THE CLINICAL SIGNIFICANCE OF DETECTING GENITAL MYCOPLASMAS AND THE CURRENT INDICATORS OF ANTIBIOTIC SUSCEPTIBILITY OF UREAPLASMA AND M. HOMINIS

Objective. To determine the detection rate of M. hominis, U. urealyticum, and U. parvum in patients with clinical and/or laboratory signs of inflammatory processes in the urogenital tract and in clinically healthy individuals; to study the indicators of antibiotic susceptibility of genital mycoplasma isolates. Subjects and methods. 409 patients, in whom a polymerase chain reaction and culture identified genital mycoplasmas, were examined. The susceptibility of the isolates to doxycycline, josamycin, tetracycline, ofloxacin, clindamycin, azithromycin, and erythromycin was studied. Results. U. urealyticum as monoinfection (n = 78; 39.6%) and association with U. parvum (n = 43; 21.8%) and M. hominis (n = 32; 16.2%) was significantly more frequently found in the patients with inflammatory diseases of the urogenital system than in the clinically healthy individuals (n = 10; 4.7%, n = 20; 9.4%, and n = 12; 5.7%, respectively). In male patients, the infectious inflammatory process manifested as urethritis; the pattern of genital mycoplasmas was characterized by a preponderance of U. urealyticum (46.9%), including that in association with U. parvum (31.25%). In female patients, U. urealyticum significantly prevailed over the other Mycoplasma species and were detected in 37.5% of patients with vaginitis, in 47.6% of those with cervicitis, and in 37.2% of those with vaginitis concurrent with urethritis or cervicitis (p<0.05). Infection with U. urealyticum, including that in association with U. parvum was more commonly accompanied by a high leukocyte reaction (52.4-74.3%; p < 0.05) than infection with M. hominis and U. parvum. Ureaplasma and M. hominis demonstrated a low level of antimicrobial resistance to doxycycline (2.8% and 3.4%, respectively), josamycin (7.8% and 5.1%), tetracycline (9.2% and 5.1%) and a high rate of resistance to erythromycin (75.2% and 71.4%, respectively), azithromycin (64.2% and 62.8%) and clindamycin (70.2% and 69.1%). Conclusion. In this study, U. urealyticum as monoinfection and in association with U. parvum was the most clinically significant etiologic agent in the development of infectious inflammatory diseases of the genitourinary system. The high susceptibility of genital mycoplasmas to doxycycline, josamycin, and tetracycline determines the possibility of their use in the therapy of urogen ital tract diseases caused by genital mycoplasmas.

U. parvum, U. urealyticum, M. hominis, genital mycoplasmas, U. parvum, U. urealyticum, M. hominis, doxycycline, josamycin, tetracycline