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2.
BMC Infect Dis ; 20(1): 314, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345231

RESUMO

BACKGROUND: Mycoplasma genitalium is an emerging sexually transmitted infection, with increasing rates of resistance to fluroquinolones and macrolides, the recommended treatments. Despite this, M. genitalium is not part of routine screening for Sexually Transmitted Infections (STIs) in many countries and the prevalence of infection and patterns of disease remain to be determined in many populations. Such data is of particular importance in light of the reported rise in antibiotic resistance in M. genitalium isolates. METHODS: Urine and urethral swab samples were collected from the primary public sexual health clinic in Singapore and tested for C. trachomatis (CT) or N. gonorrhoeae (NG) infection and for the presence of M. genitalium. Antibiotic resistance in M. genitalium strains detected was determined by screening for genomic mutations associated with macrolide and fluroquinolone resistance. RESULTS: We report the results of a study into M. genitalium prevalence at the national sexual health clinic in Singapore. M. genitalium was heavily associated with CT infection (8.1% of cases), but present in only of 2.4% in CT negative cases and not independently linked to NG infection. Furthermore, we found high rates of resistance mutations to both macrolides (25%) and fluoroquinolones (37.5%) with a majority of resistant strains being dual-resistant. Resistance mutations were only found in strains from patients with CT co-infection. CONCLUSIONS: Our results support targeted screening of CT positive patients for M. genitalium as a cost-effective strategy to reduce the incidence of M. genitalium in the absence of comprehensive routine screening. The high rate of dual resistance also highlights the need to ensure the availability of alternative antibiotics for the treatment of multi-drug resistant M. genitalium isolates.


Assuntos
Antibacterianos/farmacologia , Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/efeitos dos fármacos , Farmacorresistência Bacteriana Múltipla , Infecções por Mycoplasma/diagnóstico , Mycoplasma genitalium/efeitos dos fármacos , Instituições de Assistência Ambulatorial , Antibacterianos/uso terapêutico , Infecções por Chlamydia/complicações , Infecções por Chlamydia/tratamento farmacológico , Chlamydia trachomatis/genética , Chlamydia trachomatis/isolamento & purificação , DNA Bacteriano/genética , DNA Bacteriano/metabolismo , Farmacorresistência Bacteriana Múltipla/genética , Fluoroquinolonas/farmacologia , Fluoroquinolonas/uso terapêutico , Humanos , Macrolídeos/farmacologia , Macrolídeos/uso terapêutico , Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium/genética , Mycoplasma genitalium/isolamento & purificação , Prevalência , RNA Ribossômico 23S/química , RNA Ribossômico 23S/genética , RNA Ribossômico 23S/metabolismo , Análise de Sequência de DNA , Singapura/epidemiologia , Uretra/microbiologia
4.
BMC Vet Res ; 15(1): 371, 2019 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-31655595

RESUMO

BACKGROUND: Mycoplasma bovis is a causative agent of disease in cattle causing many clinical conditions. Currently there are no commercial M. bovis vaccines in Europe and treatment is difficult with decreased antimicrobial susceptibility of M. bovis field isolates. Using an M. bovis calf infection model the effectiveness of enrofloxacin given alone; in combination with flunixin meglumine, a nonsteroidal anti-inflammatory drug; and a group with an additional treatment of pegbovigrastim, an immunostimulator, was evaluated. RESULTS: Enrofloxacin given alone stimulated a strong immune response, reduced the clinical manifestation and lung lessions of the M. bovis infection. In contrast the combination therapy appeared ineffective. CONCLUSIONS: In this experiment enrofloxacin given alone appeared to be the most effective treatment of the M. bovis affected calves, whereas co-administration with flunixin meglumine, and pegbovigrastim was not beneficial in this trial.


