Sexually Transmitted Infections in Male Patients with Urethritis.

(1) Background: Sexually Transmitted Infections (STIs) in men are a significant public health problem due to the consequences they can have, such as chronic diseases, infertility, cancer, and even death. This study aimed to determine the frequency of microorganisms associated with STIs in men with urethritis attending urology consultations, and to explore their clinical correlations. (2) Methods: A population that attended the urology consultation of the University Hospital "Dr. José E. González" was studied. Written consent was obtained, and interviews and clinical history were conducted about specific risk factors identifying signs and symptoms associated with any genitourinary condition; after that, urine samples were collected. Identification of C. trachomatis, N. gonorrhoeae, U. urealyticum, and M. genitalium was based on amplifying species-specific DNA fragments. (3) Results: A total of 200 patients were included. The mean age was 55 years (20-95). According to the interviews, only 32.5% (n = 65) had received prior sex education. Additionally, 75% (n = 150) do not usually use any protection during sexual intercourse. Regarding clinical factors, 69.4% (n = 138) presented burning or pain when urinating. Molecular analysis revealed the presence of C. trachomatis to be 9.5% (n = 19), with U. urealyticum at 13% (n = 26), and M. genitalium at 2% (n = 4). (4) Conclusions: This is the most extensive molecular epidemiological study of the frequency of STIs in men in Mexico in third-level care and its association with different risk factors. As reported globally, a similar frequency of C. trachomatis, U. urealyticum, and M. genitalium was detected.

Prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, and Neisseria gonorrhoeae in Asymptomatic Women from Urban-Peripheral and Rural Populations of Cuenca, Ecuador.

BACKGROUND: Sexually transmitted diseases (STDs) are a serious public health issue due to their high prevalence and a substantial percentage of women being asymptomatic. The present study aimed to determine the prevalence of three STD-causative pathogens in asymptomatic women from Southern Ecuador, with the ultimate purpose of updating the epidemiological data and obtaining a timely diagnosis, which can prevent further complications. METHODS: This cross-sectional study included 102 asymptomatic women from Cuenca, Ecuador, who underwent a cervical cytology examination. They met all the inclusion criteria and signed the consent form. Nucleic acids were extracted from each sample, and PCR and flow-through hybridization were performed to detect the pathogens responsible for three STDs. Descriptive and inferential statistics were used to define and describe the study population, obtain the frequency data, and measure central tendencies to determine possible associations among the variables. RESULTS: We found that 49.02% of the participants were infected with at least one of the three microorganisms, with 48.04% and 2.94% carrying Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT), respectively. Neisseria gonorrhoeae (NG) infection was not observed. Among the participants, 1.96% presented co-infections with CT and UU. Approximately half of the participants presented with asymptomatic infections caused by at least one microorganism. CONCLUSIONS: This study demonstrates the importance of conducting regular STD screening programs for high-risk asymptomatic women.

Proctitis y enfermedad perianal de causa infecciosa: una mirada más allá de la enfermedad inflamatoria intestinal / Infectious proctitis and perianal disease: a gaze beyond inflammatory bowel disease

Resumen La proctitis infecciosa secundaria a una enfermedad de transmisión sexual ha aumentado en incidencia y deben ser consideradas especial-mente en varones homosexuales o bisexuales con síntomas rectales. Presentamos un paciente con una proctitis y enfermedad perianal por Chlamydia trachomatis que podría haber sido diagnosticado con otra enfermedad ano-rectal como es la enfermedad inflamatoria intestinal, si la historia clínica no hubiese sido considerada. Un alto nivel de sospecha es necesario para evitar un diagnóstico incorrecto, retrasar el tratamiento antimicrobiano y el desarrollo de complicaciones.

Abstract Infectious proctitis by sexually transmitted diseases are increasing in incidence and should be considered in homosexual patients with rectal symptoms. In this case, we show a patient with proctitis and perianal disease caused by Chlamydia trachomatis that could be diagnosed as another anorectal disease such as inflammatory bowel disease if the clinical history is not taken into account. A high level of suspicion is crucial, in order to avoid an incorrect diagnosis, delayed antibiotic therapy and the development of complications.

El diagnóstico de Infecciones de Transmisión Sexual por la técnica de biología molecular es la mejor estrategia para su diagnóstico oportuno y específico. Un caso clínico / The diagnosis of Sexually Transmitted Infections by the molecular biology technique is the best strategy for its timely and specific diagnosis. A clinical case

Resumen Se presenta el caso de un paciente a quien se le diagnosticó una Infección de Transmisión Sexual (ITS) por la técnica de PCR múltiple y en quién se logró por esta técnica, detectar cuatro agentes diferentes simultáneamente: Neisseria gonorreae, Mycoplasma hominis, Ureaplasma urealyticum/parvum y Trichomonas vaginalis, situación esta, que no hubiera sido posible utilizando el procedimiento estándar.

