Search Results (19)

Background: Ureaplasma spp. and Mycoplasma hominis are urogenital pathogens that may be missed by routine culture, particularly in patients with genitourinary symptoms in whom conventional methods fail to identify an etiologic agent. Limited routine implementation of targeted diagnostics and antimicrobial susceptibility testing (AST) for these organisms may contribute to diagnostic uncertainty and treatment failure. Methods: Seventy-five midstream urine samples submitted for suspected urinary tract infection and positive for Ureaplasma spp. according to a q-PCR urinary panel (Bioeksen, İstanbul, Türkiye) were tested the same day with MYCOPLASMA IST3 (bioMérieux, Marcy-l’Étoile, France) to assess growth and antimicrobial susceptibility. Results: q-PCR detected U. parvum in 54/75 (72%), U. urealyticum in 15/75 (20%), and both species in 6/75 (8%); M. hominis was not included in the PCR panel. MYCOPLASMA IST3 showed growth in 70/75 samples (positive percent agreement, 93.33%), while 5/75 (discordance, 6.66%) showed no growth. Among culture-positive samples, 57/70 (81.42%) yielded Ureaplasma spp. alone, and 13/70 (18.58%) yielded Ureaplasma spp. together with M. hominis. Resistance to levofloxacin and tetracycline was observed in 15.7% and 12.9% of Ureaplasma spp. isolates, respectively; resistance to moxifloxacin, erythromycin, and telithromycin was observed in 2.9% of isolates for each agent. In M. hominis isolates, no resistance to levofloxacin, moxifloxacin, or tetracycline was observed, whereas clindamycin resistance was observed in 7.7% of isolates. Conclusions: In addition to intrinsic resistance, acquired antimicrobial resistance in Ureaplasma and Mycoplasma species appears to be increasing; therefore, treatment decisions should be guided by AST whenever feasible. Clinical laboratories should implement appropriate diagnostic methods for these organisms and perform susceptibility testing when indicated to support clinical decision making and optimize antimicrobial selection. Full article

Background and Clinical Significance: Pelvic inflammatory disease represents a multifaceted sexually transmitted disease affecting women of reproductive age, beginning in adolescence. Clinical presentation ranges from asymptomatic patients to acute abdominal pain in the setting of tubo-ovarian abscesses; however, presentation as primary peritonitis with seemingly intact fallopian tubes is exceptional. Primary peritonitis in the absence of other comorbid conditions (e.g., liver cirrhosis and nephrotic syndrome) in healthy, immunocompetent women is rare and typically occurs without an identifiable intra-abdominal source. The diagnosis can be challenging due to its mild-to-moderate, nonspecific symptoms. Case Presentation: We report the case of a 21-year-old immunocompetent woman who presented with lower abdominal and left iliac fossa pain with hyperleukocytosis. Laparoscopic exploration confirmed the diagnosis of primary peritonitis. Following diagnosis, she underwent peritoneal lavage and was started on empiric broad-spectrum parenteral antibiotic therapy. Cervico-vaginal cultures established the diagnosis of PID following identification of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma parvum. The clinical course was favorable. Conclusions: An early multidisciplinary approach, including consultation with an infectious disease specialist and clinical pharmacologist, is recommended in cases of peritonitis with an unclear source. PID may present as primary peritonitis and this clinical scenario should be considered in sexually active young women with unexplained peritoneal infection when no gastrointestinal or gynecologic source is evident intraoperatively. Full article

