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

The vaginal microflora of 49 women in idiopathic preterm labor was compared with that of 38 term controls to determine whether the presence of bacterial vaginosis (BV) and/or specific microorganisms would influence the rate of preterm delivery. Demographic factors, pregnancy outcome, and reproductive history were also studied. BV, as defined by the presence of clue cells in a vaginal wet mount and characteristic microbial findings in a stained vaginal smear and vaginal culture, was more common in women with preterm labor and delivery than in controls (P < 0.01). The condition, diagnosed in 41% of women who had both preterm labor and delivery (n = 22) and in 11% each of women who had preterm labor but term delivery (n = 27) and controls, was associated with a 2.1-fold risk (95% confidence intervals, 1.2 to 3.7) for preterm birth prior to 37 weeks of gestation. BV was associated with low birth weight. Of 49 women with preterm labor, 67% (8 of 12) of women with BV were delivered of low-birth-weight neonates (< 2,500 g) compared with 22% (8 of 37) of women without the condition (P < 0.0005). The presence of hydrogen peroxide-producing facultative Lactobacillus spp. was strongly negatively associated with both preterm delivery and BV. BV-associated microorganisms, i.e., Mobiluncus, Prevotella, and Peptostreptococcus species, Porphyromonas asaccharolytica, Fusobacterium nucleatum, Mycoplasma hominis, and high numbers of Gardnerella vaginalis were significantly associated with preterm delivery; all species also strongly associated with BV (P = 0.0001 for each comparison). Mobiluncus curtisii and Fusobacterium nucleatum were recovered exclusively from women with preterm delivery. Our study clearly indicates that BV and its associated organisms are correlated with idiopathic premature delivery.
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PMID:Bacterial vaginosis and vaginal microorganisms in idiopathic premature labor and association with pregnancy outcome. 812 76

In this study of the vaginal flora of 171 pregnant women in labor at term, the flora was categorized as normal (Lactobacillus predominant), intermediate, or representative of bacterial vaginosis (BV) on the basis of a vaginal smear. BV was diagnosed in 39 women (23%); the vaginal flora was classified as normal in 50% of cases and as intermediate in 27%. H2O2-producing lactobacilli were recovered from 5% of women with BV, 37% of those with an intermediate flora, and 61% of those with a normal flora. H2O2-negative lactobacilli were equally frequent (57%-65%) in all three groups. The microorganisms most frequently recovered from women with BV included Gardnerella vaginalis, Prevotella bivia/disiens, Bacteroides ureolyticus, Prevotella corporis/Bacteroides levii, Fusobacterium nucleatum, Mobiluncus species, Peptostreptococcus prevotii, Peptostreptococcus tetradius, Peptostreptococcus anaerobius, viridans streptococci, Ureaplasma urealyticum, and Mycoplasma hominis (P < .05 for each). The presence of all but three of these organisms was inversely related to vaginal colonization by H2O2-producing lactobacilli; the exceptions were B. ureolyticus, F. nucleatum, and P. prevotii. Other microorganisms were equally frequent among women with and without BV. We conclude that specific groups of anaerobes are associated with BV in this population and that a strong association exists between species associated with BV and those inhibited by H2O2-producing lactobacilli.
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PMID:The normal vaginal flora, H2O2-producing lactobacilli, and bacterial vaginosis in pregnant women. 832 31

A group of microorganisms are present concurrently in high concentrations in the vaginas of women with bacterial vaginosis. The major members of the group are Gardnerella vaginalis, anaerobic gram-negative rods belonging to the genera Prevotella, Porphyromonas and Bacteroides, Peptostreptococcus species, Mycoplasma hominis, Ureaplasma urealyticum, and often Mobiluncus species. Facultative species of Lactobacillus are present in lower concentrations and are less prevalent in bacterial vaginosis than in women with a normal vaginal examination. The exact microbe(s) responsible for bacterial vaginosis is unknown whether among the organisms listed above or an unknown agent. The high concentrations of anaerobic gram-negative rods, peptostreptococci, and other opportunistic pathogens in the lower genital tract place women with bacterial vaginosis at increased risk for genital infections and adverse pregnancy outcomes.
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PMID:The microbiology of bacterial vaginosis. 835 43

