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Isolation of Mycoplasma hominis in critically ill patients with pulmonary infections: clinical and microbiological analysis in an intensive care unit

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Abstract

Objective

Mycoplasma hominis is a well recognized extragenital pathogen. However, it is an uncommon cause of respiratory infections in critically ill patients admitted to the intensive care unit (ICU).

Design and setting

Prospective clinical investigation in a 21-bed ICU in a university hospital.

Patients

Seven patients requiring intensive care who developed a ICU-acquired pneumonia in which M. hominis was recovered from bronchoalveolar lavage and pleural fluid cultures.

Interventions

M. hominis was isolated in all patients by use of conventional bacteriological cultures. All strains were identified by 16S rRNA gene sequencing analysis. Patients' charts were reviewed for each case of infection.

Results

Seven strains of M. hominis were isolated during a 4-year period. All of these isolates were recovered from adult men admitted to the ICU and all had clinical signs of pneumonia. In three patients treatment for M. hominis with quinolones was associated with a good clinical response.

Conclusion

Suspicion of M. hominis pneumonia must be heightened particularly in critically ill patients. Therefore an understanding of the microbiology of this organism is essential to successfully treat patients with these infections that are not ordinarily covered with standard antibiotic therapy.

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References

  1. 1.

    Azoulay E, Alberti C, Legendre I, Buisson CB, Le Gall JR; European Sepsis Group (2005) Post-ICU mortality in critically ill infected patients: an international study. Intensive Care Med 31:56–63

  2. 2.

    Acquarolo A, Urli T, Perone G, Giannotti C, Candiani A, Latronico N (2005) Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study. Intensive Care Med 31:510–516

  3. 3.

    Clec'h C, Timsit JF, De Lassence A, Azoulay E, Alberti C, Garrouste-Orgeas M, Mourvilier B, Troche G, Tafflet M, Tuil O, Cohen Y (2004) Efficacy of adequate early antibiotic therapy in ventilator-associated pneumonia: influence of disease severity. Intensive Care Med 30:1327–1333

  4. 4.

    Waites KB, Rikihisa Y, Taylor-Robinson D (2003) Mycoplasma and ureaplasma. In: Murray PR, Baron EJ, Jorgensen JM, Pfaller MA, Yolken RH (eds) Manual of clinical microbiology. American Society for Microbiology, Washington, pp 972–990

  5. 5.

    Meyer RD, Clough W (1993) Extragenital Mycoplasma hominis infections in adults: emphasis on immunosuppression. Clin Infect Dis 17(Suppl 1):243–249

  6. 6.

    Waites KB, Bébéar CM, Robertson JA, Talkington DF, Kenny GE (2001) Cumitech 34. Nolte FS (ed) Laboratory diagnosis of mycoplasmal infections. American Society for Microbiology, Washington

  7. 7.

    Saez A, Monteagudo I, Miñambres E, Ots E, Rodriguez-Borregan JC, García C (2003) Pneumonia due to Mycoplasma hominis in a healthy adult. Scand J Infect Dis 35:282–284

  8. 8.

    Izenberg HD (2003) Respiratory tract cultures.– In: Clinical microbiology. Procedures handbook, 2nd edn, vol 1. ASM, Washington

  9. 9.

    Kuppeveld FJ van, van der Logt JT, Angulo AF, van Zoest MJ, Quint WG, Niesters HG, Galama JM, Melchers WJ (1992) Genus- and species-specific identification of mycoplasmas by16S rRNA amplification. Appl Environ Microbiol 58:2606–2615

  10. 10.

    Roberts MC (1992) Antibiotic resistance. In: Maniloff J (ed) Mycoplasmas: molecular biology and pathogenesis. American Society for Microbiology, Washington, pp 513–523

  11. 11.

    Dosa E, Nagy E, Falk W, Szoke I, Ballies U (1999) Evaluation of the Etest for susceptibility testing of Mycoplasma hominis and Ureaplasma urealyticum. J Antimicrob Chemother 43:575–578

  12. 12.

    Mufson MA (1983) Mycoplasma hominis: a review of its role as a respiratory tract pathogen of humans. Sex Transm Dis 10(Suppl 4):226–229

  13. 13.

    Lyon GM, Alspaugh JA, Meredith FT, Harrell LJ, Tapson V, Davis RD, Kanj SS (1997) Mycoplasma hominis pneumonia complicating bilateral lung transplantation: case report and review of the literature. Chest 112:1428–1432

  14. 14.

    Giantsou E, Liratzopoulos N, Efraimidou E, Panopoulou M, Alepopoulou E Kartali-Ktenidou S, Minopoulos GI, Zakynthinos S, Manolas KI (2005) Both early-onset and late-onset ventilator-associated pneumonia are caused mainly by potentially multiresistant bacteria. Intensive Care Med 31:1488–1494

  15. 15.

    Hubmayr RD, Burchardi H, Elliot M, Fessler H, Georgopoulos D, Jubran A, Limper A, Pesenti A, Rubenfeld G, Stewart T, Villar J (2002) Statement of the 4th International Consensus Conference in Critical Care on ICU-Acquired Pneumonia-Chicago, Illinois, May 2002. Intensive Care Med 28:1521–1536

  16. 16.

    Waites KB, Canupp KC (2001) Evaluation of BacT/ALERT system for detection of Mycoplasma hominis in simulated blood cultures. J Clin Microbiol 39:4328–4331

  17. 17.

    Davies S, Spencer RC (1998) Effect of blood culture media on the in vitro recovery of Mycoplasma hominis. J Infect 17:215–220

  18. 18.

    Combes A, Figliolini C, Trouillet JL, Kassis N, Wolff M, Gibert C, Chastre J (2002) Incidence and outcome of polymicrobial ventilator-associated Pneumonia. Chest 121:1618–1623

  19. 19.

    Kenny G, Cartwright F (2001) Susceptibilities of Mycoplasma hominis, M. pneumoniae, and Ureaplasma urealyticum to GAR-936, dalfopristin, dirithromycin, evernimicin, gatifloxacin, linezolid, moxifloxacin, quinupristin-dalfopristin, and telithromycin compared to their susceptibilities to reference macrolides, tetracyclines, and quinolones. Antimicrob Agents Chemother 45:2604–2608

  20. 20.

    Kollef MH, Sherman G, Ward S, Fraser VJ (1999) Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients. Chest 115:462–474

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Acknowledgements

We are grateful to Alfonso García-Balán for correcting the English version.

Author information

Correspondence to Eduardo Miñambres.

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García, C., Ugalde, E., Monteagudo, I. et al. Isolation of Mycoplasma hominis in critically ill patients with pulmonary infections: clinical and microbiological analysis in an intensive care unit. Intensive Care Med 33, 143–147 (2007). https://doi.org/10.1007/s00134-006-0435-8

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Keywords

  • Mycoplasma hominis
  • Pneumonia
  • Intensive care unit