Comparison of PCR and culture methods to determine the prevalence of Mycoplasma hominis in woman's endocervical samples referred to Infertility Center of Hamadan Fatemieh Hospital in 2016

Document Type : Original Article

Authors

1 M.Sc. Student of Medical Microbiology, Faculty of Medicine, Hamedan University of Medical Sciences, Hamadan, Iran.

2 Ph.D. of Medical Bacteriology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

3 Gynecologist, Faculty of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.

4 Ph.D. Student of Medical Bacteriology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Abstract

Introduction: The Mycoplasma Hominis bacterium lives on in the female reproductive system. Recent studies have shown that the presence of this bacterium is associated with disorders such as vaginosis, infertility, abortion and preterm labor. This study was performed with aim to determine the frequency of Mycoplasma hominis in women referred to Infertility Clinic of Hamadan Fatemieh Hospital.
Methods: This epidemiologic-descriptive study was performed on 234 patients referred to the infertility clinic of Hamadan Fatemieh Hospital in 2016. Screening was performed using swabs from the endocervix of 234 female patients who had at least one of the symptoms of vaginosis, infertility, abortion and preterm labor. The culture medium was removed by filtration and the PCR molecular technique was used to trace the 16s rRNA gene as two methods for detection of bacteria. Data was analyzed by SPSS software and McNemar's test. P<0.05 was considered significant.
Results: The frequency of Mycoplasma hominis in both methods was 13.7%. The correlation coefficient between culture and PCR methods was relatively desirable for detection of this bacterium (k=0.5). 41 patients (24.4%) with history of at least one abortion and 148 (14.2%) with vaginosis were diagnosed as positive Mycoplasma agar. The highest prevalence of Mycoplasma hominis was observed in the age range of 30-39 years.
Conclusion: Although the PCR molecular technique has high sensitivity to diagnose Mycoplasma hominis, but the modified culture method has an acceptable sensitivity to detect this bacterium.