Summary Here we report the case of a patient with a Sexually Transmitted Disease (STI) in whom four different agents were detected by a multiple PCR technique: Neisseria gonorreae, Mycoplasma hominis, Ureaplasma urealyticum / parvum and Trichomonas vaginalis. This detection of multiple agents would not have been possible using conventional procedures.

Main etiological agents identified in 170 men with urethritis attended at the Fundação Alfredo da Matta, Manaus, Amazonas, Brazil,

Abstract Background: Sexually transmitted infections (STI) are a global public health problem. Urethritis are among the most common STIs, and can cause several complications and facilitate the transmission of the HIV virus. Objectives: To investigate the main etiologic agents of urethritis in 170 men treated at Fundação Alfredo da Matta. Methods: To identify the agents, urethral exudate and urine were collected. Gram and culture tests were performed in Thayer-Martin medium for Neisseria gonorrhoeae and polymerase chain reaction for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Mycoplasma genitalium, and herpes simplex types 1 and 2. Results: N. gonorrhoeae were identified in 102 (60.0%) patients, C. trachomatis in 50 (29.4%), U. urealyticum in 29 (17.0%), M. genitalium in 11 (6.5 %), U. parvum in ten (5.9%), and M. hominis in seven (4.1%). Herpes simplex type 2 was diagnosed in 24 (21.6%) of the 111 patients who underwent PCR for this pathogen. In 69 cases there was co-infection; the most frequent were: N. gonorrhoeae and C. trachomatis in 21 (14.7%) patients; N. gonorrhoeae and C. trachomatis in 21 (12.4%) patients; N. gonorrhoeae and herpes simplex type 2 in 11 (6.5%), and N. gonorrhoeae and U. urealyticum in nine (5.3%). Study limitations: Not relevant. Conclusion: N. gonorrhoeae, C. trachomatis, U. urealyticum, and herpes simplex type 2 were the pathogens most frequently identified in the present study. The main coinfection found was N. gonorrhoeae and C. trachomatis. T. vaginalis and herpes simplex type 1 were not identified in any of the patients.

Main etiological agents identified in 170 men with urethritis attended at the Fundação Alfredo da Matta, Manaus, Amazonas, Brazil.

BACKGROUND: Sexually transmitted infections (STI) are a global public health problem. Urethritis are among the most common STIs, and can cause several complications and facilitate the transmission of the HIV virus. OBJECTIVES: To investigate the main etiologic agents of urethritis in 170 men treated at Fundação Alfredo da Matta. METHODS: To identify the agents, urethral exudate and urine were collected. Gram and culture tests were performed in Thayer-Martin medium for Neisseria gonorrhoeae and polymerase chain reaction for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Mycoplasma genitalium, and herpes simplex types 1 and 2. RESULTS: N. gonorrhoeae were identified in 102 (60.0%) patients, C. trachomatis in 50 (29.4%), U. urealyticum in 29 (17.0%), M. genitalium in 11 (6.5 %), U. parvum in ten (5.9%), and M. hominis in seven (4.1%). Herpes simplex type 2 was diagnosed in 24 (21.6%) of the 111 patients who underwent PCR for this pathogen. In 69 cases there was co-infection; the most frequent were: N. gonorrhoeae and C. trachomatis in 21 (14.7%) patients; N. gonorrhoeae and C. trachomatis in 21 (12.4%) patients; N. gonorrhoeae and herpes simplex type 2 in 11 (6.5%), and N. gonorrhoeae and U. urealyticum in nine (5.3%). STUDY LIMITATIONS: Not relevant. CONCLUSION: N. gonorrhoeae, C. trachomatis, U. urealyticum, and herpes simplex type 2 were the pathogens most frequently identified in the present study. The main coinfection found was N. gonorrhoeae and C. trachomatis. T. vaginalis and herpes simplex type 1 were not identified in any of the patients.

Examination of Ureaplasma urealyticum and Mycoplasma hominis in 4082 Chinese patients

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.

Detección atípica de Chlamydia pneumoniae no humana en una muestra endocervical. Reporte de caso / Atypical detection of non-human Chlamydia pneumoniae in an endocervical sample. Case Report

