title: Antibiotic Susceptibility and Sequence Type Distribution of Ureaplasma Species Isolated from Genital Samples in Switzerland.
abstract: Antibiotic resistance in Ureaplasma urealyticum/Ureaplasma parvum and Mycoplasma hominis is an issue of increasing importance. However, data regarding the susceptibility and, more importantly, the clonality of these organisms are limited. We analyzed 140 genital samples obtained in Bern, Switzerland, in 2014. Identification and antimicrobial susceptibility tests were performed by using the Mycoplasma IST 2 kit and sequencing of 16S rRNA genes. MICs for ciprofloxacin and azithromycin were obtained in broth microdilution assays. Clonality was analyzed with PCR-based subtyping and multilocus sequence typing (MLST), whereas quinolone resistance and macrolide resistance were studied by sequencing gyrA, gyrB, parC, and parE genes, as well as 23S rRNA genes and genes encoding L4/L22 ribosomal proteins. A total of 103 samples were confirmed as positive for U. urealyticum/U. parvum, whereas 21 were positive for both U. urealyticum/U. parvum and M. hominis. According to the IST 2 kit, the rates of nonsusceptibility were highest for ciprofloxacin (19.4%) and ofloxacin (9.7%), whereas low rates were observed for clarithromycin (4.9%), erythromycin (1.9%), and azithromycin (1%). However, inconsistent results between microdilution and IST 2 kit assays were recorded. Various sequence types (STs) observed previously in China (ST1, ST2, ST4, ST9, ST22, and ST47), as well as eight novel lineages, were detected. Only some quinolone-resistant isolates had amino acid substitutions in ParC (Ser83Leu in U. parvum of serovar 6) and ParE (Val417Thr in U. parvum of serovar 1 and the novel Thr417Val substitution in U. urealyticum). Isolates with mutations in 23S rRNA or substitutions in L4/L22 were not detected. This is the first study analyzing the susceptibility of U. urealyticum/U. parvum isolates in Switzerland and the clonality outside China. Resistance rates were low compared to those in other countries. We hypothesize that some hyperepidemic STs spread worldwide via sexual intercourse. Large combined microbiological and clinical studies should address this important issue.
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Schneider
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
authors.forename: Regula
authors.initials: R
authors.lastname: Tinguely
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Droz
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland Department of Infectious Diseases, Bern University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Markus
authors.initials: M
authors.lastname: Hilty
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland.
authors.forename: Valentina
authors.initials: V
authors.lastname: Donà
authors.affiliation: labormedizinisches zentrum Dr. Risch, Bern-Liebefeld, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodmer
authors.affiliation: Institute for Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland andrea.endimiani@ifik.unibe.ch.
authors.forename: Andrea
authors.identifier: http://orcid.org/0000-0003-3186-5421
authors.initials: A
authors.lastname: Endimiani
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial; D004917:Erythromycin / Q000494:pharmacology; D005260:Female; D005836:Genitalia, Female / Q000382:microbiology; D005837:Genitalia, Male / Q000382:microbiology; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D009175:Mycoplasma Infections / Q000188:drug therapy / Q000382:microbiology; D019535:Mycoplasma hominis / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D015242:Ofloxacin / Q000494:pharmacology; D016133:Polymerase Chain Reaction; D015363:Quinolones / Q000494:pharmacology; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D012338:RNA, Ribosomal, 23S / Q000235:genetics*; D012269:Ribosomal Proteins / Q000235:genetics; D013557:Switzerland; D014509:Ureaplasma / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D016869:Ureaplasma Infections / Q000188:drug therapy / Q000382:microbiology; D016990:Ureaplasma urealyticum / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D015363:Quinolones; D012336:RNA, Ribosomal, 16S; D012338:RNA, Ribosomal, 23S; D012269:Ribosomal Proteins; D004917:Erythromycin; D015242:Ofloxacin