Assuntos
Doenças dos Bovinos/tratamento farmacológico , Infecções por Mycoplasma/veterinária , Pneumonia/veterinária , Adjuvantes Imunológicos/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Bovinos , Doenças dos Bovinos/microbiologia , Clonixina/análogos & derivados , Clonixina/uso terapêutico , Quimioterapia Combinada/veterinária , Enrofloxacina/uso terapêutico , Feminino , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma bovis/efeitos dos fármacos , Pneumonia/tratamento farmacológico , Proteínas Recombinantes/uso terapêutico
5.
Poult Sci ; 98(12): 6281-6288, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31579902

RESUMO

Among many avian mycoplasmas, Mycoplasma gallisepticum (MG) and Mycoplasma synoviae (MS) are recognized as the main etiological agents of respiratory diseases and infectious synovitis in chickens and turkeys causing tremendous economic losses worldwide. Therefore, proper treatment is promoted for the control of these diseases. This study was the first in Egypt to evaluate the in vitro efficacy of various antimicrobials against field MG and MS isolates recovered from chicken and turkey flocks using both conventional broth microdilution and quantitative real-time polymerase chain reaction assays. Totally, 47 mycoplasma isolates were recovered from 160 collected tracheal samples (29.4%). Of these, 44 MG (27.5%) and 3 MS (1.9%) were identified using conventional and molecular assays. The in vitro susceptibilities of 4 representative mycoplasma field isolates (3 MG and one MS) to 8 antibiotics and 4 essential oils were investigated. The tested isolates showed various susceptibilities to tested antimicrobials. Toldin CRD, followed by clove, cumin, and cinnamon oils were effective against both MG and MS clinical isolates with minimum inhibitory concentration (MIC) values ranging from 0.49 to 15.63 µg/mL. Similarly, tylvalosin was the most active antibiotic against MG and MS isolates with the lowest MIC values (0.015 to 0.03 µg/mL). DNA loads of both MG mgc2 and MS vlhA genes were markedly decreased upon treatment with majority of the tested antimicrobials confirming their effectiveness as was also evaluated by conventional MIC results. In conclusion, Toldin CRD and tylvalosin were found to be the most effective antimicrobials in this study. This finding highlights the importance of using these antimicrobials in controlling mycoplasma infections in chickens and turkeys.


Assuntos
Anti-Infecciosos/farmacologia , Galinhas , Infecções por Mycoplasma/veterinária , Mycoplasma gallisepticum/efeitos dos fármacos , Mycoplasma synoviae/efeitos dos fármacos , Doenças das Aves Domésticas/tratamento farmacológico , Perus , Animais , Egito , Testes de Sensibilidade Microbiana/veterinária , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/microbiologia , Doenças das Aves Domésticas/microbiologia
6.
BMC Infect Dis ; 19(1): 827, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547805

RESUMO

BACKGROUND: The worldwide expansion of macrolide-resistant Mycoplasma genitalium (MG) in cases of genital infections has led to an increased recurrence rate of these infections after first-line azithromycin treatment. By detecting the presence of azithromycin-resistant MG, the patient's antibiotic treatment can be targeted and the spread of resistance prevented. With this aim in mind, macrolide-resistance detection kits are helpful tools for the physician. METHODS: Azithromycin resistance mutations in MG are targeted using a four-color multiplex real-time RT-PCR assay. Tested targets include plasmid DNA (as positive controls) as well as macrolide-sensitive and macrolide-resistant genomic DNA from characterized cell lines and clinical samples. RESULTS: The analytical data presented here were generated from plasmid DNA and genomic RNA/DNA and include adaptation to an internal control, specificity between targets, specificity vs non-MG species, limit of detection (LoD) and interference studies (co-infection and endogenous substances). The clinical data were based on the application of the assay to clinical samples characterized by sequencing. CONCLUSIONS: A new NAAT (nucleic acid amplification test) prototype has been developed in collaboration with the Diagenode s.a. company, this prototype targets MG and azithromycin-resistance mutations in that pathogen.


