In-vitro activity of lipoic acid against Ureaplasma urealyticum and Ureaplasma parvum isolated from women with infections of the urogenital tract. A pilot study.

Several species of Ureaplasma bacteria are known to be present in the urogenital tract of humans, in both healthy individuals and symptomatic patients. These pathogens are associated with urogenital tract infections, infertility problems and spontaneous abortion in humans. The present study involved 77 strains of Ureaplasma species (Ureaplasma spp.), including 21 Ureaplasma urealyticum (U. urealyticum) strains and 56 Ureaplasma parvum (U. parvum) strains. Lipoic acid (LA) and its reduced form dihydrolipoic acid (DHLA) are synthesized in all prokaryotic and eukaryotic cells. Research of recent years increasingly points to therapeutic properties of exogenously supplemented LA. In our study, we examined for the first time the effect of LA on the bacteria multiplication and its bactericidal activity against U. urealyticum and U. parvum. The LA concentrations used were: 1200 µg/ml, 120 µg/ml, and 12 µg/ml. The titer for each strain of Ureaplasma spp. was estimated using the color changing units (CCU) assay. For CCU measurements, a series of 10-fold dilutions of each cell culture in 0.9% NaCl (titration) was prepared and 1 CCU/ml was defined as the highest dilution of cells at which color change was detected. The strongest bacteriostatic and bactericidal effect of LA was observed at a concentration of 1200 µg/ml. In contrast, at lower LA concentrations, stimulation of the bacteria multiplication was noted for 14% of the total number of strains tested. Taken together, the current data provide novel findings about potential beneficial antimicrobial effects of LA.

Prevalence of genital Mycoplasma and response to eradication treatment in patients undergoing assisted reproductive techniques.

OBJECTIVE: Several studies have reported greater success of fertilisation by ART in couples who were not infected by Ureaplasma. Increased semen quality and better results have also been observed in couples who were treated with antibiotics to eradicate the infection. The aim of this study was to determine the prevalence of genital mycoplasmas in urine samples from male partners enrolled in the Assisted Reproduction Program (ARP) in our healthcare area so that, positive cases can be treated prior to the use of ART in order to increase the quality of semen, improve the embryo implantation rates and minimize the risk of adverse effects during pregnancy. METHODS: This study included couples enrolled in the ARP during 2016. Mycoplasma detection was made using real-time PCR. In positive cases, both members of the couple were treated with antibiotics until eradication of the microorganism. The antibiotics used were: azithromycin, doxycycline, levofloxacin, moxifloxacin, and clindamycin. RESULTS: Of the 205 men studied, 33 were positive: Ureaplasma urealyticum 15.1%, Mycoplasma hominis 3.9%. Eradication treatment with azithromycin failed in 50% compared to 10.2% for doxycycline. Of the 5 cases treated with levofloxacin, only 2 achieved elimination of U. urealyticum. CONCLUSIONS: We consider that genital mycoplasma routine screening could be useful in order to increase the quality of semen which could simplify the in vitro fertilisation procedures and raise the success rate of embryo implantation and pregnancy, especially when fast, sensitive and specific technics as real time PCR are used.

¿Qué tratamiento empírico es el más adecuado en pacientes con uretritis? / Which is the best empirical treatment in patients with urethritis?