Resumen ANTECEDENTES: Chlamydia trachomatis es uno de los principales microorganismos de trasmisión sexual asociado de manera importante con infertilidad femenina. La detección de genotipos y nuevas variantes de Chlamydia trachomatis permite conocer su prevalencia, distribución geográfica, identificar la aparición de resistencia antimicrobiana y las asociaciones clínicas o comportamientos sexuales y desarrollar vacunas. Este caso clínico es el primer informe de infección endocervical por una cepa diferente a C trachomatis. CASO CLÍNICO: Paciente de 25 años, con diagnóstico de infertilidad primaria de 2 años de evolución por factor endocrino-ovárico (sobrepeso e hipotiroidismo subclínico) y por factor masculino de hipospermia y teratozoospermia. El cultivo microbiológico endocervical detectó la infección por Ureaplasma spp y Chlamydia spp. La identificación de la cepa de Chlamydia mediante secuenciación del gen 16S del ARNr informó que era Chlamydia pneumoniae. La existencia de un plásmido en esta cepa de C pneumoniae confirmó que la infección endocervical fue por una cepa de Chlamydia pneumoniae no humana. CONCLUSIÓN: Este caso clínico sugiere la posibilidad de que una cepa de C pneumoniae no humana sea capaz de trasmitirse sexualmente a los humanos, estar circulando en la población mexicana y causar infertilidad, aunque aún se desconocen el origen y la dirección de la trasmisión.

Abstract BACKGROUND: Chlamydia trachomatis is one of the leading sexually transmitted microorganisms that is significantly associated with the development of female infertility. The detection of genotypes and new variants ofChlamydia trachomatisallows us to know their prevalence and geographic distribution, identify the appearance of antimicrobial resistance, clinical associations, or sexual behaviors, and develop vaccines. This clinical case reports for the first time endocervical infection by a strain other thanC. trachomatis. CLINICAL CASE: A 25-year-old woman with primary infertility of 2 years of evolution due to endocrine-ovarian factor (overweight and subclinical hypothyroidism) and male factor characterized by hypospermia and teratozoospermia. Endocervical microbiological culture detected infection byUreaplasma urealyticumandChlamydiaspp. Identification of theChlamydiastrain by sequencing the 16S rRNA gene reported that it wasChlamydia pneumoniae. The presence of plasmid in this strain ofC. pneumoniaeconfirmed that the endocervical infection was by a non-humanChlamydia pneumoniaestrain. CONCLUSION: This clinical case suggests that a non-human strain ofC. pneumoniaecan be sexually transmitted to humans, circulating in the Mexican population, and causing infertility, although the origin and direction of transmission are still unknown.

Increased prevalence of endocervical Mycoplasma and Ureaplasma colonization in infertile women with tubal factor.

OBJECTIVE: Most women suffering from tubal factor infertility do not have a history of pelvic inflammatory disease, but rather have asymptomatic upper genital tract infection. Investigating the impacts of such infections, even in the absence of clinically confirmed pelvic inflammatory disease, is critical to understanding the tubal factor of infertility. The aim of this study was to investigate whether the presence of endocervical bacteria is associated with tubal factors in women screened for infertility. METHODS: This retrospective cross-sectional study involved 245 women undergoing hysterosalpingography (HSG), screened for endocervical colonization by Chlamydia trachomatis, Neisseria gonorrhea, Ureaplasma urealyticum and Mycoplasma hominis, as part of a routine female infertility investigation between 2016 and 2017. RESULTS: endocervical bacterial colonization by Chlamydia trachomatis, Ureaplasma urealiticum, Mycoplasma hominis and other bacteria corresponded to 3.7%, 9.0%; 5.7% and 9.8%, respectively. There was no colonization by Neisseria gonorrhea. The prevalence of tubal factor was significantly higher in patients with positive endocervical bacteria colonization, regardless of bacterial species. When evaluating bacteria species individually, the women who were positive for endocervical Mycoplasma hominis had significantly higher rates of tubal factor. Associations between endocervical bacterial colonization and tubal factor infertility were confirmed by multiple regression analysis adjusted for age and duration of infertility. CONCLUSION: Besides the higher prevalence of Mycoplasma and Ureaplasma infectious agents, the findings of this study suggest the possible association of endocervical bacterial colonization - not only Chlamydia trachomatis and Neisseria gonorrhea, but also Mycoplasma species with tubal performance.

Prevalence of ureaplasma urealyticum, mycoplasma hominis and human papillomavirus coinfection in people attending a sexually transmitted infections (STI)/HIV reference centre in Salvador, Bahia, Brazil / Prevalência da coinfecção por ureaplasma urealyticum, mycoplasma hominis e papilomavírus humano em pessoas atendidas em centro de referência de doenças sexualmente transmissíveis (DST)/HIV em Salvador, Bahia

