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Query: UMLS:C0026936 (Mycoplasma)
14,761 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

With the objective of determining if specific sexually transmitted diseases (STDs) are associated with prematurity (birth weight less than or equal to 2500 g and gestational age less than or equal to 36 weeks), a case-control study was conducted to evaluate women for serologic evidence of syphilis and human immunodeficiency virus infection and microbiologic evidence of cervical infection with Neisseria gonorrhoeae, Chlamydia trachomatis, and Haemophilus species and vaginal infection with genital mycoplasma, Streptococcus agalactiae, and Enterobacteriaceae. Gram stains of vaginal secretions were evaluated for bacterial vaginosis. Among 166 cases and 175 controls, infection with N. gonorrhoeae was associated with preterm birth. Four percent of controls and 11% of cases were infected with N. gonorrhoeae (odds ratio 2.9, 95% confidence interval 1.2-7.2). This association was independent of age, rupture of membranes, and hypertension. Other STDs were not associated with preterm birth. The attributable risk of gonococcal infection was 14%. Gonococcal infection appears to be responsible for a substantial proportion of premature births and is theoretically preventable by antenatal case detection and treatment.
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PMID:Maternal gonococcal infection as a preventable risk factor for low birth weight. 231 31

Bacterial vaginosis is characterized by replacement of the normal Lactobacillus-predominant vaginal flora with Gardnerella vaginalis, anaerobic bacteria, and Mycoplasma hominis. The present study evaluated the vaginal flora of women with bacterial vaginosis before and after treatment with intravaginal clindamycin cream. Sixty-seven nonpregnant women with symptoms and signs of bacterial vaginosis, and without other genital tract infections, were randomly assigned to receive placebo cream or 0.1, 1, or 2% clindamycin cream. Quantitative vaginal cultures for facultative and anaerobic bacteria and genital mycoplasmas were performed at enrollment and at 4-7 days and 4-5 weeks after completion of therapy. At enrollment, G vaginalis was recovered from 99%, Bacteroides sp from 94%, Peptostreptococcus sp from 81%, and M hominis from 58% of the 67 women with bacterial vaginosis. The vaginal cultures yielded a median of 12 isolates per specimen, with equal numbers of aerobic and anaerobic species. The mean log concentration was 1.2 X 10(9) cfu/mL for aerobic and 2.6 X 10(8) cfu/mL for anaerobic bacteria. After treatment, the frequency and concentration of bacteria per milliliter of vaginal fluid decreased for G vaginalis, Bacteroides sp, Peptostreptococcus sp, and M hominis. The 2% clindamycin cream had the greatest effect on the bacterial vaginosis-associated flora and resulted in clinical resolution of bacterial vaginosis in 15 (94%) of 16 women. Treatment with lower concentrations of clindamycin cream had less effect on the vaginal flora and resulted in clinical cure in 25 (71%) of 35 women. Therapy was associated with an increase in the frequency and concentration of Lactobacillus, and a probably transient increase in the frequency of Escherichia coli and Enterococcus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Microbiologic efficacy of intravaginal clindamycin cream for the treatment of bacterial vaginosis. 238 17

Predictors of postpartum endometritis were identified in 607 asymptomatic, laboring women. One hundred (16.5%) developed postpartum endometritis. Multivariate analysis using stepwise logistic regression identified cesarean delivery (relative risk 12.8; P less than .0001) as the dominant overall predictor. In patients with cesarean delivery (N = 124), prophylactic antibiotics (relative risk 0.54; P less than .0002) and high-virulence bacteria or Mycoplasma hominis (relative risk 1.4; P less than .01) predicted the incidence of endometritis, and in patients with vaginal delivery (N = 483), "bacterial vaginosis organisms" (relative risk 14.2; P less than .001) and aerobic gram-negative rods (relative risk 4.2; P less than .01) predicted endometritis. Despite significant associations found on univariate analysis, clinical variables such as duration of labor, rupture of membranes, and internal monitoring were not predictive of endometritis in the multivariate analysis. Our findings show that cesarean delivery and certain organisms, such as bacterial vaginosis or high-virulence organisms, predict endometritis, and that clinical variables may be facilitators rather than predictors of endometritis.
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PMID:A clinical and microbiologic analysis of risk factors for puerperal endometritis. 240 60

