An update on prevalence, diagnosis, treatment and emerging issues of genital mycoplasma infection in Indian women: A narrative review.

Despite adequate treatment of reproductive tract infection, there is persistence of symptoms in some patients. This raises the possibility of existence of other silent microbes with pathogenic potential. Apart from the common sexually transmitted organisms such as Chlamydia trachomatis and Neisseria gonorrhoeae, there are other silent and emerging pathogens, like genital mycoplasma, which have been associated with cervicitis, pelvic inflammatory disease, infertility, and pregnancy-related complications in women. Although these organisms were identified decades ago, they are still overlooked or ignored. There is a need to understand the role played by these organisms in Asian populations and their susceptibility to the standard line of treatment. Data on genital mycoplasma infections in Indian women is heterogeneous, with limited evidence of pathogenicity. Although known for their wide spectrum of reproductive morbidities in western counterparts, these microorganisms are yet to gain the attention of Indian clinicians and microbiologists. There is paucity of adequate information in India regarding these infections, so Indian literature was compiled to get an overview of these pathogens, their association with reproductive morbidities, and their response to treatment. Thus, there is a need to explore genital mycoplasma infections in Indian women, especially in the arena of antimicrobial resistance among genital mycoplasma, which has the potential to become a major problem. A literature search with keywords focusing on "genital mycoplasma", "sexually transmitted infections India", "sexually transmitted mycoplasma", and "characteristic of mycoplasma" was carried out through computerized databases like PubMed, MEDLINE, Embase, and Google Scholar.

Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in genital samples collected over 6 years at a Serbian university hospital.

BACKGROUND: Mycoplasma hominis and Ureaplasma urealyticum are implicated in a wide array of infectious diseases in adults and children. Since some species have innate or acquired resistance to certain types of antibiotics, antibiotic susceptibility testing of mycoplasma isolated from the urogenital tract assumes increasing importance. AIMS: To evaluate the prevalence and antibiotic susceptibility of M. hominis and U. urealyticum in genital samples collected between 2007 and 2012. METHODS: Three hundred and seventy three patients presenting with symptoms of sexually transmitted diseases, infertility or risky sexual behaviour, who had not taken antibiotics in the previous 6 weeks and had ≥10 WBC per high power field on genital smears were studied. Urethral samples were taken in men and endocervical samples in women. The mycoplasma IST-2 kit was used for organism identification and for testing susceptibility to doxycycline, josamycin, ofloxacin, erythromycin, tetracycline, ciprofloxacin, azithromycin, clarithromycin and pristinamycin. RESULTS: U. urealyticum was isolated from 42 patients and M. hominis from 11 patients. From 9.8% of isolates, both organisms were grown. All M. hominis isolates were resistant to tetracycline, clarithromycin and erythromycin while U. urealyticum was highly resistant to clarithromycin (94.6%), tetracycline (86.5%), ciprofloxacin (83.8%) and erythromycin (83.8%). M. hominis was sensitive to doxycycline (83.3%) and ofloxacin (66.7%) while most U. urealyticum strains were sensitive to doxycycline (94.6%). LIMITATIONS: Inability of the commercial kit used in the study to detect other potentially pathogenic urogenital mycoplasmas (Ureaplasma parvum, Mycoplasma genitalium). CONCLUSION: There is significant resistance of U. urealyticum and M. hominis to tetracycline and macrolides. The most active tetracycline for genital mycoplasmas was found to be doxycycline, which continues to be the drug of first choice.

Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in Chinese women with genital infectious diseases.

BACKGROUND: Previous studies have confirmed that the presence of Ureaplasma urealyticum (UU) and Mycoplasma hominis (MH) increases the risks of various diseases including genital infections in women. Hence, the surveillance policies for the prevalence and antimicrobial susceptibility of UU and MH are important for both the prevention and the treatment of the diseases associated with genital mycoplasmas. AIM: The objective of this study is to investigate the characteristics of UU and MH prevalence and its antimicrobial susceptibility in Chinese women with genital infection. METHODS: By using commercial mycoplasma strips, we investigated the incidence and antimicrobial resistance of UU and MH in 3306 Chinese women with genital infection between January 2005 and December 2009 in Changzhou China. RESULTS: (1) The overall positive incidence of genital mycoplasmas was 62.16%. The most common pattern was UU monoinfection (46.52%), the UU-MH coinfection pattern ranked second (13.91%) and MH monoinfection was lowest (1.71%). According to annual analysis, MH infection revealed an increasing trend between 2005 and 2009. However, a significantly higher infection rate by genital mycoplasmas was found in young women (age range: 16-35 years). (2) Overall, MH susceptibility rates remained high only to doxycycline (DOX), minocycline (MIN) and josamycin (JOS), while UU had high susceptibility rates only to DOX, MIN and clarithromycin (CLA). The resistance rates of UU-MH-mixed isolates to most of drugs were significantly higher than those of UU- or MH-single isolates. CONCLUSIONS: High infection rates and severe drug resistances of genital mycoplasmas were found in Chinese women with genital infections. The laboratory screening and antimicrobial susceptibility testing for genital mycoplasmas is vital to treat the infection.