Výskyt Mycoplasma hominis a  Ureaplasma urealyticum u žen s poruchou fertility

Výskyt Mycoplasma hominis a  Ureaplasma urealyticum u žen s poruchou fertility

Cíle:
Mycoplasma hominis a Ureaplasma urealyticum jsou podmíněně patogenní mikroorganismy, které se frekventovaně vyskytují v urogenitálním ústrojí žen. Uvedené bakteriální druhy mohou způsobovat infekce urogenitálního traktu a jsou rovněž spojovány s nepříznivým vlivem na průběh těhotenství, případně s lidskou neplodností. Cílem této práce bylo zjistit četnost výskytu M. hominis a U. urealyticum u žen z asistované reprodukce ve srovnání s kontrolní skupinou plodných žen.

Metody:
Průkaz mykoplazmat v cervikálních stěrech byl prováděn kultivačním vyšetřením a polymerázovou řetězovou reakcí. U izolovaných kmenů byla následně ověřena mikrodiluční bujónovou metodou jejich citlivost k azithromycinu, ciprofloxacinu, doxycyklinu a erythromycinu.

Výsledky:
Celkově bylo vyšetřeno 111 žen s poruchou reprodukční funkce. U. urealyticum bylo prokázáno ve stěrech 44 žen (39,6 %). Výskyt M. hominis byl zaznamenán pouze u 9 žen (8,1 %). Z tohoto počtu bylo 6 žen (5,4 %) pozitivních na přítomnost obou bakteriálních druhů. Kontrolní skupinu tvořilo 23 žen. Přítomnost U. urealyticum byla detekována u 8 žen (34,7 %). M. hominis bylo detekováno pouze ve směsi s U. urealyticum, a to ve 3 případech (13,0 %). Nejvyšší inhibiční aktivita na oba testované druhy byla pozorována u doxycyklinu.

Závěr:
Výsledky ukazují na vyšší incidenci M. hominis a U. urealyticum v genitálním traktu žen s problémy v reprodukci ve srovnání s kontrolní skupinou. Potenciální negativní efekt na reprodukční schopnost žen nebyl pozorován.

KLÍČOVÁ SLOVA:
mykoplazmata – ureaplazmata – ženy – neplodnost – asistovaná reprodukce

Autoři: R. Sleha ^1,2; V. Boštíková ¹ ; R. Hampl ³; M. Salavec ⁴; P. Halada ⁵; Martin Štěpán ⁵ ; Š. Novotná ³; R. Kukla ² ; E. Slehová ²; M. Kacerovský ⁵; P. Boštík ⁶
Působiště autorů: University of Defence, Faculty of Military Health Sciences, Department of Epidemiology, Hradec Kralove, Czech Republic ¹; University of Pardubice, Faculty of Chemical-Technology, Department of Biology and Biochemistry, Pardubice, Czech Republic ²; The Centre of Assisted Reproduction SANUS, Pardubice, Czech Republic ³; Department of Dermatovenereology, Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic ⁴; University Hospital, Department of Obstetrics and Gyneacology, Hradec Kralove, Czech Republic ⁵; University of Defence, Faculty of Military Health Sciences, The Centre of Advanced Studies, Hradec Kralove, Czech Republic ⁶
Vyšlo v časopise: Epidemiol. Mikrobiol. Imunol. 65, 2016, č. 4, s. 232-237
Kategorie: Původní práce

Souhrn

KLÍČOVÁ SLOVA:
mykoplazmata – ureaplazmata – ženy – neplodnost – asistovaná reprodukce

Zdroje

1. Keane FE, Thomas BJ, Gilroy CB, et al. The association of Mycoplasma hominis, Ureaplasma urealyticum and Mycoplasma genitalium with bacterial vaginosis: observations on heterosexual women and their male partners. Int J STD AIDS, 2000; 11(6): 356–360.

2. Horner P, Thomas B, Gilroy CB, et al. Role of Mycoplasma genita-lium and Ureaplasma urealyticum in acute and chronic nongonococcal urethritis. Clin Infect Dis, 2001; 32(7): 995–1003.

3. Taylor-Robinson D, Jensen JS, Svenstrup H, et al. Difficulties experienced in defining the microbial cause of pelvic inflammatory disease. Int J STD AIDS, 2012; 23(1): 18–24.

4. Witt A, Berger A, Gruber CJ, et al. Increased intrauterine frequency of Ureaplasma urealyticum in women with preterm labor and preterm premature rupture of the membranes and subsequent cesarean delivery. Am J Obstet Gynecol, 2005; 193(5): 1663–1669.

5. Kacerovsky M, Baudys L. Preterm premature rupture of membranes and Ureaplasma urealyticum. Ceska gynekol, 2008; 73(3): 154–159.

6. Larsen B, Hwang J. Mycoplasma, ureaplasma and adverse pregnancy outcomes: A fresh look. Inf Dis Obstet Gynecol, 2010; ID 521921.

7. Kwak DW, Hwang HS, Kwon JY, et al. Co-infection with vaginal Ureaplasma urealyticum and Mycoplasma hominis increases adverse pregnancy outcomes in patients with preterm labor or preterm premature rupture of membranes. J Mat Fet NeoMed, 2014; 27(4): 333–337.

8. Egawa T, Morioka I, Morisawa T, et al. Ureaplasma urealyticum and Mycoplasma hominis presence in umbilical cord is associated with pathogenesis of funisitis. Kobe J Med Sci, 2007; 53(5): 241–249.