Objetivo. Conocer el tratamiento empírico más adecuado de uretritis, en pacientes de la zona Centro de Madrid. Métodos. Se analizó el exudado uretral de 2.021 hombres entre Enero 2003-Diciembre 2007. Además de los cultivos tradicionales se determinó la presencia de Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis y Herpes simplex. La sensibilidad de Neisseria gonorrhoeae y Haemophilus spp. se realizó mediante el método de difusión en disco y la sensibilidad de U. urealyticum mediante Micoplasma IST2. Resultados. El porcentaje de muestras positivas fue de 30,6%. Los microorganismos aislados más frecuentemente fueron: U. urealyticum 9,9%, N. gonorrhoeae 7,4%, C. trachomatis 5,1% y Haemophilus spp 3,8%. La resistencia de N. gonorrhoeae en el primer periodo fue: penicilina 11,8%, tetraciclina 5,9%, ciprofloxacino 8,8% y presencia de betalactamasas 11,8%. En el segundo periodo: penicilina 9,7%, amoxicilina/ácido clavulánico 1,4%, tetraciclina 8,3%, ciprofloxacino 23,6% y presencia de betalactamasas 10,5%. La resistencia a ciprofloxacino en no HSH (hombres que tienen relaciones sexuales con hombres) 20% y en HSH 56,2% (p<0,05). La resistencia de Haemophilus spp en el primer periodo fue: ampicilina 38,2%, amoxicilina/ácido clavulánico 8,8%, claritromicina 35,3%, cotrimoxazol 64,7%, cefuroxima 5,9%, ciprofloxacino 8,8%, tetraciclina 12,1% y presencia de betalactamasas 26,5%. En el segundo periodo: presencia de betalactamasas 41,9%, ampicilina 53,1%, amoxicilina/ácido clavulánico 9,4%, cefuroxima 9,4%, claritromicina 18,7%, tetraciclina 34,4%, ciprofloxacino 15,6% y cotrimoxazol 68,7%. La resistencia de U. urealyticum fue: 80,7% ciprofloxacino, 32,4% ofloxacino, 17,5% eritromicina, 9,6% azitromicina, 3,5% tetraciclina y 0,8% doxiciclina. Conclusiones. N. gonorrhoeae presentó mayor resistencia a tetraciclina y ciprofloxacino en el segundo periodo, siendo estadísticamente significativo para ciprofloxacino (p<0.05). La resistencia a quinolonas fue más elevada en HSH. Haemophilus spp presentó mayor resistencia a ampicilina, ciprofloxacino y tetraciclina en el segundo periodo; siendo significativo para tetraciclina (p<0,05). U. urealyticum presentó elevada resistencia a ciprofloxacino (80,7%) y ofloxacino (32,4%) y baja para doxiciclina (0,8%) y tetraciclina (3,5%)(AU)

Objective. To know the best empirical treatment of urethritis in patients at the City Center of Madrid. Methods. 2.021 urethral exudates were analyzed in men between January 2003-December 2007. In addition to the traditional cultures, it was determined the presence of Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and Herpes simplex. The susceptibility of N.gonorrhoeae and Haemophilus spp was performed by disk diffusion method and U. urealyticum by Mycoplasma IST. Results. The percentage of positive samples was: 30.6%. The most frequently isolated microorganisms were: U. urealyticum 9.9%, N. gonorrhoeae 7.4%, C. trachomatis 5.1% and Haemophilus spp 3.8%. The resistance of N. gonorrhoeae in the first period was: penicillin 11.8%, tetracycline 5.9%, ciprofloxacin 8.8% and presence of betalactamase 11.8%. In the second period: penicillin 9.7%, amoxicillin/clavulanic acid 1.4%, tetracycline 8.3%, ciprofloxacin 23.6% and presence of betalactamase 10.5%. Resistance to ciprofloxacin in non-MSM (men having sex with men) was 20% and in MSM 56.2% (p <0.05). Resistance of Haemophilus spp in the first period was: 38.2% ampicillin, amoxicillin/ clavulanic acid 8.8%, clarithromycin 35.3%, cotrimoxazole 64.7%, cefuroxime 5.9%, ciprofloxacin 8.8%, tetracycline 12.1% and presence of betalactamase 26.5%. In the second period: presence of betalactamase 41.9%, ampicillin 53.1%, amoxicillin/ clavulanic acid 9.4%, cefuroxime 9.4%, clarithromycin 18.7%, tetracycline 34.4%, ciprofloxacin 15.6%, and cotrimoxazole 68.7%. Resistance of U. urealyticum was: ciprofloxacin 80.7%, ofloxacin 32.4%, erythromycin 17.5%, azithromycin 9.6%, tetracycline 3.5% and doxycycline 0.8%. Conclusions. N. gonorrhoeae showed a level of resistance to tetracycline and ciprofloxacin higher in the second period, being significant for ciprofloxacin (p<0.05). Quinolone resistance was higher in MSM. Haemophilus spp showed a level of resistance to ampicillin, ciprofloxacin and tetracycline higher in the second period, being significant for tetracycline (p <0.05). U.urealyticum showed high level of resistance to ciprofloxacin (80.7%) and ofloxacin (32.4%) and low level of resistance to doxycycline (0.8%) and tetracycline (3.5%)(AU)

