Detection and Evaluation of Macrolide Resistance (Erythromycin) in Mycoplasma hominis Isolated from Endocervical Specimens of Patients Referring to Ibn Sina Infertility Treatment Centre, Tehran, Iran

Document Type : Original Article

Authors

1 Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran

2 Nanobiotechnology Research Centre, Iranian Academic Centre for Education, Culture and Research, Tehran, Iran

Abstract

Background: Mycoplasma hominis (M. hominis) is an important cause of bacterial infections of the genital tract. Macrolides are the first selective agents used to treat mycoplasma infections. However, widespread use of macrolides has led to a rapid and global emergence of macrolide-resistant strains. We evaluated macrolide resistance in M. hominis
isolated from endocervical specimens of patients who referred to Ibn Sina Infertility Centre in Tehran, Iran.
Materials and Methods: In this cross-sectional descriptive-analytical study, 160 samples of Dacron endocervix  swabs (80 infertile patient samples and 80 healthy controls) were collected and transferred to the laboratory. All samples were cultured in liquid pleuropneumonia-like organisms (PPLO) broth and PPLO agar solid media. After culturing and genome extraction, polymerase chain reaction (PCR) was performed using specific primers. Then, minimum inhibitory concentration (MIC) was obtained using the broth microdilution method. The MIC was recorded and reported for all samples positive for M. hominis against erythromycin.
Results: From the 160 endocervical specimens cultured in PPLO agar medium, 19 cases (23.75%) were positive. A total 
of 35 cases (42.5%) were positive using specific primers of M. hominis species. MIC results from all samples positive for 
M. hominis were measured against erythromycin. All of the M. hominis samples were resistant to erythromycin.
Conclusion: The results of the present study showed that a significant percentage of infertile women were infected 
with M. hominis. Also, MIC results from the broth microdilution method indicated that all strains positive for M. hominis were also resistant to erythromycin.

