PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF MYCOPLASMA INFECTIONS IN

PATIENTS ATTENDING CPC/AG

TABLE OF CONTENT

LIST OF FIGURES ......................................................................................................................................iii

LIST OF TABLES ........................................................................................................................................ iv
LIST OF ABBREVIATIONS ...........................................................................................................................v
DEDICATION ............................................................................................................................................ vi
AKNOWLEDGEMENT .............................................................................................................................. vii
PRESENTATION OF THE ENTERPRISE ..................................................................................................... viii
I.Geographical location of the enterprise ......................................................................................... viii
II.Complete address............................................................................................................................. ix
III.History ............................................................................................................................................. ix
IV.Activity sector...................................................................................................................................x
V.Number of personnel ........................................................................................................................x
VI.Hierarchical organigram ................................................................................................................. xii
RESUME ................................................................................................................................................. xiii
ABSTRACT .............................................................................................................................................. viii
INTRODUCTION ....................................................................................................................................... 1
PART ONE: LITERATURE REVIEW ............................................................................................................. 2
GENERALITIES .......................................................................................................................................... 2
I.The Genital system ............................................................................................................................ 2
I.1-The Male Genital System ........................................................................................................... 2
I.2- The female Genital system ........................................................................................................ 3
II.Sexually transmissible infections...................................................................................................... 4
II.1- Viral Sexually Transmissible Infections .................................................................................... 5
II.2. Bacterial Sexually Transmissible Infections .............................................................................. 6
III.Mycoplasma infections ................................................................................................................... 7
II.1-Infections to Mycoplasma Hominis ........................................................................................... 9
III.2- Infection to Ureaplasma urealyticum ................................................................................... 10
V. Signs and Symptoms of M.hominis and U. urealyticum ................................................................ 12
VI. Epidermioloy of M.hominis and U.urealyticum ........................................................................... 13
VII. Method of diagnosis of M.hominis and U.urealyticum ............................................................... 13
VIII. Treatment and Prophylaxis ........................................................................................................ 14
IX. Consequences of Infection ........................................................................................................... 14
X. Prevention and control of Mycoplasma hominis and Ureaplasma urealyticum Infections .......... 15
XI. Antimicrobial Susceptibility .......................................................................................................... 16
PART THREE: MATERIAL AND METHOD ................................................................................................ 18

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I. MATERIALS ................................................................................................................................ 19
II.METHOD ......................................................................................................................................... 20
II.1. RETROSPECTIVE STUDY .......................................................................................................... 21
II.2. CROSS-SECTIONAL STUDY ...................................................................................................... 21
PART THREE: RESULTS AND DISCUSSION .............................................................................................. 26
I. RETROSPECTIVE STUDY .................................................................................................................. 26
I.1-General prevalence of Mycoplasma with respect to years...................................................... 26
I.2-Prevalence of infection with respect to sex ............................................................................. 27
I.3-Prevalence with respect to age ................................................................................................ 28
I.4-Prevalence with respect to germ ............................................................................................. 28
I.5-Prevalence of germ with respect to sex ................................................................................... 29
I.6-Prevalence with respect to Antimicrobial susceptibility .......................................................... 30
II CROSS-SECTIONAL STUDY .............................................................................................................. 31
II.1. General Prevalence of mycoplasmas infection ...................................................................... 32
II.2. Prevalence with respect to sex............................................................................................... 32
II.3. Prevalence with respect to age .............................................................................................. 33
II.4. Prevalence with respect to matrimonial status ..................................................................... 34
II.5. Prevalence of infection with respect to germ ........................................................................ 35
II.6-Prevalence of germ with respect to sex .................................................................................. 37
II.7. Prevalence with respect to antimicrobial susceptibility ........................................................ 37
II.8.Type of Product used............................................................................................................... 40
II.9. Clinical Information ................................................................................................................ 40
II.10.Prevalence of Protected Sex.................................................................................................. 41
PART FOUR: CONCLUSION AND PERSPECTIVES .................................................................................... 42
PART FIVE: REFERENCES AND BIBLIOGRAPHY ....................................................................................... 43
PART SIX: ANNEXES ............................................................................................................................... 45

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LIST OF FIGURES

Figure 1 : Location of CPC/AG ............................................................................................................. ix

Figure 2 : Organigrame of CPC/AG ...................................................................................................... xii
Figure 3 : Structure of Humans Urinary system..................................................................................... 3
Figure 4: Structure Female reproducive system ..................................................................................... 4
Figure 5: Strucure of a mycoplasma cell ................................................................................................ 7
Figure 6 : Mycoplasma pneumonia ........................................................................................................ 8
Figure 7 : Mycoplasma genitalium......................................................................................................... 8
Figure 8: Ureaplasma parvum ................................................................................................................ 8
Figure 9: Morphology of Mycoplasma hominis..................................................................................... 9
Figure 10: Morphology of Ureaplasma urealyticum ........................................................................... 11
Figure 11: Synoptic diagram of work carried out ............................................................................... 18
Figure 12: Mycoplasma strips and broth .............................................................................................. 19
Figure 13: Pipette and micropipettes .................................................................................................... 20
Figure 14: Collection of female swab in endocervix ........................................................................... 23
Figure 15 : Strips before and after incubation ...................................................................................... 24
Figure 16: General prevalence of Mycoplasma infections ................................................................... 27
Figure 17: Prevalence of infection with respect to sex......................................................................... 27
Figure 18: Prevalence of infection with respect to age ........................................................................ 28
Figure 19: Prevalence with respect to germ ......................................................................................... 29
Figure 20: Prevalence of germ with respect to sex............................................................................... 29
Figure 21: Prevalence of antimicrobial susceptibility of U.urealyticum .............................................. 30
Figure 22: Antimicrobial susceptibilty of Mycoplasma hominis ......................................................... 31
Figure 23: General prevalence of Mycoplasma infection .................................................................... 32
Figure 24: Prevalence with respect to sex ............................................................................................ 33
Figure 25: Prevalence with respect to age ............................................................................................ 33
Figure 26: Prevalence with respect to marital status ............................................................................ 34
Figure 27: Prevalence of infection with regard to germ ....................................................................... 35
Figure 28: Prevalence of infection with respect to Ureaplasma urealyticum ....................................... 35
Figure 29: Prevalence of infection with respect to Mycoplasma hominis ........................................... 36
Figure 30: Prevalence of germ with respect to sex............................................................................... 37
Figure 31: Prevalence of antibiotics with respect to Mycoplasma hominis ......................................... 38
Figure 32: Prevalence of antibiotics with respect to Ureaplasma urealyticum .................................... 39
Figure 33 : Type of product used for intimate toilette.......................................................................... 40
Figure 34 : Clinical information ........................................................................................................... 40
Figure 35 : Prevalence of Protected sexual intercourse........................................................................ 41

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LIST OF TABLES

Table 1 : Address of CPC/AG ................................................................................................................ ix

Table 2 : Other types of Mycoplasmas ................................................................................................... 8
Table 3 : Antibiotics with corresponding concentrations of M.homis and U.urealyticum ................... 16
Table 4: Interpretation .......................................................................................................................... 24
Table 5 : General Characteristics of the total population ..................................................................... 26

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LIST OF ABBREVIATIONS

Uu/U: urealyticum: Ureaplasma urealyticum

Mh/M: hominis: Mycoplasma hominis
DOT: Doxycyclin
JOS : Josamucine
OFL : Ofloxacine
ERY : Erythromycin
TET : Tetracycline
CIP : Ciprofloxacin
AZI : Azithromycin
CLA : Clarythromycin
PRI : Pristinamycin
STI : Sexually Transmitted Infection
CPC/AG : Centre Pasteur du Cameroun Annexe de Garoua

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DEDICATION

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AKNOWLEDGEMENT

In terms of this work, we wish to express our gratitude to those who contributed to its
realization.

We are particularly grateful to:

 The director of the Centre Pasteur Garoua for helping me gain experience and research
thoroughly in his enterprise.

