Main Article Content
Abstract
RÉSUMÉ
Introduction. La résistance des mycoplasmes aux fluoroquinolones a été rapportée par des auteurs en Chine, aux États Unis mais peu d’études ont concerné la détection moléculaire de cette résistance aux fluoroquinolones en Afrique. Le but de notre travail était de décrire le profil moléculaire des résistances aux fluoroquinolones de Mycoplasma hominis et Ureaplasma urealyticum chez les femmes à Bamako. Méthodologie. Nous avons réalisé une étude transversale descriptive dont la collecte s’est déroulée de juillet à septembre 2019 soit une période de 3 mois chez les femmes avec des demandes de prélèvement vaginal pour la recherche des mycoplasmes à l’institut national de santé publique (INSP) de Bamako. Résultats. Nous avons recruté 63 femmes et la tranche d’âge la plus représentée était celle de 15 à 49 ans (90,5%). La prévalence des mycoplasmes urogénitaux était de 41,26% pour U urealyticum et 3,17% pour M. hominis. Après réalisation de l’antibiogramme, la résistance à la ciprofloxacine était de 78,1% pour U. urealyticum contre 3,1% pour M. hominis tandis que la résistance à l’ofloxacine était de 50% pour U urealyticum contre 3,1% pour Mycoplasma hominis. La recherche des mutations sur les 4 gènes était positive pour les gènes gyrA (9,4%), gyrB (43,8%), parC (50%) et parE (46,9%). La plupart des mutations étaient portées par les souches pathogènes d’U urealyticum. Conclusion. Les mycoplasmes isolés chez les femmes présentaient fréquemment une résistance aux fluoroquinolones, avec des souches présentant les mutations des gènes gyrB, parC et parE.
ABSTRACT
Introduction. Resistance of mycoplasmas to fluoroquinolones has been reported by authors in China and the United States, but few studies have focused on the molecular detection of this resistance to fluoroquinolones in Africa. The aim of our study was to describe the molecular profile of resistance to fluoroquinolones in Mycoplasma hominis and Ureaplasma urealyticum in women in Bamako. Methodology. We conducted a descriptive cross-sectional study with data collection from July to September 2019 (a period of 3 months), among women with requests for vaginal swabs for mycoplasma research at the National Institute of Public Health (INSP) in Bamako. Results. We enrolled 63 women, with the most represented age group in our study being 15 to 49 years old (90.5%). The prevalence of urogenital mycoplasmas was 41.26% for U. urealyticum and 3.17% for M. hominis. After performing antibiogram, the resistance rate to ciprofloxacin was 78.1% for U. urealyticum compared to 3.1% for M. hominis, while that to Ofloxacin was 50% for U. urealyticum compared to 3.1% for Mycoplasma hominis. Mutation analysis of the 4 genes was positive for the gyrA (9.4%), gyrB (43.8%), parC (50%), and parE (46.9%) genes. Most mutations were carried by pathogenic strains of U. urealyticum. Conclusion. Mycoplasmas isolated from women frequently exhibited resistance to fluoroquinolones, with strains showing mutations in the gyrB, parC, and parE genes.
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References
- WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
- Boudry P., Mycoplasmes uro-génitaux: Implications en pathologie humaines. Louvain Med. 1998 ; 117 :128-141.
- Bebear C M., de Barbeyrac B., Pereyre S., Bebear C., Mycoplasmes et chlamydiae : Sensibilité et résistance aux antibiotiques. Rev Fr lab. 2007 ;37(391) :77-85.
- Bebear C., Bebear C M. Infections humaines à mycoplasmes. Rev Fr lab. 2007; 37(391):63-9.
- Demba E., Morinson L., Van Der Loeff M. S., Awasana Akum A., Gooding E., Bailey R., Mayaud P. And West B.,. Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in Gambia, West Africa. BMC Infect Dis. 2005; 5 :1-12.
- Guibert.M., V. Zupan.M. A. Attou .M. Dehan, and P. Nordmann, Colonisation de nouveau-nés prématurés par les mycoplasmes uro-génitaux : leur rôle au cours des dysplasies broncho-pulmonaires. Med Mal Infect. 1996; 26 (Suppl_5):612-617.
- M. Ag Baraïka , R. Onanga, B. Bivigou-Mboumba , A. Mabika-Mabika , U. J. Bisvigou , F. S. Touré Ndouo , N. C. Touré-Kane. Prevalence and antimicrobial susceptibility profile of Mycoplasma hominis and Ureaplasma urealyticum in female population, Gabon. J App Biol Biotech. 2020 ;8(6):28-32.
- Sangaré M., Profil de résistance aux antibiotiques des souches de Mycoplasma identifiées chez les femmes au laboratoire de bactériologie –Virologie de l’INRSP de 2014 à 2017 à Bamako, [Thèse de Pharmacie]: Faculté de Pharmacie, USTTB ; 2018.
