Efficacy of Antimicrobial Therapy for Mycoplasma genitalium Infections.

Mycoplasma genitalium has been causally linked with nongonococcal urethritis in men and cervicitis, pelvic inflammatory disease, preterm birth, spontaneous abortion, and infertility in women, yet treatment has proven challenging. To inform treatment recommendations, we reviewed English-language studies describing antimicrobial susceptibility, resistance-associated mutations, and clinical efficacy of antibiotic therapy, identified via a systematic search of PubMed supplemented by expert referral. Minimum inhibitory concentrations (MICs) from some contemporary isolates exhibited high-level susceptibility to most macrolides and quinolones, and moderate susceptibility to most tetracyclines, whereas other contemporary isolates had high MICs to the same antibiotics. Randomized trials demonstrated poor efficacy of doxycycline and better, but declining, efficacy of single-dose azithromycin therapy. Treatment failures after extended doses of azithromycin similarly increased, and circulating macrolide resistance was present in high levels in several areas. Moxifloxacin remains the most effective therapy, but treatment failures and quinolone resistance are emerging. Surveillance of M. genitalium prevalence and antimicrobial resistance patterns is urgently needed.

Effects of vitamin E on reproductive protection in pregnant mice infected with pseudorabies virus (PRV) via regulating expression of Toll-like receptors (TLRs) and cytokine balance.

Vitamin E supplement and pseudorabies virus (PRV) infection have a reciprocal role in influencing the maternal immune response, a key determinant of the success or failure of pregnancy. However, it remains unknown whether vitamin E supplement provides protection against PRV-induced failure of pregnancy. This study was therefore conducted to investigate the effect of dietary vitamin E level (0, 75, 375, 750 and 1,500 mg/kg) on the reproduction performance, immunity and expression of Toll-like receptors (TLRs) of PRV-challenged mice. The mortality and abortion rate of PRV-challenged mice decreased with the increase in vitamin E consumption. Overall, PBS-injected mice had a higher live embryo number and live litter size than PRV-challenged mice. Both live embryo number and live litter size of PRV-challenged mice increased with increasing vitamin E levels. Vitamin E supplement resulted in decreased concentration of serum IL-2 and IFN-γ, but increased concentration of serum IL-10. The concentration of serum IgG, IgA and IgM increased with increasing vitamin E levels. In the uterine and embryo mRNA abundance of TLR3, TLR7 and TLR9 was higher in PRV-challenged mice than that in PBS-injected mice fed on the same dosage of vitamin E. The mRNA abundance of embryonic TLR3, TLR7 and TLR9 in PRV-challenged mice decreased with increasing vitamin E levels. Collectively, vitamin E supplement may improve reproductive performance of PRV-challenged mice by attenuating PRV-induced negative effects on the cytokine profile, immunoglobulin synthesis and TLR expression.

Ureaplasmas as a cause of disease in man and animals: fact or fancy?

There is reluctance by some to regard ureaplasmas as a cause of nongonococcal urethritis in men largely because the organisms may also be found in healthy persons. Could they be no more than passengers in disease? A review of past work suggests that this is not likely, a notion supported by the results of more recent studies. In certain other human diseases, such as urethritis and arthritis in hypogammaglobulinemic patients, the pathogenicity of ureaplasmas appears beyond question. In a variety of other conditions, such as the urethral syndrome in women, infertility, various pregnancy-related problems, and respiratory distress in infants, the situation is confused. It is possible that ureaplasmas have some part to play in all these conditions. However, both old and new information indicates that they do not have a major role in most of them, and that assertions to the contrary are fanciful. In the veterinary field, it is easier to come to conclusions about the role of these organisms, although their involvement in genital tract disease is least well validated. Finally, the occurrence of ureaplasmas in a colony of male and female chimpanzees, some with infertility problems, is presented, and the possible value of this situation in attempting to define the role of ureaplasmas in the human condition is mentioned.