1887

Abstract

Purpose. Mycoplasma hominis is considered among the causes of urogenital infections and shows increasing resistance to fluoroquinolones. However, data regarding the fluoroquinolone resistance mechanism of M. hominis in Southwest China are limited. This study aimed to investigate gene mutations of quinolone resistance-determining regions (QRDRs) of M. hominis isolated from clinical urogenital samples in a Chinese hospital.

Methodology. Strains of M. hominis were identified by 16S rRNA gene sequencing. The minimal inhibitory concentrations (MICs) of fluoroquinolones were determined by the broth microdilution method, following CLSI guidelines. PCR was used to amplify the QRDRs of the genes gyrA, gyrB, parC and parE. Positive products were sequenced, and gene mutations and amino acid substitutions were analysed by DNAMAN software and BLAST.

Results. The resistance rates of M. hominis to ciprofloxacin (CIP), levofloxacin (LVX), moxifloxacin (MXF) and gatifloxacin (GAT) were 90.5, 85.7, 73.8 and 71.4 %, respectively. A total of 57 isolates of M. hominis were screened, among which 52 strains demonstrated different resistant phenotypes to fluoroquinolones, 41 harboured amino acid substitutions of GyrA S153L, 51 harboured ParC S91I and 22 harboured ParC K144R. ParE A463S and ParC A154T were recorded for the first time and no amino acid change was detected in GyrB.

Conclusion. The resistance of M. hominis to fluoroquinolones in Southwest China is mainly related to mutations in QRDRs of either gyrA or parC. High-level resistance is associated with mutations in both DNA gyrase and topoisomerase IV.

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2019-01-11
2019-10-19
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References