 The director of IUT Ngaoundere Pr. MOUHAMMADOU BOUBA ADJI for the
opportunity he has given me to be able to be formed in IUT Ngaoundere.
 All the staff of IUT Ngaoundere for the quality formation, professional and moral
training they have given me.
 My industrial supervisors Mr. TAPONDJOU RAPHAEL and Mrs AICHA
OUMAR for their understanding and sacrifice for us.
 Dr GHOMDIM NZALI H. for her supervision, we can’t forget your encouragements
and advices.
 The whole staff of the laboratory at the Centre Pasteur Garoua for their warm
welcome and their support during internship.
 My parent Mrs. BAYEMI PAULINE SANDRINE for her love, support and
understanding. Not forgetting my brother DIOP BAYEM TOUSSAINT.
 To my friends Loraine, Samanta, Magasting and Scherannelle for always being
there during hard times throughout my study.
 All the G.B.I.O family for their inspiration, encouragement and support throughout
this academic year.
 All the ABB family for their inspiration, encouragement and support throughout this
academic year.
 All those whose names do not figure out here but helped me in one way or the other to
the realisation of this work.

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PRESENTATION OF THE ENTERPRISE

I.Geographical location of the enterprise

Centre Pasteur du Cameroun Annexee of Garoua place where our internship was done is
found in the north region of Cameroon, Benoue division, subdivision of Garoua premier in the
quarter haut plateau, close to Islamic school
 A magazine
 A garage and parking space
 Homes for the executives of the institute.
 An incinerator;
 Green space
 An executive block ;
 A reception service
 Cash registrars
 A service for sampling spacemen to be analyzed ;
 Vaccination service ;
 Laboratories
 A maintenance and preparation service.
 A conference hall and a library ;
 A cold store( room) sterilization service
 Launderette service.

The access plan or Location to Centre Pasteur annexe of Garoua is shown in figure 1.

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Figure 1 : Location of CPC/AG

II.Complete address
Centre Pasteur annexe de Garoua respond to the following address shown in Table 1.

Table 1 : Address of CPC/AG

P.O. box 921 921 Garoua

Telephone 22 27 22 22 or 22 27 22 44
E-Mail garogaroua@pasteur/yaoundé.org

III.History
This institute was created in 1959 after a convention signed by the Pasteur Institute and the
Cameroon government, to be a research center for infectious diseases and a microbiology teaching
center. Five laboratories existed then: microbiology, hygiene, microorganisms and morphology,
microbial technique laboratories, and antirebies vaccines.

The Centre Pasteur du Cameroun is a public administrative Cameroonian establishment

endowed of a financial autonomy and having an attachment in Garoua since 1985.it is placed under
the supervision of the ministry of public health and finance.

The Centre Pasteur Annexe de Garoua, created by the presidential degree N°635 of 13 th
December 1986, is a reference laboratory of public health in the northern region of Cameroon it
exercises in the following medical milieu:

Medical analyses;

 Bacteriological analyses and physio-chemical of foodstuffs and water ;

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 Antirabic treatment and diagnostic of rabies;

 Public health activities;
 Keep a close watch on epidemiological disease ;
 Vaccination
 Research: Clinical trials on ant venomous serum and ant rabies serum in Africa.

Since October 1980, the CPC/AG continued to play its role as the reference laboratory of the
grand north

IV.Activity sector
The Centre Pasteur exercise in public health activities and research. Among the research
activities we have:

 Laboratory of mycobacteriology
 Laboratory of hematology
 Laboratory of bacteriology
 Laboratory of virology
 Laboratory of parasitology.

And the service activities are;

 LAM (Laboratories of Medical Analyses) ;

 Anatomy, cytology, pathology and vaccination services.

V.Number of personnel
The effective of personnels of the CPAG is 16 personels who are:

 The director (biology pharmacy) ;

 Vice director (biologist) ;
 A secretary ;
 Five laboratory techniciens ;
 A nurse;
 Four maintenance preparation and sterilisation agents;
 An accountant ;
 Two cashier ;
 Maintenance agent and mechanic.

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Socio-economic Situation

The Centre Pasteur Annexe de Garoua is a public administrative establishment with a fixed
budget and mixed personels detached civil servants put at the disposition of the center and are
governed by the work code. This institute gets its revenue from;

 Laboratory exams ;
 Sells of vaccine ;
 Subvention from the state ;
 Backer and ‘ l’Institut Pasteur de Paris.

Missions of CPAG

Placed under the supervision of the ministry of public health, it’s in charge of;

 The implementation of biological and clinical examens designed for prophylactic and
therapeutic diagnostic in men.
 The study and constant watch on the epidemiology of transmissible human and animal
Diseases in Cameroon.
 Cooperation techniques with different state members of the OMS to create and develop
simple laboratory services for clinical and public health services.
 From the control of drinks and food, in link with the concerned organizations. ;
 concernés ;
 The training of laboratory technicians.
 The publication of reseach work from the centre Pasteur (reference annual report CPC
1984/1985).

Amongst others, the CPC participate in the education and training of students. It accords
internship in its establishment.

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VI.Hierarchical organigram
The Centre Pasteur Annexe de Garoua is placed under the supervision of the ministry of
public health, and has an administrative council and a scientific committee. It has as head a
director in charge of a general administration and an assistant director head of laboratory. The

hierarchical organigram of the structure is represented in figure 2;

Figure 2 : Organigrame of CPC/AG

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RESUME

Mycoplasma hominis et Ureaplasma urealyticum sont des mycoplasmes pathogènes

de maladies sexuellement transmissibles qui sont associés à des infections génitales, à
l'infertilité, à des complications obstétricales et néonatales. Le but de notre étude était de
determiner la prévalence et la sensibilté aux antibiotiques de M.hominis et U.urealyticum chez
les patients présentants un examen de Mycoplasmes au CPC/AG. Nous avons fait durant notre
travail une étude rétrospective sur les années 2020,2021 et 2022 et une étude prospective
allant du 13 mars au 26 mai 2023. Dans l’étude rétrospective, le germe le plus infectant était
U.urealyticum avec des prevalences de 38,20%, 36,02%, et 48,40% pour les années 2020,
2021, et 2022 respectivement. Dans l’étude prospective l’infection générale des mycoplasmes
est de 70,31 %, U.urealyticum et M.hominis présentent des prévalences respectives de 29,69
% et 3,13% et une co-infection de 37,50%. La population la plus infectée est les femmes,
80,85%. Quelle que soit le type d’étude, il en ressort pour les deux germes que la sensibilité
est élevé à la Doxycycline hors la résistance est élevés à la Ciprofloxacine pour
U.Urealyticum et à l’Erythromycin pour M.hominis. La résistance aux antibiotiques justifie la
nécessité d'un dépistage de routine et d'un test de sensibilité aux antibiotiques de ces agents
pathogènes.

Mot clés ; Infection générale, Co-infection, M.hominis, U.urealyticum, prévalence,

résistances aux antibiotiques.

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ABSTRACT

Mycoplasma hominis and Ureaplasma urealyticum are sexually transmitted diseases

pathogens that are associated with genital infections, infertility, obstetric and neonatal
complications. The aim of our study was to determine the prevalence of sensitivity to
antibiotics of M.hominis and U.urealyticum in patients at CPC/AG presenting with
Mycoplasma Exam. We did during our work a retrospective study on the years 2020, 2021
and 2022 and a prospective study from 13th March to 26th May, 2023. In the retrospective
study, the most infective germ was U.urealyticum with prevalences of 38, 20%, 36.02%, and
48.40% for the years 2020, 2021, and 2022 respectively. In the prospective study, the general
infection of mycoplasmas is 70.31%, U.urealyticum and M.hominis have respective
prevalences of 29.69% and 3.13% and a co-infection of 37.50%. The most infected population
is women, 37.50%. Whatever the type of study, it emerges for the two germs that the
sensitivity is high to Doxycycline except the resistance is high to Ciprofloxacin for
U.Urealyticum and to Erythromycin for M.hominis. Antibiotic resistance justify the need for
routine screening and antibiotic susceptibility testing of these pathogens.

Keywords: General infection, Co-infection, M.hominis, U.urealyticum, prevalence, resistance

to antibiotics.

