RESUMO
BACKGROUND: The aim of this study was to investigate the epidemiological characteristics and antibiotic resistance patterns of Ureaplasma urealyticum (UU) infection among women and children in southwest China. METHODS: A total of 8,934 specimens, including urogenital swabs and throat swabs were analyzed in this study. All samples were tested using RNA-based Simultaneous Amplification and Testing (SAT) methods. Culture and drug susceptibility tests were performed on UU positive patients. RESULTS: Among the 8,934 patients, the overall positive rate for UU was 47.92%, with a higher prevalence observed among women of reproductive age and neonates. The majority of UU positive outpatients were women of reproductive age (88.03%), while the majority of UU positive inpatients were neonates (93.99%). Overall, hospitalization rates due to UU infection were significantly higher in neonates than in women. Further analysis among neonatal inpatients revealed a higher incidence of preterm birth and low birth weight in UU positive inpatients (52.75% and 3.65%, respectively) than in UU negative inpatients (44.64% and 2.89%, respectively), especially in very preterm and extremely preterm neonates. Moreover, the incidence rate of bronchopulmonary dysplasia (BPD) among hospitalized neonatal patients was significantly higher in the UU positive group (6.89%) than in the UU negative group (4.18%). The drug susceptibility tests of UU in the neonatology, gynecology and obstetrics departments exhibited consistent sensitivity patterns to antibiotics, with high sensitivity to tetracyclines and macrolides, and low sensitivity to fluoroquinolones. Notably, UU samples collected from the neonatology department exhibited significantly higher sensitivity to azithromycin and erythromycin (93.8% and 92.9%, respectively) than those collected from the gynecology and obstetrics departments. CONCLUSIONS: This study enhances our understanding of the current epidemiological characteristics and antibiotic resistance patterns of UU infection among women and children in southwest China. These findings can aid in the development of more effective intervention, prevention and treatment strategies for UU infection.
Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Infecções por Ureaplasma , Ureaplasma urealyticum , Humanos , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/microbiologia , Infecções por Ureaplasma/tratamento farmacológico , Ureaplasma urealyticum/efeitos dos fármacos , Ureaplasma urealyticum/isolamento & purificação , Ureaplasma urealyticum/genética , Feminino , China/epidemiologia , Recém-Nascido , Antibacterianos/farmacologia , Adulto , Masculino , Adolescente , Lactente , Pessoa de Meia-Idade , Adulto Jovem , Pré-Escolar , Criança , PrevalênciaRESUMO
OBJECTIVE: The objective of this study was to assess the clinical and uterine cervix characteristics of patients displaying vaginal discharge with positive results for Mycoplasma sp. and/or Ureaplasma spp. METHODS: An analytical cross-sectional study involving women aged 18-45 years was conducted. Microbiological assessments included Ureaplasma and Mycoplasma cultures, as well as human papillomavirus hybrid capture using ecto and endocervix swabs. All tests were two-tailed, and significance was set at p<0.05. RESULTS: Among 324 women, Ureaplasma prevalence was 17.9%, and Mycoplasma prevalence was 3.1%. The Ureaplasma-positive group exhibited a higher frequency of urinary tract infections (39.1 vs. 19%, p=0.002) and human papillomavirus (39.7 vs. 12.8%, p≤0.001) compared with controls. The Mycoplasma-positive group showed a higher frequency of non-contraceptive use compared with controls (66.2 vs. 30.0%, p=0.036). Abnormal colposcopic findings were more prevalent in the Mycoplasma/Ureaplasma-positive group than in controls (positive: 65% vs. control: 35%, p=0.001). Pap smear findings did not differ between the groups. CONCLUSION: Ureaplasma spp. was associated with urinary tract infections and human papillomavirus, while the presence of Mycoplasma sp. was linked to reduced contraceptive use. When analyzing both pathogens together, a higher frequency of abnormal colposcopic findings was observed, with no difference in cytological findings in the positive group.