Introduction: Ureaplasma urealyticum and Mycoplasma hominis are frequently found at many women's and men's urogenital tract, and have been associated with non-gonococcal urethritis, cervicitis, infertility, chorioaminionitis and adverse pregnancy outcomes. Some studies show high prevalence of human papillomavirus (HPV) in patients with non-gonococcal urethritis, while also presenting high frequency of Ureaplasma urealyticum infection in women with cervicalcytology abnormalities and men with genital warts. Objectives: To evaluate the prevalence of Ureaplasma urealyticum, Mycoplasma hominis and HPV coinfection in people attending a sexually transmitted infections (STI)/HIV reference centre and to identify the risk factors associated. Methods: A cross-sectional study with patients aged >18 years, carried out for Ureaplasma urealyticum and Mycoplasma hominis from July 1st to December 31, 2015, in a STI/HIV reference centre from the State of Bahia, Brazil. Sociodemographic and clinical data were obtained from secondary data from patients' charts and laboratory findings, and analyzed using SPSS 20.0. Pearson's χ2 test or Fisher's exact test was used to evaluate categorical variables. HPV clinical diagnosis was considered positive as the presence of genital warts. Results: In this study, 849 patients were included ­ 196 men and 653 women. Of the sample, 51.4% was diagnosed with at least one of the two bacteria. The prevalence of Mycoplasma hominis infection was higher in coinfection (16.7%) than in isolated infection (2.2%). The prevalence of Ureaplasma urealyticum isolated infection was 32.4%. A strong association was found between the presence of genital warts and Ureaplasma urealyticum infection, with an estimated risk of 1.230 (p=0.014). Conclusion: Our findings suggest the need for further investigation for Ureaplasma urealyticum infection in patients presenting genital warts on physical examination. In addition, in this context, greater attention should be given to women and pregnant women.

Introdução: Ureaplasma urealyticum e Mycoplasma hominis são frequentemente encontrados no trato urogenital de homens e mulheres, e têm sido associados à ocorrência de uretrites não gonocócicas, cervicites, infertilidade, corioamnionite e outras patologias obstétricas. Alguns estudos mostraram alta prevalência de papilomavírus humano (HPV) em pacientes com uretrites não gonocócicas, bem como alta frequência de infecção por Ureaplasma urealyticum em mulheres com anormalidades na citologia cervical e homens apresentando verruga genital. Objetivos: Avaliar a prevalência da coinfecção por Ureaplasma urealyticum, Mycoplasma hominis e HPV em pessoas atendidas em um centro de referência de DST/HIV e identificar os fatores de risco associados. Métodos: Estudo transversal com pacientes maiores de 18 anos, testados para Ureaplasma urealyticum e Mycoplasma hominis entre 1º de julho e 31 de dezembro de 2015, em um centro de referência de DST/HIV da Bahia, Brasil. Os dados clínicos e sociodemográficos foram obtidos por coleta de dados secundários a partir dos prontuários e achados laboratoriais dos pacientes e analisados usando SPSS 20.0. O teste de χ2 Pearson ou teste exato de Fisher foram usados para avaliar as variáveis categóricas. O diagnóstico clínico do HPV foi considerado positivo quando houve presença de verruga genital. Resultados: Foram incluídos neste estudo, 849 pacientes, sendo 196 homens e 653 mulheres. Da amostra, 51,4% foi diagnosticada com infecção por pelo menos uma das duas bactérias. A prevalência de infecção por Mycoplasma hominis foi maior na coinfecção (16,7%) do que isoladamente (2,2%). A prevalência da infecção isolada por Ureaplasma urealyticum foi de 32,4%. Houve forte associação entre a presença de verruga genital e infecção por Ureaplasma urealyticum, com estimativa de risco de 1,230 (p=0,014). Conclusão: Nossos achados sugerem a necessidade de investigação adicional para a infecção por Ureaplasma urealyticum nos pacientes apresentando verruga genital ao exame físico. Além disso, nesse contexto, maior atenção deve ser dada a mulheres e gestantes.

Identificación de microorganismos vaginales en pacientes en trabajo de parto pretérmino / Identification of vaginal microorganisms of patients in preterm labor

Resumen OBJETIVO: Identificar los microorganismos vaginales más frecuentes en pacientes en trabajo de parto pretérmino, mediante el A.F. Genital System-Liofilchem®. MATERIALES Y MÉTODOS: Estudio descriptivo, prospectivo y transversal llevado a cabo en pacientes en trabajo de parto pretérmino atendidas en el servicio de Ginecología y Obstetricia de la Fundación Hospital Infantil Universitario de San José de Bogotá, entre julio de 2015 y febrero de 2016 de quienes se obtuvieron muestras de flujo del introito vaginal y se sembraron en el panel del A.F. Genital System-Liofilchem®, de acuerdo con las instrucciones del fabricante. Para el análisis de los datos se utilizó el programa estadístico Stata versión 13 (StataCorp®) y se implementó la prueba no paramétrica de Wilcoxon. RESULTADOS: Los microorganismos aislados con mayor frecuencia fueron: Staphylococcus aureus (89.1%), Ureaplasma urealyticum (43.4%) y Mycoplasma hominis (19.5%). De las muestras positivas para especies de micoplasma, 52.2% tuvo concentración mayor de 105 UFC/mL. De los agentes aislados, Ureaplasma urealyticum y Mycoplasma hominis mostraron resistencia de 100% para clindamicina y eritromicina, respectivamente. CONCLUSIONES: Los microorganismos vaginales representan un factor de riesgo de parto pretérmino. Ureaplasma urealyticum y Mycoplasma hominis muestran resistencia total a clindamicina y eritromicina.

