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. 2020 Jan 23;9(1):19.
doi: 10.1186/s13756-020-0681-5. eCollection 2020.

Spread of multidrug resistance among Ureaplasma serovars, Tunisia

Safa Boujemaa  1 , Béhija Mlik  1 , Amina Ben Allaya  1 , Helmi Mardassi  2 , Boutheina Ben Abdelmoumen Mardassi  1
Affiliations

Spread of multidrug resistance among Ureaplasma serovars, Tunisia

Safa Boujemaa et al. Antimicrob Resist Infect Control. .

Abstract

Background: Ureaplasma spp. have been implicated in a variety of clinical conditions and certain serovars are likely to be disease-associated. Hence, the ascending trend of Ureaplasma spp. resistance to antimicrobials should deserve more attention. Here we assessed the extent of antimicrobial resistance of Ureaplasma serovars in Tunisia, and investigated the underlying molecular basis.

Methods: This study included 101 molecularly typed Ureaplasma spp. clinical strains isolated over a 12-year time period (2005-2017). The antimicrobial susceptibility was tested against nine antibacterial agents using the broth microdilution method. Neighbor-joining tree was constructed to establish the phylogenetic relationships among isolates.

Results: We found that all ureaplasma isolates were resistant to ciprofloxacin and erythromycin, intermediately resistant to azithromycin, and susceptible to doxycycline, moxifloxacin and josamycin. Ofloxacin and levofloxacin resistance was found in 73.27 and 17.82%, respectively, while 37.62% of isolates proved resistant to tetracycline. Consequently, we detected an elevated multidrug resistance rate among ureaplasma isolates (37.62%), particularly among serovars 2, 5, 8, and 9 (77.77% overall), as well as serovars 4, 10, 12, and 13 (52.63% overall). In most cases, drug resistance was found to be associated with known molecular mechanisms, yet we have identified two novel mutations in the L22 protein, which might be associated with macrolide-resistance.

Conclusion: To our knowledge, this is the first study that reports the widespread expansion of multidrug resistance among Ureaplasma serovars, a finding of importance in terms of both surveillance and antimicrobial usage.

Keywords: Biotyping; Fluoroquinolones; Infertility; L22 mutation; Multidrug resistance; Serovars; Tetracyclines; Ureaplasma spp..

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Boxplots comparing MICs for each antibiotic tested between U. parvum (UPA) and U. urealyticum (UUR) isolates. Interquartile and median MIC values are represented by boxes and centerline, respectively. Lower and upper whiskers represent minimum and maximum values, respectively. * Represents there is significant difference between the species
Fig. 2
Fig. 2
Antimicrobial susceptibility of Ureaplasma spp. strains to the antibacterial agents. * Represents there is significant difference
Fig. 3
Fig. 3
Antibiotic resistance rates of Ureaplasma serovars to TET, OFX, and LVX. * Represents there is significant difference among the serovars
Fig. 4
Fig. 4
Neighbor-joining tree of 101 Ureaplasma spp. isolates based on the 5′-end of mba gene sequences. The branches are colored according to the serovar. Black circles correspond to reference strains and MDR isolates are represented by red circles
See this image and copyright information in PMC

References

    1. 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;35:197–200. doi: 10.1128/JCM.35.1.197-200.1997. - DOI - PMC - PubMed
    1. Paralanov V, Lu J, Duffy LB, Crabb DM, Shrivastava S, Methé BA, et al. Comparative genome analysis of 19 Ureaplasma urealyticum and Ureaplasma parvum strains. BMC Microbiol. 2012;12:88. doi: 10.1186/1471-2180-12-88. - DOI - PMC - PubMed
    1. Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005;18:757–789. doi: 10.1128/CMR.18.4.757-789.2005. - DOI - PMC - PubMed
    1. Murtha AP, Edwards JM. The role of mycoplasma and Ureaplasma in adverse pregnancy outcomes. Obstet Gynecol Clin N Am. 2014;41:615–627. doi: 10.1016/j.ogc.2014.08.010. - DOI - PubMed
    1. Waites KB, Schelonka RL, Xiao L, Grigsby PL, Novy MJ. Congenital and opportunistic infections: Ureaplasma species and mycoplasma hominis. Semin Fetal Neonatal Med. 2009;14:190–199. doi: 10.1016/j.siny.2008.11.009. - DOI - PubMed

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