Coinfection of ureaplasma urealyticum/mycoplasma hominis in hpv positive women: Frequency, risk factors and multidrug resistance

Abstract

Objective: In the development of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN), the most significant cause is high-risk human papillomavirus (HPV) persistence. There are studies reporting high rates of co-prevalent Ureaplasma urealyticum in those who have an HPV infection. In this study, U. urealyticum positivity and antibiotic resistance rates were investigated in HPV positive women who were asymptomatic in terms of sexually transmitted disease. Material and Methods: In this retrospective cohort study, demographic data of the patients with HPV whose cervical swap were sent to the microbiology laboratory for Mycoplasma culture were obtained from hospital data management system. Mycoplasma culture is done by using a commercial kit (Mycoplasma IES (AutoBio Diagnostics, China) detecting Mycoplasma hominis and U. urealyticum and antibiotic susceptibility, simultaneously. The demographic data of the cases, HPV test, cervical smear, colposcopy findings and cervical biopsy results were compared according to the Mycoplasma/Ureaplasma culture and antibiogram results. Patients with multidrug-resistant U. urealyticum were evaluated according to risk factors. Results: HPV and U. urealyticum, HPV and M. hominis coinsidence were found as 43.1% and 1.5%, respectively. No significant difference was found in terms of demographic data. HPV type, cervical smear, colposcopy and cervical biopsy findings were also not correlated with culture positivity. The multidrug-resistant (MDR) U. urealyticum ratio was 35.7%. The most resistant and susceptible antibiotics are ciprofloxacin (96.4%) and minocyclin (100%), respectively. In patients with high-risk HPV positive, MDR positivity was significantly higher. Conclusion: In this study, it could not find any correlation of HPV type of cases, cervical smear results, colposcopy findings, cervical biopsy results with U. urealyticum culture results. Multi-drug resistant U. urealyticum (MDR-UU) positivity rates were detected statistically higher in the patients with high-risk-HPV. When HPV positivity is detected in reproductive women, existence of MDR-UU positivity should be considered.