Abstract OBJECTIVE: Determine the frequency of microorganisms present in the vagina of women in preterm labor. MATERIALS AND METHODS: Descriptive, prospective, cross-sectional study of a series of cases of 46 patients treated at the Fundación Hospital Infantil Universitario de San José de Bogotá for preterm labor, who were sampled from the vaginal introitus and planted on the A.F. Genital System-Liofilchem® panel. Genital System by Liofilchem®, according to the manufacturer's instructions. The statistical package Stata version 13 (StataCorp®) was used. The statistical analysis was descriptive, the nonparametric Wilcoxon test was run. RESULTS: The most isolated microorganism was Staphylococcus aureus with a frequency of 89.13%. Ureaplasma urealyticum was detected in 43.48% and Mycoplasma hominis in 19.57 Of the positive samples for genital Mycoplasmas, 52.2% showed a concentration >105 CFU/mL. Ureaplasma urealyticum isolates showed 100% resistance to clindamycin and 100% Mycoplasma hominis for erythromycin. CONCLUSIONS: Microorganisms that have been identified as risk factors for preterm delivery were identified in 93.5% of the vaginal discharge samples. For Ureaplasma urealyticum and Mycoplasma hominis, 100% resistance for clindamycin and erythromycin is identified.

Ureaplasma urealyticum and U. parvum in sexually active women attending public health clinics in Brazil.

Ureaplasma urealyticum and U. parvum have been associated with genital infections. The purpose of this study was to detect the presence of ureaplasmas and other sexually transmitted infections in sexually active women from Brazil and relate these data to demographic and sexual health, and cytokines IL-6 and IL-1ß. Samples of cervical swab of 302 women were examined at the Family Health Units in Vitória da Conquista. The frequency of detection by conventional PCR was 76·2% for Mollicutes. In qPCR, the frequency found was 16·6% for U. urealyticum and 60·6% U. parvum and the bacterial load of these microorganisms was not significantly associated with signs and symptoms of genital infection. The frequency found for Trichomonas vaginalis, Neisseria gonorrhoeae, Gardnerella vaginalis and Chlamydia trachomatis was 3·0%, 21·5%, 42·4% and 1·7%, respectively. Higher levels of IL-1ß were associated with control women colonized by U. urealyticum and U. parvum. Increased levels of IL-6 were associated with women who exhibited U. parvum. Sexually active women, with more than one sexual partner in the last 3 months, living in a rural area were associated with increased odds of certain U. parvum serovar infection.

Evaluación de la implementación de PCR Real Time en la detección de Chlamydia Trachomatis y Micoplasmas urogenitales en pacientes con diagnóstico de infertilidad / Evaluation of the implementation of Real Time PCR in the detection of Chlamydia Trachomatis and urogenital Mycoplasmas in patients diagnosed with infertility