Assuntos
Colo do Útero , Infecções por Mycoplasma , Mycoplasma , Infecções por Ureaplasma , Ureaplasma , Humanos , Feminino , Adulto , Infecções por Ureaplasma/microbiologia , Infecções por Ureaplasma/epidemiologia , Estudos Transversais , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Ureaplasma/isolamento & purificação , Adulto Jovem , Pessoa de Meia-Idade , Adolescente , Colo do Útero/microbiologia , Colo do Útero/patologia , Mycoplasma/isolamento & purificação , Descarga Vaginal/microbiologia , Prevalência , Infecções por Papillomavirus/microbiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/epidemiologia , Brasil/epidemiologia , Esfregaço VaginalRESUMO
PURPOSE: Ureaplasma species are associated with urogenital infections, infertility and adverse pregnancy outcomes as well as neonatal infections. Involvement of the central nervous system in adults is extremely rare. We report an unusual case of a brain abscess secondary to otitis media with Ureaplasma parvum in a patient with granulomatosis with polyangiitis (GPA). METHODS: Imaging and laboratory findings, treatment decisions, and outcome of this case are explicated. RESULTS: A young adult with GPA presented with progredient earache after ambulant diagnosis of otitis media. Despite different courses of broad-spectrum antibiotic therapy, she developed meningoencephalitis due to mastoiditis following temporal abscess formation. Mastoidectomy and neurosurgical abscess removal were performed. Standard cultures of cerebrospinal fluid, blood and intracranial abscess material, as well as polymerase chain reaction (PCR) for common bacterial and viral meningitis pathogens remained negative. Only eubacterial PCR of intracranial abscess material returned positive for Ureaplasma parvum. The patient finally improved under antibiotic therapy with moxifloxacin and doxycycline. CONCLUSION: Ureaplasma species are rare causative pathogens in immunocompromised patients. They should be considered in patients with humoral immunodeficiencies with culture-negative infections failing standard therapy. Eubacterial PCR should be performed in early states of infection in these patients for immediate diagnosis and initiation of appropriate treatment to prevent adverse outcomes.
Assuntos
Abscesso Encefálico , Granulomatose com Poliangiite , Otite Média , Infecções por Ureaplasma , Recém-Nascido , Gravidez , Feminino , Adulto Jovem , Humanos , Ureaplasma , Granulomatose com Poliangiite/complicações , Antibacterianos/uso terapêutico , Otite Média/complicações , Otite Média/tratamento farmacológico , Infecções por Ureaplasma/complicações , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/microbiologiaRESUMO
RATIONALE: Artificial joint infection caused by Mycoplasma hominis and Ureaplasma urealyticum is rare and has not been reported. PATIENTS CONCERNS: A 59-year-old man underwent left total knee arthroplasty for 1 year of pain in the left knee joint. The indwelling urinary catheter was removed after 48 hour of the surgery. On day 8 after the surgery, the patient had fever, increased skin temperature, swelling and redness around the surgical site, and floating patella test (+). According to experience, Vancomycin, Ciprofloxacin and Linezolid were administrated. Evident decrease in C-reactive protein was observed after Linezolid administration, while there was no significant improvement in clinical symptoms. Microbiome sequencing was performed, resulting in diagnosis of positive M hominis and U urealyticum. The patient was then treated with Doxycycline in the following 3 months. During the 11-month outpatient follow-up, there was no evidence of recurrence of infection. DIAGNOSIS: Microbiome sequencing was performed, resulting in diagnosis of positive M hominis and Ureaplasma urealyticum. INTERVENTIONS: The patient recovered following with Doxycycline in the following 3 months. OUTCOMES: During the 11-month outpatient follow-up, there was no evidence of recurrence of infection. LESSONS: M hominis and U urealyticum are common pathogens of the urinary system infections but they are rare in osteoarticular infections. In cases of fever, swelling and heat pain around the surgical site, joint fluid, negative blood culture and being irresponsive to anti-bacterial agents against the cell wall, special bacteria-related infection should be highly suspected.