Assuntos
Azitromicina/farmacologia , Farmacorresistência Bacteriana/genética , Reação em Cadeia da Polimerase Multiplex/métodos , Mutação , Mycoplasma genitalium/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Antibacterianos/farmacologia , Humanos , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/microbiologia , Especificidade por Substrato
9.
Poult Sci ; 98(12): 6296-6310, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31376349

RESUMO

Mycoplasma gallisepticum (MG) infection produces a profound inflammatory response in the respiratory tract and evade birds' immune recognition to establish a chronic infection. Previous reports documented that the flavonoid baicalin possess potent anti-inflammatory, and antioxidant activities. However, whether baicalin prevent immune dysfunction is largely unknown. In the present study, the preventive effects of baicalin were determined on oxidative stress generation and apoptosis in the spleen of chickens infected with MG. Histopathological examination showed abnormal morphological changes including cell hyperplasia, lymphocytes depletion, and the red and white pulp of spleen were not clearly visible in the model group. Oxidative stress-related parameters were significantly (P < 0.05) increased in the model group. However, baicalin treatment significantly (P < 0.05) ameliorated oxidative stress and partially alleviated the abnormal morphological changes in the chicken spleen compared to model group. Terminal deoxynucleotidyl transferase-mediated dUTP nick endlabeling assay results, mRNA, and protein expression levels of mitochondrial apoptosis-related genes showed that baicalin significantly attenuated apoptosis. Moreover, baicalin restored the mRNA expression of mitochondrial dynamics-related genes and maintain the balance between mitochondrial inner and outer membranes. Intriguingly, the protective effects of baicalin were associated with the upregulation of nuclear factor erythroid 2-related factor 2 (Nrf2)/Heme oxygenase-1 (HO-1) pathway and suppression of nuclear factor-kappa B (NF-κB) pathway in the spleen of chicken. In summary, these findings indicated that baicalin promoted mitochondrial dynamics imbalance and effectively prevents oxidative stress and apoptosis in the splenocytes of chickens infected with MG.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Galinhas , Flavonoides/farmacologia , Infecções por Mycoplasma/veterinária , Doenças das Aves Domésticas/tratamento farmacológico , Baço/fisiologia , Animais , Apoptose/efeitos dos fármacos , Proteínas Aviárias/fisiologia , Heme Oxigenase-1/fisiologia , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/fisiologia , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma gallisepticum/fisiologia , Fator 2 Relacionado a NF-E2/fisiologia , NF-kappa B/fisiologia , Estresse Oxidativo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Baço/efeitos dos fármacos
10.
Rev. esp. quimioter ; 32(4): 327-332, ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-188827

RESUMO

INTRODUCTION: 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. MATERIAL AND 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


INTRODUCCIÓN: Se han publicado estudios que demuestran mayores tasas de éxito en las técnicas reproducción asistida (TRA) en parejas no infectadas por micoplasmas. El objetivo de este estudio fue determinar la prevalencia de los micoplasmas genitales en muestras de orina del miembro masculino de las parejas incluidas en el Programa de Reproducción Asistida en nuestro Área Sanitaria realizando un tratamiento descolonizador con el fin de incrementar la calidad del semen, mejorar las tasas éxito de la embriotransferencia y minimizar los efectos adversos sobre la gestación. MATERIAL Y MÉTODOS: Participaron parejas incluidas en el Programa de Reproducción Asistida durante 2016. La detección de los micoplasmas se realizó por PCR en tiempo real. En los casos positivos, la pareja fue tratada con antibióticos hasta la erradicación del microorganismo. Los antibióticos usados fueron: azitromicina, doxiciclina, levofloxacino, moxifloxacino y clindamicina. RESULTADOS: De los 205 hombres estudiados, 33 fueron positivos: Ureaplasma urealyticum 15,1%, Mycoplasma hominis 3,9%. Azitromicina fracasó en el 50% de los casos y doxiciclina en el 10,2%. Con levofloxacino solo en 2 de 5 se consiguió la erradicación de U. urealyticum. CONCLUSIONES: El cribado de rutina de los micoplasmas genitales puede ser útil para mejorar la calidad del semen. Esto permitiría simplificar los procedimientos de fertilización in vitro e incrementar las tasas de éxito en la implantación de los embriones y en la gestación, especialmente con la aplicación de técnicas diagnósticas rápidas y específicas como la PCR en tiempo real


