MYCO WELL D-ONE: Can a new rapid diagnostic detect Ureaplasma spp. and Mycoplasma hominis in genitourinary medicine samples?

Morris, Daniel 2019. MYCO WELL D-ONE: Can a new rapid diagnostic detect Ureaplasma spp. and Mycoplasma hominis in genitourinary medicine samples? MPhil Thesis, Cardiff University.

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Abstract

The genital mycoplasmas – Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum – are frequently associated with symptomatic genitourinary medicine patients. Currently there is no provision to test for these organisms within the National Health Service. Ureaplasma spp. are isolated from 11–26% of men with non-gonococcal urethritis. Bacterial vaginosis (BV) – present in 20–30% of females attending – has been repeatedly linked to M.hominis. The MYCO WELL D-ONE is a rapid culture-based assay that utilises specialist media to detect these organisms in samples collected as part of routine sexual health screenings. Alongside detection, the MYCO WELL D-ONE concurrently screens organisms for antibiotic resistance. IRAS ethics number 230693 was granted for this study. 983 Samples were collected from 857 patients attending sexual health clinics in Cwm Taf: 528 female patients (121 provided both urine and swabs) and 329 male patients. This is the first clinical validation of the MYCO WELL D-ONE to be carried out in the UK against the current ‘gold standard’ molecular detection methods. Isolates highlighted as resistant by MYCO WELL D-ONE were subjected to confirmatory antibiotic susceptibility testing (AST) in accordance with the current CLSI guidelines. Isolates confirmed as resistance underwent whole genome sequencing to determine the underlying genetic mechanism conferring their resistance. Ureaplasma spp. was isolated from 57.2% of female patients compared to 21.6% of males. For M. hominis, 16.3% of females and 4.3% of males were infected. The MYCO WELL D-ONE displayed sensitivity values of 91.8% and 78.2%, alongside specificity values of 96.49% and 98.84%, for the detection of Ureaplasma spp. and M. hominis, respectively. Antibiotic resistance rates in Ureplasma spp. were found to be 0.54% for tetracycline and levofloxacin, with a tetracycline resistance rate of 1% for M. hominis. The prevalence of genital mycoplasma in the South Wales Valleys convergence area is significantly higher in the female population, consistent with other studies at different geographic locations. The MYCO WELL D-ONE is a simple, sensitive and specific means of detecting these organisms. It offers clinicians a rapid, easy-to-use and inexpensive method of determining the presence of mycoplasma in symptomatic sexual health patients.

Item Type:	Thesis (MPhil)
Date Type:	Completion
Status:	Unpublished
Schools:	Medicine
Date of First Compliant Deposit:	12 November 2019
Last Modified:	29 Mar 2021 12:51
URI:	https://orca.cardiff.ac.uk/id/eprint/126727

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