Assuntos
Artroplastia do Joelho , Infecções Bacterianas , Infecções por Mycoplasma , Infecções por Ureaplasma , Masculino , Humanos , Pessoa de Meia-Idade , Mycoplasma hominis , Ureaplasma urealyticum , Artroplastia do Joelho/efeitos adversos , Doxiciclina/uso terapêutico , Linezolida/uso terapêutico , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/microbiologia , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/tratamento farmacológico , Infecções por Ureaplasma/microbiologia , DorRESUMO
A 45-year-old female patient receiving rituximab for B cell non-Hodgkin follicular lymphoma presented unexplained recurrent fever, abdominal discomfort, and pollakiuria. We performed shotgun metagenomic sequencing from peri-kidney collection that identified a co-infection with Mycoplasma hominis and Ureaplasma urealyticum. The patient recovered with sequelae after appropriate antibiotic treatment was given.
Assuntos
Infecções por Mycoplasma , Infecções por Ureaplasma , Antibacterianos/uso terapêutico , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Pessoa de Meia-Idade , Infecções por Mycoplasma/microbiologia , Mycoplasma hominis , Rituximab/uso terapêutico , Ureaplasma , Infecções por Ureaplasma/microbiologia , Ureaplasma urealyticumRESUMO
Genital tract ureaplasma infections are associated with numerous complications, ranging from inflammation, through infertility, to problematic pregnancy. In the course of ureaplasma infection, the risk of human papillomavirus infection increases. Diagnostic tests for urea-plasma infections are not always carried out, especially in women with the normal Nugent test results. The study attempts to check whether it is possible to find a prognostic indicator that could suggest a high abundance of ureaplasmas (≥ 104 CFU/ml) at the stage of the initial examination of vaginal discharge. Such a prognostic factor could qualify women for further tests to detect infections with these atypical bacteria. Six hundred twenty-seven white women with a score of 0-3 on the Nugent scale were tested, including 322 patients with a high abundance of ureaplasmas (≥ 104 CFU/ml) and 305 who tested negative for these bacteria. Ureaplasma infections were detected statistically significant in women who had few or no epithelial cells in the genital swab specimens compared to the results obtained for women with numerous or very numerous epithelial cells (p < 0.001). The risk of the high density of ureaplasmas was 38.7% higher with fewer or no epithelial cells than with high numbers. In patients aged 18-40 years with few or no epithelial cells, a high density of ureaplasmas (≥ 104 CFU/ml) was observed significantly more frequently (p = 0.003). Determining the number of epithelial cells in Gram-stained slides may be the prognostic indicator of ureaplasma infection. Testing for genital ureaplasma infection should be considered, especially in women of childbearing age (18-40 years), even if the Nugent test value is normal and pH ≤ 4.6.
Assuntos
Infecções por Ureaplasma , Células Epiteliais , Epitélio , Feminino , Humanos , Gravidez , Prognóstico , Ureaplasma , Infecções por Ureaplasma/complicações , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/microbiologiaRESUMO
Ureaplasma species are increasingly recognized as relevant pathogens in prenatal, perinatal and postnatal morbidity. They are commonly found as commensals on the mucous membranes of the lower urogenital tract of pregnant women, but when ascending, they can cause bacterial vaginosis, chorioamnionitis, premature birth and postnatal morbidities such as bronchopulmonary dysplasia, and early-onset neonatal sepsis and meningitis. The detection of Ureaplasma species is challenging and is not covered by routine diagnostics, and current empiric antibiotic treatment in neonates suspected of infection is not directed against Ureaplasma species. The aim of this review is to discuss the pathophysiology of Ureaplasma infections, the clinical consequences and the current difficulties in diagnosis and treatment by providing an overview of the current literature.