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INTRODUCTION

Genital mycoplasma are eubacteria lacking cell walls. Among them, mycoplasma
genitalium, M.hominis, U.urealyticum and ureaplasma parvum have emerged as common
causes of STI. These organisms commonly colonise urogenital tract and causes genital
infections such as urethritis, cervicitis, vaginitis, pelvic inflammatory diseases and bacterial
vaginosis. They also play a role in men and women sterility, abortions, gynecologic and
obstetric morbidity with associated complications in men, women and neonates (Sneha and
al., 2021).

Sexually transmitted infections involved the transmission of an organism between

sexual partners through different routes of sexual contact. The evidence of mycoplasma is a
sexually transmitted pathogen is virtually incontrovertible based on the concordance rates
among partners.The relevance of screening, accuracte laboratory detection and treatment of
genital mycoplasma infections is also highlighted by the increasing antibiotics (Ken, 2012).

The epidemiology of mycoplasmas infections in the world is range between 40-80%

and 21-53% asymptomatic and sexually active women habor U. urealyticum and M. hominis,
somewhat lower in men (Tomislav, 2019) and 4.5-40%, 1.3-51% for U.urealyticum and
M.hominis, in another study (Tatiana and al., 2018).

In Cameroon, particularly in Yaounde, a study shows a total prevalence of 65% of which

41% had Ureaplasma urealyticum, 4% had Mycoplasma hominis and 20% had a coinfection
(Anna, 2011).

Prevalence, epidemiology and antimicrobial resistance of genital mycoplasmas have been

studied minimally, leading to us to have as main objective:

 To evaluate the prevalence and loads of sexually transmissible urogenital

mycoplasmas infections and determine the resistance profile of antibiotics isolated
bacteria in men and women atteinding CPC/AG.

More specifically, to determine:

 The prevalence with respect to socio demographic parameters

 The prevalence with respect to germs
 The prevalence with respect to antibiotics

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PART ONE: LITERATURE REVIEW

GENERALITIES

I.The Genital system

The genital system of an organism also known as the reproductive system is the biological
system made up of all the anatomical organs involved in sexual reproduction. The
reproductive system is a collection of internal and external organs in both males and females
that work together for the purpose of procreating (www.wikipedia.org).

I.1-The Male Genital System

The male reproductive system contain the external genitals (the penis, testes and the scrotum)
and the internal parts including the prostate gland, vas deferens and urethra. A man’s fertiliy
and sexual traits depend on the normal functionning of the male reproductive system, as well
as hormones released from the brain (Andrology, 2018).

I.1.1-Anatomy and Physiology

 The Penis

The penis is the organ for urination and sexual intercourse. It contain erectile tissue,
deposits sperm in vagina of female, produces pleasurable sensation during sexual activity

 The Testis

Testes are oval-shaped glands responsible for the manufacture of sperm and the sex
hormone testosterone. From each testis, sperm pass into a coiled tube-the epididymis-for the
final stages of maturation.

 The Scrotum

The scrotum contains two testes where sperm are manufactued within tubes called
semiferous tubules, and the two epididymides where sperm are stored. It surrounds the testes
and controls their temperature (Larissa, 2019).

Figure 3 represent the stucture of a male reproductive system with its respectives parts

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Figure 3 : Structure of Humans Urinary system

(Andrology, 2018)

I.2- The female Genital system

The vulva and its structures form the external genitalia while the uterine tubes, the uterus and
the vagina form the internal genitalia (John, 2022).

 The Vulva

The vulva is the outer part of the female reproductive system that surrounds the
opening of the vagina including the labia majora, minora and clitoris.

 The Vagina
The vagina is an elastic, muscular canal with a soft, nerves, mucus membrane,
flexible lining that provides lubrication and sensation. It connects the uterus and cervix
to the outside body, allowing for menstruation, intercourse and childbirth.
 The Uterine Tubes
Also called the fallopian tubes or oviducts are attached to the upper part the
body of the uterus into the uterine cavity. The uterine tubes transport the ova from the
ovary to the uterus each month.
 The Uterus
The uterus is a hollow muscular organ located in the female pelvis between the
bladder and rectum. The rectus is responsible for the processes of implantation,
gestation, menstruation and labour (le-Ming, 2016)

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Figure 4 show a representation of the external and internal part of a female

reproductive system

Figure 4: Structure Female reproducive system

(Cleveland, 2022)

II.Sexually transmissible infections

Sexually transmitted infections are disease processes from close physical contact between
males and females by transmission through sexual contact. Sexually transmitted infections,
previously known as sexually transmitted diseases, involve the transmission of an organism
between sexual partners through different routes of sexual contact, either oral, anal, or
vaginal. Sexually transmitted infections affect all people and can be prevented with proper
education and barrier control. STIs are more frequently under recognized and have a higher
incidence in medically underserved population. At any given time, it is estimated that 80% of
sexually active people are infected, including 42% of adults 18 to 59 years.

More than 30 different bacteria, viruses and parasites are known to be transmitted through
sexual contact. Some STIs can also be transmitted from mother-to-child during pregnancy,
childbirth and breastfeeding. STIs are either viral or bacterial. A viral infection is caused by a
virus and cannot be cured. However, although a virus will remain in the body for life,
symptoms of the virus might not be present at all times. Whether an infection is viral or
bacterial, the infection can have long-term effects on the body, such as infertility or sterility,
and can leave the body vulnerable to more serious diseases (Michael, 2023).

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II.1- Viral Sexually Transmissible Infections

Viral infections are typically more serious infections with higher rates of negative
health outcomes. Common viral STIs include HIV, Herpes, HPV, and Hepatitis (Jaton and
al., 2005).

II.1.1-Genital Herpes (HSV)

Genital herpes is caused by the herpes simplex virus 1(HSV-1) or herpes simplex virus
2 (HSV-2).HSV-1/HSV-2 is a double-stranded DNA virus coated by a lipoglycoprotein with
an affinity to infect target cells.HSV-1 is usually associated with orolabial infections, but
according to CDC, HSV-1 is now leading in the cause of genital herpes in young and
homosexual patients.It is estimated that 50 million people in the US are infected with HSV
(www.who.int.com ).

II.1.2-Human Papillomavirus (HPV)

HPV is a double-stranded DNA virus that replicates in the basal cell layer of the stratified
squamous epithelial cells. This replication cycle induces hyperplasia and possible conversion
carcinoma.HPV types 16 and 18 are oncogenic strains that induce malignant
transformation.HPV types 6 and 11 are common strains that induce anogenital warts,
commonly known as condyloma acuminata.

II.1.3-Human Immunodeficiency Virus (HIV) and Acquired

Immunodeficiency Syndrome (AIDS)

Enveloped retrovirus encapsulated with two single-stranded RNA. Primary HIV signs
and symptoms are described as flu-like and often diagnosed as an acute viral syndrome. The
duration of onset of symptoms ranges from 4 to 10 weeks. AIDS is described as the late stage
of HIV disease. An estimated 0.7% of adult aged 15-49years world wide are living with HIV,
although the burden continues to vary considerably between countries and regions
(www.who.int.com )

II.1.4-Hepatitis B

Unvaccinated adults who have multiple sex partners, along with sex partners of people
with chronic hepatitis B infection, are at increased risk for transmission. Injection-drug use
and sexual contact are other common modes of hepatitis B transmission in the United States.
Among adults seeking treatment in STD clinics, as many as 10%–40% have evidence of past

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or current hepatitis B virus infection. Many of these infections could have been prevented
through universal vaccination during delivery of STD prevention or treatment services
(Christian and al., 2018).

II.2. Bacterial Sexually Transmissible Infections

II.2.1-Chlamydia

Chlamydia trachomatis is a bacterium of the genus Chlamydia belonging to the family

of Chlamydiaceae. It is an obligate intracellular bacterium, not Gram-stainable.This bacterium
is responsible for Chlamydial urethritis (or chlamydiosis), a diseasesexually transmitted
(Goulet and al, 2010). Three species are pathogenic forhumans including Chlamydia
trachomatis which causes trachoma and of sexually transmitted infections. The minimally
symptomatic nature of the infections urogenital disorders explains why this chronic disease is
often diagnosed only in presence of late complications (Jaton and al, 2005).

