Antibiotic Resistance among Clinical Ureaplasma Isolates Recovered from Neonates in England and Wales between 2007
Michael L Beeton1, Victoria J Chalker2, Lucy C Jones3
1Department of Biomedical Sciences, Cardiff Metropolitan University, School of Health Sciences, Cardiff, United Kingdom mbeeton@cardiffmet.ac.uk.
Abstract:
Ureaplasma spp. are associated with numerous clinical sequelae with treatment options being limited due to patient and pathogen factors. This report examines the prevalence and mechanisms of antibiotic resistance among clinical strains isolated from 95 neonates, 32 women attending a sexual health clinic, and 3 patients under investigation for immunological disorders, between 2007 and 2013 in England and Wales. MICs were determined by using broth microdilution assays, and a subset of isolates were compared using the broth microdilution method and the Mycoplasma IST2 assay. The underlying molecular mechanisms for resistance were determined for all resistant isolates. Three isolates carried the tet(M) tetracycline resistance gene (2.3%; confidence interval [CI], 0.49 to 6.86%); two isolates were ciprofloxacin resistant (1.5%; CI, 0.07 to 5.79%) but sensitive to levofloxacin and moxifloxacin, while no resistance was seen to any macrolides tested. The MIC values for chloramphenicol were universally low (2 μg/ml), while inherently high-level MIC values for gentamicin were seen (44 to 66 μg/ml). The Mycoplasma IST2 assay identified a number of false positives for ciprofloxacin resistance, as the method does not conform to international testing guidelines. While antibiotic resistance among Ureaplasma isolates remains low, continued surveillance is essential to monitor trends and threats from importation of resistant clones.
Insights
Antibiotic resistance in Ureaplasma species remains low, with tetracycline and ciprofloxacin resistance detected in a small percentage of clinical isolates. Continued surveillance is crucial for monitoring emerging resistance trends.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Ureaplasma species are linked to various clinical issues, yet treatment is often challenging.
- Understanding antibiotic resistance in Ureaplasma is vital for effective patient management.
Purpose of the Study:
- To investigate the prevalence and resistance mechanisms of Ureaplasma strains.
- To assess antibiotic susceptibility in clinical isolates from diverse patient groups.
Main Methods:
- Broth microdilution assays determined Minimum Inhibitory Concentrations (MICs).
- Molecular mechanisms of resistance were identified in resistant isolates.
- Comparison of broth microdilution with the Mycoplasma IST2 assay was performed.
Main Results:
- Low prevalence of antibiotic resistance observed: 2.3% carried tet(M) for tetracycline resistance, 1.5% were ciprofloxacin resistant.
- Isolates remained sensitive to macrolides; chloramphenicol MICs were low, gentamicin MICs were high.
- The Mycoplasma IST2 assay showed false positives for ciprofloxacin resistance.
Conclusions:
- Antibiotic resistance in Ureaplasma isolates is currently low.
- Ongoing surveillance is necessary to detect imported resistant strains and evolving resistance patterns.
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