  1. Al-Sweih NA, Al-Fadli AH, Omu AE, Rotimi VO. Prevalence of Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum infections and seminal quality in infertile and fertile men in Kuwait. J Androl 2012;33:1323–1329 [CrossRef][PubMed]
    [Google Scholar]
  2. Huang C, Long X, Jing S, Fan L, Xu K et al. Ureaplasma urealyticum and Mycoplasma hominis infections and semen quality in 19,098 infertile men in China. World J Urol 2016;34:1039–1044 [CrossRef][PubMed]
    [Google Scholar]
  3. González-Jiménez MA, Villanueva-Díaz CA. Epididymal stereocilia in semen of infertile men: evidence of chronic epididymitis?. Andrologia 2006;38:26–30 [CrossRef][PubMed]
    [Google Scholar]
  4. Waites KB, Schelonka RL, Xiao L, Grigsby PL, Novy MJ. Congenital and opportunistic infections: Ureaplasma species and Mycoplasma hominis. Semin Fetal Neonatal Med 2009;14:190–199[PubMed]
    [Google Scholar]
  5. Skiljevic D, Mirkov D, Vukicevic J. Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in genital samples collected over 6 years at a Serbian university hospital. Indian J Dermatol Venereol Leprol 2016;82:37–41 [CrossRef][PubMed]
    [Google Scholar]
  6. Song T, Ye A, Xie X, Huang J, Ruan Z et al. Epidemiological investigation and antimicrobial susceptibility analysis of ureaplasma species and Mycoplasma hominis in outpatients with genital manifestations. J Clin Pathol 2014;67:817–820 [CrossRef][PubMed]
    [Google Scholar]
  7. García C, Ugalde E, Monteagudo I, Saez A, Agüero J et al. Isolation of Mycoplasma hominis in critically ill patients with pulmonary infections: clinical and microbiological analysis in an intensive care unit. Intensive Care Med 2007;33:143–147 [CrossRef][PubMed]
    [Google Scholar]
  8. Pascual A, Perez MH, Jaton K, Hafen G, di Bernardo S et al. Mycoplasma hominis necrotizing pleuropneumonia in a previously healthy adolescent. BMC Infect Dis 2010;10:335 [CrossRef][PubMed]
    [Google Scholar]
  9. Le Guern R, Loïez C, Loobuyck V, Rousse N, Courcol R et al. A new case of Mycoplasma hominis mediastinitis and sternal osteitis after cardiac surgery. Int J Infect Dis 2015;31:53–55 [CrossRef][PubMed]
    [Google Scholar]
  10. Cho H, Park KG, Han SB, Chung NG, Park YJ. First Case of Skin and Soft Tissue Infection Caused by Mycoplasma hominis in a Pediatric Immunocompromised Patient. Ann Lab Med 2017;37:346–348 [CrossRef][PubMed]
    [Google Scholar]
  11. Pailhoriès H, Rabier V, Eveillard M, Mahaza C, Joly-Guillou ML et al. A case report of Mycoplasma hominis brain abscess identified by MALDI-TOF mass spectrometry. Int J Infect Dis 2014;29:166–168 [CrossRef][PubMed]
    [Google Scholar]
  12. Zhou M, Wang P, Chen S, Du B, Du J et al. Meningitis in a Chinese adult patient caused by Mycoplasma hominis: a rare infection and literature review. BMC Infect Dis 2016;16:557 [CrossRef][PubMed]
    [Google Scholar]
  13. Capoccia R, Greub G, Baud D. Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis 2013;26:231–240 [CrossRef][PubMed]
    [Google Scholar]
  14. Wildenbeest JG, Said I, Jaeger B, van Hest RM, van de Beek D et al. Neonate with Mycoplasma hominis meningoencephalitis given moxifloxacin. Lancet Infect Dis 2016;16:e261e266 [CrossRef][PubMed]
    [Google Scholar]
  15. Hartmann M. Genital mycoplasmas. J Dtsch Dermatol Ges 2009;7:371–377 [CrossRef][PubMed]
    [Google Scholar]
  16. Pereyre S, Renaudin H, Charron A, Bébéar C, Bébéar CM. 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;57:753–756 [CrossRef][PubMed]
    [Google Scholar]
  17. Xiao L, Crabb DM, Duffy LB, Paralanov V, Glass JI et al. Chromosomal mutations responsible for fluoroquinolone resistance in Ureaplasma species in the United States. Antimicrob Agents Chemother 2012;56:2780–2783 [CrossRef][PubMed]
    [Google Scholar]
  18. Hooper DC. Bacterial topoisomerases, anti-topoisomerases, and anti-topoisomerase resistance. Clin Infect Dis 1998;27 Suppl 1:S54–S63[PubMed]
    [Google Scholar]
  19. Bébéar CM, Renaudin H, Charron A, Clerc M, Pereyre S et al. DNA gyrase and topoisomerase IV mutations in clinical isolates of Ureaplasma spp. and Mycoplasma hominis resistant to fluoroquinolones. Antimicrob Agents Chemother 2003;47:3323–3325[PubMed]
    [Google Scholar]
  20. Govender S, Gqunta K, Le Roux M, de Villiers B, Chalkley LJ. Antibiotic susceptibilities and resistance genes of Ureaplasma parvum isolated in South Africa. J Antimicrob Chemother 2012;67:2821–2824 [CrossRef][PubMed]
    [Google Scholar]