An improved understanding of bacterial vaginosis and of clinical intraamniotic infection and histologic chorioamnionitis has produced data showing strong associations among these conditions. It has recently been shown that the microorganisms in both bacterial vaginosis and clinical intraamniotic infection are similar, of which anaerobes, Gardnerella vaginalis, and Mycoplasma hominis are the predominant organisms in both. Furthermore, in the amniotic fluid of women with intraamniotic infection, strong associations among anaerobes, G. vaginalis, and M. hominis have recently been observed. In two epidemiologic studies (one in a high-risk group of women in labor and another in a lower risk group of antepartum women), the presence of bacterial vaginosis has been associated with the development of intraamniotic infection. Additional recent studies have provided new evidence that histologic inflammation of the placental membranes is associated with both clinical intraamniotic infection and positive cultures of the placenta. Multiple logistic regression analysis has shown a relationship between isolation of organisms from the chorioamnion and bacterial vaginosis.
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PMID:Chorioamnionitis and bacterial vaginosis. 835 45

Of 101 women, 15-50 years of age, presenting with vaginal discharge, 34 had bacterial vaginosis and were randomly assigned to a seven-day course of oral treatment with either erythromycin (0.5 g b.i.d.) or metronidazole (0.4 g b.i.d.) in a single-blind, cross-over study. Treatment failure (> or = three clinical signs of bacterial vaginosis) occurred in 13 (81%) of 16 patients given erythromycin, as compared with three (17%) of 18 women treated with metronidazole (p < 0.001). Persistence of Gardnerella vaginalis, Mobiluncus species and/or Mycoplasma hominis was found in 14 of 16 patients treated with erythromycin, and in four of 16 patients treated with metronidazole. Treatment with metronidazole was successful (< or = two clinical signs of bacterial vaginosis) in eight of 10 cases of erythromycin treatment failure. Neither of two cases of metronidazole treatment failure was cured with erythromycin. At three-month follow-up of 31 women, persistence or recurrence of bacterial vaginosis was diagnosed in 11 cases (36%).
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PMID:Erythromycin versus metronidazole in the treatment of bacterial vaginosis. 839 27

Bacterial vaginosis is a condition with a flora change in the vaginal where a lactobacilli-dominated flora is exchanged with an abundant complex flora dominated by strict and facultative anaerobic bacteria. The condition seldom occurs in prepubertal girls and post-menopausal women, suggesting an hormonal component in its etiology. Recurrent episodes of bacterial vaginosis are frequent. Three out of four criteria should be fulfilled for establishing the diagnosis of bacterial vaginosis, i.e., an increased (often homogeneous) vaginal discharge, a positive amine test, the presence of a great number of clue cells, a vaginal pH > or = 4.5. There are no hard data supporting that bacterial vaginosis is a sexually transmitted disease. Cytological changes (CIN I, II, III) have been found more often in women with bacterial vaginosis than in those without this condition. It has been proposed that nitrosamines from the abundant vaginal bacterial flora may be oncogenic, a correlation which, however, needs to be proved. The reservoir for one or more of the bacterial vaginosis-associated organism, e.g., some Bacteroides and Mobiluncus spp., Gardnerella vaginalis and Mycoplasma hominis, is probably the distal intestinal tract and the mouth. Sparse or even a moderate number of clue cells are present in many women who do not have bacterial vaginosis. A vaginal pH of 4.7 seems to be a better cut-off level than 4.5. There is a statistical correlation between bacterial vaginosis and obstetrical complications.
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PMID:[The definition and epidemiology of bacterial vaginosis]. 848 86

Bacterial vaginosis is characterized by a change in the vaginal ecosystem in which Lactobacillus spp, the dominant members of the normal flora, are replaced by an association of various bacterial species including Gardnerella vaginalis, anaerobes (Bacteroides spp, Prevotella spp, Porphyromonas spp, Peptostreptococcus spp and Mobiluncus spp) and Mycoplasma hominis. The reasons for this imbalance are unknown, although the loss of lactobacilli that produce hydrogen peroxide (which is toxic for G. vaginalis and numerous anaerobes) may be an essential element. The introduction of one or several of these species into the vagina (they can occasionally be isolated in small numbers even in the absence of vaginosis) following intercourse or from the intestinal tract may also play a role. G. vaginalis itself is not considered to cause vaginosis, but is almost always present and multiplies rapidly; in addition, it has a high capacity for adherence to epithelial cells both in vivo and in vitro. It is now agreed that the concomitant growth of one or several anaerobic species is required for bacterial vaginosis to develop. Our knowledge of the bacteriology of bacterial vaginosis has implications for diagnosis and treatment. It is now possible to obtain a precise bacteriologic diagnosis, not by culturing G. vaginalis (a costly and low-yield procedure), but by direct examination of the vaginal flora after Gram staining, which shows the replacement of lactobacilli by a characteristic polymorphic flora. Therapy is based on the use of antibiotics such as the imidazoles, which are active against G. vaginalis and anaerobes, but not against the commensal lactobacilli.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Recent bacteriologic data: from physiopathology to treatment]. 848 89