II.2.2-Gonorrhea

Gonorrhea is a sexually transmitted infection (STI) caused by the bacterium Neisseria

gonorrhea. It could lead to long-term health problems and infertility, but antibiotics can cure
it and reduce the chance of complications. Gonorrhea can affect people of any age or gender,
but it’s particularly common among teens and young adults between the ages of 15 and
24.The prevalence of symptoms depends on a person’s sex. Only 20% of females and roughly
10% to 15% of males will develop symptoms of a gonorrhea infection (Angelica, 2022).

II.2.3-Syphilis

Syphilis is a bacterial sexually transmitted infection (STI) caused by Treponema

pallidum which results in substantial morbidity and mortality, and it is curable. Syphilis is
transmitted through sexual contact with the infectious lesions, via blood transfusion or from a
pregnant woman to her fetus. A study showed that syphilis was having a prévalence of 16.9%.
(Livinus, 2019)

II.2.4-Mycoplasmas

Mycoplasma are the smallest self replicating organisms with the smallest genomes that
cause infections in the respiratory tract, urinary and genital tracts. Some of them primarily
live in the urogenital tract that is Mycoplasma genitalium, Mycoplasma hominis and
Ureaplasma spp and their infections depends on the sex life style humans do. The frequency

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of isolation in men and women varies according to the studies. However, it is significantly
higher for U.urealyticum than for M. hominis. Colonization varies with age, level
socioeconomic status, sexual activity, race, and use of oral contraceptives (Boudry, 1998).

III.Mycoplasma infections
Mycoplasma is a bacterium that causes infections in different areas of your body
including your respiratory, urinary and genital tracts. There are different types of mycoplasma
that target specific locations in your body including your respiratory, urinary and genital tracts
Mycoplasmas are unique because they don’t have cell walls. Most bacteria have cell walls,
and some antibiotics attack cell walls to destroy the bacteria and make you feel better. Since
mycoplasma don’t have cell walls, those antibiotics don’t work on them
(ClevelandClinic.org).

Mycoplasmas are spherical to filamentous cells with no cell walls. There is an

attachment organelle at the tip of filamentous M pneumoniae, M genitalium, and several other
pathogenic mycoplasmas. Fried-egg-shaped colonies are seen on agar. (Baron, 1996). Figure
5 represent the structure of a mycoplasma cell

Figure 5: Strucure of a mycoplasma cell

(www.news-medical.net)

There are several types of mycoplasma that most commonly cause infections in humans.
Table 2 represent the other types of Mycoplasmas

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Table 2 : Other types of Mycoplasmas

Mycoplasma pneumonia Mycoplasma genitalium Ureaplasma parvum

Location -Mucous surface of -Mucous epithelial cells -Respiratory and
respiratory tract (Basma of urinary ang genital urogenital tract.
et al,2023) tracts in humans Cervix or vagina and
urethra
Characteristics Absence of -Absence of -Hydrolyse urea and
pepetidoglycan cell wall peptidoglycan cell wall use it as a metabolic
(www.wikipedia.org ) - Unique flask shape substrate for
generation (Ken
2015)
Infection -Lungs infections -STIs -Bacterial vaginosis
-Upper Respiratory -Pelvic inflammotry -Pregnancy
infections (Basma et al, diseases including complications (Ken
2023) endometritis and 2015)
salpingitis
Epidermiology 1-5% 1-6% in women and 1- 38.3% (Christian,
4% in men 2018)
(Gnanadurai,2019)
Symptoms -Chest cold -Pain during sex and/or -Usually it shows no
-Cough discharge from vagina symptoms but they
-Fever or penis occur they includes
-Headache(Shmuel -Burning while inflammation of the
1996) urination urethra in both men
and women
(Shmuel, 1996)
Incubation 2 to 3 weeks (Basma et 2 to 35 days 2 to 10 days (cdc.gov)
period al, 2023)
Form

Figure 6 : Mycoplasma Figure 7 : Mycoplasma Figure 8: Ureaplasma

pneumonia genitalium parvum

(www.microbix.com) (Center for Diseases Control (www.pulse clinic.com)

and Prevention)

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II.1-Infections to Mycoplasma Hominis

III.1.1. Definition

Mycoplasma hominis is a common mollicute bacteria, present in almost all humans, it is

an opportunistic human mycoplasma species residing in the lower urogenital tract in the
urinary tract. However, it can sometimes cause infection which can be transmitted sexually. It
is different from other STIs, in that monogamous couples can suddenly experience
mycoplasma hominis even after years of exclusivity (www.confidantetest.com). It is a
common human urogenital Mycoplasma species affect mostly women as compared to men
(Carmen, 2007).

III.1.2. Responsible Agent

The responsible agent to this infection is the bacteria Mycoplasma hominis.

III.1.3. Taxonomy Classification

Binomial name: Mycoplasma hominis

III.1.4. Morphology

The structure of M. hominis is represented in figure 9

Figure 9: Morphology of Mycoplasma hominis

(info.medadom.com)

III.1.5. Pathophysiology of Mycoplasma Hominis

Several species of Mycoplasma (including Mycoplasma genitalium, Mycoplasma

hominis, and others), as well as Ureaplasma urealyticum and Ureaplasma parvum have been
isolated from the human male and female urogenital tracts (Uuskula and al, 2002). Although

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in some cases their pathogenic significance has been questioned, M. genitalium and
Ureaplasma in particular have been associated with urethritis in men, cervicitis or bacterial
vaginosis in women, and fetal chorioamnionitis and adverse pregnancy outcome. Elevated
antibody responses against them have been recorded in human serum, breast milk, and
cervicovaginal secretions (Iverson-Cabral and al, 2011).

Generation of inflammatory responses by mycoplasmas has been shown in several

systems. In pregnant rats, Mycoplasma pulmonis induces chorioamniotic infection with
neutrophil influx and elevation of TNF-α. M. genitalium activates NF-κB and induces
inflammatory cytokines in human epithelial cells by a mechanism involving the interaction of
protein. M. hominis has been shown to elicit IL-23 in human dendritic cells and to drive the
production of IL-17 in CD4+ T cells (Truchetet and al, 2011).

The morbidity associated with some mycoplasma infections and difficulty of treatment
with antibiotics have led to consideration of vaccine development as a desirable goal,
especially for mycoplasmas of veterinary concern. (Michael and al 2015)

III.2- Infection to Ureaplasma urealyticum

III.2.1. Definition

Ureaplasma urealyticum is a bacterium belonging to the genus Ureaplasma and the family
Mycoplasmataceae in the order Mycoplasmatales. This family consists of a group of tiny
bacteria that inhabit the urogenital (urinary and reproductive) tract. It is commonly found in
the urinary or genital tract. It does not usually cause problems but may contribute to certain
infections and other conditions that can lead to pain, a discharge, or difficulty to conceive.
Most people have Ureaplasma in their bodies and never know it. But, Ureaplasma has been
linked to diseases and conditions that affect the male and female reproductive systems. It can
also infect newborns if the mother passes the bacteria to the infant during pregnancy. At least
60% of women have been shown to harbor ureaplasma bacteria in their genital tract without
showing any symptoms of infection (Razin, 2022).

III.2.2. Responsible Agent

The responsible agent to Ureaplasma infection is the bacteria Ureaplasma ureatylicum

(Uu)

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III.2.3. Taxonomy Classification

Binomial name: Ureaplasma urealyticum

III.2.4. Morphology of U.urealyticum

The morpholohy of U.ureaplasma is represented in figure 10

Figure 10: Morphology of Ureaplasma urealyticum

(Science Photo Library)

III.2.5. Pathophysiology

Ureaplasma species are considered to be of low virulence, and 40-80% of healthy women
have Ureaplasma species (U. urealyticum and U. parvum) in their genital tract.

Controversial evidence exists supporting the association between genital colonization by

Ureaplasma species and complications of pregnancy such as preterm delivery.

