The prevalence of Mycoplasma hominis in Outpatients at a Tertiary Care Hospital in East India

Abstract

IntroductionMycoplasma hominis (M. hominis) is the first Mycoplasma isolated from humans in the year 1937. Though regarded as a commensal of the urogenital tract, it has been implicated in various genital and extra-genital infections namely bacterial vaginosis, cervicitis, pelvic inflammatory diseases, pyelonephritis, premature rupture of the membrane in pregnancy, infertility, sepsis in newborns, etc. The pathogenesis, prevalence, and epidemiology of genital mycoplasmas in general and M. hominis in particular in Indian women have been studied very minimally. This study aimed to study the prevalence of M. hominis carriage among symptomatic and asymptomatic sexually active women attending to the outpatient department of a tertiary care hospital in East India with or without clinically suspected genitourinary infections and to compare the detection of M. hominis by polymerase chain reaction (PCR) as compared to that of culture. MethodsIn this observational study, sterile Dacron swabs were used to collect two samples each from the genitourinary tract of 110 sexually active women aged 15-45 years (80 cases and 30 control). One sample was inoculated in mycoplasma broth for culture. The other was used for PCR to detect the presence of the M. hominis gene. ResultsCulture positivity for mycoplasma was seen in 4/80 (5%) patients clinically suspected of genitourinary infection (cases) based on their presenting signs and symptoms. In those without such suspicion (control), all cultures were negative (p=0.021). PCR was positive for M. hominis in 22 (20%) samples. Considering the PCR as the gold standard the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of culture are found to be 18.18%, 100%, 100%, and 88.25% respectively. The highest prevalence of M. hominis was in the age group 20-24 years (9/24) and 50% of all detections (11/22) were among 25-29 years. Detections were more frequent among patients with multiparity, multiple sexual partners, intrauterine contraceptive devices, lower socioeconomic status, and lower educational status. ConclusionOur study results showed that the presence of M. hominis is significantly higher in cases than in the control group. The study also indicates the need for continued research on this bacterium both in patients with genital symptoms and in asymptomatic patients.

Detection of Causative Agents of Sexually Transmitted Diseases in Symptomatic Infertile Women Using Real Time Pcr Technique

“…The rate of M. hominis infection was 21% in the current study which agreed with results of Majhi et al (2022) who found that 20% of sexually active women were positive, while lower than the results of Fatlawy and Abduljabbar (2019) who found that 31.12% of the infertile women from Iraq were positive. On another hand, these results were higher than the results of Mortazavi et al (2021) in Iran who found that 7.62% of the infertile women were positive.…”

“…Similar results were reported by Majhi & Coworker (2022) and Zdrodowska -Stefanow coworker (2006) who also found the highest prevalence of M. hominis in the age group 20-24 and 26-30 years respectively. Infections with M. hominis were more frequent among patients with multiparity, multiple sexual partners, intrauterine contraceptive devices, lower socioeconomic status, and lower educational status (Majhi et a., 2022).…”

An overview regarding the relationship between Mollicutes, infertility and antibiotic resistance (Review)

“…Ureaplasmas represent a fragment of the normal commensal flora in the human genital tract, with colonization rates ranging from 60 to 80% globally. While generally harmless, Ureaplasmas have been linked to various clinical conditions, including non-gonococcal urethritis, pelvic inflammatory disease, infertility, adverse pregnancy outcomes and neonatal respiratory issues due to vertical transmission ( 2 , 4 ). The colonization of the male and female mucosal surfaces in the urogenital tracts, as well as of the neonatal respiratory tract, with Ureaplasma parvum is more common than that with Ureaplasma urealyticum .…”

“…Reproductive tract infections can induce leukocytosis in semen, trigger the release of inflammatory factors and disrupt levels of reactive oxygen species (ROS), potentially resulting in vas deferens obstruction and subsequent infertility in men ( 1 , 3 ). On the other hand, Ureaplasma and Mycoplasma hominis in women can contribute to various conditions, such as acute urethritis, bacterial vaginosis, pelvic inflammatory disease and tubal infertility ( 2 , 4 ).…”