Background The risks of untreated sexually transmitted infections in association with termination of pregnancy are known to increase the risk of post-termination complications. Local studies have shown a high genital tract carriage of mycoplasmas. Tetracyclines are widely used as first line agents against when ureaplasmal infection is detected However, there is limited data on the susceptibility profiles and mechanisms of resistance amongst Ureaplasma strains circulating in the Pretoria community. This study was undertaken to determine antimicrobial resistance to tetracycline among Ureaplasma species isolated from women presenting for termination of pregnancy at a tertiary referral hospital in South Africa.
Methods Two vaginal swabs were collected from each of 100 women after written informed consent was obtained. The first swab was used for PCR detection of genital ureaplasmas and tetracycline- resistance genes. The second swab was used for culture (Mycoplasma Duo kit) and phenotypic antimicrobial susceptibility testing (SIR Mycoplasma kit).
Results Ureaplasma species were isolated from 46 women (46%). Forty-two women were infected with U. urealyticum, 1 with U. parvum and 3 were dually infected. Susceptibility profiles were obtained for 41 isolates. Fifteen (36.6%) demonstrated resistance to tetracycline. Fourteen (34.1%) were also resistant to doxycycline with 1 isolate showing intermediate resistance. All 41 strains contained the tetM gene, 39 contained the 1.7kb fragment of the tetracycline resistance gene and 36 strains contained the int-Tn gene.
Conclusion Genital ureaplasmas were isolated from nearly half the study population of women presenting for TOP. The predominant species identified was U urealyticum. Tetracycline and doxycycline resistance was detected nearly a third of the isolates and this has implications for management of patients to prevent post-partum complications. The study will be expanded and communicated to the National Department of Health as this will impact future strategies of intervention in this country.
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