Maternal Intravenous Treatment with either Azithromycin or Solithromycin Clears Ureaplasma parvum from the Amniotic Fluid in an Ovine Model of Intrauterine Infection

Miura, Yoshio; Payne, Matthew S.; Keelan, Jeffrey A.; Noé, Andrés; Carter, Sean; Watts, Rory; Spiller, O. Brad; Jobe, Alan H.; Kallapur, Suhas G.; Saito, Masatoshi; Stock, Sarah; Newnham, John P.; Kemp, Matthew W.

doi:10.1128/aac.03187-14

Cited by 43 publications

(40 citation statements)

References 56 publications

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“…In pregnant sheep, a single intra-amniotic injection of azithromycin achieved therapeutic concentrations that were sustained for 48 h; however, there was poor maternal-fetal transfer (296). Despite this, a single maternal intravenous azithromycin injection or a single maternal intravenous azithromycin injection combined with an intra-amniotic azithromycin injection completely eradicated an established U. parvum infection from the amniotic fluid, chorioamnion, and fetal lung in pregnant sheep (299). Similarly, studies in rhesus macaques demonstrated that maternal intravenous azithromycin (25 mg/kg/day for 10 days) administered 6 to 8 days after intra-amniotic U. parvum inoculation successfully eradicated Ureaplasma from the amniotic fluid (300,301).…”

Section: Treatment Of Ureaplasma Chorioamnionitis and Therapeutic Conmentioning

confidence: 99%

“…In vitro, solithromycin has potent activity against human clinical Ureaplasma isolates (303,304), in addition to a range of other important pathogens (305)(306)(307)(308)(309). Both maternal intravenous solithromycin and maternal intravenous solithromycin combined with intra-amniotic solithromycin effectively eradicated U. parvum from the amniotic cavity of pregnant sheep but, similarly to azithromycin, failed to reduce inflammation of the chorioamnion and fetal lung (299). These findings suggest that solithromycin may not accumulate in high-enough concentrations to exert anti-inflammatory effects and that coadministration of immune modulators should be investigated.…”

Section: Treatment Of Ureaplasma Chorioamnionitis and Therapeutic Conmentioning

confidence: 99%

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The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

et al. 2017

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SUMMARY The human Ureaplasma species are the most frequently isolated microorganisms from the amniotic fluid and placentae of women who deliver preterm and are also associated with spontaneous abortions or miscarriages, neonatal respiratory diseases, and chorioamnionitis. Despite the fact that these microorganisms have been habitually found within placentae of pregnancies with chorioamnionitis, the role of Ureaplasma species as a causative agent has not been satisfactorily explained. There is also controversy surrounding their role in disease, particularly as not all women infected with Ureaplasma spp. develop chorioamnionitis. In this review, we provide evidence that Ureaplasma spp. are associated with diseases of pregnancy and discuss recent findings which demonstrate that Ureaplasma spp. are associated with chorioamnionitis, regardless of gestational age at the time of delivery. Here, we also discuss the proposed major virulence factors of Ureaplasma spp., with a focus on the multiple-banded antigen (MBA), which may facilitate modulation/alteration of the host immune response and potentially explain why only subpopulations of infected women experience adverse pregnancy outcomes. The information presented within this review confirms that Ureaplasma spp. are not simply “innocent bystanders” in disease and highlights that these microorganisms are an often underestimated pathogen of pregnancy.

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Section: Treatment Of Ureaplasma Chorioamnionitis and Therapeutic Conmentioning

confidence: 99%

Section: Treatment Of Ureaplasma Chorioamnionitis and Therapeutic Conmentioning

confidence: 99%

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

et al. 2017

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“…A n t i m i c r o b i a l s u s c e p t i b i l i t y t e s t i n g w a s performed against eight antimicrobial agents that included fluoroquinolones, macrolides, TETs and aminoglycosides, as shown in Table 1 [2,10]. Each antimicrobial agent was prepared according to the manufacturers' instructions at a stock concentration of 250 mg/5 mL.…”