Assuntos
Doenças do Recém-Nascido/microbiologia , Complicações na Gravidez/microbiologia , Infecções por Ureaplasma/microbiologia , Ureaplasma , Imunidade Adaptativa , Corioamnionite/microbiologia , Feminino , Humanos , Imunidade Inata , Lactente , Recém-Nascido/imunologia , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/terapia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Nascimento Prematuro/microbiologia , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/terapiaRESUMO
PURPOSE: To evaluate the agreement of wet smear microscopy with Gram stain microscopy and to assess whether it is possible to predict Mycoplasmas/Ureaplasmas when analysing vaginal secretion with Gram stain and wet smear microscopy. METHODS: Women with complaints of the abnormal vaginal discharge were invited to participate. A sample of vaginal secretion was taken for wet smear microscopy and for Gram staining analysis. A sample from the endocervical canal was taken for DNA detection of seven infections: Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma parvum, Ureaplasma urealyticum, Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. The percentage agreement between wet smear and Gram stain was determined and the Cohen's Kappa values were calculated. RESULTS: Of 158 consecutive women included, one (or a few) of the infections were detected in 54% of them and the most frequent infection was Ureaplasma parvum (79% of all the cases with infections). The percentage agreement between vaginal wet smear and Gram stain was 73% (Cohen's Kappa value 0.63). A statistically significant association between the DNA detected Mycoplasmas/Ureaplasmas and bacterial vaginosis was found (positive amine test p = 0.046, wet smear p = 0.005 and Gram stain p = 0.03). CONCLUSIONS: There was a statistically significant association between bacterial vaginosis and the DNA detected Mycoplasmas/Ureaplasmas. The agreement of vaginal wet smear with Gram stain was good.
Assuntos
Infecções por Mycoplasma/diagnóstico , Mycoplasma/isolamento & purificação , Infecções por Ureaplasma/diagnóstico , Ureaplasma/isolamento & purificação , Esfregaço Vaginal/métodos , Vaginose Bacteriana/microbiologia , Adulto , Feminino , Violeta Genciana , Humanos , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Fenazinas , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/microbiologia , Vaginose Bacteriana/epidemiologiaRESUMO
The objective of this study was to analyze the infection rate and drug resistance of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) in the genitourinary tract of Chinese patients. From December 2018 to June 2019, vaginal secretion or urinary secretion of outpatients in our hospital were selected for culture and drug sensitivity analysis of Ureaplasma urealyticum and Mycoplasma hominis. In 4082 Chinese samples, 1567 Mycoplasma were detected, a detection rate of 38.39%, among which 1366 cases were UU single positive, accounting for 33.47%, 15 cases were MH single positive, accounting for 0.36%, 186 cases were UU and MH mixed positive, accounting for 4.56%. The most affected age groups were 21-30 years and 31-40 years, accounting for 19.09 and 15.05%, respectively. The results of drug sensitivity showed that doxycycline, minocycline, josamycin, clarithromycin, and roxithromycin were more sensitive to mycoplasma infection. The distribution of Ureaplasma urealyticum and Mycoplasma hominis in the human genitourinary system and their sensitivity to antibiotics is different for sex and age groups.
Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Ureaplasma urealyticum/efeitos dos fármacos , Infecções por Ureaplasma/microbiologia , Mycoplasma hominis/efeitos dos fármacos , Testes de Sensibilidade Microbiana , China , Ureaplasma urealyticum/isolamento & purificação , Mycoplasma hominis/isolamento & purificação , Povo Asiático , Antibacterianos/farmacologiaRESUMO
Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.
Assuntos
Antibacterianos/uso terapêutico , Artrite Infecciosa/microbiologia , Osteoartrite do Joelho/microbiologia , Infecções por Ureaplasma/diagnóstico , Ureaplasma/isolamento & purificação , Idoso , Antibacterianos/farmacologia , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Artroscopia , DNA Bacteriano/isolamento & purificação , Desbridamento , Farmacorresistência Bacteriana , Quimioterapia Combinada , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/microbiologia , Articulação do Joelho/cirurgia , Imageamento por Ressonância Magnética , Meniscectomia , Osteoartrite do Joelho/diagnóstico , Osteoartrite do Joelho/terapia , Reação em Cadeia da Polimerase , Análise de Sequência de DNA , Índice de Gravidade de Doença , Sinovectomia , Resultado do Tratamento , Ureaplasma/efeitos dos fármacos , Ureaplasma/genética , Infecções por Ureaplasma/microbiologia , Infecções por Ureaplasma/terapiaRESUMO
We report a case of an immunosuppressed 67-year-old woman who presented with fever of unknown origin. Further investigation revealed multiple left renal and perinephric abscesses. These were managed with percutaneous drainage and broad-spectrum antibiotics; however, no clinical improvement resulted. No organism was identifiable on standard microscopy and culture of all drain, blood and urine samples taken. Left nephrectomy with right urinary diversion was performed for sepsis management and to protect the patient's right kidney. Eventually, Ureaplasma species' RNA was detected in the patient's drain fluid using PCR and 16S ribosomal RNA gene sequencing. The patient was treated successfully with targeted antibiotic therapy and underwent extensive rehabilitation following this. Histopathology of the nephrectomy specimen suggested xanthogranulomatous pyelonephritis.