Visual DNA microarrays for simultaneous detection of Ureaplasma urealyticum and Chlamydia trachomatis coupled with multiplex asymmetrical PCR.

Visual DNA microarrays, based on gold label silver stain (GLSS) and coupled with multiplex asymmetrical PCR, were developed for simultaneous, sensitive and specific detection of Ureaplasma urealyticum and Chlamydia trachomatis. 5'-end-amino-modified oligonucleotides, which were immobilized on glass surface, acted as capturing probes that were designed to bind complementary biotinylated targets DNA. The gold-conjugated streptavidins were introduced to the microarray for specific binding to biotin. The black image of microarray spots, resulting from the precipitation of silver onto nanogold particles bound to streptavidins, were used to detect biotinylated targets DNA visually or with a visible light scanner. Multiplex asymmetrical PCR of U. urealyticum, C. trachomatis and Bacillus subtilis (used as positive control) was performed to prepare abundant biotinylated single-stranded targets DNA, which affected detection efficiency and sensitivity of hybridization on microarray. Plenty of clinical samples of U. urealyticum and C. trachomatis from infected patients were tested using home-made DNA microarrays. For its high sensitivity, good specificity, simplicity, cheapness and speed, the present visual gene-detecting technique has potential applications in clinical fields.

Prevalence and treatment of Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis in patients with non-gonococcal urethritis.

The aim of present study was to evaluate the occurrence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in non-gonococcal urethritis (NGU) and to determine the bacterial resistance to six antibiotics in order to determine the most suitable treatment strategy. A total of 50 patients were enrolled into the study. Urethral samples were taken with a dacron swab placed into urethra 2 - 3 cm in males, and vaginal samples were taken from the endocervical region in women. The patient samples that did not grow Neisseria gonorrhoeae were accepted as NGU. Direct immunofluorescence technique was used for the investigation of C. trachomatis. Mycoplasma IST was used for the isolation of M. hominis and U. urealyticum. U. urealyticum was isolated from 24 patients. Thirteen of them had only U. urealyticum, and the rest had mixed pathogen organisms (7 U. urealyticum + M. hominis; 3 U. urealyticum + C. trachomatis, and 1 U. urealyticum + M. hominis + C. trachomatis). C. trachomatis was detected in 12 patients. While 8 patients had C. trachomatis only, the rest had a mixture of the pathogen organisms listed above. Partner examinations could be performed for only 22 patients' partners. In the evaluation of antibiotic susceptibility, higher resistance was obtained against ofloxacin in U. urealyticum, and against erythromycin with M. hominis. Our results indicated that doxycycline or ofloxacin should be the first choice when empirical treatment is necessary.

[Antibacterial effect of niaoluqing oral liquid on clinical drug-resistant strains and different serotype strains of Ureaplasma urealyticum in vitro].