Lactobacilli help maintain the vaginal acidity, preventing the invasion of bacteria.
However, the urease activity of Ureaplasma species such as U. urealyticum increases the pH
of the vagina via the hydrolysis of urea into carbon dioxide and ammonia. This increases the
susceptibility to mixed infection with other pathogenic bacteria.Ureaplasma and other
pathogenic bacteria induce the secretion of pro-inflammatory cytokines such as IL-1, TNF-α,
IL-6, and chemokines such as IL-8, leading to the recruitment of leukocytes and production of
prostaglandins. Uterine stimulation by prostaglandins result in preterm delivery.

Ureaplasmal lipoprotein also induce apoptosis, and it is possible that the apoptotic cells
sustain genital tract inflammation which promote preterm delivery.Studies have also shown a
higher rate of vaginal colonization by Ureaplasma species in women with preterm deliveries
compared to those with full-term deliveries (Michael G. and al., 2020).

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IV. Causes of Mycoplasma hominis and Ureaplasma urealyticum

 They are opportunistic bacteria which has the highest probability of being the cause of
genital infections.
 M. hominis and U. urealyticum are primarily transmitted by sexual contact. That
being said, ureaplasma is a prevalent condition in adults who are sexually active.
 M. hominis and U. urealyticum can also be spread from an infected mother to the baby
during delivery.
 These germs may cause infections of the newborn and extra genital infections,
especially in immunosuppressed subjects. Infections in utero are rare but possible.
 They may also be the culprit behind developing PID or pelvic inflammatory disease in
women Also, people with a weakened immune system have a high risk of getting the
infection. The population group who fall under this scenario includes people who have
had an organ transplant or people who have been infected by HIV (HIV positive).
 It has also been identified that women have a high risk of getting the infection along
with vaginal infections if they have had multiple sexual partners (Centers for Disease
Control and Prevention. Sexually transmitted disease survaillance 2010. 2011).

V. Signs and Symptoms of M.hominis and U. urealyticum

Their symptoms can be very similar to that of many other STIs including chlamydia and
gonorrhoea, so can sometimes be mistaken for these. Those with urogenital or extragenital
infections caused by M. hominis have symptoms similar to other sexually transmitted
infections and its presence cannot be determined by its symptoms. Since ureaplasma is a
potential cause for inflammation of the urethra, it might lead to urethritis in both men and
women. Here are some of the symptoms of urethritis (www.visiblebody.com).

Here are the symptoms experience in men

 Unusual discharge.
 Pain during urination.
 Irritation.
 Burning sensation.

The following symptoms are experience in women

 Watery vaginal discharge.

 Unpleasant odor from the vagina.
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 Vaginal itching.
 Green or gray color occasional discharge (Christopher, 2020).

VI. Epidermioloy of M.hominis and U.urealyticum

The colonization of M. hominis and U.urealyticum is associated with sexual activities of
those been infected. 5-10% of men and sexually active and 40-80% of sexually active women
have this infection (Thomas, 2020). In a study carried out in Yaounde, it was found that
5.40% was attain with M.hominis and 18.90% was attain with U.urealyticum (Ahouga, 2020).

VII. Method of diagnosis of M.hominis and U.urealyticum

There are several method of Diagnosis of M.hominis and U.urealyticum which are

Molecular method: This method has been made possible by powerful molecular-based
tecnhiques that can be used for primary detection in clinical specimens. The principle of this
method of diagnosis is based on a complete genome sequence available for one or more
strains of all important human pathogens in the Mycoplasma and Ureaplasma genera. This
method permits to determine a major family of surface proteins, the multiple-banded antigens,
is immunogenic during ureaplasmal infections. Variation in surface antigens may be related to
persistence of these organisms at invasive sites.

Culture: The appaearance of brown granular colonies on agar is sufficient for the
diagnosis of Ureaplasma species but culture alone cannot distinguish between various species.
M.hominis grow well in broth or agar supplemented with arginine. Colonies appear on agar
withi 2 to 3 days visible with a stereomicroscope. Culture also has additional advantages in
that it provides an isolate on which antimicrobial susceptibility testing can be performed.

PCR: It is more sensitive than culture diagnosis purposes, even fof organisms such as
M.hominis and Ureaplasma species which are relatively easily and quickly cultivated. PCR is
theoretically able to detect fewer organisms, therefore, PCR-positive, culture negative
specimens likely represent true positives.

Serological Analysis: Serological testing was the firt method for detection of
Mycoplasma infection. Complement fixation assays were used for many years until the
development of alternative serological methods sold such as enzyme immunpoassays,
immunofluorescence, and particle agglutination assays. Serological tests method to
M.hominis and U.urealyticum include microimmunofluorescence, metabolism inhibition and

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enzyme immunoassay, but ubiquity of ureaplasma and M.hominis in healthy people makes
interpretation of antibody titers against these organisms difficult (Ken, 2012).

Direct axam is not carried for these mycoplasma because they are not visible after Gram
staining because of the absence of cell wall (Sabine, 2003)

VIII. Treatment and Prophylaxis

 Treatment

Doxycycline is the treatment of choice for M. hominis and U. urealyticum. Duration and
dose vary by site of infection, and are usually in combination with other antibiotics. Examples
include doxycycline 100mgorally twice daily for 14 days (as part of a combination regimen
for pelvic inflammatory disease), and doxycycline 100mg orally twice dailyfor 7 days for
uncomplicated nongonococcal urethritis in men.

M. hominis is resistant to macrolide antibiotics. In some studies, up to 10% ofisolates were

resistant to tetracyclines, including doxycycline. If doxycycline cannot be used as first-line
therapy, alternatives include clindamycin or a fluoroquinolone. (Susan, 2019)

 Doxycycline - 100 mg twice daily for 2 weeks

 Azithromycin - a single 1-g dose, which can be repeated after 10 to 14 days
 Erythromycin - 500 mg 4 times daily
 Ofloxacin - 300 mg twice daily for 10 to 14 days
 Prophylaxis

Practicing safe sex will significantly reduce your risk of infection, that is by the use of
condoms during sex and avoiding having multiple sexual partners and other sexually
transmitted infections (STI's). Birth control doesn’t prevent STDs. You’ll need to use barrier
methods like condoms and dental dams to help prevent infection.

IX. Consequences of Infection

IX.1. Reproductive disorders

Ureaplasma urealyticum and to a lesser extent Mycoplasma hominis are implicated in

reproductive disorders such as chorioamnionitis, premature rupture of membranes and
postpartum infections. Urogenital mycoplasmas would also be associated with a higher risk of
spontaneous abortions.

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IX.2. Neonatal damage

Ureaplasmas can be responsible for prematurity and low birth weight. In addition,
colonization of the newborn by Ureaplasma urealyticum and Mcoplasma hominis can be
responsible for pneumonia, bacteraemia and meningitis but also for respiratory distress
syndrome and bronchopulmonary dysplasia. The presence of U. urealyticum in pregnant
women may equally increase the risk of mortality and morbidity in newborn babies passing
through insufficient period of gestation and the weight at birth.

IX.3. Extragenital infections

Mycoplasmas, especially Ureaplasma urealyticum and Mycoplasma hominis, should be

sought during infections in immunocompromised patients. They may in particular be
responsible for septic arthritis in hypogammaglobulinaemic subjects, sternal wounds with
mediastinitis after thoracic surgery, bacteremia, osteomyelitis, retroperitoneal abscesses and
superinfections of hematomas. Usually discovered by chance, the species in question is most
often, apart from arthritis, M. hominis which grows on blood agar. M.genitalium and
Ureaplasma spp. also cause reactive arthritis. Ureaplasma species may play a role in the
following pregnancy complications (Sabine et al., 2022):

 preterm labor
 intra-amniotic infection
 placental invasion
 low birth weight

X. Prevention and control of Mycoplasma hominis and Ureaplasma urealyticum

Infections
 Prevention

There's no vaccine to prevent mycoplasma infections, and the bacteria is highly

contagious. You can take steps to protect yourself and others from the bacteria by:

 Practicing safe sex by talking about any genital symptoms, limiting the number of
sex partners you have and using a condom.
 Practicing good hygiene and washing your hands often with soap and water.
 Taking doctor-prescribed antibiotics as instructed.
 Control

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 With treatment of antibiotics, your symptoms should start to fade after a couple of
days.
 If you experience symptoms like fever, painful urination or genital discharge, visit
your healthcare provider for treatment.
 Mycoplasma bacteria easily spread, so take steps to stop the spread by practicing
good hygiene and safe sex (www.my.clevelandclinic.org).