La infección genital es una de las principales causas de infertilidad en la población mundial, afecta a cada una de las diversas partes de la anatomía reproductiva, tanto masculina como femenina. Los microrganismos de transmisión sexual como Neisseria gonorrohoeae (Ng), Trichomonas vaginalis (Tv), Chlamydia trachomatis (Ct), Mycoplasma hominis (Mh) y Ureoplasma urealiticum (Uu), se encuentran asociados a una disminución del potencial de fertilidad en parejas en edad reproductiva. Las infecciones por Neisseria gonorrrohoeae y Trichomonas vaginalis, generalmente tienen síntomas clínicos y con tratamientos adecuados son erradicadas completamente. Sin embargo, las infecciones por Chlamydia trachomatis, Mycoplasma hominis o Ureaplasma urealiticum, pueden transcurrir asintomáticas o subclínicas y por tal motivo la investigación de estos microorganismos está indicada antes de cualquier procedimiento y/o técnica de reproducción medicamente asistida. La Ct es una bacteria intracelular obligada que no crese en cultivos bacteriológicos convencionales. La infección en el hombre produce uretritis, prostatitis, epididimitis, que si no son tratadas a tiempo, pueden dañar al epitelio germinal del testículo ocasionando una infertilidad secundaria. En la mujer la infección inicialmente es en cuello uterino, con signos y síntomas de cervicitis, como ser, un cuello friable con secreción mucopurulenta y si la infección asciende del endocervix causando endometritis, salpingitis, abscesos tubaricos y peritonitis, se lo conoce como Enfermedad Inflamatoria Pélvica (EIP) pueden generar severas secuelas como infertilidad por obstrucción cicatrizal de las trompas y embarazos ectópicos. También puede afectar a la uretra femenina y causar piuria, disuria y aumento en la frecuencia urinaria. Las Ct son bacterias patógenas de transmisión sexual, vale decir que no forman parte de la flora habitual de la uretra distal del varón ni de la flora normal vaginal. En cambio los Mh y Uu, pueden estar como colonizantes de la uretra distal del hombre, y también pueden ser la causa de uretritis, prostatitis, epididimitis, cuyas consecuencias crónicas asintomáticas se conocen como obstrucciones tubaricas (conductos eferentes y deferentes, epidídimo), y sus efectos directos sobre el espermatozoide provocando enrollamiento de la cola espermática que afecta a su movilidad (aztenozoospermia). En la mujer, el Mh y el Uu, pueden colonizar la vagina o la uretra, y cuando la concentración de estos microorganismos se elevada y el microambiente lo permite suelen encontrarse asociadas a un "estado de vaginosis" o de una uretritis no gonocócica como es el caso de las infecciones por Uu. OBJETIVO Evaluar la utilidad de la reacción en cadena de la polimerasa en tiempo real (qPCR) en la detección de Ct, Mh y Uu en pacientes femeninos y masculinos que ingresen al laboratorio con un diagnóstico de infertilidad. Así como también, comprobar la posible asociación con otros parámetros evaluados en el laboratorio como el espermograma y el exudado vaginal. MATERIAL Y MÉTODO Se estudiaron 38 muestras de pacientes que ingresaron al laboratorio con diagnóstico de infertilidad (INFT); hisopados uretrales (hu), endocervicales (he), semen, orina de 1er porción, mediante qPCR. Las muestras endocervicales y vaginales se tomaron por duplicado con hisopos de dacrón, colocando uno de ellos en un tubo seco y el otro en medio conservante hasta el proceso de extracción de ADN (siguiendo algoritmo establecido para microrganismo de difícil crecimiento. Ver Anexo I, pág. 7). Todos los pacientes firmaron un consentimiento informado (CI) para el uso de sus resultados. Para la extracción del ADN bacteriano se utilizó un kit de extracción de ácidos nucleicos. RESULTADOS Del total de 38 pacientes de ambos sexos, dentro de un protocolo de fertilidad; 28 (74%) dieron no detectables y 10 (26%) detectables por qPCR. Siendo el Uu el de mayor frecuencia con un 80%, seguido de Mh con un 20%. Ct fue no detectable tanto en hombre como en mujeres. Los Uu fueron hallados en secreciones vaginales, las que al mismo tiempo fueron analizadas y evaluadas con el criterio de BACOVA en área de bacteriología clínica arrojando un Score +1 o +2, es decir, poseían un microbioma vaginal normal y equilibrado. DISCUSIÓN Dado el alto porcentaje de pacientes que dieron positivo para la detección de Uu, y que por métodos de bacteriología convencional no se obtuvo desarrollo; se recomienda el uso de qPCR en muestras de pacientes que se encuentran en el inicio de un protocolo de infertilidad y ante una inminente aplicación de técnicas de reproducción asistida

Micoplasmas urogenitales como causa de infertilidad femenina. Hospital Ginecobstétrico Provincial de Matanzas. 2014-2015 / Urogenital micoplasmas as a cause of feminine infertility. Provincial Gynecoobstetric Hospital of Matanzas. 2014-2015

Introducción: los micoplasmas urogenitales (Mycoplasma hominis, Ureaplasma urealyticum), a pesar de formar parte de la flora habitual de vagina, se encuentran entre las especies bacterianas más frecuentemente involucradas en la infertilidad de la pareja. Objetivos: determinar la incidencia de micoplasmas urogenitales en muestras de exudados endocervicales de pacientes, de la Consulta Provincial de Atención a la Pareja Infértil, clasificar la severidad de la infección detectada e identificar la sensibilidad-resistencia a diferentes antimicrobianos de los micro-organismos aislados Materiales y métodos: Se efectuó estudio observacional descriptivo transversal en el Hospital Gineco-Obstétrico Docente Provincial “Dr. Julio Rafael Alfonso Medina”, de Matanzas, entre los meses de noviembre de 2014-enero de 2015. El universo estuvo constituido por las 117 pacientes que cumplieron los criterios de inclusión y exclusión. Resultados: el 56,4 % de las muestras analizadas fueron positivas, siendo la especie más frecuente el Ureaplasma urealyticum. Predominaron las infecciones leves, en un 59,09 %. El síntoma más referido fue leucorrea con 42,73 %. Ureaplasma urealyticum mostró mayor resistencia frente a ofloxacino, con un 82 %. No se encontró resistencia de Mycoplasma hominis frente a los antimicrobianos usados en la investigación. Las coinfecciones fueron más resistentes a azitromicina (100 %), ofloxacino (90 %), y eritromicina (80 %). Conclusiones: el microorganismo más aislado fue Ureaplasma urealyticum. El síntoma más frecuente fue la leucorrea. Predominaron las infecciones leves. Ureaplasma urealyticum muestra mayor resistencia a los antimicrobianos que Mycoplasma hominis. Ambos son altamente sensibles a pefloxacino y minociclina.