- Taylor-Robinson D., and Bebear C. Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections. J Antimicrob Chemother. 1997;40(5), 622-30.
- Xinyou X., Zhang J. Trends in the rates of resistance of Ureaplasma Urealyticum to antibiotics and identification of the mutation site the quinolone resistance-determining region Chinese patients. FEMS Microbiol Lett. 2006;259(2):181-186.
- Bébéar C. M., Renaudin H., Charron A., Gruson D., Lefrancois M., Bébéar C. In vitro activity of trovafloxacin compared to those of five antimicrobials against mycoplasmas including Mycoplasma hominis and Ureaplasma uralyticum fluoroquinolone-resistant isolates that have been genetically characterized. Antimicrob Agents Chemother. 2000;44(9): 2557-2560.
- Bébéar C. M., Renaudin H., Charron A., Clerc M., Pereyre S., Bébéar C. DNA gyrase and topoisomerase IV mutations in clinical isolates of Ureaplasma spp. and Mycoplasma hominis resistant to fluoroquinolones. Antimicrob Agents Chemother. 2003;47(10): 3323-3325.
- Duffy, L., Glass, J., Hall, G., Avery, R., Rackley, R., Peterson, S., and Waites, K. Fluoroquinolone resistance in Ureaplasma parvum in the United States. J Clin Microbiol. 2006;44(4):1590-1.
- Qing-Yong Wang, Rong-Hai Li, Lu-Qing Zheng, Xiao-Hong Shang. Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009-2013. J. Microbiol Immunol infect. 2016;49(3):359-62.
- Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297-301.
- Kawai Y, Nakura Y, Wakimoto T, Nomiyama M, Tokuda T, Takayanagi T et al. In vitro activity of five quinolones and analysis of the quinolone resistance-determining regions of gyrA, gyrB, parC, and parE in Ureaplasma parvum and Ureaplasma urealyticum clinical isolates from perinatal patients in Japan. Antimicrob Agents Chemother. 2015;59(4):2358-64.
- Mare M., Valentin S. N., Doroftei B., Chifiriuc M. C., Bleotu C., Socolov D. Profils de sensibilité des Mycoplasma hominis et Ureaplasma urealyticum Isolé des populations de femmes Infertiles dans le Nord de Roumanie. Braz J Microbiol. 2011; 42:256-260.
- Faye-Kette H., La Ruche G., Ali Napo L., Messou N., Viho L., Welfens Ekra C., Dosso M. Genital mycoplasmas among pregmant women in cote d’Ivoire. West Africa prevalence and risk factors. Int J STD AIDS. 2000;11(9):599-602.
- Everett, M. J., Jin Y. F., Ricci V., and Piddock L. J. Contribution of individual mechanisms to fluoroquinolones resistant in 36 Escherichia coli in strains isolat from humans and animals. Antimicrobial Agents Chemother, 1996; 40(10):2380-6.
- Drlica, K., et Zhao X. ADN gyrase, topoisomérase IV et 4-quinolones. Microbiol. Mol. Biol. Rev. 1997. 61(3):377-392.
- Sharratt, M.; Sands, K.; Portal, E.A.R.; Boostrom, I.; Mondeja, B.A.; Rodríguez, N.M.; Jones, L.C.; Spiller, O.B. Defining Fluoroquinolone Resistance-Mediating Mutations from Non-Resistance Polymorphisms in Mycoplasma hominis Topoisomerases. Antibiotics (Basel). 2021;10(11) :1379.
- Vila J., Ruiz J., Goni P., and De Anta M.T. Datection of mutation in parC in quinolone-resistant clinical isolates of Escherichia coli. Antimicrob Agents Chemother. 1996;40(2):491-3.
References
WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.
Boudry P., Mycoplasmes uro-génitaux: Implications en pathologie humaines. Louvain Med. 1998 ; 117 :128-141.
Bebear C M., de Barbeyrac B., Pereyre S., Bebear C., Mycoplasmes et chlamydiae : Sensibilité et résistance aux antibiotiques. Rev Fr lab. 2007 ;37(391) :77-85.
Bebear C., Bebear C M. Infections humaines à mycoplasmes. Rev Fr lab. 2007; 37(391):63-9.
Demba E., Morinson L., Van Der Loeff M. S., Awasana Akum A., Gooding E., Bailey R., Mayaud P. And West B.,. Bacterial vaginosis, vaginal flora patterns and vaginal hygiene practices in patients presenting with vaginal discharge syndrome in Gambia, West Africa. BMC Infect Dis. 2005; 5 :1-12.