Assuntos
Abscesso/microbiologia , Abscesso/terapia , Pielonefrite Xantogranulomatosa/microbiologia , Pielonefrite Xantogranulomatosa/terapia , Infecções por Ureaplasma/microbiologia , Infecções por Ureaplasma/terapia , Abscesso/diagnóstico por imagem , Idoso , Terapia Combinada , Diagnóstico Diferencial , Feminino , Humanos , Hospedeiro Imunocomprometido , Nefrectomia , Pielonefrite Xantogranulomatosa/diagnóstico por imagem , Infecções por Ureaplasma/diagnóstico por imagem , Ureaplasma urealyticum/efeitos dos fármacosRESUMO
Preterm birth is the leading cause of neonatal morbidity and mortality worldwide, and the human Ureaplasma species are most frequently isolated from the amniotic fluid and placenta in these cases. Ureaplasma colonisation is associated with infertility, stillbirth, histologic chorioamnionitis, and neonatal morbidities, including congenital pneumonia, bronchopulmonary dysplasia, meningitis and perinatal death. The human Ureaplasma spp. are separated into Ureaplasma urealyticum and Ureaplasma parvum with 14 known serotypes. The small genome has several genes, which code for surface proteins; most significantly the Multiple Banded Antigen (MBA) where an antigenic C-terminal domain elicits a host antibody response. Other genes code for various virulence factors such as IgA protease and urease. Ureaplasma spp. infection is diagnosed by culture and polymerase chain reaction (PCR) and commercial assays are available to improve turnaround time. Microbroth dilution assays are routinely used to test antimicrobial susceptibility of clinical Ureaplasma spp. especially against doxycycline, azithromycin, ofloxacin and josamycin. Resistance to macrolides, fluoroquinolones and tetracyclines has been reported. A concise review of Ureaplasma spp. and their role in pregnancy outcomes, especially preterm birth, offers insight into the early diagnosis and appropriate antibiotic therapy to prevent long-term complications of Ureaplasma spp. infections.
Assuntos
Doenças do Recém-Nascido/microbiologia , Nascimento Prematuro/microbiologia , Infecções por Ureaplasma/microbiologia , Ureaplasma/fisiologia , Líquido Amniótico/microbiologia , Animais , Antibacterianos/uso terapêutico , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/tratamento farmacológico , Ureaplasma/genética , Ureaplasma/isolamento & purificação , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/tratamento farmacológicoRESUMO
Ureaplasma spp. usually causes genitourinary infections; few reports in the literature describe extragenital infections, usually in immunocompromised patients. We present a case of Ureaplasma parvum ventriculitis in an immunocompetent patient related to ventriculoperitoneal drainage and surgery. Ureaplasma parvum was detected with broad range 16S rRNA PCR and cultured on A8 agar.