Background: Placental infections caused by Schistosoma spp. and sexually transmitted microorganisms can adversely impact pregnancy outcomes. However, the association between molecular detection of these pathogens in placental tissue and corresponding histopathological inflammation remains unclear, particularly in sub-Saharan African populations. Methods: In this cross-sectional study, placental parenchyma specimens with limited membrane sampling were collected from 103 Ivorian and Ghanaian mothers without known pregnancy or birth complications. Tissue pieces adjacent to PCR-tested samples were analyzed by real-time PCR targeting Chlamydia trachomatis, Mycoplasma hominis, Neisseria gonorrhoeae, Schistosoma spp., Streptococcus agalactiae, Trichomonas vaginalis, Ureaplasma parvum and Ureaplasma urealyticum. Corresponding adjacent tissues were examined by routine histopathology, supplemented with immunohistochemistry when higher pathogen DNA quantities were detected, to assess inflammatory changes. Results: Real-time PCR detected U. urealyticum in 15 out of 103 cases (14.6%, ±0.7%), U. parvum in 13 (12.6%, ±0.6%), S. agalactiae in 11 (10.7%, ±0.5%), the S. haematobium complex in four (3.9%, ±0.2%), M. hominis in four (3.9%, ±0.2%), confirmed N. gonorrhoeae in two (1.9%, ±0.1%) and non-confirmed N. gonorrhoeae in one (1.0%, ±0.1%), T. vaginalis in two (1.9%, ±0.1%), and C. trachomatis (non-lymphogranuloma venereum serovar) in one (1.0%, ±0.1%). Overall, pathogen DNA levels were low, with only four positive PCR results yielding cycle threshold (Ct) values below 30 and none below 25. Histopathological examination revealed no relevant inflammatory changes in any samples. Conclusions: Placental parenchyma tissues with limited membrane sampling testing positive for Schistosoma spp. or sexually transmitted pathogens by molecular methods demonstrated no corresponding histopathological inflammation. These findings warrant confirmatory studies to better characterize potential region-specific placental infection phenotypes and their clinical significance. Full article

Hemotrophic mycoplasmas (HMs) are cell wall-less, small and uncultivable pathogens, which can cause infections in pigs with no to severe clinical signs and can contribute to significant economic losses in the pig industry. In addition to the known mechanical transmission routes of HMs (e.g., via blood-contaminated instruments or lesions from ranking fights), transmission to pigs by arthropod vectors such as Stomoxys calcitrans is being discussed. To date, there is scant available data concerning the transmission of HMs by stable flies. The objective of this study is to gain more data concerning the occurrence of HMs in Stomoxys calcitrans. Therefore, quantitative real-time PCR was conducted on different stable fly samples (surface washings and whole flies). We found Mycoplasma (M.) suis in 5.2% of crushed flies and 4.2% of fly wash solutions, and M. parvum was detected in 5.2% of flies and 9.4% of fly wash solutions. ‘Candidatus (Ca.) M. haemosuis’ was not detected in any sample. The mean bacterial loads were 2.0 × 10² M. suis/fly, 9.3 × 10² M. suis/fly wash solution and, for M. parvum, 2.4 × 10³ M. parvum/fly and 2.1 × 10³ M. parvum/fly wash solution. This molecular occurrence of porcine HMs in blood-sucking flies and reasonable bacterial loads in the two- to three-digit range demonstrate that these flies serve as mechanical vectors in stables and are, therefore, of epidemiological importance. Full article

Urease-positive urogenital mycoplasmas are considered to be responsible for the formation of urinary stones. They are usually a part of the normal flora in the human urogenital tract, causing asymptomatic infections. However, many symptomatic infections with these bacteria have been reported. M. genitalium is recognized as a cause of male urethritis and other common genitourinary diseases. The role of other urogenital mycoplasmas is still unclear. The aim of this study was to estimate the quantitative prevalence of Ureaplasma spp., M. genitalium and M. hominis in men with urolithiasis using quantitative real-time PCR (qPCR). The study group comprised 100 men with urolithiasis. A total of 60 men were included in the control group. Urogenital mycoplasma DNA in urine samples was detected significantly more often among men with urolithiasis than in healthy subjects—43.0% vs. 26.6%, p = 0.0382, respectively. The majority of positive results (38/43) concerned U. parvum species, the frequency of which was higher in the study group (38.0% (38/100)) than in the control group (23.3% (14/60)), p = 0.0552. The median concentration of U. urealyticum DNA was higher in the study group compared with the control, p = 0.5714. However, further studies are needed to confirm the usefulness of quantitative studies in determining the role of urogenital mycoplasmas in pathology. Full article