Guibert.M., V. Zupan.M. A. Attou .M. Dehan, and P. Nordmann, Colonisation de nouveau-nés prématurés par les mycoplasmes uro-génitaux : leur rôle au cours des dysplasies broncho-pulmonaires. Med Mal Infect. 1996; 26 (Suppl_5):612-617.
M. Ag Baraïka , R. Onanga, B. Bivigou-Mboumba , A. Mabika-Mabika , U. J. Bisvigou , F. S. Touré Ndouo , N. C. Touré-Kane. Prevalence and antimicrobial susceptibility profile of Mycoplasma hominis and Ureaplasma urealyticum in female population, Gabon. J App Biol Biotech. 2020 ;8(6):28-32.
Sangaré M., Profil de résistance aux antibiotiques des souches de Mycoplasma identifiées chez les femmes au laboratoire de bactériologie –Virologie de l’INRSP de 2014 à 2017 à Bamako, [Thèse de Pharmacie]: Faculté de Pharmacie, USTTB ; 2018.
Taylor-Robinson D., and Bebear C. Antibiotic susceptibilities of mycoplasmas and treatment of mycoplasmal infections. J Antimicrob Chemother. 1997;40(5), 622-30.
Xinyou X., Zhang J. Trends in the rates of resistance of Ureaplasma Urealyticum to antibiotics and identification of the mutation site the quinolone resistance-determining region Chinese patients. FEMS Microbiol Lett. 2006;259(2):181-186.
Bébéar C. M., Renaudin H., Charron A., Gruson D., Lefrancois M., Bébéar C. In vitro activity of trovafloxacin compared to those of five antimicrobials against mycoplasmas including Mycoplasma hominis and Ureaplasma uralyticum fluoroquinolone-resistant isolates that have been genetically characterized. Antimicrob Agents Chemother. 2000;44(9): 2557-2560.
Bébéar C. M., Renaudin H., Charron A., Clerc M., Pereyre S., Bébéar C. DNA gyrase and topoisomerase IV mutations in clinical isolates of Ureaplasma spp. and Mycoplasma hominis resistant to fluoroquinolones. Antimicrob Agents Chemother. 2003;47(10): 3323-3325.
Duffy, L., Glass, J., Hall, G., Avery, R., Rackley, R., Peterson, S., and Waites, K. Fluoroquinolone resistance in Ureaplasma parvum in the United States. J Clin Microbiol. 2006;44(4):1590-1.
Qing-Yong Wang, Rong-Hai Li, Lu-Qing Zheng, Xiao-Hong Shang. Prevalence and antimicrobial susceptibility of Ureaplasma urealyticum and Mycoplasma hominis in female outpatients, 2009-2013. J. Microbiol Immunol infect. 2016;49(3):359-62.
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297-301.
Kawai Y, Nakura Y, Wakimoto T, Nomiyama M, Tokuda T, Takayanagi T et al. In vitro activity of five quinolones and analysis of the quinolone resistance-determining regions of gyrA, gyrB, parC, and parE in Ureaplasma parvum and Ureaplasma urealyticum clinical isolates from perinatal patients in Japan. Antimicrob Agents Chemother. 2015;59(4):2358-64.
Mare M., Valentin S. N., Doroftei B., Chifiriuc M. C., Bleotu C., Socolov D. Profils de sensibilité des Mycoplasma hominis et Ureaplasma urealyticum Isolé des populations de femmes Infertiles dans le Nord de Roumanie. Braz J Microbiol. 2011; 42:256-260.
Faye-Kette H., La Ruche G., Ali Napo L., Messou N., Viho L., Welfens Ekra C., Dosso M. Genital mycoplasmas among pregmant women in cote d’Ivoire. West Africa prevalence and risk factors. Int J STD AIDS. 2000;11(9):599-602.
Everett, M. J., Jin Y. F., Ricci V., and Piddock L. J. Contribution of individual mechanisms to fluoroquinolones resistant in 36 Escherichia coli in strains isolat from humans and animals. Antimicrobial Agents Chemother, 1996; 40(10):2380-6.
Drlica, K., et Zhao X. ADN gyrase, topoisomérase IV et 4-quinolones. Microbiol. Mol. Biol. Rev. 1997. 61(3):377-392.
Sharratt, M.; Sands, K.; Portal, E.A.R.; Boostrom, I.; Mondeja, B.A.; Rodríguez, N.M.; Jones, L.C.; Spiller, O.B. Defining Fluoroquinolone Resistance-Mediating Mutations from Non-Resistance Polymorphisms in Mycoplasma hominis Topoisomerases. Antibiotics (Basel). 2021;10(11) :1379.
Vila J., Ruiz J., Goni P., and De Anta M.T. Datection of mutation in parC in quinolone-resistant clinical isolates of Escherichia coli. Antimicrob Agents Chemother. 1996;40(2):491-3.