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Antibacterianos/uso terapêutico , Doenças dos Genitais Masculinos/tratamento farmacológico , Infecções por Mycoplasma/tratamento farmacológico , Técnicas de Reprodução Assistida , Análise do Sêmen , Azitromicina/uso terapêutico , Clindamicina/uso terapêutico , Doxiciclina/uso terapêutico , Implantação do Embrião , Doenças dos Genitais Femininos/tratamento farmacológico , Doenças dos Genitais Femininos/microbiologia , Doenças dos Genitais Masculinos/microbiologia , Doenças dos Genitais Masculinos/urina , Levofloxacino/uso terapêutico , Moxifloxacina/uso terapêutico , Mycoplasma hominis/genética , Mycoplasma hominis/isolamento & purificação , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Fatores Sexuais , Resultado do Tratamento , Infecções por Ureaplasma/tratamento farmacológico , Ureaplasma urealyticum/genética
12.
Microb Pathog ; 135: 103635, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31352064

RESUMO

OBJECTIVES: Mycoplasma hominis (M.hominis) infections are sexually transmitted and usually associated with urogenital and respiratory diseases. The aim of our study was to (i) detect M. hominis in the vaginal and urine samples of sexually active women using three different detection methods and (ii) to determine the antimicrobial susceptibility and recurrence after the treatment. METHODS: Both vaginal and urine samples were collected from 110 sexually active women at the Obstetrics and Gynecology Clinic, Baskent University Ankara Hospital, Turkey, between March 2015 and February 2016. The presence of M. hominis in the vaginal and urine samples was detected by in vitro culture, two biochemical diagnostics kits (Mycoplasma IES (Autobio, China) and Mycoplasma IST-2 (BioMérieux, France) and PCR. The antibiotic susceptibility of each sample was tested using the kits. The women positive for M. hominis were treated either singly or along with their sexual partners by tetracycline. RESULTS: M. hominis was detected in 72 of 220 (32.7%) samples (both vaginal and urine). Of which 37 showed contrary results with two different kits and then were confirmed by PCR. In 13 samples the IES kit identified M. hominis missed by IST-2, and in 8 samples the MIST-2 kit identified M. hominis missed by IES, while both kits missed 6 samples that were agar culture positive for M. hominis." The highest susceptibility rate was observed against pristinamycin (100%), followed by 91%, 83%, and 75% for doxycycline, tetracycline, and josamycin, respectively. Twenty-five patients treated with tetracycline were followed after one month. The recurrence of M. hominis was not observed in any of the 18 cases where both sexual partners were treated but recurred in 5 of the 7 singly treated women. CONCLUSIONS: The rate of M. hominis detection was significantly higher in the vaginal samples compared to the urine samples. The probability of detecting M. hominis by IST-2 kit was 1.18 times less than IES kit (p < 0.001). When the relationship between the samples was examined, the difference between IES and IST-2 for detecting M. hominis was statistically significant (p < 0.01). Antibiotic susceptibility tests indicated that the tetracycline group of antibiotics was effective in eliminating M. hominis when given to both the sexual partners.


Assuntos
Técnicas de Cultura de Células/métodos , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Mycoplasma hominis/crescimento & desenvolvimento , Mycoplasma hominis/isolamento & purificação , Patologia Molecular/métodos , Antibacterianos/farmacologia , Doxiciclina/farmacologia , Feminino , Hospitais Universitários , Humanos , Josamicina/farmacologia , Testes de Sensibilidade Microbiana , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma hominis/genética , Obstetrícia , Tetraciclina/farmacologia , Turquia , Vagina/microbiologia
14.
Rev Esp Quimioter ; 32(4): 327-332, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31271277

RESUMO

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.