Assuntos
Ventriculite Cerebral/microbiologia , Drenagem/efeitos adversos , Infecções por Ureaplasma/microbiologia , Ureaplasma/patogenicidade , Derivação Ventriculoperitoneal/efeitos adversos , Adolescente , Antibacterianos/uso terapêutico , Ventriculite Cerebral/diagnóstico , Ventriculite Cerebral/tratamento farmacológico , Doxiciclina/uso terapêutico , Feminino , Humanos , Imunocompetência , Reação em Cadeia da Polimerase , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/microbiologia , RNA Ribossômico 16S , Resultado do Tratamento , Ureaplasma/genética , Ureaplasma/isolamento & purificação , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/tratamento farmacológico , Ureaplasma urealyticum/genéticaRESUMO
BACKGROUND: Ureaplasma urealyticum is a fastidious bacteria which lacks a cell wall. Extragenital infections are rare in immunocompetent adults. There are few literature reports of perinephric abscess. We present a case of non-resolving multifocal "culture-negative" abscesses in a hypogammaglobulinemic adult female due to U. urealyticum. CASE PRESENTATION: 66-year-old female with a one-week history of fever, malaise and new right hip and leg pain. Past medical history was notable for chronic pancytopenia secondary to in remission B cell follicular lymphoma, ESRD on intermittent hemodialysis with bilateral nephrostomy tubes and Crohn's. CT abdomen/pelvis revealed a small left perinephric hematoma and proximal right femur fluid collection. Persistent right thigh pain led to additional ultrasound with anterior thigh collection and CT revealed an irregular rim-enhancing fluid collection in the left posterior pararenal space. Antimicrobial therapy included ertapenem and vancomycin followed by meropenem, trimethoprim-sulfamethoxazole, daptomycin and metronidazole in setting of persistent culture-negative results and clinical deterioration. Following detection of U. urealyticum by 16S rDNA PCR in both left pararenal and right trochanteric bursa abscesses doxycycline was started. Despite this, the patient died four days later. CONCLUSIONS: Disseminated infection by U. urealyticum has been documented in immunocompromised adult patients with few reports of perinephric abscess. We propose that ascending genitourinary route led to perinephric abscess. The multiple disseminated fluid collections make it highly suspicious for hematogenous spread given the lack of radiographic enhancement to suggest contiguous spread. Diagnosis and treatment of U. urealyticum-disseminated infection is extremely challenging as culture is laborious and not routinely performed. Furthermore, the lack of cell wall renders beta-lactams and vancomycin ineffective and therefore requirement for "atypical" coverage. Early diagnosis and treatment are key to prevent further complications and death.
Assuntos
Hospedeiro Imunocomprometido , Infecções por Ureaplasma/diagnóstico , Ureaplasma urealyticum/genética , Abscesso/tratamento farmacológico , Abscesso/microbiologia , Idoso , Antibacterianos/uso terapêutico , DNA Bacteriano/análise , DNA Ribossômico/análise , Suscetibilidade a Doenças/imunologia , Doxiciclina/uso terapêutico , Evolução Fatal , Feminino , Humanos , Reação em Cadeia da Polimerase , Infecções por Ureaplasma/tratamento farmacológico , Infecções por Ureaplasma/microbiologiaRESUMO
Idiopathic hyperammonemia is a rare, poorly understood, and often lethal condition that has been described in immunocompromised patients. This report describes an immunocompromised patient with acute myelogenous leukemia who developed persistent hyperammonemia up to 705 µmol/L (normal, 0 to 47 µmol/L) refractory to multiple different therapies. However, after beginning azithromycin and then doxycycline therapy for Ureaplasma species infection, the patient showed immediate and sustained clinical improvement and resolution of ammonia levels. Recognizing disseminated Ureaplasma species infection as a potential cause of idiopathic hyperammonemia, an unexplained, often fatal condition in immunocompromised patients, and empirically treating for this infection could potentially be lifesaving.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Hiperamonemia/etiologia , Hospedeiro Imunocomprometido/efeitos dos fármacos , Quimioterapia de Indução/efeitos adversos , Leucemia Mieloide Aguda/tratamento farmacológico , Infecções por Ureaplasma/complicações , Ureaplasma/efeitos dos fármacos , Adolescente , Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , Feminino , Humanos , Hiperamonemia/tratamento farmacológico , Hiperamonemia/patologia , Leucemia Mieloide Aguda/microbiologia , Leucemia Mieloide Aguda/patologia , Prognóstico , Infecções por Ureaplasma/induzido quimicamente , Infecções por Ureaplasma/microbiologiaRESUMO
The main plan of the current study was to develop a rapid, robust, and field-applicable loop-mediated isothermal amplification (LAMP) assay for the detection of Ureaplasma diversum. A strain-specific 16S rRNA gene of Ureaplasma diversum was used for detection which was cloned, sequenced, and characterized earlier. LAMP results were visualized within 90 min with the naked eye. Cervico-vaginal swabs of 50 buffaloes were randomly collected from Livestock Research Center of NDRI as per the Institute Animal ethics guidelines. Out of 50 cervico-vaginal swab samples collected randomly, 34 were found positive with LAMP while 16 samples were negative. Conventional PCR results showed the same result. Therefore, the accuracy of the developed LAMP was about 100%. The developed LAMP assay can also be used to screen the animals for Ureaplasma diversum infection in cervico-vaginal swab. However, further study is needed to assess sensitivity and accuracy towards their detection and their relationship in disease diagnosis.