OBJECTIVES: To study the antibacterial effect of Niaoluqing Oral Liquid (NOL) on clinical drug-resistant strains and 14 serotype strains Ureaplasma Urealyticum (UU). METHODS: Sixty-three clinical strains of UU were detected to determine their serology and antibiotic susceptibilities by the metabolic inhibition test (MIT). Mininum inhibitory concentration (MIC) was used to evaluate the sensitivity of NOL to different serotypes of UU. The sensitivity of NOL, erythromycin and tetracycline to 63 clinical strains of UU was also studied. RESULTS: In 63 clinical strains of UU, the range of MIC to NOL was from 0.48 mg/ml to 15.63 mg/ml, MIC50 < or = 1.95 mg/ml, MIC90 < or = 3.91 mg/ml. Among them, 31 strains were resistant to tetracycline and 31 were resistant to erythromycin. No obvious correlation between the sensitivity of NOL to UU clinical strains and that of erythromycin and tetracycline to UU clinical strains (P > 0.05). Clinical strains of UU in this experiment contains all of its serotypes, also having a higher sensitivity to NOL (MIC < or = 3.91 mg/ml) except serology 1, 2, 3 and 11 (MIC > or = 7.81 mg/ml). CONCLUSIONS: NOL exerts a strong in vitro antibacterial effect on erythromycin-resistant and tetracycline-resistant clinical strains of UU. All kinds of serotype strains had a higher sensitivity to NOL, too. Chinese medicinal herbs are of momentous significance in the treatment of UU infection.

[The diagnostic and therapeutic characteristics of inflammatory urogenital diseases in women associated with Ureaplasma urealyticum]. / Osobennosti diagnostiki i terapii vospalitel'nykh urogenital'nykh zabolevanii u zhenshchin, assotsiirovannykh s Ureaplasma urealyticum.

Complex examination of 40 female in- and outpatients at the age 20 to 42 years with inflammatory urogenital diseases was performed. To verify the diagnosis, current clinical, microbiological, endoscopic and ultrasonic procedure were used. It was shown that the inflammatory processes in the urogenital tracts were mainly due to association of opportunistic and/or pathogenic organisms. Optimization of antibacterial therapy of urogenital infections was found possible with using homeopathic agents in the complex therapy. The significance of cooperation of the allied specialists in the choice of the examination and therapy policy for female patients with inflammatory urogenital diseases is indicated.

Microbiology of acute arthropathies among children in Argentina: Mycoplasma pneumoniae and hominis and Ureaplasma urealyticum.

OBJECTIVE: To describe the isolation of mycoplasmas and ureaplasmas from synovial fluid in pediatric patients with joint disorders. METHODS: During 1 year 45 samples of synovial fluid, blood and urine were collected from 33 hospitalized pediatric patients up to 17 years old who had joint disorders. Mycoplasmas and ureaplasmas were isolated in joint fluid by culture methods. RESULTS: Of the 33 patients 12 (36%) had joint disorders associated with pathogens (bacteria, Mycoplasma/Ureaplasma, Chlamydia) present at the site of inflammation. Mycoplasma hominis and Ureaplasma urealyticum were isolated from 3 and 1% of joint fluid samples, respectively. M. pneumoniae was isolated from nasopharyngeal secretion in a patient with evidence of a reactive arthritis. CONCLUSION: Our results raise the question of the possible role of Mycoplasma as a cofactor in the triggering of inflammatory joint disease, as well as the hypothesis that arthropathies may be caused by chronic local infection. These findings may contribute to early diagnosis of the disease and initiation of specific treatment.

Ureaplasma in semen and IVF.

Ureaplasma urealyticum (U.U.) screening has been systematically performed in tests carried out before IVF cycles. In 42% of the cases (306 couples), at least one partner presented a monomicrobian U.U. infection. U.U. infection of at least one fraction of the split ejaculate was observed in 32% of the cases and found in similar proportions at the prostatic and seminal vesicle levels. The U.U.-infected group presented a similar number of cytological abnormalities to the noninfected samples. However, there was a significant reduction in the pregnancy rate after embryo transfer in the infected group whereas U.U. did not alter fertilization parameters, embryo retrieval or pregnancy rates per puncture. The preliminary results of a complementary prospective study (70 couples) point to the likely role of sexually transmitted Ureaplasma at the endometrial level.