XI. Antimicrobial Susceptibility

Antimicrobial susceptibility tests are used to determine which specific antibiotics a
particular bacteria or fungus is sensitive to. Most often, this testing complements a Gram stain
and culture, the results of which are obtained much sooner. Antimicrobial susceptibility tests
can guide the physician in drug choice and dosage for difficult-to-treat infections. Reports
typically contain a quantitative result in mg/L and a qualitative interpretation. The
interpretation usually categorizes each result as sensitive (S), intermediate (I) and resistant
(R). Mycoplasma are normally susceptible to antibiotics that inhibits protein synthesis and
intrinsically resistant to cell acting agents due to the absence of the latter. M.hominis exhibit
natural resistance to macrolides but sensitive to 16 membered macrolide, josamycin (Sneha
and al., 2021).
The susceptibility test are determined with respect to the cupules found in the strip of
Mycoplasma. The susceptibility of of M. hominis, U. urealyticum and co-infections to nine
antimicrobials mentioned below equally reported using the Mycoplasma kit (Mycoplasma
IST 2). While many antibiotics are ineffective at destroying mycoplasma bacteria, the
macrolide class of antibiotics is effective at eliminating the bacteria from your body when
taken as directed. Table 3 shows the differents antibiotics with their respective concentration
for M.hominis and U.urealyticum (Tyler, 2022). Table 3 illustrate the differents abtibiotics of
M.hominis and U.urealyticum.
Table 3 : Antibiotics with corresponding concentrations of M.homis and U.urealyticum
(Mycoplasma IST 2 KIT)

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Antibiotics Abbreviations Concentration mg/l

Doxycycline DOT 4 8
Josamycin JOS 2 8
Ofloxamin OFL 1 4
Erythromycin ERY 1 4
Tetracycline TET 4 8
Ciprofloxacin CIP 1 2
Azithromycin AZI 0.12 4
Clarythromycin CLA 1 4
Pristinamycin PRI 2
The lack of a cell wall in mycoplasmas makes them intrinsically resistant to all
antimicrobials that target the cell wall. The resistance mechanism of M. hominis and U.
urealyticum is as follow:

The emergence of antimicrobial resistance (AMR) is a major concern worldwide and

already compromises treatment effectiveness and control of several bacterial sexually
transmitted infections (STIs). Widespread AMR in these bacteria is likely to persist and even
worsen in the future, owing to the high number of infections, widespread and uncontrolled use
of antimicrobials, limited surveillance of AMR and clinical failures, as well as the
extraordinary capacity of these bacteria to develop AMR. This development would not only
result in an increased prevalence of Ureaplasma and Mycoplasma ST infections but also in a
considerably increasing number of severe complications affecting reproductive health.
(Magnus, 2019).

New resistances mechanisms are emerging and spreading globally, threatening or

ability to treat common infectious diseases. Antibiotics resistance has the potential to affect
people at any stage of life, as well as the healthcare. This makes it one of the world’s most
urgent public health problem. Resistance to one’s antibiotic can mean serious problem like
antibiotic-resistance infection that require the use of second and third line treatment which can
harm the patient by causing serious side effects such as organ failure, prolong care and
recovery.

Due to their reduced genome sizes, mycoplasmas exhibit restricted metabolic and
physiological pathways for replication and survival. This explains why these bacteria display
strict dependence to their hosts for acquisition of amino acids, nucleotides, lipids, and sterols
as biosynthetic precursors (Sneha and al., 2021).

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PART THREE: MATERIAL AND METHOD

This work has been done using certain materials and methods. The following synoptic
plan was follow which permitted us to properly do our work and study which consisted of a
retrospective study (from January 2020 to December 2022) and a cross-sectional study (from
the 13th of March to the 26th of May).

Figure 11 below represent the synoptic diagram of the work carry out during our internship

RETROSPECTIVE STUDY CROSS-SECTIONAL STUDY

Pre-analytical
phase

Analytical
phase

Post analytical phase

Figure 11: Synoptic diagram of work carried out

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I. MATERIALS
I.1. Biological Material

The biological material used in this study at CPC/AG was the cervical and urethral
swabs samples collected from urogenitals of patients attending the structure. In female
patients, cervical swabs samples (discharge) were collected and in male patients, urethral
samples were collected too.

I.2. Physical material

At the laboratory we had used the following materials;

-Specimen collection swabs

-Sperculum
-Mycoplasma reactive kit; Mycoplasma IST 2 (Mycoplasma IST 2 strip)
-Mycoplasma reactif 1 (Broth, 25 * 3.1 vials)
-Mycoplasma reactif 2 (Lyophilization pellets, 25 * 1ml vials)
-Mycoplasma IST 2 (25 strips containing 22 tests)
- Paraffin oil

I.3. Equipements

The following materials and equipement were used

-Pipettes and Micropipettes between 20 to 200 µL
-Bacteriological incubator at 37°C
- Bunsen burner
-Vortex.
Figure 12 and 13 illustrates are some of the materials and reactives used during our
work.

Figure 12: Mycoplasma strips and broth

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Figure 13: Pipette and micropipettes

II.METHOD
Place and site of study: Our study were done at Centre Pasteur du Cameroun Annexe
Garoua (CPC/AG) on patients attending for Mycoplasma exams.

Type of study: We did a cross-sectional and retrospective

Period of study: For the cross-sectional study, which was carried out from the 13th April
to the 26th may 2023 while the retrospective study was carried out from January 2020 to
December 2022.

Population studied: Our studies were carry out on samples for all patients which were
attending the center for the exam of Mycoplasma

Inclusion criteria: Were included in our study all patients attending CPC/AG both men
and women with exam of Mycoplasma as prescription

Exclusive criteria: In our study we did take into consideration results of patients who did
not accept to participate in our study by answering our questionnaire.

Socio-demographic variables

 Sex
 Age
 Marital status

Other variables

 Types of germs

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II.1. RETROSPECTIVE STUDY

The collection of informations has been done by sorting information in registers for
the past three years. This sort were to collects socio demographic informations such as age,
sex and clinical informations.

II.2. CROSS-SECTIONAL STUDY

II.2.1. Pre-Analytical Phase

 Welcoming of patients

Patients are receives at the reception hall where a number are given to them according
the order of arrival and then called to the registering place in order of number attributed. A
secretary takes vare of noting on an examination coupon informations of the patients, which
was the name, the age, the date of birth, the axam to be carried out.Then the patient goes to
the cash desk for payment procedures, where she is given an invoice. The examination sheet
is taken to the waiting room of the sampleing room with the patient along. The technician
called the patient and direct her at the sampling room.

 Questioning and collection of informations

For the sampling collections, some conditions were to be respected by patients in order to
have good samples. The conditions to be respected were the following;

- For females

o Avoid doing intimate toilette

o Abstain of doing sexual intercourse atleast before the previous four days
o Be out menstrual period
o Not consume antibiotics and antifongicide for atleast four days

- For males

o Abstain from sexual intercourse atleast before the period of four days
o Not consume antibiotics and antifongicide for atleast four days

A personnal questionnaire was establish for patients for our study. And a personnal
interview conducted by us. The questionnaire was anonymous and linked to the patient by a
code number.

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II.2.2. Analytical Phase

Analysis of samples where done by Mycoplasma IST 2 kit which is a complete kit for
the diagnosis of urogenital mycoplasmas.

It allows culture, identification, indicative counting and determination of antibiotic

susceptibility of Ureaplasma urealyticum and Mycoplasma hominis. Mycoplasma STI2
combines a selective culture broth and a gallery comprising 22 tests. The broth is adapted to
the optimal growth of mycoplasmas (pH, substrates, association of severalgrowth factors).
The presence of specific substrates (urea for Ureaplasma spp. and arginine for M. hominis)
and an indicator (phenol red) allows in case of culture positive, to visualize a change in color
of the broth linked to an increase in pH.

