The Occurrence and Antimicrobial Susceptibility Patterns of Mycoplasma hominis and Ureaplasma urealyticum in Pregnant Women in Three District Hospitals in Douala, Cameroon

Abstract

Background: Mycoplasma hominis and Ureaplasma urealyticum are bacteria without cell wall, mostly isolated from the genito-urinary tract of both men and women. They are associated with infertility, pelvic inflammatory disease, cervicitis, epididymitis, obstetric pathologies as well as perinatal disorders. M. hominis and U. urealyticum have higher mutation rates and increasing antimicrobial resistance being reported. Proper treatment will reduce adverse maternal and foetal outcomes during and after pregnancy. Aim: This study was carried out to determine the prevalence and antimicrobial susceptibility profile of Mycoplasma hominis and Ureaplasma urealyticum in pregnant women in Douala. Study Design: This was a cross-sectional study involving pregnant women. Methods: One hundred pregnant women enrolled from the antennal care unit of three district hospitals in Douala. A questionnaire was administered to each consenting participant and a cervical swab collected. Isolation, enumeration and sensitivity tests were done using Mycoplasma IES kit. Results: Overall, the prevalence of genital mycoplasmas was 38% (95% CI: 28.5 – 48.3). The prevalence of M. hominis, U. urealyticum and coinfection with M. hominis and U. urealyticum were 4%, 29%, and 5% respectively. Prevalence of genital mycoplasmas was significantly higher in women between 21 and 25 years, hairdressers, and women who had a history of two spontaneous abortions. M. hominis isolates were most sensitive to pristinamycin (100%), josamycin (75%), clindamycin (75%) and levofloxacin (75%), while U. urealyticum were most sensitive to josamycin (79.31%) and pristinamycin (72.41%). All M. hominis isolates were resistant to erythromycin, roxythromycin, ciprifloxacin, clarithromycin, and tetracycline, meanwhile all U. urealyticum isolates were resistant to clindamycin. Conclusion: This study revealed a high prevalence of genital mycoplasmas in the target population. The mycoplasmas were most sensitive to josamycin and pristinamycin. These findings underscore the need for regular screening and appropriate treatment of mycoplasmas in pregnant women in Douala.