Background/Objectives: Polycystic ovary syndrome (PCOS) is one of the most frequently diagnosed endocrine and metabolic disorders in women of reproductive age before menopause. It is associated with excess androgens and ovarian dysfunction, reduced fertility, the presence of obstetric disorders, but also metabolic disorders, and, among others, insulin resistance, obesity and type II diabetes. Its close relationship with changes in the diversity of the vaginal microbiome, vaginal inflammation and changes in the vaginal microenvironment, which can pave the way for pathogenic microorganisms, is emphasized. Methods: The research in the presented paper focuses on a group of women with PCOS (n = 490) of reproductive age (26–43 years), in whom the frequency of infections of the reproductive system caused by atypical pathogens, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma spp., were analyzed, and then the immune system response was assessed in terms of the level of serum proinflammatory cytokines, IL-1β, IL-6 and TNF-α. Results: Our results showed a 40% infection rate in the studied group of patients with PCOS, with C. trachomatis being the most common pathogen (17.7%), followed by Ureaplasma spp. (10%) and M. hominis (4.9%). In some cases, co-infections such as Mycoplasma and Ureaplasma were also observed in 3.1% or all three atypical bacteria, M. hominis, Ureaplasma spp. and C. trachomatis, in 4.3% of patients with PCOS. In our study, in women with PCOS and confirmed infection with any atypical pathogen (n = 196), we analyzed the levels of proinflammatory cytokines, IL-1 β a, IL-6 and TNF-α. The results were compared with a control group (control group A) consisting of patients with the same underlying disease, i.e., PCOS (n = 39), who did not experience infection with atypical pathogens or symptoms of gynecological infection. Additionally, a control group B (n = 28) consisting of healthy women (without PCOS and without infection) was introduced. The results regarding the levels of cytokines studied in this work (IL-1β, IL-6, TNF-α) may suggest that the presence of intracellular C. trachomatis in the infection will play a dominant role in the immune system response. In the infections with atypical pathogens analyzed in this study in patients with PCOS, no characteristic clinical features were observed, apart from indications in the form of an increase in the number of leukocytes in the assessment of the vaginal biocenosis, suggesting cervicitis and reported reproductive failure or lower abdominal pain. An additional problem is the inability to detect the presence of atypical pathogens in routine microbiological tests; therefore, confirmation of such etiology requires referral of the patient for targeted tests. Conclusions: Invasion of host cells by atypical pathogens such as C. trachomatis and infections with “genital mycoplasmas” can disrupt the function of these cells and lead to many complications, including infertility. The immune response with the production of proinflammatory cytokines such as TNF-α, IL-1β, and IL-6, observed in response to infection with C. trachomatis, M. hominis, and Ureaplasma spp., induces or amplifies inflammation by activating immune cells or controlling infection, but may lead to the facilitation of the survival of pathogenic microorganisms and irreversible damage to fallopian tube tissues. Especially in the case of the proinflammatory cytosine TNF-α, there seems to be a close correlation with infections with atypical pathogens and a marked immune response, as well as with increased IL-1β and IL-6 values compared with the absence of infection (both in the presence and absence of PCOS). The presented study may suggest the importance of extended diagnostics to include atypical pathogens in the case of PCOS and the importance of research in this area also from the point of view of the immune response. Full article

Dysbiosis, or an altered microbiota composition, has been implicated in chronic endometrial inflammation and recurrent implantation failure. Despite growing research on the relationship between the genital microbiome and reproductive health, few studies have examined its role in ectopic pregnancy. Therefore, our study focuses on the microbiota of the cervical canal in women diagnosed with an ectopic pregnancy. Material and methods: The study group consisted of nine women of a reproductive age who were hospitalized at the Department of Maternal and Child Health, Gynecology and Obstetrics, Clinical Hospital of the University of Poznań, between February and September 2023. In nine patients, an ectopic pregnancy was diagnosed based on a transvaginal ultrasound examination. The swabs were collected for quantitative microbiological culture (using Amies transport medium). The microbiological analyses involved quantitative culture on selected selective and differential media, following the Standard Operating Procedure developed by the Institute of Microecology. Results: A reduced Lactobacillus spp. count (≤5 × 10⁷ CFU/mL) was observed in 78% of the patients participating in the study, including those that produce H₂O₂, i.e., with strong protective properties for the environment of the female reproductive tract. The molecular analyses revealed Ureaplasma spp. (U. parvum and U. urealyticum) in 33% of the samples (three patients). However, Chlamydia trachomatis and Mycoplasma genitalium were not detected in any of the analyzed samples. Conclusions: The ease of obtaining material and the minimally invasive nature of lower reproductive tract examinations may allow for the evaluation of microbiota imbalances, helping to identify individuals at an increased risk of reproductive complications. Full article