Assuntos
Antibacterianos/uso terapêutico , Doenças dos Genitais Masculinos/tratamento farmacológico , Infecções por Mycoplasma/tratamento farmacológico , Técnicas de Reprodução Assistida , Análise do Sêmen , Adulto , Azitromicina/uso terapêutico , Clindamicina/uso terapêutico , Doxiciclina/uso terapêutico , Implantação do Embrião , Feminino , Doenças dos Genitais Femininos/tratamento farmacológico , Doenças dos Genitais Femininos/epidemiologia , Doenças dos Genitais Femininos/microbiologia , Doenças dos Genitais Masculinos/epidemiologia , Doenças dos Genitais Masculinos/microbiologia , Doenças dos Genitais Masculinos/urina , Humanos , Levofloxacino/uso terapêutico , Masculino , Pessoa de Meia-Idade , Moxifloxacina/uso terapêutico , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/urina , Mycoplasma hominis/efeitos dos fármacos , Mycoplasma hominis/genética , Mycoplasma hominis/isolamento & purificação , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Fatores Sexuais , Resultado do Tratamento , Infecções por Ureaplasma/tratamento farmacológico , Infecções por Ureaplasma/epidemiologia , Infecções por Ureaplasma/urina , Ureaplasma urealyticum/efeitos dos fármacos , Ureaplasma urealyticum/genética , Ureaplasma urealyticum/isolamento & purificação , Adulto Jovem
17.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 37(6): 394-397, jun.-jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-189346

RESUMO

INTRODUCCIÓN: El objetivo de este trabajo fue analizar la susceptibilidad de Mycoplasma genitalium a macrólidos y fluoroquinolonas mediante técnicas moleculares. MÉTODOS: La susceptibilidad a macrólidos se analizó (Gipuzkoa, 2014-2017) mediante PCR en tiempo real con sondas (gen 23S ARNr) y a fluoroquinolonas mediante secuenciación tras PCR convencionales (genes parC/gyrA). RESULTADOS: Se detectaron mutaciones asociadas con resistencia a macrólidos en 43/263 (16,3%) casos y con posible resistencia a fluoroquinolonas en 21/267 (7,9%). La resistencia a macrólidos fue más frecuente tras tratamiento previo con azitromicina (76,5 vs. 7,4%; p < 0,001) y con la pauta única de 1 g (31,3 vs. 7% pauta ampliada, p < 0,001). Se detectaron 5/245 (2%) casos con mutaciones de posible resistencia para ambos antibióticos. CONCLUSIONES: La técnica empleada para el estudio de la susceptibilidad de Mycoplasma genitalium a la azitromicina permitió una respuesta rápida con un tratamiento antibiótico dirigido. Moxifloxacino puede ser una buena alternativa en casos con resistencia a macrólidos


INTRODUCTION: The objective of this study was to analyse the susceptibility of Mycoplasma genitalium to macrolides and fluoroquinolones using molecular techniques. METHODS: Susceptibility to macrolides was tested (Gipuzkoa, 2014-2017) by a rapid probe-based real-time polymerase chain reaction assay (23S rRNA gene) and to fluoroquinolones by sequencing the parC and gyrA genes. RESULTS: Mutations associated with macrolide resistance were detected in 43/263 (16.3%) cases and potential fluoroquinolone resistance in 21/267 (7.9%). Macrolide resistance was more frequent in patients previously treated with azithromycin (76.5% vs 7.4%, P < .001) as well as in those treated with a single 1g dose (31.3%) vs the extended regimen (7%, P < .001). There were 5/245 (2%) cases with mutations probably associated with resistance to both antibiotics. CONCLUSIONS: The technique used for testing Mycoplasma genitalium susceptibility to azithromycin allowed the rapid implementation of resistance-guided antibiotic therapy. Moxifloxacin could be a good option in cases of macrolide resistance


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Fluoroquinolonas/farmacocinética , Macrolídeos/farmacologia , Mycoplasma genitalium/isolamento & purificação , Infecções por Mycoplasma/tratamento farmacológico , Mutação , Antibacterianos/uso terapêutico , Macrolídeos/uso terapêutico , Mycoplasma genitalium/efeitos dos fármacos , Azitromicina/administração & dosagem , Terapia de Alvo Molecular/métodos , Técnicas Microbiológicas/métodos , Espanha/epidemiologia , Infecções por Mycoplasma/epidemiologia
18.
Emerg Infect Dis ; 25(7): 1297-1303, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31211669

