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Coinfection of Ureaplasma urealyticum/Mycoplasma hominis in HPV Positive Women: Frequency, Risk Factors and Multidrug Resistance
Received: 13 May 2020 | Received in revised form: 17 Jul 2020
Accepted: 24 Aug 2020 | Available online: 12 Nov 2020İsmail BIYIKa, Nadi KESKİNa, Aynur GÜLCANb, Onur İNCEa, Özlem ERTENa, Halil İbrahim ŞİŞMANa
aDepartment of Obstetrics and Gynecology, Kütahya Health Sciences University Faculty of Medicine, Kütahya, TURKEY
bDepartment of Medical Microbiology, Kütahya Health Sciences University Faculty of Medicine, Kütahya, TURKEY
J Clin Obstet Gynecol. 2020;30(3):92-9
DOI: 10.5336/jcog.2020-76299
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: In the development of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN), the most significant cause is high-risk human papillomavirus (HPV) persistence. There are studies reporting high rates of co-prevalent Ureaplasma urealyticum in those who have an HPV infection. In this study, U. urealyticum positivity and antibiotic resistance rates were investigated in HPV positive women who were asymptomatic in terms of sexually transmitted disease. Material and Methods: In this retrospective cohort study, demographic data of the patients with HPV whose cervical swap were sent to the microbiology laboratory for Mycoplasma culture were obtained from hospital data management system. Mycoplasma culture is done by using a commercial kit (Mycoplasma IES (AutoBio Diagnostics, China) detecting Mycoplasma hominis and U. urealyticum and antibiotic susceptibility, simultaneously. The demographic data of the cases, HPV test, cervical smear, colposcopy findings and cervical biopsy results were compared according to the Mycoplasma/Ureaplasma culture and antibiogram results. Patients with multidrug-resistant U. urealyticum were evaluated according to risk factors. Results: HPV and U. urealyticum, HPV and M. hominis coinsidence were found as 43.1% and 1.5%, respectively. No significant difference was found in terms of demographic data. HPV type, cervical smear, colposcopy and cervical biopsy findings were also not correlated with culture positivity. The multidrug-resistant (MDR) U. urealyticum ratio was 35.7%. The most resistant and susceptible antibiotics are ciprofloxacin (96.4%) and minocyclin (100%), respectively. In patients with high-risk HPV positive, MDR positivity was significantly higher. Conclusion: In this study, it could not find any correlation of HPV type of cases, cervical smear results, colposcopy findings, cervical biopsy results with U. urealyticum culture results. Multi-drug resistant U. ure alyticum (MDR-UU) positivity rates were detected statistically higher in the patients with highrisk-HPV. When HPV positivity is detected in reproductive women, existence of MDR-UU positivity should be considered.
REFERENCES:- Bosch FX, Lorincz A, Mu-oz N, Meijer CJLM, Shah KV. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol. 2002;55(4):244-65. [Crossref] [PubMed] [PMC]
- Castellsagué X, Mu-oz N. Chapter 3: cofactors in human papillomavirus carcinogenesis--role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr. 2003;(31):20-8. [Crossref] [PubMed]
- Arnheim Dahlström L, Andersson K, Luostarinen T, Thoresen S, Ögmundsdottír H, Tryggvadottír L, et al. Prospective seroepidemiologic study of human papillomavirus and other risk factors in cervical cancer. Cancer Epidemiol Biomarkers Prev. 2001;20(12): 2541-50. [Crossref] [PubMed]
- Tully JG, Taylor-Robinson D, Cole RM, Rose DL. A newly discovered mycoplasma in the human urogenital tract. Lancet. 1981;13;1(8233):1288-91. [Crossref] [PubMed]
- Ljubin-Sternak S, Me?trović T. Chlamydia trachomatis and Genital Mycoplasmas: Pathogens with an Impact on Human Reproductive Health. J Pathog. 2014;2014:183167. [Crossref] [PubMed] [PMC]
- Verteramo R, Pierangeli A, Mancini E, Calzolari E, Bucci M, Osborn J, et al. Human papillomaviruses and genital co-infections in gynaecological outpatients. BMC Infect Dis. 2009;12;9:16. [Crossref] [PubMed] [PMC]
- Kim SI, Yoon JH, Park DC, Lee DS, Lee SJ, Choe HS, et al. Co-infection of ureaplasma urealyticum and human papilloma virus in asymptomatic sexually active individuals. Int J Med Sci. 2018;12;15(9):915-20. [Crossref] [PubMed] [PMC]