Assuntos
Colo do Útero/microbiologia , Endometriose/veterinária , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Infecções por Ureaplasma/diagnóstico , Ureaplasma/isolamento & purificação , Vagina/microbiologia , Animais , Búfalos , Endometriose/diagnóstico , Endometriose/microbiologia , Feminino , Microscopia Eletrônica de Varredura , Reação em Cadeia da Polimerase , RNA Ribossômico 16S/genética , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Infecções por Ureaplasma/microbiologiaRESUMO
INTRODUCTION: We sought to quantify targeted metabolites (d-lactate, pyruvate, urea, ammonia) and the cytokine IL-8 produced by human cervicovaginal epithelial cells co-cultured with Ureaplasma urealyticum (a preterm birth-associated bacterium) or Lactobacillus crispatus (a healthy vaginal commensal associated with term birth). METHODS: Concentrations of d-lactate, pyruvate, urea and ammonia measured by enzyme-based spectrophotometry and IL-8 by ELISA were determined and compared between monolayer-cultured HeLa cells (ATCC 35241) infected with strains of U. urealyticum (ATCC 27618, 0.5â¯mLâ¯=â¯3640â¯CFU/mL, U. urealyticum) or L. crispatus (ATCC 33820, MOIâ¯=â¯10,000, 1000 and 100, L. crispatus) and incubated in 5% CO2 at 37⯰C for 24â¯h. Uninfected HeLa cells (Hc) were used as controls and cytotoxicity was determined by the amount (optical density) of lactate dehydrogenase (LDH) released by the dead HeLa cells. RESULTS: The amount of LDH released by untreated Hc (Pâ¯=â¯0.002) and U. urealyticum-infected cells (Pâ¯<â¯0.0001) was higher than those of L. crispatus-infected cells, with U. urealyticum-infected cells recording the highest % cytotoxicity and L. crispatus-infected cells MOI 10,000 (Lc10,000) the least (Pâ¯<â¯0.0001). Though there was no significant difference in the concentration of urea between the samples, U. urealyticum-infected cells showed higher ammonia compared to other samples (pâ¯=â¯0.03). In contrast, all L. crispatus samples had higher d-lactate than untreated Hc (pâ¯=â¯0.01) and U. urealyticum-infected cells (Pâ¯=â¯0.01). Also, Lc10,000 had the highest d-lactate (pâ¯=â¯0.001) and lowest pyruvate (Pâ¯=â¯0.04, excluding UU) compared to other samples. Furthermore, U. urealyticum-infected cells produced the highest IL-8 (Pâ¯=â¯0.01) compared to other samples, with Lc10,000 producing undetectable levels. CONCLUSION: Infection of cervicovaginal epithelial cells by U. urealyticum stimulates production of ammonia from urea and induces elevated IL-8 production possibly leading to significantly higher cytotoxicity. In contrast, L. crispatus appeared protective against HeLa cell inflammation and death, producing more d-lactate and less IL-8, consistent with a role for L. crispatus in promoting vaginal floral health and reducing infection/inflammation-associated preterm birth.