Background: urogenital mycoplasmas (Mycoplasma hominis, Ureaplasma urealyticum) are among the most frequent bacterial species involved in the couple infertility, although they are part of the vagina regular flora. Aims: determining the incidence of urogenital mycoplasmas in the samples of endocervical exudates of patients of the Provincial Consultation of Attention to Infertile Couple; classifying the severity of the detected infection and; identifying the isolated microorganisms’ sensibility-resistance to different antimicrobials. Materials and methods: a cross-sectional, descriptive, observational study was carried out in the Provincial Teaching Gyneco-obstetric Hospital “Dr. Julio Rafael Alfonso Medina” of Matanzas in the period from November 2014 to January 2015. The universe was formed by the 117 female patients who fulfilled the criteria of inclusion and exclusion. Outcomes: 56.4 % of the analyzed samples were positive, being Ureaplasma urealyticum the most frequent specie. Light infections predominated, in 59.09 %. The most referred symptom was leucorrhea with 42.73 %. Ureaplasma urealyticum showed higher resistance toward ofloxacin, with 82 %. There was not resistance of Mycoplasma hominis toward the antimicrobials used in the research. The co-infections were more resistant to azythromycin (100 %), ofloxacin (90 %), and erythromycin (80 %). Conclusions: Ureaplasma urealyticum was the most isolated microorganism. The most frequent symptom was leucorrhea. Light infections predominated. Ureaplasma urealyticum shows higher resistance to antimicrobials than Micoplasma hominis. Both are highly sensible to pefloxacin and minocycline.

Influence of storage time on DNA of Chlamydia trachomatis, Ureaplasma urealyticum, and Neisseria gonorrhoeae for accurate detection by quantitative real-time polymerase chain reaction

The shipment and storage conditions of clinical samples pose a major challenge to the detection accuracy of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Ureaplasma urealyticum (UU) when using quantitative real-time polymerase chain reaction (qRT-PCR). The aim of the present study was to explore the influence of storage time at 4°C on the DNA of these pathogens and its effect on their detection by qRT-PCR. CT, NG, and UU positive genital swabs from 70 patients were collected, and DNA of all samples were extracted and divided into eight aliquots. One aliquot was immediately analyzed with qRT-PCR to assess the initial pathogen load, whereas the remaining samples were stored at 4°C and analyzed after 1, 2, 3, 7, 14, 21, and 28 days. No significant differences in CT, NG, and UU DNA loads were observed between baseline (day 0) and the subsequent time points (days 1, 2, 3, 7, 14, 21, and 28) in any of the 70 samples. Although a slight increase in DNA levels was observed at day 28 compared to day 0, paired sample t-test results revealed no significant differences between the mean DNA levels at different time points following storage at 4°C (all P>0.05). Overall, the CT, UU, and NG DNA loads from all genital swab samples were stable at 4°C over a 28-day period.

Neumonía por Ureaplasma urealyticum en un neonato

El género Ureaplasma pertenece a la familia Mycoplasmataceae, corresponde al grupo de bacterias que carecen de pared celular y tienen la capacidad de adherirse a las superficies mucosas humanas del tracto genitourinario en los adultos y las vías respiratorias en los recién nacidos. Su principal factor de virulencia está asociado a la estimulación de citoquinas y mediadores de la in amación que se asocian a la patogénesis de la lesión pulmonar crónica y la enterocolitis necrotizante descrita en neonatos. El cuadro clínico asociado a la infección por U. urealyticum en neonatos es inespecífico. El diagnóstico definitivo de la infección por U. urealyticum debe incluir el aislamiento del microorganismo en cultivo, sin embargo, la técnica de reacción en cadena de polimerasa (PCR) es sensible para la detección. Actualmente existe escasa información en cuanto a factores de virulencia, factores inmunes que afectan la susceptibilidad a estos patógenos. A continuación se describe el caso de un neonato con prematuridad de 28 semanas quien curso con infección pulmonar por Ureaplasma urealyticum.