Understanding the interactions between the cervico-vaginal microbiome, immune responses, and sexually transmitted infections (STIs) is crucial for developing targeted diagnostic and therapeutic strategies. Although microbiome analyses are not yet standard practice, integrating them into routine diagnostics could enhance personalized medicine and therapies. We investigated the extent to which partial 16S short-read amplicon microbiome analyses could inform on the presence of six commonly encountered STI-causing pathogens in a patient cohort referred for colposcopy, and whether relevant taxonomic or diagnostic discrepancies occur when using vaginal rather than cervical swabs. The study cohort included cervical and vaginal samples collected from women referred for colposcopy at the University Hospital Bonn between November 2021 and February 2022, due to an abnormal PAP smear or positive hrHPV results. 16S rRNA gene sequencing libraries were prepared targeting the V1–V2 and V4 regions of the 16S RNA gene and sequenced on the Illumina MiSeq. PCR diagnostics for common STI-causing pathogens were conducted using the Allplex STI Essential Assay Kit (Seegene, Seoul, Republic of Korea). Concerning the bacterial microbiome, no significant differences were found between vaginal and cervical samples in terms of prevalence of taxa present or diversity. A total of 95 patients and 171 samples tested positive for at least one among Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, Chlamydophila trachomatis or Neisseria gonorrhoeae. Sequencing the V1–V2 region enabled detection of one-third to half of the PCR-positive samples, with the detection likelihood increasing at lower cycle threshold (Ct) values. In contrast, sequencing the V4 region was less effective overall, yielding fewer species-level identifications and a higher proportion of undetermined taxa. We demonstrate that the vaginal microbiome closely mirrors the cervical microbiome, a relationship that has not been explored previously, but which broadens the possibilities for microbiome analysis and pathogen detection and establishes vaginal swabs as a reliable method for detecting the investigated pathogens, with sensitivities comparable with or superior to endocervical swabs. On the other hand, the sensitivity of partial 16S amplicon sequencing appears insufficient for effective STI diagnostics, as it fails to reliably identify or even detect pathogens at higher Ct values. Full article

Genital Mycoplasmas are implicated in adverse pregnancy outcomes and the development of infertility. However, the role of Mycoplasma fermentans in these outcomes has not been adequately studied; therefore, its participation in these sufferings requires further investigation. This study aimed to evaluate the prevalence of M. fermentans in pregnant and non-pregnant women. End-point PCR was used to analyze two hundred and twenty-eight endocervical samples for M. hominis, M. genitalium, M. fermentans, M. pirum, Ureaplasma urealyticum, and U. parvum diagnoses. The prevalence of Mycoplasma spp. was as follows: U. parvum was found in 83 samples (36.4%), U. urealyticum in 39 instances (17.1%), M. hominis in 36 (15.7%), M. fermentans in 32 (14%), M. genitalium in 15 (6.6%), and M. pirum in 0 samples. No association was found between the Mycoplasma spp. and some infertility conditions or adverse pregnancy. However, M. fermentans and M. hominis were found to be associated with bacterial vaginosis (RR = 3.4 CI 95% 1.85–6.3, p < 0.005). In conclusion, M. fermentans and M. hominis were isolated more often in women with bacterial vaginosis, which suggests that these bacteria could contribute to the development of this pathology. Full article

