Mycoplasma hominis as an etiological agent of tubo-ovarian abscess and pyosalpinx: Myth or reality?
Background. Despite the fact that M. hominis is commonly assigned to opportunistic microorganisms, there are many reports of clinical cases with the involvement of M. hominis as the only microorganism in the development of severe inflammatory processes in the lung, intervertebral discs, kidney, liver, heart, and brain. The role of M. hominis in the development of pelvic inflammatory diseases (PID) remains unexplored.Gushchin A.E., Rumyantseva T.A., Khairullina G.A., Makhova T.I., Dukhin A.O.
Clinical case reports. The paper gives data on two patients admitted to hospital to be treated for tubo-ovarian abscess and pyosalpinx. The patients underwent a comprehensive examination, as well as laparoscopy, during which intraoperative samples were obtained and investigated by PCR to detect DNA of a broad spectrum of microorganisms. The material obtained from the two patients with PID displayed M. hominis DNA at a concentration of 108 GE/ml (that corresponded to total concentration of DNA of the bacteria that were present in the biomaterial). Other microorganisms were not found in one case; their concentration was 100 and more times lower than that of M. hominis in the other case.
Conclusion. The most probable etiological role of M. hominis was established in two clinical cases of PID. The possible role of M. hominis in the development of PID should be taken into account when elaborating the tactics of examination and treatment for patients with this condition.
Keywords
tubo-ovarian abscess
pyosalpinx
Mycoplasma hominis
pelvic inflammatory diseases
Supplementary Materials
- Table 1. PCR results using the test "Florotsenoz" and NCMT
- Table 2. PCR results using the test "Florotsenoz" and NCMT
- Figure. Patient A, 29 years old. Intraoperative: The pelvic cavity 150 ml of liquid pus
References
1. Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. MMWR Recomm. Rep. 2010; 59: 45.
2. Ross J., Judlin P., Jensen J. 2012 European guideline for the management of pelvic inflammatory disease. Int. J. STD AIDS. 2014;25: 1-7.
3. Yang T.K., Chung C.J., Chung S.D., Muo C.H., Chang C.H., Huang C.Y. Risk of endometrial cancer in women with pelvic inflammatory disease: a nationwide population-based retrospective cohort study. Medicine(Baltimore). 2015; 94(34): e1278. doi: 10.1097/MD.0000000000001278.
4. Ness R.B., Kip K.E., Hillier S.L., Soper D.E., Stamm C.A., Sweet R.L. A cluster analysis of bacterial vaginosis-associated microflora and pelvic inflammatory disease. Am. J. Epidemiol. 2005; 162(6): 585-90.
5. Haggerty C.L., Totten P.A., Tang G., Astete S.G., Ferris M.J., Norori J. et al. Identification of novel microbes associated with pelvic inflammatory disease and infertility. Sex. Transm. Infect. 2016; 92(6): 441-6. doi: 10.1136/sextrans-2015-052285.
6. Hussain S.T., Gordon S.M., Tan C.D., Smedira N.G. Mycoplasma hominis prosthetic valve endocarditis: the value of molecular sequencing in cardiac surgery. J. Thorac. Cardiovasc. Surg. 2013; 146(1): e7-9. doi: 10.1016/j.jtcvs.2013.03.039.
7. Vogel U., Lüneberg E., Kuse E.R., Neulinger A.L., Frosch M. Extragenital Mycoplasma hominis infection in two liver transplant recipients. Clin. Infect. Dis. 1997; 24(3): 512-3.
8. Camara B., Mouzin M., Ribes D., Esposito L., Guitard J., Game X. et al. Perihepatitis and perinephric abscess due to Mycoplasma hominis in a kidney transplant patient. Exp. Clin. Transplant. 2007; 5(2): 708-9.
9. Flouzat-Lachaniette C.H., Guidon J., Allain J., Poignard A. An uncommon case of Mycoplasma hominis infection after total disc replacement. Eur. Spine J. 2013; 22(Suppl. 3): S394-8. doi: 10.1007/s00586-012-2511-9.
10. Hos N.J., Bauer C., Liebig T., Plum G., Seifert H., Hampl J. Autoinfection as a cause of postpartum subdural empyema due toMycoplasma hominis. Infection. 2015; 43(2): 241-4. doi: 10.1007/s15010-014-0713-2.
11. Randall C.L., Baetz R.W., Hall D.W., Birtch P.K. The effect of treatment on the incidence of abortion. N. Y. State J. Med. 1950; 50(21):2525-30.
12. Melen B., Gotthardson A. Complement fixation with human pleuropneumonia-like organisms. Acta Pathol. Microbiol. Scand. 1955; 37(2):196-200.
13. Mardh P.A., Weström L. Tubal and cervical cultures in acute salpingitis with special reference to Mycoplasma hominis and T-strain mycoplasmas. Br. J. Vener. Dis. 1970; 46(3): 179-86.
14. Mardh P.A., Weström L. Antibodies to Mycoplasma hominis in patients with genital infections and in healthy controls. Br. J. Vener. Dis. 1970;46(5): 390-7.
15. Møller B.R., Taylor-Robinson D., Furr P.M., Freundt E.A. Acute upper genital-tract disease in female monkeys provoked experimentally by Mycoplasma genitalium. Br. J. Exp. Pathol. 1985; 66(4): 417-26.