Vaginal swabs for microbiological culture were taken from 174 pregnant women whose vaginal flora had been evaluated by Gram's stain; 50 had grade III flora (bacterial vaginosis, BV), 50 grade II (intermediate), 41 had vaginal flora graded as abnormal which then reverted to grade I (revertants) and 33 had normal flora (controls). The aim was to determine whether bacterial species isolated from women with grade II flora differed from those with grade III flora. Isolation of Lactobacillus spp. decreased from grade I to grade III and that of other aerobic and anaerobic bacterial species increased. There was little difference in the species isolated from women with grade II and grade III flora, but there was a distinct order in which organisms in different species increased in numbers. The vaginal flora of revertants was intermediate between that of healthy controls and those with grade II flora. Coagulase-negative Staphylococcus spp. were isolated from a greater number of revertants than grade I controls but the incidence did not increase in grade II or grade III. Bifidobacterium spp. were isolated from a greater number of revertants than grade I controls and increased further in grade II and grade III. However, Gardnerella vaginalis and Mycoplasma hominis were isolated from a much larger number of women with grade III flora than the other groups. The conclusion is that grade II is a transitional phase between grade I and grade III and that some organisms such as G. vaginalis and M. hominis only reach large numbers in the late stage. The sequence of appearance of the various bacterial species may be a result of the pathophysiological alteration of the vaginal ecosystem associated with BV.
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PMID:Bacterial vaginosis in pregnancy: distribution of bacterial species in different gram-stain categories of the vaginal flora. 868 47

Since 1937, 13 Mycoplasma species, two Acholeplasma species, and one Ureaplasma species have been isolated from humans. Six of these have the urogenital tract as the primary site of colonisation but others, which have the oropharynx and respiratory tract as the primary site, are found occasionally in the urogenital tract because of orogenital contact. Mycoplasma hominis was the first to be isolated and is most strongly associated with bacterial vaginosis (BV), together with a variety of other bacteria. Its involvement in pelvic inflammatory disease (PID) and other conditions may be as part of BV, although when isolated in pure culture from the blood of women who have postpartum or postabortal fever there is no reason to suspect its aetiological role. There is evidence for an aetiological role for Ureaplasma urealyticum organisms (ureaplasmas) in acute non-gonococcal urethritis (NGU) and particularly chronic NGU in men, but they rank third to Chlamydia trachomatis and M. genitalium. Whether the association of ureaplasmas with miscarriage and preterm labour is in the context of BV is not clear. Of no doubt, however, is the ability of ureaplasmas to cause septic arthritis in hypogammaglobulinaemic patients and there is evidence that they may cause some cases of sexually acquired reactive arthritis. The advent of polymerase chain reaction technology has seen an advance in the understanding of the role of M. genitalium; there is strong evidence that it is one of the causes of both acute and chronic NGU independent of C. trachomatis. There is some support for the role of M. genitalium in PID, but this needs to be substantiated. Other mycoplasmas, for example M. fermentans, M. pivum, M. primatum, M. penetrans, M. spermatophilum and even M. pneumoniae have the capacity to cause urogenital tract disease but there is no evidence to indicate that they do so.
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PMID:Genital mycoplasma infections. 928 63

Mycoplasma hominis and Ureaplasma urealyticum can be isolated with considerable frequency from the human urogenital tract and are thought to cause various syndromes such as nongonococcal urethritis, pelvic inflammatory disease, pyelonephritis or infertility. The aim of this study was the evaluation of the presence of different genital pathogens in patients with sexually transmitted diseases (STD) and, in particular, the detection of mycoplasmas in individuals infected with genital microbes and an assessment of the presence of genital microorganisms in patients harbouring Mycoplasma hominis or Ureaplasma urealyticum. Furthermore, the occurrence of mycoplasmas in women with bacterial vaginosis was established. Specimens were collected from a total of 41,980 persons attending the Outpatients' Centre for Infectious Venero-Dermatological Diseases in Vienna from 1994 to 1996. Of all genital pathogens, Ureaplasma urealyticum was cultured most frequently in men and women. Mycoplasma hominis and Ureaplasma urealyticum were detected more often in the vaginal fluid than in the male urethra. By contrast, infection rates with Neisseria gonorrhoeae and Chlamydia trachomatis were higher in men than in women. In both men and women, trichomoniasis increased colonisation with Mycoplasma hominis, while mycoplasmas occurred less frequently together with genital candidiasis. Mycoplasma hominis was cultivated significantly more often in women with bacterial vaginosis than in those without. In contrast to urethral infections in men, cervical infections with Neisseria gonorrhoeae or Chlamydia trachomatis raised the incidence of Mycoplasma hominis in the vaginal fluid.
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PMID:Mycoplasma hominis and Ureaplasma urealyticum in patients with sexually transmitted diseases. 928 64


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