Recent European data show an increase in sexually transmitted infections (STIs), particularly N. gonorrhoeae, among young heterosexuals, surpassing pre-pandemic numbers. Italy’s varied local health restrictions during the COVID-19 pandemic likely affected STI management and reporting. To evaluate COVID-19’s impact on STI spread in Italy, we analyzed microbiological data from before and during the pandemic in an area with minimal restrictions on clinical services. This retrospective study (2017–2022) included 5503 subjects: 2586 from STI clinics (STD group) and 3687 diagnosed with primary infertility (ART group). Samples were tested for Mycoplasmas/Ureaplasmas, C. trachomatis, N. gonorrhoeae, and T. vaginalis by a multiplex PCR. During the pandemic, overall STI prevalence increased significantly (p < 0.01). U. parvum was the most frequent microorganism in the STD group (26.1% vs. 23.9%), with a notable increase in women (52.1% vs. 32.7%) (p < 0.001). C. trachomatis and M. hominis positive rates decreased significantly (p < 0.001 and p < 0.01, respectively). N. gonorrhoeae cases rose among young people (19–29), predominantly heterosexual, with high ciprofloxacin resistance. In the ART group, U. parvum was the most common infection, particularly in young infertile women (p = 0.01). This study indicates a notable rise in STIs among young people, including heterosexuals, despite social restrictions. The long-term impact of this trend requires further evaluation. Full article

Haemotrophic mycoplasmas (haemoplasmas) are a group of highly specific and adapted bacteria. Three different haemoplasma species in pigs are known to date: Mycoplasma (M.) suis, M. parvum and ‘Candidatus (Ca.) M. haemosuis’. Even though these bacteria have been known in pig farming for a long time, it is difficult to draw general conclusions about the relevance of their infections in pigs. This review summarizes the current knowledge on the three porcine haemoplasma species with regards to clinical and pathological descriptions, pathobiology, epidemiology and diagnostics as well as prevention and therapy. Overall, it is clear that considerably more data are available for M. suis than for the other two species, but generally, porcine haemoplasmas were found to be highly prevalent all over the world. Mycoplasma suis is the most virulent species, causing acute infectious anaemia in pigs (IAP), whereas M. parvum usually results in chronic and subclinical infections associated with performance losses. Little is known about the clinical significance of the recently discovered third porcine species ‘Ca. M. haemosuis’. So far, the described pathogenic mechanisms mainly include direct destruction of erythrocytes via adhesion, invasion, eryptosis and nutrient scavenging, indirect erythrocyte lysis due to immune-mediated events and immune dysregulation processes. A review of published diagnostic data confirms PCR assays as the current standard method, with various cross-species and species-specific protocols. Overall, there is a need for further examination to obtain valuable insights for practical application, specifically regarding the importance of subclinical infections in naturally infected animals. An essential requirement for this will be to gain a more comprehensive understanding of the mechanisms operating between the host and the pathogen. Full article

Trichomonas vaginalis causes trichomoniasis, the most recurrent sexually transmitted infection (STI) worldwide. Genital mycoplasmas, not considered STI agents, are frequently isolated from the female genital tract. A symbiosis between Mycoplasma species and T. vaginalis has been described. The aim of this study was to conduct molecular-based analyses of vaginal specimens, thus assessing the prevalence of non-STI Mycoplasma infections. In total, 582 samples from female patients and an additional 20 T. vaginalis isolates were analyzed by PCR using Mycoplasma specific 16S rRNA primers, and the obtained PCR products were sequenced. Mycoplasma species were detected in 28.2% of the collected vaginal samples. Mycoplasma hominis was found in 21.5% of the specimens, Ureaplasma species were found in 7.5% of the samples. The molecular data of the newly described species, CandidatusMycoplasma girerdii, were obtained for the first time in Austria, in a sample also positive for T. vaginalis. Analyses of the cultivated T. vaginalis strains confirmed the presence of M. hominis in two out of 20 samples. A comparably high prevalence of genital mycoplasmas was revealed through advanced diagnostic assays, with M. hominis and U. parvum being the most prevalent species. The previously described symbiotic relationship between M. hominis and T. vaginalis was confirmed. Full article