  21. Hamasuna R. Identification of treatment strategies for Mycoplasma genitalium-related urethritis in male patients by culturing and antimicrobial susceptibility testing. J Infect Chemother 2013;19:1–11 [CrossRef][PubMed]
    [Google Scholar]
  22. Ye G, Jiang Z, Wang M, Huang J, Jin G et al. The resistance analysis of Ureaplasma urealyticum and Mycoplasma hominis in female reproductive tract specimens. Cell Biochem Biophys 2014;68:207–210 [CrossRef][PubMed]
    [Google Scholar]
  23. Bebear CM, Bové JM, Bebear C, Renaudin J. Characterization of Mycoplasma hominis mutations involved in resistance to fluoroquinolones. Antimicrob Agents Chemother 1997;41:269–273[PubMed]
    [Google Scholar]
  24. Bébéar CM, Renaudin H, Charron A, Bové JM, Bébéar C et al. Alterations in topoisomerase IV and DNA gyrase in quinolone-resistant mutants of Mycoplasma hominis obtained in vitro. Antimicrob Agents Chemother 1998;42:2304–2311[PubMed]
    [Google Scholar]
  25. Bebear CM, Renaudin J, Charron A, Renaudin H, de Barbeyrac B et al. Mutations in the gyrA, parC, and parE genes associated with fluoroquinolone resistance in clinical isolates of Mycoplasma hominis. Antimicrob Agents Chemother 1999;43:954–956[PubMed]
    [Google Scholar]
  26. Gruson D, Pereyre S, Renaudin H, Charron A, Bébéar C, Be´be´ar C et al. In vitro development of resistance to six and four fluoroquinolones in Mycoplasma pneumoniae and Mycoplasma hominis, respectively. Antimicrob Agents Chemother 2005;49:1190–1193 [CrossRef][PubMed]
    [Google Scholar]
  27. Meng DY, Sun CJ, Yu JB, Ma J, Xue WC. Molecular mechanism of fluoroquinolones resistance in Mycoplasma hominis clinical isolates. Braz J Microbiol 2014;45:239–242[PubMed]
    [Google Scholar]
  28. Bosshard PP, Zbinden R, Abels S, Böddinghaus B, Altwegg M et al. 16S rRNA gene sequencing versus the API 20 NE system and the VITEK 2 ID-GNB card for identification of nonfermenting Gram-negative bacteria in the clinical laboratory. J Clin Microbiol 2006;44:1359–1366 [CrossRef][PubMed]
    [Google Scholar]
  29. CLSI Methods for Antimicrobial Susceptibility Testing for Human Mycoplasmas; Approved Guideline. CLSI document M43-A Wayne, PA: Clinical and Laboratory Standards Institute; 2011
    [Google Scholar]
  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 [CrossRef][PubMed]
    [Google Scholar]
  31. Ngan CC, Lim T, Choo CM, Toh GL, Lim YS. Susceptibility testing of Singapore strains of Mycoplasma hominis to tetracycline, gatifloxacin, moxifloxacin, ciprofloxacin, clindamycin, and azithromycin by the Etest method. Diagn Microbiol Infect Dis 2004;48:207–210 [CrossRef][PubMed]
    [Google Scholar]
  32. Samra Z, Rosenberg S, Soffer Y. In vitro susceptibility of Mycoplasma hominis clinical isolates to tetracyclines, quinolones and macrolides. Diagn Microbiol Infect Dis 2002;44:359–361[PubMed]
    [Google Scholar]
  33. Choi JB, Lee SJ, Lee MK, Lee SJ, Park DC et al. Prevalence and Antimicrobial Susceptibility of Ureaplasma spp. and Mycoplasma hominis in Asymptomatic Individuals in Korea. Microb Drug Resist 2018;24:1391–1396 [CrossRef][PubMed]
    [Google Scholar]
  34. Kong Y, Qiao Y, Song J, Ruan Z, Fei C et al. Comparative analysis of male and female populations on prevalence and antibiotic resistance of Mycoplasma hominis in China, 2005-2014. J Glob Antimicrob Resist 2016;6:69–72 [CrossRef][PubMed]
    [Google Scholar]
  35. Beeton ML, Spiller OB. Antibiotic resistance among Ureaplasma spp. isolates: cause for concern?. J Antimicrob Chemother 2017;72:330–337 [CrossRef][PubMed]
    [Google Scholar]
  36. Bebear CM, Renaudin H, Charron A, Gruson D, Lefrancois M et al. In vitro activity of trovafloxacin compared to those of five antimicrobials against mycoplasmas including Mycoplasma hominis and Ureaplasma urealyticum fluoroquinolone-resistant isolates that have been genetically characterized. Antimicrob Agents Chemother 2000;44:2557–2560[PubMed]
    [Google Scholar]
  37. Gushchin AE, Ladygina VG, Govorun VM, Taraskina AM, Savicheva AM. [Analysis of regions determining resistence to fluoroquinolones in genes gyrA and parC in clinical isolates of Mycoplasma hominis]. Mol Gen Mikrobiol Virusol 2000;4:33–35[PubMed]
    [Google Scholar]
  38. Fürnkranz U, Walochnik J, Henrich B. Mycoplasma hominis shows strain-dependent increase in resistance to selected antibiotics after symbiosis with Trichomonas vaginalis. J Glob Antimicrob Resist 2018;14:169–175 [CrossRef][PubMed]
    [Google Scholar]
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