The diagnosis of bacterial vaginosis is usually based on clinical criteria including homogeneous vaginal discharge, an elevated vaginal pH, the presence of clue cells, and an amine odor. We have evaluated the vaginal flora and clinical signs for 593 pregnant women. Gardnerella vaginalis, Bacteroides spp., and Mycoplasma hominis were isolated more frequently among women with clinical signs than among those without clinical signs of bacterial vaginosis in multivariable analyses that controlled for other bacteria. To determine the laboratory method that best predicted bacterial vaginosis, we calculated the sensitivity, specificity, and predictive value of positive and negative tests for Gram-stained vaginal smears, gas-liquid chromatography of vaginal fluid, and G. vaginalis cultures compared with clinical signs. G. vaginalis culture was sensitive (92%) and both gas-liquid chromatography (78%) and Gram-stained vaginal smears (62%) were moderately sensitive in identifying women with three of the four clinical signs of bacterial vaginosis. However, the Gram-stained vaginal smear (95%) was more specific than G. vaginalis culture (69%) or gas-liquid chromatography (81%). The predictive value of a positive test was also higher for the Gram staining (76%) than for G. vaginalis culture (41%) or gas-liquid chromatography (48%).
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PMID:Comparison of methods for diagnosing bacterial vaginosis among pregnant women. 247 92

Premature birth is the principal cause of perinatal mortality and morbidity, despite major technological advances in neonatology and maternal-fetal medicine. Tabulation of new risk factors stimulate further research and innovative patient management ideas. These risk factors include the following concepts of risk: 1)stress, physical and psychosocial, 2) uterine irritability, 3) Events triggering uterine contractions, 4) Cervical changes detected before onset of labor, 5) Selected infections such as mycoplasma, C. trachomatis, and possibly bacterial vaginosis, 6) Inadequate plasma volume expansion and 7) Progesterone deficiency. New strategies offered for reduced preterm labor now aim prevention of premature labor rather than utilizing various treatments. Past and present management of premature labor, and new research protocols are recommended for a broader approach to preterm labor. Updated strategies for nurses employed in family planning are stressed, as well as the need for a prevention-oriented nurse base.
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PMID:New strategies for preterm labor. 271 Apr 30

We performed a two-part study to determine relationships of bacterial vaginosis and intraamniotic infection. In the first part of the study, we determined whether bacterial vaginosis organisms (Gardnerella vaginalis, Mycoplasma hominis, and anaerobes) were associated with each other in the amniotic fluid of 408 cases of intraamniotic infection. In the second part, we determined the association of bacterial vaginosis itself with intraamniotic infection in 125 cases at high risk for intraamniotic infection. Strong associations were observed among the bacterial vaginosis organisms in amniotic fluid (p less than 0.01 to p less than 0.001). Women with bacterial vaginosis were more likely to develop intraamniotic infection than those without bacterial vaginosis (69% vs. 46%, p = 0.03). Women with bacterial vaginosis were more likely to have G. vaginalis and M. hominis in the amniotic fluid (p less than 0.01 and 0.04, respectively). These observations implicate bacterial vaginosis as a cause of intraamniotic infection.
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PMID:Evidence relating bacterial vaginosis to intraamniotic infection. 278 65

The authors studied the prevalence of genital microorganisms among 300 female prostitutes in brothels in New York City and 60 female prostitutes attending a sexually transmitted diseases clinic in Rotterdam, The Netherlands. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in the two cities were 9.3% and 8.3%, 25.3% and 16.6%, 57.3% and 74.9%, and 73% and 79%, respectively. Trichomonas vaginalis was detected in 3.6% of New York prostitutes and in 16.6% of those in Rotterdam. Nonspecific vaginitis was found in 33% of prostitutes examined in New York. In New York, Asian prostitutes were more likely to be infected with C. trachomatis (33 of 102; 32.3%) than were prostitutes of other ethnic backgrounds (44 of 194; 21.5%; P less than .05.
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PMID:Prevalence of genital pathogens among female prostitutes in New York City and in Rotterdam. 301 5

