title: Antibiotic Resistance among Clinical Ureaplasma Isolates Recovered from Neonates in England and Wales between 2007 and 2013.
abstract: Ureaplasma spp. are associated with numerous clinical sequelae with treatment options being limited due to patient and pathogen factors. This report examines the prevalence and mechanisms of antibiotic resistance among clinical strains isolated from 95 neonates, 32 women attending a sexual health clinic, and 3 patients under investigation for immunological disorders, between 2007 and 2013 in England and Wales. MICs were determined by using broth microdilution assays, and a subset of isolates were compared using the broth microdilution method and the Mycoplasma IST2 assay. The underlying molecular mechanisms for resistance were determined for all resistant isolates. Three isolates carried the tet(M) tetracycline resistance gene (2.3%; confidence interval [CI], 0.49 to 6.86%); two isolates were ciprofloxacin resistant (1.5%; CI, 0.07 to 5.79%) but sensitive to levofloxacin and moxifloxacin, while no resistance was seen to any macrolides tested. The MIC values for chloramphenicol were universally low (2 μg/ml), while inherently high-level MIC values for gentamicin were seen (44 to 66 μg/ml). The Mycoplasma IST2 assay identified a number of false positives for ciprofloxacin resistance, as the method does not conform to international testing guidelines. While antibiotic resistance among Ureaplasma isolates remains low, continued surveillance is essential to monitor trends and threats from importation of resistant clones.
authors.affiliation: Department of Biomedical Sciences, Cardiff Metropolitan University, School of Health Sciences, Cardiff, United Kingdom mbeeton@cardiffmet.ac.uk.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Beeton
authors.affiliation: Public Health England, Respiratory and Vaccine Preventable Bacteria Reference Unit, London, United Kingdom.
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Chalker
authors.affiliation: Department of Sexual Health and HIV, Royal Glamorgan Hospital, Cwm Taf University Trust, Glamorgan, United Kingdom School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom.
authors.forename: Lucy C
authors.initials: LC
authors.lastname: Jones
authors.affiliation: Neonatal Intensive Care Unit, Derriford Hospital, Plymouth, United Kingdom.
authors.forename: Nicola C
authors.initials: NC
authors.lastname: Maxwell
authors.affiliation: School of Medicine, Cardiff University, University Hospital of Wales, Cardiff, United Kingdom.
authors.forename: O Brad
authors.initials: OB
authors.lastname: Spiller
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002701:Chloramphenicol / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004739:England / Q000453:epidemiology; D062665:Epidemiological Monitoring; D024841:Fluoroquinolones / Q000494:pharmacology; D005839:Gentamicins / Q000494:pharmacology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D064704:Levofloxacin / Q000494:pharmacology; D018942:Macrolides / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D000077266:Moxifloxacin; D012189:Retrospective Studies; D013752:Tetracycline / Q000494:pharmacology; D014509:Ureaplasma / Q000187:drug effects* / Q000235:genetics / Q000254:growth & development / Q000302:isolation & purification; D016869:Ureaplasma Infections / Q000453:epidemiology / Q000382:microbiology; D014852:Wales / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D005839:Gentamicins; D018942:Macrolides; D002939:Ciprofloxacin; D002701:Chloramphenicol; D064704:Levofloxacin; D013752:Tetracycline; D000077266:Moxifloxacin