Keywords

References

  1. Peerayeh SN, Samimi R. Detection of ureaplasma urealyticum in clinical samples from infertile women by polymerase chain reaction. Iran J Pharmacol Ther 2007; 6(1):23-6.
  2. Barbara DJ, Morton A, Clark MF, Davies DL. Immunodominant membrane proteins from two phytoplasmas in the aster yellows clade (chlorante aster yellows and clover phyllody) are highly divergent in the major hydrophilic region. Microbiology 2002; 148(1):157-67.
  3. Razin S, Yogev D, Naot Y. Molecular biology and pathogenicity of mycoplasmas. Microbiol Mol Biol Rev 1998; 62(4):1094-156.
  4. Stackebrandt SP. The prokaryotes: an evolving electronic resource for the microbiological community. New York: Defining Taxonomic Ranks Springer; 2000. P. 29-57.
  5. Stagey CM, Munday PE, Taylor‐Robinson D, Thomas BJ, Gilchrist C, Ruck F, et al. A longitudinal study of pelvic inflammatory disease. Br J Obstet Gynaecol 1997; 99(12):994-9.
  6. Peltier MR, Freeman AJ, Mu HH, Cole BC. Characterization and partial purification of a macrophage‐stimulating factor from mycoplasma hominis. Am J Reprod Immunol 2005; 54(6):342-51.
  7. Himmelreich R, Plagens H, Hilbert H, Reiner B, Herrmann R. Comparative analysis of the genomes of the bacteria Mycoplasma pneumoniae and Mycoplasma genitalium. Nucl Acids Res 1997; 25(4):701-12.
  8. Herrmann R, Reiner B. Mycoplasma pneumoniae and Mycoplasma genitalium: a comparison of two closely related bacterial species. Curr Opin Microbiol 1998; 1(5):872-9.
  9. Razin S, Jacobs E. Mycoplasma adhesion. J Gen Microbiol 1992; 138(3):407-22.
  10. Regula J, Boguth G, Görg A, Hegermann J, Mayer F, Frank R, et al. Defining the mycoplasma ‘cytoskeleton’: the protein composition of the Triton X-100 insoluble fraction of the bacterium Mycoplasma pneumoniae determined by 2-D gel electrophoresis and mass spectrometry. Microbiology 2001; 147(Pt 4):1045-57.
  11. Koutsky LA, Stamm WE, Brunham RC, Stevens C, Cole B, Hale J, et al. Persistence of Mycoplasma hominis after therapy: importance of tetracycline resistance and of coexisting vaginal flora. Sex Transm Dis 1982; 10(4 Suppl):374-81.
  12. Miyata M, Ryu WS, Berg HC. Force and velocity of Mycoplasma mobile gliding. J Bacteriol 2002; 184(7):1827-31.
  13. Barykova YA, Logunov DY, Shmarov MM, Vinarov AZ, Fiev DN, Vinarova NA, et al. Association of Mycoplasma hominis infection with prostate cancer. Oncotarget 2011; 2(4):289-97.
  14. Amirmozafari N, Mirnejad R, Kazemi B, Sariri E, Bojari MR, Darkahi FD. Comparison of polymerase chain reaction and culture for detection of genital mycoplasma in clinical samples from patients with genital infections. Saudi Med J 2009; 30(11):1401-5.
  15. Farhadifar F, Khodabandehloo M, Ramazanzadeh R, Rouhi S, Ahmadi A, Ghaderi E, et al. Survey on association between Mycoplasma hominis endocervical infection and spontaneous abortion using Polymerase Chain Reaction. Int J Reprod Biomed 2016; 14(3):181-6.
  16. Milanezi F, Falconi A, Schnabel B, Ricardi LR, Monfredini PM, Ziliotto AT, et al. Prevalence of Mycoplasma hominis and ureaplasma spp. in routine gynecological care in Sao Paulo City, Brazil. Arch Clin Infect Dis 2016; 11(3):e36668.
  17. McKechnie ML, Hillman RJ, Jones R, Lowe PC, Couldwell DL, Davies SC, et al. The prevalence of urogenital micro-organisms detected by a multiplex PCR-reverse line blot assay in women attending three sexual health clinics in Sydney, Australia. J Med Microbiol 2011; 60(7):1010-6.
  18. Jamalizadeh Bahaabadi S, Mohseni Moghadam N, Kheirkhah B, Farsinejad A, Habibzadeh V. Isolation and molecular identification of Mycoplasma hominis in infertile female and male reproductive system. Nephrourol Mon 2014; 6(6):e22390.
  19. Yoshida T, Maeda S, Deguchi T, Ishiko H. Phylogeny-based rapid identification of mycoplasmas and ureaplasmas from urethritis patients. J Clin Microbiol 2002; 40(1):105-10.
  20. Schlicht MJ, Lovrich SD, Sartin JS, Karpinsky P, Callister SM, Agger WA. High prevalence of genital mycoplasmas among sexually active young adults with urethritis or cervicitis symptoms in La Crosse, Wisconsin. J Clin Microbiol 2004; 42(10):4636-40.
  21. Ramazanzadeh R, Khodabandehloo M, Farhadifar F, Rouhi S, Ahmadi A, Menbari S, et al. A case–control study on the relationship between Mycoplasma genitalium infection in women with normal pregnancy and spontaneous abortion using polymerase chain reaction. Osong Public Health Res Perspect 2016; 7(5):334-8.
  22. Pascual A, Jaton K, Ninet B, Bille J, Greub G. New diagnostic real-time PCR for specific detection of Mycoplasma hominis DNA. Int J Microbiol 2010; 2010:317512. 
  23. Taylor‐Robinson D, Lamont RF. Mycoplasmas in pregnancy. BJOG 2011; 118(2):164-74.
  24. Phillips L, Goodrich KH, Turner RM, Faro S. Isolation of Mycoplasma species and ureaplasma urealyticum from obstetrical and gynecological patients by using commercially available medium formulations. J Clin Microbiol 1984; 24(3):337-9.
  25. Zhang Q, Wise KS. Molecular basis of size and antigenic variation of a Mycoplasma hominis adhesin encoded by divergent vaa genes. Infect Immun 1996; 64(7):2737-44.