We screened 392 women attending the Laboratory of Microbiology of Toulouse Purpan Hospital for symptoms of lower genital tract infection for six microorganisms. Rates of isolation of Neisseria gonorrhoeae, Chlamydia trachomatis, Candida albicans, Mycoplasma hominis, and Gardnerella vaginalis were 1%, 7.7%, 29.8%, 23.8%, and 37.5%, respectively. Trichomonas vaginalis was detected by direct examination in specimens from 3.1% of patients. Another goal of this study was to determine the relative prevalence of these microorganisms in relation to clinical and epidemiologic findings. C. trachomatis was isolated significantly more often from patients under 25 year old (P less than 0.001), from those who use oral contraceptives (P less than 0.01), from those who have a male sexual partner with symptoms of sexually transmitted disease (P less than 0.001), and from those who present signs of cervicitis (P less than 0.05). Isolation of C. albicans was significantly associated with vulvar pruritus (P less than 0.01), vulvitis (P less than 0.01), and vaginitis (P less than 0.001). G. vaginalis and M. hominis are significantly associated with bacterial vaginosis (P less than 0.001). This syndrome was diagnosed clinically in 27.2% of our study population and was highly correlated with use of an intrauterine device (P less than 0.05).
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PMID:Lower genital tract infections in women: comparison of clinical and epidemiologic findings with microbiology. 313 8

The reported study investigates the relationship of genital infections, pathobiochemical findings and demographic data to preterm labor, premature rupture of membranes (PROM) and premature delivery. The predictability of chorioamnionitis, puerperal and neonatal infections by these parameters was evaluated concurrently. 301 patients were included in this study between July 1985 and June 1986. 147 of these patients were studied longitudinally during pregnancy, delivery and puerperium (longitudinal group). A second group consisted of 154 women who presented themselves on start of labor to the labor and delivery unit of our Department (peripartal group). The incidence of preterm labor and of PROM was 26%. The incidence of premature delivery, chorioamnionitis, puerperal and neonatal infection was 11.4%, 5.5%, 7.6% and 3% respectively. Cervical colonization with Mycoplasma hominis correlated positively with PROM (relative risk 2.2), premature delivery (3.9) and neonatal infection (6.9). Chorioamnionitis, premature delivery and puerperal infection were also significantly increased in patients with positive vaginal Ureaplasma urealyticum cultures during pregnancy and delivery. Premature delivery (2.8) and puerperal infection (4.0) were associated with a vaginal group B-Streptococci (GBS) colonization during pregnancy, as was a positive GBS culture during delivery associated with puerperal infection. Bacterial vaginosis also correlated positively with premature delivery (5.6) and puerperal infection. Preterm labor correlated negatively with the socioeconomic level, PROM correlated negatively with the marital status, positively with age, a history of cervical cerclage, conization or PROM during former pregnancies. Sexual intercourse more often than once weekly during the last month of pregnancy was also associated with an increased number of PROM. Gardnerella vaginalis, Candida and Trichomoniasis during pregnancy and delivery were associated with preterm labor and puerperal infections. Levels of maternal plasma fibrinogen concentrations in patients with PROM were elevated 48 hours after delivery in accordance to the characteristics of acute phase proteins. In contrast, the maternal PMN-granulocyte-elastase concentration was significantly elevated at time of delivery and 24 hours thereafter in those patients who developed puerperal infections. The derived positive predictive value was 26%, the negative 94.7%, respectively. The overall accuracy of the prediction was 83.1%. Six out of seven mothers with neonates treated because of neonatal infection showed significantly elevated plasma concentration of PMN-granulocyte-elastase.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Genital infections and the course of pregnancy: a prospective study]. 321 43

The role of Mycoplasma hominis in pelvic inflammatory disease (PID) was studied among 35 patients with laparoscopically confirmed salpingitis or histopathologically confirmed plasma cell endometritis. M. hominis was isolated from the cervix of 15 patients, from the rectum of 13 patients, and from the endometrium of 5 patients. Only two of these five patients had M. hominis isolated from the endometrium in the absence of Chlamydia trachomatis or Neisseria gonorrheae, the major PID-causing organisms. None of the patients had M. hominis isolated from the fallopian tubes. Of the 35 patients, 7 demonstrated a significant change in enzyme immunoassay antibody levels to M. hominis, suggesting a recent infection with the organism. Six of the seven patients had M. hominis isolated from the cervix, and one had the organism isolated from the endometrium. Compared with patients not having M. hominis isolated from the cervix or endometrium, those who did more frequently had positive serum antibody findings for M. hominis and abnormal gas-liquid chromatographic findings of the vaginal fluid, indicative of bacterial vaginosis.
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PMID:Mycoplasma hominis in patients with pelvic inflammatory disease. 331 9


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