Assuntos
Citocinas/metabolismo , Lactobacillus crispatus/fisiologia , Mucosa/metabolismo , Mucosa/microbiologia , Ureaplasma urealyticum/fisiologia , Vagina/metabolismo , Vagina/microbiologia , Biomarcadores , Células Epiteliais/metabolismo , Células Epiteliais/microbiologia , Feminino , Infecções por Bactérias Gram-Negativas/microbiologia , Células HeLa , Interações Hospedeiro-Patógeno , Humanos , L-Lactato Desidrogenase/metabolismo , Infecções por Ureaplasma/microbiologiaAssuntos
Coinfecção/epidemiologia , Infecções por Mycoplasma/epidemiologia , Mycoplasma/isolamento & purificação , Papillomaviridae/isolamento & purificação , Lesões Pré-Cancerosas/epidemiologia , Infecções por Ureaplasma/epidemiologia , Ureaplasma/isolamento & purificação , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Genótipo , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Mycoplasma/classificação , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Papillomaviridae/genética , Reação em Cadeia da Polimerase , Prevalência , Ureaplasma/classificação , Infecções por Ureaplasma/diagnóstico , Infecções por Ureaplasma/microbiologiaRESUMO
Recently, there are controversial opinions on the presence of Mycoplasmas/Ureaplasmas as colonizers or pathogens, and on the use of a targeted therapy. This study aimed to characterize Mycoplasmas/Ureaplasmas infections in reproductive age women, including the acquisition of sexually transmitted (ST) pathogens and poor birth outcomes. A total of 646 healthy Italian women fulfilled the inclusion criteria including 521 infertile women, 65 pregnant women, and 60 fertile women with identified risk factors and symptomatic for vaginitis/cervicitis. Multiplex and quantitative molecular techniques and direct automatic DNA sequencing were performed to assess the genome structure of Mycoplasma/Ureaplasma species and ST infected pathogens. Ureaplasma parvum serovar 3 represented the predominant colonizer of the urogenital tract of this series and the unique species significantly associated with ST pathogens coinfection (p < 0.01). U. parvum load >104 bacteria/ml, suggestive of active infection, has been measured only in asymptomatic high-risk human papillomavirus infected women (24.3%) and in 40% of women with idiopathic infertility. To note, 16% of the follicular fluid from these idiopathic women resulted infected with U. parvum. In conclusion, the present study focused the attention on U. parvum serovar 3 as emerging microorganism in sexually active women that may have the benefit of targeted therapy.
Assuntos
Infertilidade Feminina/microbiologia , Infertilidade Feminina/virologia , Infecções por Papillomavirus/microbiologia , Ureaplasma/patogenicidade , Adulto , Feminino , Humanos , Mycoplasma/genética , Mycoplasma/patogenicidade , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/virologia , Estudos Retrospectivos , Sorogrupo , Ureaplasma/genética , Infecções por Ureaplasma/microbiologia , Infecções por Ureaplasma/virologia , Adulto JovemRESUMO
PURPOSE: Cervical cancer is the most frequently diagnosed female cancer in The Gambia, representing approximately 30â% of cases. In 2014, the quadrivalent human papilloma virus (HPV) vaccine was introduced, which offers protection against HPV genotypes 6, 11, 16 and 18. To evaluate the potential effectiveness of this vaccine, genotype distribution and risk factor analysis were assessed. METHODOLOGY: Endocervical samples (n=232) were collected from women aged 20-49 years residing in urban Gambia. A questionnaire was administered to capture socio-demographic and cervical cancer risk factors. HPV detection and genotyping was performed by PCR amplification of the L1 major capsid gene and analysis of sequenced PCR products.Results/Key findings. The prevalence of HPV was 12â% (28/232), and the high-risk (HR) genotype HPV 52 (5/28) was the most prevalent genotype. HR-HPV sequences had high identity (≥90â%) to isolates which originated from America, Europe and Asia but not from Africa. Half (14/28) of participants were co-infected with Ureaplasma urealyticum/parvum, which increases the risk of progression to cervical cancer. Female genital mutilation and the use of hormone contraception for >5 years were identified as potential risk factors for HPV infection. Ethnicity-associated differences were also noted; participants of the Fula ethnic group had a higher prevalence of HR-HPV infection (31.3â%) compared to the Mandinka (18.8â%) and Wollof (12.5â%) groups. CONCLUSION: These data may have a significant public health impact as the HPV quadrivalent vaccine may be of limited value if the circulating non-HPV 16/18 HR-genotypes are responsible for cytological abnormalities of the cervix.