Principle: Mycoplasma IST 2 combines a selective broth with a strip containing 22

tests. The broth provides optimum growth conditions for mycoplasma (pH, substrates,
association of several growth factors). The combination of three antibiotics and one antifungal
agent provides selectivity, ensuring that any contaminating flora present in the specimen does
not affect the test

The selectivity with respect to the contamination flora possibly present in the sampling
is provided by the combination of 3 antibiotics and an antifungal. Brothis distributed, after
sowing, in the gallery.
This gallery allows you to simultaneously obtain:

 Identification;
 Counting;
 Sensitivity to 9 antibiotics
 Collecting of samples

Cervical and urethral swabs were used to collecte samples from urogenital tracts. In
female patients, cervical samples were obtained by cervical swabs from the vagina area by
cleaning the exocervical mucus. In mals patients, urethral samples were slowly taken from
urthra inside about 2 cm after the external meatus had been cleaned; semen, prostatic fluid
and vaginal mucus collected were collected and placed in Mycoplasma R1 broth flask. All
samples were left in the sampling room at room temperature within 2 hours before
manipulation. Figure 14 show us the endocervix of sample collection in women.

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Figure 14: Collection of female swab in endocervix

 Culture
The procedure is done in accordance with the manufacturer's instructions of
Mycoplasma IST 2 KIT and includes 3 steps

Preparation of the strip

 Allow the strip to come to room temperature
 The strip was removed from its packaging and the dessicant found in it discard
 The corresponding lid was place on the strip and the code number of the
patient was labelled on the elongated flap of the strip
Preparation of the inoculum
 Vortex the R1 broth flask containting the sample and transfer the inoculum R1
solution into the vial of Mycoplasma R2.
 Shake on the vortex to ensure that the lyophilization pellet is completely
dissolved
Incubation
 Using a pipette and a micropitte, 55µl of the broth was introduced in each of
the 22 test cupules on the Mycoplasma IST 2 strip
 Then 2 drops of paraffin oil was added to each cupule and the lid replace on
the strip
 The strip and the remaining broth in the Mycoplasma R2 vial was then place
inside an incubator for 24 and 48 hours at 36°C +- 2°C.

II.2.3. Post Analytical phase

Interpretaion of the result obtained from the culture is done by the laboratory technician
and the validation of the result is done by the biologist. The final confirm result is directed at
the bench of withdrawing results.

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II.2.4. Interpretation of result

The interpretation of the results performed during the culture is with regard to colour
changes and is read after 48hours. This is shown in figure 15.

Figure 15 : Strips before and after incubation

The above representation is illustrated in table 4
Table 4: Interpretation
(Mycoplasma IST 2 kit results)
Ident Enumera- Susceptibility tes (mg/l)
ificat tion
ion

Cupules 0 Uu Mh Uu ≥ Mh ≥ DOT JOS OFL ERY TET CIP AZI CLA PRI
10^4 10^4 4 8 2 8 1 4 1 4 4 8 1 2 0.1 4 1 4 2
2

Positive Orange to red Red Orange to red Orange

reading to red

Negative Yellow Yellow to Orange Yellow Yellow

reading

Positivity Presence of Uu≥ Mh≥10^4 The strain is: -Sensitive

Interpreta- Uu Uu M 10^4 CFU/sp - -Sensitive (S) +
tion or h CFU/sp + -Intermediate (I) Resistant

Mh + +Resistant (R)

Where 0 indicatie the control test.

II.2.5. Statistical analysis

The data obtained were processed by Microsoft Excel 2010 software, and this software
was used to draw our different graphs and tables. The different prevalences were obtaines
using the formula;

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Where
P= n/N x 100
P: Prevalence

N: Total patients

n: Positive patients

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PART THREE: RESULTS AND DISCUSSION

Characteristics of the population

Our study was focused on 604 samples four our retrospective sudy for the past three years
(2020, 2021, 2022) and 64 samples for our prospective study in CPC/AG FOR Mycoplasma
exam. These patients were divided into age group, sex for retrospective study and marital
status in addition for cross-sectional study. Table 5 summarises the general characteristics of
the population studied.
Table 5 : General Characteristics of the total population
Parameters Effectives
2020 2021 2022 Prospective
Age 15-25 18 46 82 15
26-35 61 101 126 31
36-45 38 45 58 11
46-55 7 13 15 4
>55 4 6 2 3
Gender Male 13 21 25 17
Female 115 190 258 47
Marital Married - - - 39
status Singled - - - 25

I. RETROSPECTIVE STUDY

For our retrospectives studies we had the following results

I.1-General prevalence of Mycoplasma with respect to years

Figure 15 show the generel prevalence of Mycoplasma infection for the past three
years in CPC/AG and the values that permitted us to draw this is represented at the annexe
page

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80,00
69,58
70,00 60,85
59,38
60,00
Prevalence 50,00 40,63 39,15
40,00
30,42
30,00
20,00
10,00
-
2020 2021 2022
Years

Prevalence of positive Prevalence of negative

Figure 16: General prevalence of Mycoplasma infections

The figure shows that positives cases of Mycoplasma are significantly increasing from
years. This increase may be due to the knowledge of people on this infection. This germs are
normally presents in urogenital tract, and an alteration of the flora, divers sexual partner may
influence to attract this infection.

I.2-Prevalence of infection with respect to sex

Figure 16 below show the prevalence of Mycoplasma infection with respect to sex for
the past three years in CPC/AG and the values that permitted us to elaborate this is at the
annex page 43

120,00
98,68 94,53 95,92
100,00
Prevalence

80,00
52,63 53,91
60,00
37,23
40,00 10,94
15,79 8,67
20,00 1,32 5,47 4,08
-
Male Female Male Female Male Female
2020 2021 2022
Years

Prevalence of positive Prevalence of negative

Figure 17: Prevalence of infection with respect to sex

For the past three years it is observe that the gender the most infected by mycoplasma
infection are females varying from years. On the other side the prevalence of male is been

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seen to increase too, years by years. This is explain by the fact that, people are more aware of
this infection and are often testing themselves to do know their health status on these germs

I.3-Prevalence with respect to age

Figure 17 shows the prevalence of Mycoplasma infection with respect to age for the
past three years in CPC/AG and the values that permitted us to draw this is represented at the
annexe page.

60,00
51,32 50,39
50,00 43,15
40,00
Prevalence

28,95 29,95
30,00 22,84
22,05
19,69
20,00 15,79

10,00 7,09
2,63 1,32 4,06
0,79 -
-
26-35
15-25

36-45

46-55

15-25

26-35

36-45

46-55

15-25

26-35

36-45

46-55
<55

<55

<55
2020 2021 2022
Years

Figure 18: Prevalence of infection with respect to age

The age range most attend are those between 26-35 and 15-25 in all the years. We
explain this by a large population of young peoples sexually active from years to years.

I.4-Prevalence with respect to germ

Figure 18 show the prevalence of Mycoplasma infection with respect to the germ for the
past three years in CPC/AG and the values that permitted us to draw this is represented at the
annexe page

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Prevalence
60,00
48,41
50,00
38,28 36,02
Perentage

40,00
30,00
17,97 18,01 18,02
20,00
10,00 1,56 3,32 3,89
0 0
-
U.urealyticum

U.urealyticum

U.urealyticum
M.hominis

M.hominis

M.hominis
Co-infection

Co-infection

Co-infection
2020 2021 2022
Years

Figure 19: Prevalence with respect to germ

Here we see that, the infection of M. hominis and the co-infection is graduallly
increasing within the past three years meanwhile U. urealyticum is the highest infecting germ.
U. urealyticum is more a commensal urogenital bacteria compare to M. hominis improper
respect to utilization of sexually transmitted prevention method and use of chemicals at the
genital site affect the quantity of this germ susceptible to cause an infection.

