Pleuropneumonialike Organisms: Their Effect on Chicken Chorioallantoic Membrane and Their Resistance to Antibiotics

Abstract

In view of the possible relationships between pleuropneumonialike organisms (PPLO) and nongonococcal urethritis and because of the heavy increase of the latter in Germany (Marchionini and Kockl, 1957), England (Willcox, 1958), and in other countries, the dermatologist is interested particularly in three questions among the problems dealing with the pathology and microbiology of PPLO. (1) Are any cases of urethritis and vaginitis exclusively produced by PPLO? (2) Are there any PPLO strains having primary pathogenicity for humans; which are the conditions that may give them secondary pathogenicity?( 3 ) Which is the optimal method of eliminating PPLO present in the human body?Let us consider first the question of the relationship between the PPLO and nongonococcal urethritis. We studied 443 patients, consisting of 277 men, 129 women, and 37 children for the presence of PPLO in the genitourinary tract. Serum-agar plates were used for the cultivation of the organisms. The investigations conducted on men covered 115 healthy persons without urethritis and 162 patients having diseases of the genitourinary tract. TABLE 1 shows the frequency of PPLO determinations made in the individual groups. The percentage difference of positive PPLO determinations between healthy men and those with nongonococcal urethritis is not significant.In women PPLO can be isolated from the genitourinary tract much more frequently than in men (TABLE 2).Examinations were conducted also in children (TABLE 3 ) .These clinical studies yielded the following results of particular interest: 5 cases of nongonococcal urethritis were observed in the group of men from whom neither bacteria nor PPLO could be isolated. In another case of urethritis, however, a great number of PPLO were found without the presence of any bacteria. In 6 men PPLO could be demonstrated apart from Trichomonas vaginalis.In 31 prostitutes we found T . vagirzalis in 26 per cent, and PPLO in 74 per cent of the cases. Of the 117 women examined, 16.2 per cent showed the simultaneous presence of PPLO and T . raginalis in the cervical and urethral secrction. Some women with gonorrhea also showed PPLO and T . vaginalis in the genital flora.The relatively frequent occurrence of PPLO in the female genitourinary tract seems to indicate that these organisms are probably harmless saprophytes that perhaps may be classified among the regular flora of the genitourinary tract.This opinion appears to be corroborated by the fact that PPLO, without causing any symptoms, occur in the healthy urethra of males, and that these organisms were found even in four healthy children. The high percentage of PPLO infections observed in prostitutes suggests that social and sexual-sanitary conditions may play a certain role in regard to the acquisition of PPLO. The risk of infection is likely to be increased by frequent change in sexual partners. 588