Ureaplasma belongs to the family Mycoplasmataceae corresponds to the group of bacteria that lack a cell wall and have the ability to adhere to human mucosal surfaces of the urogenital tract in adults and respiratory tract in newborns. Its main virulence factor is associated with stimulation of cytokines and inflammatory mediators that are associated with the pathogenesis of chronic lung injury and neonatal necrotizing enterocolitis described. The clinical picture associated with U. urealyticum infection in newborns is nonspecific. The definitive diagnosis of U. urealyticum infection should include isolation of the organism in culture, however, the technique of polymerase chain reaction (PCR) is sensitive for detection. Currently there is little information as to virulence factors, immune factors that affect susceptibility to these pathogens. Then the case of a neonate is described, with whom 28 weeks prematurity course with pulmonary infection Ureaplasma urealyticum.

Infertilidad tubárica e infección genital por Chlamydia trachomatis-Ureaplasma urealyticum / Genital infection and tubal infertility by Chlamydia tra-chomatis or Ureaplasma urealyticum

Objetivo: establecer la asociación entre la infertilidad tubarica y la infección cervical por Chlamydia trachomatis (CT) o Ureaplasma urealiticum (UU), en mujeres infértiles. Métodos: investigación comparativa y aplicada, con diseño de tipo no experimental, de casos y controles, contemporáneo transeccional y de campo, que incluyó 60 mujeres, separadas en dos grupos pareados de acuerdo si eran infértiles (casos) o fértiles (controles), a las cuales se les tomó una muestra de hisopado endocervical para el diagnóstico molecular de CT o UU y se les realizó una histerosalpingografía para evaluar la permeabilidad de las trompas uterinas. Resultados: se detectó una prevalencia en mujeres infértiles y fértiles de infección por CT o UU del 18 por ciento y 35 por ciento, respectivamente; siendo mayor entre las mujeres infértiles, diferencia significativa solo para UU (p<0,05). Se detectó una mayor permeabilidad tubárica en las pacientes fértiles que en las infértiles (80 por ciento vs. 40 por ciento), siendo el compromiso tubárico mayor en las pacientes infértiles (p<0,05). Al asociar el diagnóstico de CT o UU con los resultados de la histerosalpingografía se constató que la detección de uno de estos microorganismos aumentaba casi 3 o 5 veces más la probabilidad de presentar obstrucción tubárica, respectivamente, diferencias no significativas (p>0,05). Conclusión: una gran parte de las mujeres infértiles presentan infección por CT o UU, patógenos de transmisión sexual que pudiesen tener responsabilidad en el daño tubárico.

Objective: to establish the association between tubal infertility and cervical infection by Chlamydia tra-chomatis (CT) or Ureaplasma urealyticum (UU) in infertile women. Methods: a comparative, and applied research with a non-experimental, case-control, contemporary-transactional and field design, including 60 women, separated into two groups matched according whether they were infertile (cases) or fertile (controls), in which was took a sample of endocervical swabs for molecular diagnosis of cT or UU and underwent hysterosalpingography to assess the permeability of the fallopian tubes. Results: it was detected in infertile and fertile women a prevalence of CT or UU infection of 18 percent and 35 percent, respectively; being higher detection among infertile women, although this difference was significant only for UU (p <0.05). Also detected more tubal permeability in fertile patients that in infertile (80 percent vs. 40 percent), being higher in engagement tubal in infertility patients (p<0.05). By associating the diagnosis of both CT and UU with hysterosalpingography'sresults found that the diagnosis of one of these microorganisms increased almost 3 to 5 times more likely to have obstruction of the fallopian tubes, respectively; although this higher risk doesn't showed significance (p>0.05). Conclusion: a large proportion of infertile women have CT or UU infection, sexually transmitted pathogens that might have tubal damage liability.

Ureaplasma urealyticum e mycoplasma hominis no parto pré-termo / Ureaplasma urealyticum and mycoplasma hominis in preterm labor

Mycoplasma hominis and Ureaplasma urealyticum are considered genital mycoplasmas, because infection occurs through sexual contact. The presenceof these bacteria has been associated with non gonococcal urethritis, cervicitis, vaginitis, pelvic inflammatory disease (PID) and pathology of pregnancyand newborns.Complications of genital mycoplasmas on the outcome of pregnancy include ectopic pregnancy, premature birth and preterm premature rupture of membranes (PPROM), chorioamnionitis, post partum endometritis, salpingitis, low weight and late abortion. This review article focuses on theim portance of these microorganisms leading to preterm labor.

Mycoplasma hominis e Ureaplasma urealyticum são considerados micoplasmas genitais, pois a infecção ocorre através do contato sexual. A presença dessas bactérias tem sido associada A uretrite não gonocócica, cervicite, vaginite, doença inflamatória pélvica (DIP) e patologia da gravidez e de recém-nascidos.As complicações de micoplasmas genitais sobre os resultados da gravidez incluem gravidez ectópica, parto prematuro e ruptura prematura das membranas ovulares (PPROM), corioamnionite, endometrite pós-parto, salpingite, baixo peso e abortamento tardio. Este artigo de revisão concentra-se na importância destes microrganismos, levando a trabalho de parto prematuro.