RESUMO

Mycoplasma genitalium infections of the urogenital tract are usually treated with azithromycin; however, for the past several years, rates of azithromycin treatment failure have increased. To document the occurrence and frequency of macrolide resistance-mediating mutations (MRMMs) in M. genitalium infections, we collected 894 M. genitalium-positive samples during April 2014-December 2017 and retrospectively tested them for MRMMs. We designated 67 samples collected within 6 weeks after a positive result as test-of-cure samples; of these, 60 were MRMM positive. Among the remaining 827 samples, the rate of MRMM positivity rose from 22.7% in 2014 and 22.3% in 2015 to 44.4% in 2016 but decreased to 39.7% in 2017. Because of these high rates of MRMMs in M. genitalium infections, we recommend that clinicians perform tests of cure after treatment and that researchers further explore the clinical consequences of this infection.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Macrolídeos/farmacologia , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Mycoplasma genitalium/efeitos dos fármacos , Adulto , Antibacterianos/uso terapêutico , Feminino , História do Século XXI , Humanos , Macrolídeos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/história , Mycoplasma genitalium/genética , Países Baixos/epidemiologia , Vigilância em Saúde Pública , Estações do Ano , Doenças Bacterianas Sexualmente Transmissíveis/epidemiologia , Doenças Bacterianas Sexualmente Transmissíveis/microbiologia , Adulto Jovem
19.
Sex Transm Infect ; 95(5): 328-335, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31055469

RESUMO

BACKGROUND: Mycoplasma genitalium is increasingly seen as an emerging sexually transmitted pathogen, and has been likened to Chlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determine M. genitalium incidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID). METHODS: We searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies. RESULTS: We screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I2 0%). Median persistence of M. genitalium was estimated from one to three months in four studies but 15 months in one study. In 10 studies measuring M. genitalium infection status in couples, 39%-50% of male or female sexual partners of infected participants also had M. genitalium detected. In prospective studies, PID incidence was higher in women with M. genitalium than those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I2 0%, two studies). DISCUSSION: Incidence of M. genitalium in very highly developed countries is similar to that for C. trachomatis, but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections, M. genitalium is not the new chlamydia. Synthesised data about prevalence, incidence and persistence of M. genitalium infection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics of M. genitalium. REGISTRATION NUMBERS: CRD42015020420, CRD42015020405.


Assuntos
Infecções por Mycoplasma/microbiologia , Mycoplasma genitalium/isolamento & purificação , Adolescente , Adulto , Antibacterianos/administração & dosagem , Feminino , Humanos , Incidência , Masculino , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/psicologia , Mycoplasma genitalium/classificação , Mycoplasma genitalium/efeitos dos fármacos , Mycoplasma genitalium/genética , Comportamento Sexual , Parceiros Sexuais , Adulto Jovem
20.
Int J STD AIDS ; 30(5): 512-514, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30999836

RESUMO

Mycoplasma genitalium (MG) infection is a sexually transmitted infection that causes up to 25% of nongonococcal urethritis (NGU). MG strains carrying genetic markers of antimicrobial resistance that may affect treatment outcomes are increasingly recognized as a public health concern. We present two cases of persistent MG NGU with strains carrying both macrolide and quinolone resistance-associated mutations that were eradicated successfully by an extended course of minocycline.


Assuntos
Antibacterianos/uso terapêutico , Disuria/etiologia , Minociclina/uso terapêutico , Infecções por Mycoplasma/tratamento farmacológico , Mycoplasma genitalium/isolamento & purificação , Uretrite/etiologia , Adulto , Homossexualidade Masculina , Humanos , Masculino , Infecções por Mycoplasma/diagnóstico , Mycoplasma genitalium/efeitos dos fármacos , Resultado do Tratamento
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