9. Jobe AH. Effects of Chorioamnionitis on the Fetal Lung. Clin Perinatol, 2012; 39(3): 441–457.

10. Gwee A, Chinnappan M, Starr M, et al. Ureaplasma meningitis and subdural collections in a neonate. Pediatr Infect Dis J, 2013; 32(9): 1043–1044.

11. Rao R, Ghanayem N, Kaufman B, et al. Mycoplasma hominis and Ureaplasma species brain abscess in a neonate. Pediatr Infect Dis J, 2002; 21(11): 1083–1085.

12. Koshiba H, Koshiba A, Daimon Y, et al. Hematoma and abscess formation caused by Mycoplasma hominis following cesarean section. Int J Womens Health, 2011; 3: 15–18.

13. Michou V, Constantoulakis P, Makarounis K, et al. Molecular investigation of menstrual tissue for the presence of Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma hominis collected by women with a history of infertility. J Obstet Gynaecol Res, 2014; 40(1): 237–242.

14. Witkin SS, Kligman I, Grifo JA, et al. Ureaplasma urealyticum and Mycoplasma hominis detected by the polymerase chain reaction in the cervices of women undergoing in vitro fertilisation: prevalence and consequences. J Assist Reprod Gen, 1995; 12(9): 610–614.

15. Redelinghuys MJ, Ehlers MM, Dreyer AW, et al. Antimicrobial susceptibility patterns of Ureaplasma species and Mycoplasma hominis in pregnant women. BMC Infect Dis, 2014; 14: 171.

16. Naher HS, Said IH. Culturing and PCR Methods for detection of Mycoplasma hominis and Ureaplasma urealyticum in women with genitourinary tract infections. Int Res J Medical Sci, 2013; 1(3): 25–29.

17. Pascual A, Jaton K, Ninet B, et al. New diagnostic Real-Time PCR for specific detection of Mycoplasma hominis DNA. Int J Microbiol, 2010; pii:317512.

18. Bayraktar MR, Ozerol IH, Gucluer N, et al. Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women. J Infect Dis, 2009; 14: 90–95.

19. Waites KB, Duffy LB, Bébéar CM, et al. Standardized methods and quality control limits for agar and broth microdilution susceptibility testing of Mycoplasma pneumoniae, Mycoplasma hominis, and Ureaplasma urealyticum. J Clin Microbiol, 2012; 50(11): 3542–3547.

20. Beeton ML, Chalker VJ, Maxwell NC, et al. Concurrent titration and determination of antibiotic resistance in ureaplasma species with identification of novel point mutations in genes associated with resistance. Antimicrob Agents Chemother, 2009; 53(5): 2020–2027.

21. Blanchard A, Yanez K, Dybvig HL, et al. Evaluation of intraspecies genetic variation within the 16S rRNA gene of Mycoplasma hominis and detection by polymerase chain reaction. J Clin Microbiol, 1993; 31: 1358–1361.

22. Blanchard A, Hentschel J, Duffy L, et al. Detection of Ureaplasma urealyticum by polymerase chain reaction in the urogenital tract of adults, in amniotic fluid, and in the respiratory tract of newborns. Clin Infect Dis, 1993;17(Suppl. 1): S148–153.

23. Lee JS, Kim KT, Lee HS, et al. Concordance of Ureaplasma urealy-ticum and Mycoplasma hominis in infertile couples: Impact on semen parameters. Urology, 2013; 81(6): 1219–1224.

24. Zdrodowska-Stefanow B, Klosowska WM, Ostaszewska-Puchalska I, et al. Ureaplasma urealyticum and Mycoplasma hominis infection in women with urogenital diseases. Adv Med Sci, 2006; 51: 250–253.

25. Casari E, Ferrario A, Morenghi E, et al. Gardnerella, Trichomonas vaginalis, Candida, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in the genital discharge of symptomatic fertile and asymptomatic infertile women. New Microbiol, 2010; 33(1): 69–76.

26. Witkin SS, Kligman I, Grifo JA, et al. Ureaplasma urealyticum and Mycoplasma hominis detected by the polymerase chain reaction in the cervices of women undergoing in vitro fertilization: prevalence and consequences. J Assist Reprod Genet, 1995; 12(9): 610–614.

27. Roberts MC, Koutsky LA, Holmes KK, et al. Tetracycline-resistant Mycoplasma hominis strains contain streptococcal tetM sequences. Antimicrob Agents Chemother, 1985; 28(1): 141–143.

28. Cummings MC, McCormack WM. Increase in resistance of Mycoplasma hominis to tetracyclines. Antimicrob Agents Chemother, 1990; 34: 2297–2299.

29. Dégrange S, Renaudin H, Charron A, et al. Tetracycline resistance in Ureaplasma spp. and Mycoplasma hominis: Prevalence in Bordeaux, France, from 1999 to 2002 and description of two tet(M)-positive isolates of M. hominis susceptible to tetracyclines. Antimicrob Agents Chemother, 2008; 52(2): 742–744.

30. Krausse R, Schubert S. In-vitro activities of tetracyclines, macrolides, fluoroquinolones and clindamycin against Mycoplasma hominis and Ureaplasma ssp. isolated in Germany over 20 years. Clin Microbiol Infect, 2010; 16: 1649–1655.

31. Gruson D, Pereyre S, Renaudin H, et al. In vitro development of resistance to six and four fluoroquinolones in Mycoplasma pneumoniae and Mycoplasma hominis, respectively. Antimicrob Agents Chemother, 2005; 49(3): 1190–1193.

32. Pereyre S, Renaudin H, Charron A, et al. Emergence of a 23S rRNA mutation in Mycoplasma hominis associated with a loss of the intrinsic resistance to erythromycin and azithromycin. J Antimicrob Chemother, 2006; 57(4): 753–756.