DETECTION OF MYCOPLASMA HOMINIS IN PATIENTS WITH URINARY TRACT INFECTIONS

Abstract

Mycoplasma hominis is one of the well known genital mycoplasma agent that has been recognized as potentially pathogenic species and associated with various infectious diseases in adult men and woman. The organism could cause pelvic inflammatory disease, postpartum, postabortion fever and pyelonephritis. The Aim of this prospective study was to detemine the occurrence and prevalence of Mycoplasma hominis in patients with urinary tract infections, since they are usually not detected by routine microbiological examination of urine samples in laboratory department. For this purpose, Culture method was to be attempted as the current laboratory methods of choice for detection urogenital mycoplasmas infections. This study was designed as a case-control study in which a total of 100 patients with mean age of the of 42.78±22.49 (95% CI = 39-49.17) in case group as well as a mean age of 48.18±18.81 ((95% CI = 42.83-53.53) in the control group. The patients of both sexes were investigated for the presence of M. hominis and they were admitted to the urology department at asser central hospital in Abha (a city in southwest region of Saudi Arabia), during over a period of one year (February, 2013-March, 2014). A detailed history with specific urinary symptoms and signs was obtained as a result. These patients were divided into two groups: The first group (or case group) and the second group (or control group): The case group, included 50 symptomatic patients who had been admitted in hospital and they were examined for the presence of one or more of the following specific urinary symptoms and signs: Urinary frequency, dysuria, suprapubic/pelvic pain. Unlike the case group, the control group included 50 asymptomatic patients who were free of any specific urinary symptoms and they were matched by the first group for their age index. First voided urine specimens were tested using urine microscopy, culture for M hominis was performed and the isolates were identified serologically by growth inhibition test (disc method). In the case group, 8 cases out of 50 and in control group 1 out 50 were positive for M. hominis infection. The incidence of M. hominis was higher and statistically significant among case symptomatic patients group (8/50, 16%) than control asymptomatic patients group patients (1/50, 2%). On applying tests of significance to the observed data for isolation of Mycolplasma hominis among cases and controls, the values were found to statistically significant. Chi-square test with Yate’s correction [χ² 4.396; p value 0.036] and the Fisher’s exact test (2 tailed) [p value = 0.0309] indicated the relevance of the findings. The Relative Risk (RR) for the occurrence of Mycoplasma hominis infection was estimated to be 8 (95% C.I = 1.0386 -61.6235). The odds ratio was determined to be 0.1071 (95% CI = 0.129-0.892) and the risk ratio was 0.2063 (95% CI = 0.0322-1.3224). This is the first report study for the detection of M hominis in patients with urinary tract infections performed in Saudi Arabia. Infection caused by M hominis was associated with higher incidence rate in patients with symptomatic urinary tract diseases. Further work studies is needed for their rapid detection of these organism in urine samples using other diagnostic methods such as PCR. Further knowledge of the role and the effect of this pathogen in patients with urinary tract infections can be a prospective field of study.