Prevalence and Antimicrobial Susceptibility of GenitalMycoplasmataceaein Korean Women: Correlation between Phenotypic Test and Resistance Genes

Jiyoung Chang, Jin Kyung Yu, Changeun Song, In Yang Park, Yeon-Joon Park
2016 Annals of Clinical Microbiology  
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
more » ... ere 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. (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Ureaplasma와 mycoplasma는 세포벽이 없는 균속으로 독립 적인 증식이 가능한 가장 작은 미생물체이다[1]. 이들은 Myco-plasmataceae과에 속하나, Ureaplasma 균속은 urea를 가수분해 하는 능력이 있어 Mycoplasma 균속과 구별된다[2]. Ureaplasma 와 mycoplasma는 건강 성인의 비뇨생식기에서도 분리되나, 요 도염, 골반염, 불임, 자연유산, 조기분만, 조기진통, 조기양막파 수, 저체중아, 조산아의 호흡기 감염, 패혈증 등의 원인으로 여 겨지고 있다[1-3]. Ureaplasma에는 두 가지의 뚜렷한 변종이 알 려져 있는데, biovar 2 (Ureaplasma urealyticum)은 상기 질환들 을 일으키나 biovar 1 (Ureplasma parvum)의 역할은 뚜렷하지 않다[4,5]. 그러나 Martínez 등[6]의 연구에서는 두 biovars 모두 양막강 내 침입하여 임신기 합병증과 관련이 있다고 하였고 De Francesco 등[7]은 생식기 감염 증상이 있는 여자 환자의 44%에서 U. parvum serovar 3/14가 발견되었으며, Kong 등[8] 은 임신부 질도말 검체 87%에서 U. parvum이 동정되었고 이는 임신 시 합병증과 관련이 있었다고 하였다. 한편 Xiao 등[2]의 연구에 따르면 변종들의 감별이 임상적으로 ureaplasma 병원성 을 구별하는데 도움을 주지 못하며 감염된 숙주의 특이적 면역
doi:10.5145/acm.2016.19.1.13 fatcat:7vwpyojt3bealhzuogqtaavioi