“Genital Mikoplazma” sıklığının multipleks gerçek zamanlı polimeraz zincir reaksiyonu ile saptanması: Klinikte önemli olabilir mi?

Öz

Amaç: Genital mikoplazma etkenleri, erişkin ve infantlarda birçok enfeksiyon ile ilişkilidir. Bu nedenle etkenlerin doğru ve hızlı tanısı önemlidir. Kültür yöntemlerinde karşılaşılan sorunlar ve mikoplazmaların fastidiyöz özellik taşıması nedeniyle, günümüzde enfeksiyöz ajanların tanısında yaygın olarak kullanılan moleküler yöntemler genital mikoplazma enfeksiyonlarının tanısında da kullanılabilmektedir. Bu çalışmada merkezimize rutin tanı amacıyla gönderilen semptomatik hastalarda Multipleks Gerçek Zamanlı Polimeraz Zincir Reaksiyonu ile genital mikoplazma sıklığının araştırılması amaçlanmıştır. Yöntem: Ocak 2016-Aralık 2017 tarihleri arasında Halk Sağlığı Genel Müdürlüğü, Cinsel Yolla Bulaşan Hastalıklar Referans Laboratuvarı’na tanı amacıyla gönderilen, 0-72 yaş olguları içeren 359 semptomatik hastaya 179 kadın, 180 erkek ait ürogenital örnek çalışmaya dahil edilmiştir. Toplam 359 hastaya ait akıntı veya idrar örneğinden Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum ticari Gerçek Zamanlı PZR testi ile çalışılmıştır. Bulgular: Toplam 359 hastanın %25,62’sinin 92/359 tek ve çoklu etken ile kolonize olduğu tespit edilmiştir. Çoklu etken pozitifliği 18 %5 hastada saptanmıştır. Ureaplazma pozitif örneklerin %52,70 39/74 ’i U. parvum, %47,3 35/74 ’i U. urealyticum; Mikoplazma pozitif hastaların ise %81,08 30/37 ’i M. hominis ve %18,92 7/37 ’si M. genitalium olarak tespit edilmiştir. Kadınlarda U. parvum ve erkeklerde U. urealyticum sıklığının diğer etkenlere göre daha yüksek olduğu tespit edilmiştir. M. hominis, M. genitalium ve U. parvum en fazla 30-34 yaş grubunda görülürken, U. urealyticum 18-24 yaş grubunda görülmüştür.. Sonuç: Genital mikoplazmaların patojenik rolünün gittikçe arttığı kabul edildiğinden, semptomatik olgularda enfeksiyon etkenleri araştırılırken genital mikoplazmaların akılda tutulması gerektiği düşünülmüştür. Ayrıca, erken tedavi ve komplikasyonların zamanında önlenebilmesi için duyarlılık ve özgüllüğü yüksek olan tanı metodlarının kullanılarak etkenlerin ayırımının yapılması gerektiği düşüncesine varılmıştır.

Anahtar Kelimeler

• Genital mikoplazma, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Mycoplasma genitalium

Detection of “Genital Mycoplasma” incidence by multiplex real-time polymerase chain reaction: Could it be clinically important?

Öz

Objective: Genital mycoplasma agents are associated with many infections in adults and infants. Therefore rapid and accurate diagnosis of the agents is important. Molecular methods commonly used in the diagnosis of infectious agents can also be used to diagnose genital mycoplasma infections because of the problems encountered in culture methods and the fastidious characteristic of mycoplasmas. In this study, it was aimed to investigate the frequency of genital mycoplasma with multiplex Real Time Polymerase Chain Reaction in symptomatic patients sent to our center for routine diagnosis. Methods: Urogenital samples of 359 symptomatic patients 179 women, 180 men aged 0-72 years, sent to the Public Health General Directorate, Sexually Transmitted Diseases Reference Laboratories for diagnosis between January 2016 and December 2017 were included in the study. Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Ureaplasma parvum were investigated by commercially available Real-Time PCR test from urine or discharge samples of 359 patients. Results: It was determined that 25.62% 92/359 of 359 patients were colonized with single and multiple agents. Multiple agents positivity was detected in 18 patients 5% . Among Ureaplasma positive patients 52.70% 39/74 of them were detected as U. Parvum and % 47, 3 35/74 of them as U. urealyticum. Among mycoplasma positive patients 81.08% 30/37 of them were detected as M. hominis and 18.92% 7/37 of them were detected as M. genitalium. U. parvum and U. urealyticum were found to be the most frequent agents in females and males respectively. M. hominis, M. genitalium and U. parvum were most commonly present in the 30-34 ages group, while U. urealyticum was mostly detected in the 18-24 ages group. Conclusion: In conclusion, since the pathogenic role of genital mycoplasma agents is increasingly accepted, it is considered that genital mycoplasmas should be kept in mind while investigating the infection agents during symptomatic cases. It has been thought that for early treatment and for the prevention of complications in a timely manner, it is necessary to differentiate the agents by using highly sensitive and specific methods.

Anahtar Kelimeler

• Genital mycoplasma, Ureaplasma urealyticum, Ureaplasma parvum, Mycoplasma hominis, Mycoplasma genitalium

Kaynakça

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