Keywords

References

1. Maldonado-Arriaga B, Escobar-Escamilla N, Pérez-Razo JC, Alcaráz-Estrada SL, Flores-Sánchez I, Moreno-García D, et al. Mollicutes antibiotic resistance profile and presence of genital abnormalities in couples attending an infertility clinic. J Int Med Res. 2020; 48(1): 300060519828945.
2. Babaei Z, Pouladi I, Ashtari A, Azimi G, Niakan M. The prevalence of atypical pneumonia caused by mycoplasma pneumoniae (P1 gene) in patients with respiratory infections by culture and molecular PCR methods in Tehran, Iran. Jundishapur J Microbiol. 2019; 12(11): e84174.
3. Valentine-King MA, Brown MB. Antibacterial resistance in ureaplasma species and mycoplasma hominis isolates from urine cultures in college-aged females. Antimicrob Agents Chemother. 2017; 61(10): e01104-17. 
4. Yang T, Pan L, Wu N, Wang L, Liu Z, Kong Y, et al. Antimicrobial resistance in clinical ureaplasma spp. and mycoplasma hominis and structural mechanisms underlying quinolone resistance. Antimicrob Agents Chemother. 2020; 64(6): e02560-19. 
5. Ozturk S, Yildiz S, Dursun P, Yener Ilce B, Kaymaz O. Mycoplasma hominis profile in women: culture, kit, molecular diagnosis, antimicrobial resistance, and treatment. Microb Pathog. 2019; 135: 103635.
6. Bayraktar MR, Ozerol IH, Gucluer N, Celik O. Prevalence and antibiotic susceptibility of mycoplasma hominis and ureaplasma urealyticum in pregnant women. Int J Infect Dis. 2010; 14(2): e90-e95.
7. Choi JB, Lee SJ, Lee MK, Lee SJ, Park DC, Kim HY, et al. Prevalence and antimicrobial susceptibility of ureaplasma spp. and mycoplasma hominis in asymptomatic individuals in Korea. Microb Drug Resist. 2018; 24(9): 1391-1396. 
8. Lee JY, Yang JS. Prevalence and antimicrobial susceptibility of mycoplasma hominis and ureaplasma species in nonpregnant female patients in South Korea indicate an increasing trend of pristinamycin-resistant isolates. Antimicrob Agents Chemother. 2020; 64(10): e01065-20.
9. Maraki S, Mavromanolaki VE, Nioti E, Stafylaki D, Minadakis G. Prevalence and antimicrobial susceptibility of ureaplasma species and mycoplasma hominis in greek female outpatients, 2012-2016. J Chemother. 2018; 30(3): 140-144. 
10. Zhu X, Li M, Cao H, Yang X, Zhang C. Epidemiology of ureaplasma urealyticum and mycoplasma hominis in the semen of male outpatients with reproductive disorders. Exp Ther Med. 2016; 12(2): 1165-1170.
11. Boujemaa S, Mlik B, Mardassi H, Ben Abdelmoumen Mardassi B. Clonal spread of tetracycline resistance among mycoplasma hominis clinical strains, Tunisia. Infect Drug Resist. 2020; 13: 2093-2097. 
12. Big Mohammadi H, Pouladi I, Zolfaghari MR, Niakan M. The prevalence of 23S rRNA mutations in ML-resistant M. pneumoniae isolates to clarithromycin in patients with respiratory infections. Rep Biochem Mol Biol. 2020; 9(2): 156-162. 
13. Pouladi I, Mirnejad R, Rostampur S, Viesy S, Niakan M. Molecular detection and evaluation of MLـ resistance M. pneumoniae associated with mutation in 23S RNA gene among Iranian patients with respiratory infections. Rep Biochem Mol Biol. 2020; 9(2): 223-229.
14. Seifoleslami M, Safari A, Khayyat Khameneie M. Prevalence of ureaplasma urealyticum and mycoplasma hominis in high vaginal swab samples of infertile females. IRCMJ. 2015; 17(12): e16823. 
15. Amirmozaffari N, Ahmadi MH, Gilani MAS, Kazemi BA, Masjedian Jazi F. Detection of mycoplasma hominis and ureaplasma urealyticum from semen samples of infertile men referred to royan institute in 2008. RJMS. 2010; 17(71): 14-26.
16. Pereyre S, Gonzalez P, De Barbeyrac B, Darnige A, Renaudin H, Charron A, et al. Mutations in 23S rRNA account for intrinsic resistance to macrolides in mycoplasma hominis and Mycoplasma fermentans and for acquired resistance to macrolides in M. hominis. Antimicrob Agents Chemother. 2002; 46(10): 3142-3150.
17. Furneri PM, Rappazzo G, Musumarra MP, Di Pietro P, Catania LS, Roccasalva LS. Two new point mutations at A2062 associated with resistance to 16-membered macrolide antibiotics in mutant strains of Mycoplasma hominis. Antimicrob Agents Chemother. 2001; 45(10): 2958-2960. 
18. Vosooghi S, Kheirkhah B, Kariminik A, Mirshekari TR. A review of the role of mycoplasma infections in humans' infertility. NCMB. 2012; 2(8): 9-20.
19. Jang YS, Min JW, Kim YS. Positive culture rate and antimicrobial susceptibilities of mycoplasma hominis and ureaplasma urealyticum. Obstet Gynecol Sci. 2019; 62(2): 127-133.
20. Petrikkos GL, Hadjisoteriou M, Daikos GL. PCR versus culture in the detection of vaginal ureaplasma urealyticum and mycoplasma hominis. Int J Gynaecol Obstet. 2007; 97(3): 202-203. 
21. Wang QY, Li RH, Zheng LQ, Shang XH. Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and 
Mycoplasma hominis in female outpatients, 2009-2013. J Microbiol Immunol Infect. 2016; 49(3): 359-362. 
22. Zhou YH, Ma HX, Yang Y, Gu WM. Prevalence and antimicrobial resistance of ureaplasma spp. and mycoplasma hominis isolated from semen samples of infertile men in Shanghai, China from 2011 to 2016. Eur J Clin Microbiol Infect Dis. 2018; 37(4): 729-734.
23. Doroftei B, Ilie OD, Armeanu T, Anton E, Scripcariu I, Maftei R. The prevalence of ureaplasma urealyticum and mycoplasma hominis infections in infertile patients in the northeast region of Romania. 
Medicina (Kaunas). 2021; 57(3): 211.

Files

Share

How to cite

Statistics