Investigation Of The Prevalence Of Neisseria Gonorrhoeae, Chlamydia Trachomatis, Mycoplasma Hominis And Ureaplasma Urealyticum In Genitouriner Tract Of Patient With HPV

Öz

Objective: In this study, investigation of the prevelance of C.trachomatis, N.gonorrhoeae, U.urealyticum and M.hominis patogens in patients with HPV and elemination of incorrect treatment choices are aimed. Material and Method: Ninety-two women patients with vaginal discharge who admitted OMU faculty of medicine obstetrics and gynecology deparments were included in the study. Of ninety-two women, fortysix were included in the HPV positive patient group and other fortysix were included in the HPV negative control group. C.trachomatis and N.gonorrhoeae were performed by real-time PCR and U.urealyticum and M.hominis were performed by Mycoplasma IST 2 kit. Results: Growth was detected in eighty patients by Mycoplasma IST 2 kit. Also, both U.urealyticum and M.hominis were detected in five patients in the patient group. M.hominis was observed in five individuals and U.urealyticum was observed in eighty individuals. Totally, U.urealyticum growth of ≥104 cfu/ml was detected in eighty individuals and M.hominis growth of ≥104 cfu/ml was detected in five individuals. U.urealyticum was isolated in forty-three individuals in the patient group and in thirty-seven individuals in the control group. In the antibiotic susceptibilities testing of the microorganism from the patient group, the highest resistance rates were seen against erythromycin, tetracycline and clarithromycine. All of the M.hominis strains were found to be resistant to erythromycin and tetracycline. In one patient, resistance to all tested antibiotics was detected and U.urealyticum and M.hominis were isolated together in this patient. In thirty-seven U.urealyticum growth in the control group, the highest resistance rates were seen ofloksasin and erythromycin. PCR results test of two patients were found to be positive by Duplica Real Time Advanced C.trachomatis and Duplica Real Time Advanced N.gonorrhoeae kit. N.gonorrhoeae DNA was detected in no patients. The two patients with C.trachomatis DNA positive was in the patient group and U.urealyticum and M.hominis positivities werw detected by Mycoplasma IST 2 kit in these patients. Conclusion: As a conclusion, U.urealyticum was more prevelant than M.hominis, similar to other studies. Clinicly a significant association between HPV positivity and the existence of C.trachomatis, N.gonorrhoeae, U.urealyticum and M.hominis wasn’t detected. More comprensive studies are needed to evaluate the relationship among this organisms.

Anahtar Kelimeler

• C.trachomatis
• U.urealyticum
• M.hominis
• Real-time PCR
• HPV

HPV Tanısı Konmuş Hastaların Genitoüriner Sisteminde Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis ve Ureaplasma urealyticum Sıklığının Araştırılması

Öz

Amaç: Bu çalışmada cinsel yolla bulaşan Neisseria gonorrhoeae, Chlamidya trachomatis, Mycoplasma hominis ve Ureaplasma urealyticum patojenlerinin klinik olarak HPV tanısı konmuş hastalardaki sıklığının araştırılması ve yanlış tedavi seçeneklerinin ortadan kaldırılması amaçlanmıştır. Yöntem: Çalışma kapsamına OMÜ Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilimdalı polikliniğine başvuran vajinal akıntısı olan 92 kadın dahil edilmiştir. 92 kadının 46’sı klinik olarak HPV(+) tanısı almış hasta grubunu, 46’sı klinik olarak HPV(-) kontrol grubunu oluşturmuştur. C.trachomatis ve N.gonorrhoeae Real-time PCR yöntemi ile, M.hominis ve U.urealyticum Mycoplasma IST 2 kit yöntemi ile araştırılmıştır. Bulgular: Mycoplasma IST 2 kiti ile çalışılan örneklerden kontrol ve hasta grubundaki toplam 92 kadından 80’inde (≥104 CFU/ml) üreme saptanmıştır. Ayrıca hasta grubunda 5 kişide hem M.hominis (≥104 CFU/ml) hem de U.urealyticum (≥104 CFU/ml) tespit edilmiştir. Hasta grubundan 43 kişide, kontrol grubundan 37 kişide U.urealyticum izole edilmiştir. Yapılan Fisher ve düzeltilmiş Yates istatistiksel analizde hasta ve kontrol grupları arasında HPV(+)’liğiyle anlamlı bir fark bulunmamıştır (p>0,05). Hasta grubundan izole edilen mikroorganizmaların antibiyotik duyarlılıkları değerlendirildiğinde; en yüksek derecede direnç eritromisin, tetrasiklin, klaritromisine karşı görülmüştür. Tüm M.hominis suşları eritromisin ve tetrasikline dirençli bulunmuştur. Bir hastada test edilen bütün antibiyotiklere direnç saptanmıştır ve bu hastada M.hominis ve U.urealyticum birlikte izole edilmiştir. Kontrol grubunda üreyen 37 U.urealyticum da ise en yüksek derecede direnç ofloksasin ve eritromisine karşı görülmüştür. Duplica Real Time Advanced C.trachomatis ve Duplica Real Time Advanced N.gonorrhoeae kitleri ile çalışılan örneklerden 2 kişide C.trachomatis PCR sonucu pozitif bulunmuştur. Hiçbir hastada N.gonorrhoeae DNA tespit edilememiştir. Pozitif bulunan 2 C.trachomatis DNA sonucu HPV (+) olan hasta grubuna dahil ve bu 2 hastada Mycoplasma IST 2 kiti ile yapılan çalışmada M.hominis ve U.urealyticum pozitifliği de tespit edilmiştir. Sonuç: Sonuç olarak bizim çalışmamızda da diğer çalışmalarla benzer olarak U.urealyticum’a M.hominis’ten daha sık rastlanmıştır. İstatistiksel analizde klinik olarak HPV (+)’liğinin C.trachomatis, U.urealyticum ve M.hominis birlikteliğiyle anlamlı bir ilişkisinin olduğu saptanmamıştır (p>0,05). C.trachomatis, N.gonorrhoeae, M.hominis ve U.urealyticum’un hakkında çalışmalar arttıkça daha doğru sonuçlar elde edilebilecektir.

Anahtar Kelimeler

• C.trachomatis
• U.urealyticum
• M.hominis
• Real-time PCR
• HPV

Kaynakça

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