- Lukic A, Canzio C, Patella A, Giovagnoli M, Cipriani P, Frega A, et al. Determination of cervicovaginal microorganisms in women with abnormal cervical cytology: the role of Ureaplasma urealyticum. Anticancer Res. 2006;26(6C):4843-9. [PubMed]
- Liu J, Liu W, Liu Y, Zhou X, Zhang Z, Sun Z, et al. Prevalence of microorganisms co- infections in human papillomaviruses infected women in Northern China. Arch Gynecol Obstet. 2016;293(3):595-602. [Crossref] [PubMed]
- Zhang D, Li T, Chen L, Zhang X, Zhao G, Liu Z, et al. Epidemiological investigation of the relationship between common lower genital tract infections and high-risk human papillomavirus infections among women in Beijing, China. PLoS One. 2017;22;12(5):e0178033. [Crossref] [PubMed] [PMC]
- Macpherson I, Russell W. Transformations in hamster cells mediated by mycoplasmas. Nature. 1966;25;210(5043):1343-5. [Crossref] [PubMed]
- Tsai S, Wear DJ, Shih JW, Lo SC. Mycoplasmas and oncogenesis: persistent infection and multistage malignant transformation. Proc Natl Acad Sci USA. 1995;24;92(22):10197-201. [Crossref] [PubMed] [PMC]
- Nayar R, Wilbur DC. The Pap test and Bethesda 2014. Cancer Cytopathol. 2015;123(5):271-81. [Crossref] [PubMed]
- Smith JHF. Bethesda 2001. Cytopathology. 2002;13(1):4-10. [Crossref] [PubMed]
- Khan MJ, Werner CL, Darragh TM,Guido RS, Mathews C, Moscicki AB, et al. ASCCP colposcopy standards: role ofcolposcopy, benefits, potential harms, and terminology for colposcopic practice. J Low Genit Tract Dis. 2017;21(4):223-9. [PubMed]
- Ye H, Song T, Zeng X, Li L, Hou M, Xi M, et al. Association between genital mycoplasmas infection and human papillomavirus infection, abnormal cervical cytopathology, and cervical cancer: a systematic review and meta-analysis. Arch Gynecol Obstet. 2018;297(6):1377-87. [Crossref] [PubMed]
- Parthenis C, Panagopoulos P, Margari N, Kottaridi C, Spathis A, Pouliakis A, et al. The association between sexually transmitted infections, human papillomavirus, and cervical cytology abnormalities among women in Greece. Int J Infect Dis. 2018;73:72-7. [Crossref] [PubMed]
- Ekiel AM, Friedek DA, Romanik MK, Józ?wiak J, Martirosian G. Occurrence of Ureaplasma parvum and Ureaplasma urealyticum in women with cervical dysplasia in Katowice, Poland. J Korean Med Sci. 2009;24(6):1177-81. [Crossref] [PubMed] [PMC]
- Biernat-Sudolska M, Szostek S, Rojek-Zakrzewska D, Klimek M, Kosz-Vnenchak M. Concomitant infections with human papillomavirus and various mycoplasma and ureaplasma species in women with abnormal cervical cytology. Adv Med Sci. 2011;56(2):299-303. [Crossref] [PubMed]
- Pisani S, Gallinelli C, Seganti L, Lukic A, Nobili F, Vetrano G, et al. Detection of viral and bacterial infections in women with normal and abnormal colposcopy. Eur J Gynaecol Oncol. 1999;20(1):69-73. [PubMed]
- Lopez-Arias M, Vazquez-Jimenez S, Martinez-Abundis E, Gomez-Crisostomo NP, Chavez-Blanco A, Contreras-Paredes A, et al. Genital association of human papillomavirus with Mycoplasma and Ureaplasma spp. in Mexican women with precancerous lesions. Int J STD AIDS. 2019;30(10):969-77. [Crossref] [PubMed]
- Arokiyaraj S, Seo SS, Kwon M, Lee JK, Kim MK. Association of cervical microbial community with persistence, clearance and negativity of Human Papillomavirus in Korean women: a longitudinal study. Sci Rep. 2018;19;8(1): 15479. [Crossref] [PubMed] [PMC]
- Lv P, Zhao F, Xu X, Xu J, Wang Q, Zhao Z, et al. Correlation between common lower genital tract microbes and high-risk human papillomavirus infection. Can J Infect Dis Med Microbiol. 2019;22;2019:9678104. [Crossref] [PubMed] [PMC]
- Beþli Y, Karatuna O, Akyar I. [Evaluation of in vitro antimicrobial susceptibility in ureaplasma urealyticum and mycoplasma hominis strains isolated from genitourinary tract samples]. ANKEM Derg. 2017;31(3):97-105.
- Bayraktar MR, Ozerol IH, Gucluer N, Celik O. Prevalence and antibiotic susceptibility of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women. Int J Infect Dis. 2010;14(2):e90-5. [Crossref] [PubMed]
- Khan J, Farzand R, Ghumro PB. Antibiotic sensitivity of human genital mycoplasmas. African Journal of Microbiology Research. 2010;4(9):704-7.
- Beeton ML, Chalker VJ, Jones LC, Maxwell NC, Spiller OB. Antibiotic resistance among clinical Ureaplasma isolates recovered from Neonates in England and Wales between 2007 and 2013. Antimicrobial Agents and Chemotherapy. 2016:60(1):52-6. [Crossref] [PubMed] [PMC]