16. Rumyantseva T.A., Savochkina Yu.A., Dolgova T.V., Zaitseva S.V., Kakherskaya M.A., Kudryavtseva L.V., Gushchin A.E. Diagnosis of vuvlovaginal candidiasis: Comparison of the informative value of clinical and laboratory findings. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2015; 3: 55-61. (in Russian)
17. Rumyantseva T.A., Varlamova A.V., Guschin A.E., Bezrukov V.M. Comparison of various kits for the detection of Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis: «Mycoplasma Duo», «Ureaplasma microtest», «Mycoplasma microtest», «Florocenosis-Mycoplasmas». Klinicheskaya Laboratornaya Diagnostika/Clinical Laboratory Diagnostics. 2014; 8: 52-57. (in Russian)
18. Rumyantseva T., Golparian D., Nilsson C.S., Johansson E., Falk M., Fredlund H. et al. Evaluation of the new AmpliSens multiplex real-time PCR assay for simultaneous detection of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis. APMIS. 2015; 123(10): 879-86 doi: 10.1111/apm.12430.
19. Rumyantseva T., Shipitsyna E., Guschin A., Unemo M. Evaluation and subsequent optimizations of the quantitative AmpliSens Florocenosis/Bacterial vaginosis-FRT multiplex real-time PCR assay for diagnosis of bacterial vaginosis. APMIS. 2016; Oct 7. doi: 10.1111/apm.12608.
20. Rumyantseva T.A., Bellen G., Savochkina Y.A., Guschin A.E., Donders G.G. Diagnosis of aerobic vaginitis by quantitative real-time PCR. Arch. Gynecol. Obstet. 2016; 294(1): 109-14.
21. Sonnex C. Toll-like receptors and genital tract infection. Int. J. STD AIDS. 2010; 21(3): 153-7.
22. Peltier M.R., Freeman A.J., Mu H.H., Cole B.C. Characterization and partial purification of a macrophage-stimulating factor from Mycoplasma hominis. Am. J. Reprod. Immunol. 2005; 54(6): 342-51.
23. Hasebe A., Mu H.H., Cole B.C. A potential pathogenic factor from Mycoplasma hominis is a TLR2-dependent, macrophage-activating, P50-related adhesin. Am. J. Reprod. Immunol. 2014; 72(3): 285-95. doi: 10.1111/aji.12279.
24. Menard J.P., Fenollar F., Henry M., Bretelle F., Raoult D. Molecular quantification of Gardnerella vaginalis and Atopobium vaginae loads to predict bacterial vaginosis. Clin. Infect. Dis. 2008; 47(1): 33-43. doi: 10.1086/588661.
25. Cox C., Watt A.P., McKenna J.P., Coyle P.V. Mycoplasma hominis and Gardnerella vaginalis display a significant synergistic relationship in bacterial vaginosis. Eur. J. Clin. Microbiol. Infect. Dis. 2016; 35(3): 481-7. doi: 10.1007/s10096-015-2564-x.
26. Hedges S.R., Barrientes F., Desmond R.A., Schwebke J.R. Local and systemic cytokine levels in relation to changes in vaginal flora. J. Infect. Dis. 2006; 193(4): 556-62.
27. Allen-Daniels M.J., Serrano M.G., Pflugner L.P., Fettweis J.M., Prestosa M.A., Koparde V.N. Identification of a gene in Mycoplasma hominis associated with preterm birth and microbial burden in intra-amniotic infection Am. J. Obstet. Gynecol. 2015; 212(6): 779. e1-779. e13.
28. Taylor B.D., Darville T., Ferrell R.E., Ness R.B., Haggerty C.L. Racial variation in toll-like receptor variants among women with pelvic inflammatory disease. J. Infect. Dis. 2013; 207(6): 940-6. doi: 10.1093/infdis/jis922.
Received 23.11.2016
Accepted 23.12.2016
About the Authors
Alexander Guschin, PhD, Head of the Laboratory for Molecular Diagnostics of Reproductive Tract Infections, Central Research Institute of Epidemiology.111123, Russia, Moscow, Novogireevskaya str. 3a. Tel.: +74959749646, ext. 1122, +79161440556. E-mail:aguschin1965@pcr.ru
Tatiana Rumyantseva, PhD, Gynecologist, Research officer, Clinical Diagnostoc Center, Central Research Institute of Epidemiology.
111123, Russia, Moscow, Novogireevskaya str. 3a. Tel.: +74959749646, ext. 1313, +79161547067. E-mail: Ivanovatatiana86@yandex.ru
Guzel Khayrullina, PhD, Research officer, Laboratory for Molecular Diagnostics of Reproductive Tract Infections, Central Research Institute of Epidemiology.
111123, Russia, Moscow, Novogireevskaya str. 3a. Tel.: +74959749646, ext. 1108, +79160702595. E-mail: guzel.khairullina@gmail.com
Tamara Makhova, Junior researcher, Laboratory for Molecular Diagnostics of Reproductive Tract Infections, Central Research Institute of Epidemiology.
111123, Russia, Moscow, Novogireevskaya str. 3a. Tel.: +74959749646, ext. 1108, +79055471210. E-mail: tamara.dolgova89@gmail.com
Armen Dukhin, MD, PhD, Professor, Peoples’ Friendship University of Russia.
117198, Russia, Moscow, Mikluho-Maklaya str. 6. Tel.: +74957873827, +79689013083. E-mail: aodukhin@mail.ru
For citations: Gushchin A.E., Rumyantseva T.A., Khairullina G.A., Makhova T.I.,
Dukhin A.O. Mycoplasma hominis as an etiological agent
of tubo-ovarian abscess and pyosalpinx: Myth or reality?
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 176-82. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.176-82
Similar Articles
