Incidence and antimicrobial susceptibilities of genital mycoplasmas in outpatient women with clinical vaginitis in Athens, Greece

Objectives: The incidence and antimicrobial susceptibilities of Ureaplasma urealyticum and Mycoplasma hominis, isolated from vaginal and endocervical swabs collected from 369 outpatient women, were determined. Methods: Isolation, identification and typing of the pathogens were performed by means of conventional methods. The antimicrobial susceptibilities of the genital mycoplasmas were determined with commercially available kits and evaluated according to the CLSI. Results and conclusions: In 65 (47.44%) out of the 137 positive specimens, U. urealyticum was grown as a single pathogen, in 0.72% M. hominis was grown as a single pathogen and in 2.92% both urogenital mycoplasmas were grown. In the remaining specimens (48.90%), there was a mixed growth with other microbes. Of the isolated U. urealyticum strains, 87.4% and 98.2% were susceptible to tetracycline and doxycycline, respectively, 79.2% were susceptible to josamycin, 48.6% were susceptible to clarithromycin and 91.8% were susceptible to pristinamycin, while erythromycin, azithromycin, ciprofloxacin and ofloxacin proved to be inactive against most of the strains. M. hominis isolates were 100% susceptible to tetracycline, doxycycline and pristinamycin, while susceptibilities to the other antimicrobial agents varied mainly in the range of 'intermediate' or 'resistant'. As results originating from similar studies from various countries are very controversial, the simplest way to avoid therapeutic failures would be the implementation of rational treatment regimens based on culture isolation and the in vitro determination of the antimicrobial susceptibility of genital mycoplasmas in each clinical case