  26. Ladefoged SA, Christiansen G. Mycoplasma hominis expresses two variants of a cell-surface protein, one a lipoprotein, and one not. Microbiology 1998; 144(Pt 3):761-70.
  27. Cultrera R, Roulland-Dussoix D, Romani R, Contini C. Use of PCR to detect mycoplasma DNA in respiratory tract specimens from adult HIV-positive patients. J Med Microbiol 1998; 47(11):983-6.
  28. Yoshida T, Maeda SI, Deguchi T, Miyazawa T, Ishiko H. Rapid detection of Mycoplasma genitalium, Mycoplasma hominis, ureaplasma parvum, and ureaplasma urealyticum organisms in genitourinary samples by PCR-microtiter plate hybridization assay. J Clin Microbiol 2003; 41(5):1850-5.
  29. Andrade-Rocha FT. Ureaplasma urealyticum and Mycoplasma hominis in men attending for routine semen analysis. Prevalence, incidence by age and clinical settings, influence on sperm characteristics, relationship with the leukocyte count and clinical value. Urol Int 2002; 71(4):377-81.
  30. Luki N, Lebel P, Boucher M, Doray B, Turgeon J, Brousseau R. Comparison of polymerase chain reaction assay with culture for detection of genital mycoplasmas in perinatal infections. Eur J Clin Microbiol Infect Dis 1998; 17(4):255-63.
  31. Vojdani A, Franco AR. Multiplex PCR for the detection of mycoplasma fermentans, m. hominis, and m. penetrans in patients with chronic fatigue syndrome, fibromyalgia, rheumatoid arthritis, and Gulf War syndrome. J Chron Fatigue Syndrome 1999; 5(3-4):187-97.
  32. Mygind T, Zeuthen Søgaard I, Melkova R, Boesen T, Birkelund S, Christiansen G. Cloning, sequencing and variability analysis of the gap gene from Mycoplasma hominis. FEMS Microbiol Lett 2000; 183(1):15-21.
  33. Mygind T, Birkelund S, Christiansen G. DNA sequencing reveals limited heterogeneity in the 16S rRNA gene from the rrnB operon among five Mycoplasma hominis isolates. Int J Syst Bacteriol 1998; 48(Pt 3):1067-71.
  34. Fenkci V, Yilmazer M, Aktepe OC. Have Ureaplasma urealyticum and Mycoplasma hominis infections any significant effect on women fertility? Infez Med 2002; 10(4):220-3.
  35. Peerayeh SN, Samimi R. Comparison of culture with the polymerase chain reaction for detection of gennital Mycoplasma. Eur J Gen Med 2008; 5:107-11.
  36. Farahani MT, Hoseini F, Minai-Tehrani A, Novin MG. The effect of infection with genital Mycoplasma hominis and the presence of antisperm antibodies in Iranian women with unexplained infertility. Int J Womens Health Reprod Sci 2016; 4(1):18-22.
  37. Amirmozafari N, Jeddi F, Masjedian F, Haghighi L. Prevalence of Mycoplasma hominis and Ureaplasma urealyticum in genital tract infections. Razi J Med Sci 2009; 15(60):19-25. (Persian). 
  38. Casari E, Ferrario A, Morenghi E, Montanelli A. Gardnerella, Trichomonas vaginalis, Candida, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum in the genital discharge of symptomatic fertile and asymptomatic infertile women. New Microbiol 2010; 33(1):69-76.
  39. Petrikkos GL, Hadjisoteriou M, Daikos GL. PCR versus culture in the detection of vaginal Ureaplasma urealyticum and Mycoplasma hominis. Int J Gynecol Obstet 2007; 97(3):202-3.
  40. Zheng X, Olson DA, Tully JG, Watson HL, Cassell GH, Gustafson DR, et al. Isolation of Mycoplasma hominis from a brain abscess. J Clin Microbiol 1997; 35(4):992-4.
  41. Clegg A, Passey M, Yoannes M, Michael A. High rates of genital mycoplasma infection in the highlands of Papua New Guinea determined both by culture and by a commercial detection kit. J Clin Microbiol 1997; 35(1):197-200.
  42. Odendaal HJ, Popov I, Schoeman J, Grove D. Preterm labour--is Mycoplasma hominis involved? South Afr Med J 2002; 92(3):235-7.
  43. Paul VK, Gupta U, Singh M, Nag VL, Takkar D, Bhan MK. Association of genital mycoplasma colonization with low birth weight. Int J Gynecolo Obstet 1998; 63(2):109-14.
  44. Chua KB, Ngeow YF, Ng KB, Chye JK, Lim CT. Ureaplasma urealyticum and Mycoplasma hominis isolation from cervical secretions of pregnant women and nasopharyngeal secretions of their babies at delivery. Singapore Med J 1998; 39(7):300-2.
  45. Abdel-Haq N, Asmar B, Brown W. Mycoplasma hominis scalp abscess in the newborn. Pediatr Infect Dis J 2002; 21(12):1171-3.
  46. Zheng X, Teng LJ, Watson HL, Glass JI, Blanchard A, Cassell GH. Small repeating units within the Ureaplasma urealyticum MB antigen gene encode serovar specificity and are associated with antigen size variation. Infect Immun 1995; 63(3):891-8.
  47. Capoccia R, Greub G, Baud D. Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis 2013; 26(3):231-40.
  48. Yeganeh O, Jeddi-Tehrani M, Yaghmaie F, Kamali K, Heidari-Vala H, Zeraati H, et al. A survey on the prevalence of Chlamydia trachomatis and Mycoplasma genitalium infections in symptomatic and asymptomatic men referring to urology clinic of Labbafinejad Hospital, Tehran, Iran. Iran Red Crescent Med J 2013; 15(4):340-4.

Zdrodowska-Stefanow B, Kłosowska WM, Ostaszewska-Puchalska I, Bułhak-Kozioł V, Kotowicz B. Ureaplasma urealyticum and Mycoplasma hominis infection in women with urogenital diseases. Adv Med Sci 2006; 51(1):250-3.

The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 20, Issue 11
January 2018
Pages 83-92

Files

Share

How to cite

Statistics