Mycoplasma hominis infection

Micoplasma hominis infection
Classification and external resources
ICD-10	P23.6, A63.8, A49.3
eMedicine	med/2340
MeSH	D016869

Micoplasma hominis infection is caused by the bacteria Mycoplasma hominis.^{[1][2][3][4][5]} Micoplasma hominis infection is spread through vaginal intercourse, oral-to-genital contact, and vertically from mother to her infant in utero or by the colonization by the bacteria as the baby descends through the birth canal or by nosocomial acquisition through transplanted tissues.^[6] It is not present in the normal vaginal microbiota. It can also be present in bacterial vaginosis.^[7][8]

Signs and symptoms

pyelonephritis

Those with urogenital or extragenital infections caused by M. homonis have symptoms similar to other sexually transmitted infections and its presence cannot be determined by its symptoms. Unfortunately, some clinicians are not completely familiar with Mycoplasma and Ureaplasma species as sexually transmitted diseases. There is also a lack of testing facilities that can culture or use PCR testing to diagnose this infection. This infection is sometimes identified as 'last resort" after all other infections or diseases are ruled out. This is especially true if antibiotic treatment with medications are ineffective.The following effects and symptoms can be caused by Mycoplasma hominis:

• pyelonephritis
• cystitis
• pelvic inflammatory disease
• endometritis
• chorioamnionitis
• infectious arthritis
• surgical and nonsurgical wound infections
• bacteremia
• pneumonia
• meningitis
• salpingitis
• urethritis
• septic arthritis
• cervicitis
• PID

Mycoplasma hominis often is present in polymicrobial infections, When present in patients with some of these conditions being one of several organisms may be present causing the infection.^[9]

Neonatal infection

Neonates, especially if preterm, are susceptible to Mycoplama infections organisms through vertical transmission or colonization through passing the birth canal or in utero. If the bacteria is present in the bloodstream it can access the central nervous system. If Mycoplasma hominis and Ureaplasma organisms are specifically sampled and cultured, they are of etiologic significance in neonatal lung disease, bacteremia, and meningitis. There are no characteristic signs and symptoms that can determine the type of pathogen present. Subtle manifestations, such as temperature instability, blood pressure fluctuations, heart rate, and respiratory efforts, may be the only clues that an infection is present. Clinicians can consider Mycoplasma species if signs and symptoms of infection are present and if the infant does not improve with administration of beta-lactam medications.^[10] Deaths have occurred in neonates with septicemia and meningitis^[11] caused by Mycoplasma hominis. In some studies, the bacteria became undetectable cerebrospanal fluid (CSF) without treatment.^[12]

Prevention

If symptomatic, testing is recommended.^[13] The risk of contracting Micoplasma infection can be reduced by the following:

• Using barrier methods such as condoms
• Seeking medical attention if you are experiencing symptoms suggesting a sexually transmitted infection.
• Seeking medical attention after learning that a current or former sex partner has, or might have had a sexually transmitted infection.
• Getting a STI history from your current partner and insisting they be tested and treated before intercourse.
• Avoiding vaginal activity, particularly intercourse, after the end of a pregnancy (delivery, miscarriage, or abortion) or certain gynecological procedures, to ensure that the cervix closes.
• Abstinence^[14]

Treatment

Mycoplasmas have a triple-layered membrane and lack a cell wall. Commonly used antibiotics are generally ineffective because their efficacy is due to their ability to inhibit cell wall synthesis. Micoplasmas are not affected by penicillins and other antibiotics that act on the cell wall. The growth of micoplasmas in their host is inhibited by other broad-spectrum antibiotics. These broad-spectrum antibiotics inhibit the multiplication of the mycoplasma but does not kill them. Tetracyclines, macrolides, erythromycin, macrolides, ketolides, quinolones are used to treat mycoplasma infections. In addition to the penicillins, mycoplasmas are resistant to rifampicin. Mycoplasmas may be difficult to eradicate from human or animal hosts or from cell cultures by antibiotic treatment because of resistance to the antibiotic, or because it does not kill the mycoplasma cell. Mycoplasma cells are able to invade the cells of their hosts.^[15]