Section: Experimental Antimicrobial Agentsmentioning

confidence: 99%

“…U. parvum had higher mutation rate than conventional bacteria which meant it could rapidly develop resistance to drugs including quinolone, ERY and AZM. Resistance developed in U. parvum by point mutation in parC (Pro-57 Leu), and two novel mutations in parE (Ile-73Thr and a methionine insertion at codon 86) were found in an ofloxacin-resistant strain [9,10,15].…”

Section: Introductionmentioning

confidence: 99%

Susceptibility and Antimicrobial Resistance of Genital Ureaplasma Parvum

Al-Khafaji¹

2017

Nano BioMed ENG

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The object of this study concentrated on investigating the antimicrobial susceptibilities of Ureaplasma parvum isolates to determine the most suitable antibiotic for treating the infection. In total, 35 samples of Ureaplasma parvum isolates were included in this study. Antibiotic susceptibility was studied by broth dilution method which was for the purpose of susceptibility testing of serovar isolates of Ureaplasma parvum against eight antibiotics. The results revealed the serovar 3 isolates were fully resistant (100%) to gentamicin, azithromycin and erythromycin while susceptible at the rates of 80% to doxycycline, 60% to levofloxacin and 60% to clarithromycin. Serovar 14 isolate was revealed fully susceptible (100%) to clarithromycin, ciprofloxacin and doxycycline, while fully resistant (100%) to gentamicin and azithromycin. Serovar 1 and serovar 6 were showed to be fully resistant (100%) to azithromycin and gentamicin. Sevorar 1 was susceptible to at the rates of 70% to doxycycline, 60% to tetracycline, 90% to ciprofloxacin, 70% to levofloxacin, 70% to erythromycin and 70% to clarithromycin. Serovar 6 was susceptible at the rates of 80% to doxycycline, 100% to tetracycline, 100% to ciprofloxacin, 80% to levofloxacin, 80% to erythromycin and 80% to clarithromycin. These results evidently demonstrated that doxycycline, clarithromycin and levofloxacin should be the preferred drug when empirical treatment was required.

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“…tested were sensitive to solithromycin, indicating its promise as an agent for treating intra uterine infections. However, it has not yet been administered in pregnancy and the necessary safety studies in pregnant women have not been conducted 25,30,31) .…”

Section: Ureaplasma and Diagnosismentioning

confidence: 99%

Bronchopulmonary Dysplasia andUreaplasma: What Do We Know So Far?

Haye

Hütten²,

Kunzmann

et al. 2017

Neonatal Med

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Bronchopulmonary dysplasia (BPD) is the most common morbidity of prematurity. BPD is a chronic respiratory disease related to lung-injury during the primary course of critical lung disease such as respiratory distress syndrome or when abnormal development of the preterm lung occurs. Abnormal lung development not only results from primary lung injury in the first days after birth, but also secondary injury through abnormal repair resulting in arrested and abnormal alveolarization, fibrosis and pulmonary vascular dysgenesis. Chorioamnionitis is a risk factor that plays an important role in the development of BPD. Ureaplasma subspecies (spp.) are the most common isolated organisms from chorioamniotic tissue after premature births. Therefore Ureaplasma spp. appear to play an important role in the development of BPD, and treatment or prophylactic treatment of these infections or coloni zation may reduce the incidence, morbidity and mortality of BPD. Ureaplasma spp. infections are challenging not only to treat, but also to diagnosis in a timely manner. This review summarizes the current state of treatment and new developments in the treatment of Ureaplasma exposure in premature infants.

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Maternal Intravenous Treatment with either Azithromycin or Solithromycin Clears Ureaplasma parvum from the Amniotic Fluid in an Ovine Model of Intrauterine Infection

Cited by 43 publications

References 56 publications

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

The Human Ureaplasma Species as Causative Agents of Chorioamnionitis

Susceptibility and Antimicrobial Resistance of Genital Ureaplasma Parvum

Bronchopulmonary Dysplasia andUreaplasma: What Do We Know So Far?

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