Mycoplasma (M.) parvum is a hemotrophic bacterium circulating in the blood of pigs but is not considered a primary pathogen. Only a handful of studies dealing with this agent have been published since its first description in 1951, and many issues, including epidemiology and the impact of subclinical infections, are yet to be elucidated. This study aimed to establish a M. parvum specific real-time PCR for its detection and quantification in porcine blood and the application of this assay to obtain insights into the occurrence of M. parvum in German pigs. Furthermore, 16S rDNA amplicons of M. parvum positive blood samples were phylogenetically analyzed using MEGA 11 software. The established qPCR targeting the M. parvum glyceraldehyde-3-phosphate dehydrogenase encoding gene (gap) showed a lower detection limit of 10 gene copies per reaction and no cross-reactivity within the specificity test. A total of 36.0% (n = 72) of the sampled fattening pigs, 25.0% (n = 15) of the sows, and 4.37% (n = 8) of the boars tested M. parvum positive. The dendrogram showed the typical allocation of the M. parvum isolates into the “haemominutum group” subgroup within the hemotrophic Mycoplasma species. Both the novel established qPCR and the obtained epidemiological data can serve as an important basis for future studies dealing with M. parvum. Full article

This study provides updated information on the prevalence and co-infections caused by genital microorganisms and pathogens: Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, Trichomonas vaginalis, and Gardnerella vaginalis, by retrospectively analyzing a cohort of patients living in the Naples metropolitan area, Campania region, Southern Italy. To investigate the genital infections prevalence in clinical specimens (vaginal/endocervical swabs and urines) collected from infertile asymptomatic women and men from November 2018 to December 2020, we used a multiplex real-time PCR assay. Of the 717 specimens collected, 302 (42.1%) resulted positive for at least one of the targets named above. Statistically significant differences in genital prevalence of selected microorganisms were detected in both women (62.91%) and men (37.08%). G. vaginalis and U. parvum represented the most common findings with an 80.2% and 16.9% prevalence in vaginal/endocervical swabs and first-voided urines, respectively. Prevalence of multiple infections was 18.18% and 8.19% in women and men, respectively. The most frequent association detected was the co-infection of G. vaginalis and U. parvum with 60% prevalence. Our epidemiological analysis suggests different infection patterns between genders, highlighting the need to implement a preventative screening strategy of genital infections to reduce the complications on reproductive organs. Full article

Chlamydia trachomatis is an important cause of sexually transmitted infections (STI) in Western countries. It is often asymptomatic, and thus, left untreated, and can have severe negative consequences, such as tubal infertility or adverse pregnancy outcomes. Other sexually transmitted microorganisms, such as Neisseria gonorrhoeae and Trichomonas vaginalis, as well as normal residents of the vaginal flora, such as genital mycoplasmas, also negatively impact human sexual and reproductive health. We evaluated the reliability of the Seegene Allplex STI Essential Assay for C. trachomatis detection using the real-time qPCR routinely used in our diagnostic laboratories as the gold standard. The Seegene assay displayed a sensitivity of 97.8% and a specificity of 98.9%. As this assay can also detect six other urogenital pathogens, we applied it to 404 samples from women who attended Lausanne University Maternity Hospital and obtained the following prevalence rates: 2.5% for C. trachomatis, 3.5% for Mycoplasma hominis, 6.3% for Ureaplasma urealyticum, and 27.7% for Ureaplasma parvum. Two samples were positive for Trichomonas vaginalis, and one sample was positive for Mycoplasma genitalium. Bacterial vaginosis was present in 4.5% of the cases and was strongly associated with M. hominis. Finally, we confirmed the association between C. trachomatis infection and pre-term birth (p = 0.03) but could not detect any association of this condition with other urogenital pathogens (Mycoplasma/Ureaplasma). In conclusion, given its high sensitivity and specificity for C. trachomatis DNA detection as well as its multiplex format, which simultaneously provides results for six other urogenital pathogens, the Seegene Allplex™ STI Essential Assay represents an appealing diagnostic tool in modern microbiology laboratories. Full article