References

1. Caini, Saverio; Gandini, Sara; Dudas, Maria; Bremer, Viviane; Severi, Ettore; Gherasim, Alin (2014). "Sexually transmitted infections and prostate cancer risk: A systematic review and meta-analysis". Cancer Epidemiology. 38 (4): 329–338. doi:10.1016/j.canep.2014.06.002. ISSN 1877-7821. PMID 24986642.
2. Taylor-Robinson D, Clin Infect Dis. 1996 Oct;23(4):671-82; quiz 683-4. Infections due to species of Mycoplasma and Ureaplasma: an update.
3. Ljubin-Sternak, Sunčanica; Meštrović, Tomislav (2014). "Chlamydia trachomatisand Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health". Journal of Pathogens. 2014: 1–15. doi:10.1155/2014/183167. ISSN 2090-3057. PMC 4295611. PMID 25614838.
4. Schlicht, M. J.; Lovrich, S. D.; Sartin, J. S.; Karpinsky, P.; Callister, S. M.; Agger, W. A. (2004). "High Prevalence of Genital Mycoplasmas among Sexually Active Young Adults with Urethritis or Cervicitis Symptoms in La Crosse, Wisconsin". Journal of Clinical Microbiology. 42 (10): 4636–4640. doi:10.1128/JCM.42.10.4636-4640.2004. ISSN 0095-1137.
5. McIver, C. J.; Rismanto, N.; Smith, C.; Naing, Z. W.; Rayner, B.; Lusk, M. J.; Konecny, P.; White, P. A.; Rawlinson, W. D. (2009). "Multiplex PCR Testing Detection of Higher-than-Expected Rates of Cervical Mycoplasma, Ureaplasma, and Trichomonas and Viral Agent Infections in Sexually Active Australian Women". Journal of Clinical Microbiology. 47 (5): 1358–1363. doi:10.1128/JCM.01873-08. ISSN 0095-1137.
6. "Ureaplasma Infection: Background, Pathophysiology, Epidemiology". Retrieved 2015-06-21.
7. Clark, Natalie; Tal, Reshef; Sharma, Harsha; Segars, James (2014). "Microbiota and Pelvic Inflammatory Disease". Seminars in Reproductive Medicine. 32 (01): 043–049. doi:10.1055/s-0033-1361822. ISSN 1526-8004. PMC 4148456. PMID 24390920.
8. Larsen, Bryan; Hwang, Joseph (2010). "Mycoplasma, Ureaplasma, and Adverse Pregnancy Outcomes: A Fresh Look". Infectious Diseases in Obstetrics and Gynecology. 2010: 1–7. doi:10.1155/2010/521921. ISSN 1064-7449.
9. "Ureaplasma Infection Clinical Presentation: History, Physical, Causes". Retrieved 2015-06-21.
10. "Ureaplasma Infection Clinical Presentation: History, Physical, Causes". Retrieved 2015-06-21.
11. Wildenbeest, Joanne G, Ines Said, Bregje Jaeger, Reinier M van Hest, Diederik van de Beek, Dasja Pajkrt, Neonate with Mycoplasma hominis meningoencephalitis given moxifloxacin, The Lancet Infectious Diseases, Volume 16, Issue 11, November 2016, Pages e261-e266, ISSN 1473-3099, http://dx.doi.org/10.1016/S1473-3099(16)30162-1.
12. "Ureaplasma Infection: Background, Pathophysiology, Epidemiology". Retrieved 2015-06-21.
13. Smith KJ, Cook RL, Roberts MS (2007). "Time from sexually transmitted infection acquisition to pelvic inflammatory disease development: influence on the cost-effectiveness of different screening intervals". Value Health. 10 (5): 358–66. doi:10.1111/j.1524-4733.2007.00189.x. PMID 17888100.
14. "Prevention - STD Information from CDC". Center For Disease Control. Retrieved 2015-02-21.
15. Taylor-Robinson, D (1997). "Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections". Journal of Antimicrobial Chemotherapy. 40 (5): 622–630. doi:10.1093/jac/40.5.622. ISSN 1460-2091.