of Clinical Microbiology, School of Laboratory Medicine, Beihua University, 132013 Jilin, Jilin, China
*Correspondence: limingcheng@beihua.edu.cn (Mingcheng Li)
These authors contributed equally.
Clin. Exp. Obstet. Gynecol. 2023, 50(2), 29; https://doi.org/10.31083/j.ceog5002029
Submitted: 29 August 2022 | Revised: 25 November 2022 | Accepted: 1 December 2022 | Published: 31 January 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Concerns are increasing over the mechanisms of drug resistance pathogens among non-gonococcal urethritis (NGU) or cervicitis. The study aims to explore the distribution of Ureaplasm urealyticum (U. urealyticum) and Mycoplasma homins (M. homins) isolates, characteristics of multidrug resistance, and the underlying mechanism to allow clinicians to deliver rational therapy for NGU. Methods: Samples from cervical secretions of 246 patients with NGU were collected. Mycoplasma culture and drug susceptibility tests were performed, respectively. The resistance genes were detected by multiplex Polymerase Chain Reaction (PCR), and the PCR products were cloned and sequenced. Results: Out of 246 samples, the overall prevalence of U. urealyticum and/or M. hominis infection was 39.02% (96/246). In 96 culture positive samples, the overall infection rate of U. urealyticum was higher than that of the single M. hominis (46.87% vs. 28.13%) (p < 0.05), and the coinfection rate was 25.00% (24/96). Each U. urealyticum and M. hominis isolate exhibited resistance to at least three types of antimicrobial agents (manifest by more than 70% resistance to erythromycin, tetracycline, ciprofloxacin, and spiramycin, followed by ofloxacin, roxithromycin, azithromycin and josamycine (with resistance thereto of more than 50%)). More than 80% of U. urealyticum and M. hominis isolates were susceptible to minomycine and doxycycline, whereas 81.16% and 77.44% of both U. urealyticum and M. hominis isolates were also susceptible to minomycine and doxycycline. Surprisingly, the resistance rate of the mixed infection was higher that of erythromycin, tetracycline and ciprofloxacin comparison to the single infection (p < 0.05). All tetracycline-resistant isolates carried the tetM gene and 50% of erythromycin-resistant isolates carried the ermA gene. Conclusions: Among outpatients with recurrent NGU, the U. urealyticum infection dominated, followed by M. hominis, mixed U. urealyticum and M. hominis infection. Minomycine and doxycycline are recommended for empirical clinical treatment. The determination of U. urealyticum and M. hominis infection, antibiotic susceptibility testing is crucial for effective therapy.

Keywords
non-gonococcal urethritis (cervix)
mycoplasma
infection
drug resistance
Funding
20190304101YY/Jilin Science and Technology Development Program
20190301014NY/Jilin Science and Technology Development Program
2018J098/Health and Family Planning Commission of Jilin Province
JJKH20220076KJJ/“14th Five-Year Plan” Science and Technology Project of Jilin Provincial Department of Education
Figures
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