I.5-Prevalence of germ with respect to sex

Prevalence
120
100
100 85,71
70,21
Percentage

80 65,33 62,50
58,33 26,06
60
33,33 35,83
40 12,50 25,00
14,29
20
0 2,04 0 -6,67 3,72
0
Mh

Mh

Mh
Co-ifection

Uu
Uu

Uu
Co-infection

Co-infection

2021 2022
Years

Male Famele

Figure 20: Prevalence of germ with respect to sex

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Figure 19 shows that the germ most affecting gender is U.urelyticum contrarily to
M.hominis for the past three years.

I.6-Prevalence with respect to Antimicrobial susceptibility

I.4.1-Antimicrobial susceptibility with respect to U.urealyticum

Figure 18 shows the prevalence of antimicrobial susceptibily with respect to U.

urealyticum for the past three years in CPC/AG and the values that permitted us to elaborate
this table is at the annex page

120,00

100,00

80,00
Prevalence

60,00

40,00

20,00

-
Resistant

Resistant

Resistant
Intermedite

Intermedite

Intermedite
Sensitive

Sensitive

Sensitive

2020 2021 2022

Years

Doxycline Pristinamycin Josamycin Ofloxacin Ciprofloxacin

Azithromycin Erythromycin Tetracycline Clarythromycin

Figure 21: Prevalence of antimicrobial susceptibility of U.urealyticum

From our table we observed that Pristinamycin and Doxycycline were the antibiotics
the more sensitive for U.urealyticum. As well, the antibiotics noted to be more resistant for
those past three years is ciprofloxacin firstly, followed by tetracycline in 2020 and 2021 and
azithromycin in 2022. The antibiotics which was intermediate was ofloxacin for the three
years.

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I.4.2-Prevalence of antimicrobial susceptibility with respect to M.hominis

Figure 21 shows the prevalence of antimicrobial susceptibily with respect to M. hominis

for the past three years in CPC/AG and the values that permitted us to elaborate this table is at
the annex page

120,00

100,00

80,00
Prevelence

60,00

40,00

20,00

-
Resistant

Resistant

Resistant
Intermedite

Intermedite

Intermedite
Sensitive

Sensitive

Sensitive
2020 2021 2022
Years

Doxycline Pristinamycin Josamycin Ofloxacin Ciprofloxacin

Azithromycin Erythromycin Tetracycline Clarythromycin

Figure 22: Antimicrobial susceptibilty of Mycoplasma hominis

From our table we observed that Doxycycline was the antibiotic which was more
susceptible for M. hominis. As well, the antibiotics noted to be more resistant for those past
three years was Tetraccycline 2020, Erythomycin and clarythhromycin in 2021 and
Erythomycin in 2022. The antibiotics which was intermediate was ofloxacin for the three
years.

II CROSS-SECTIONAL STUDY
The study had been evaluated on 64 patients coming to CPC/AG for our cross-sectional
study, which permitted us to have the following results.

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II.1. General Prevalence of mycoplasmas infection

The general prevalence of Mycoplasma infections on patients tested is represented in

figure 22. The values that permitted us to draw this graph is represented at the annexe table.

Infection

29.69 % Prevalence of
Infected
70.31% Prevalence of non
infected

Figure 23: General prevalence of Mycoplasma infection

The above chart shows us that, out of our 64 patients tested, 70.31% of them were
positive to one of the germs or the two germs, meanwhile 29.69% were not infected by any of
the germs. This result is compare to that carried out in Garoua (Fadima, 2022) who showed a
positive infection of 67.33% literaly similar to our own result. This result is not equally too
far from that carried out in Yaounde showing a general prevalence of 65% (Anna, 2011). This
can be due to the fact that, sexual behaviours of individuals, less or no sexual protections and
socio-cultural factors such as polygamy and which seemed to propagation of the infection.

In the different responds to our questionnaire, we noticed that the highest majority of
patients, both men and women, including single and married ones who were sexually active
were not using means of protection for their sexual reports, while these pathogens are highly
transmitted.

II.2. Prevalence with respect to sex

Figure 23 represent the prevalence of the infection with respect to sex and the values
that permitted us to draw our graph is represented at the annexe page.

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100,00
84,44
80,00

Prevalence 60,00 52,63

47,37
40,00
15,56
20,00
-
Male Female
Sex

Prevalence of positive Prevalence of negative

Figure 24: Prevalence with respect to sex

The above figure show us that more female were attained by the infection than male,
giving a percentage of 84.44% females and 15.56% males tested positive. This result has been
compare to that carry out in Yaounde (Ahouga and al., 2022) who had a prevalence of 89.2%
for females on 10.8% for males. The infections had been found to be present in women with
multiple lifetime partners than those with one having least number of sexual partner. Also, the
genital system of women is larger and more vulnerable to infections than the male genital
system.

II.3. Prevalence with respect to age

The prevalence of the infection with respect to age is represented in the graph on figure
24 and the values that permitted us to draw this graph is represented at the annexe table.
60,00
53,33
50,00

40,00 36,84
Prevalence

30,00 24,44
21,05 22,22 21,05
20,00 15,79

10,00 5,26
- -
-
15-25 26-35 36-45 46-55 >55
Years

Prevalence of positive Prevalence of negative

Figure 25: Prevalence with respect to age

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The age range most affected by the infection are those included between 26-35.The
older ones have been seen to be least affected by this infection. This agrees with the global
reports which rates the aged group 15 to 35 years as the affected rates (78.39%). This age
range most affected can be explain by an important sexual activity in comparism to the other
age ranges. In a study, sexual mycoplasma infections were reported being high among
patients in the age group from 15-19 years and it was attributed to the higher sexual activity
among adolescents (Sneha et al, 2021). Most young people do not use condoms and
frequently changes sexual partners.

II.4. Prevalence with respect to matrimonial status

The prevalence with regard to the marrital status of Mycoplasma infections on patient is
shown on figure 25. The values that permitted us to draw this graph is represented at the
annexe table.

Titre du graphique
70,00
60,00 57,89
60,00
50,00 42,11
Prevalence

40,00
40,00
30,00
20,00
10,00
-
Singled Married
Marital Status

Prevalence of positive Prevalence of negative

Figure 26: Prevalence with respect to marital status

The highest percentage of patients attaint by the infection were seemed to be single ones
with a percentage of 60% rather than married one having a percentage of 40%. The study
carried by (Ahouga et al, 2020) has a lighter result of 71.62% on infected singled patients and
24.32% infected for married patients. We had notice from our questionnaire that single
persons have sexual intercourse least controled compare to married persons. The high
percentage of single patient can be justified by high number of sexual partners in this group
and unprotected sexual intercourse.

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II.5. Prevalence of infection with respect to germ

The prevalence with regard to germs of Mycoplasma infections is of two types as follows;

Prevalence of positive

29,6875
37,5

3,125

U.ureaplasma M.hominis Co-infetion

These two germs are commensal bacterias of the urogenital tract. Onlike for our
retrospective study, the most infected germ is U. Urealyticum which arises from the flora
alteration.
Figure 27: Prevalence of infection with regard to germ

II.5.1. Prevalence of infection with respect to Ureaplasma urealyticum

Figure 27 represent the general prevalence for the infection of U. urealyticum and the values
that permitted us to draw our graph is represented at the annexe page.

Ureaplasma urealyticum

29,69%

71,88%

Prevalence of positives Prevalence of negatives

Figure 28: Prevalence of infection with respect to Ureaplasma urealyticum

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The above figure show us that 29.69% of the patients tested were positives to
Ureaplasma urealyticum against 71.88% of patients not having the germs. This study was
compare to that done by (Ramazan and al, 2022) who had a rate of positivity of 34.98%
tendering not far from our prevalence and another study who was carried in Indian (Bhatt and
al, 2019) reported a prevalence of 38.6% for U.urealyticum in women with genital tract
infections. The percentage of U.urealyticum have been found to be high in women than men
because of the alteration of the vaginal flora. U. urealyticum is part of the commensal flora
but it turns out that colonization is more important for causing and infection. The imbalance
in the vaginal flora can lead to the appearance of U.urealyticum in large quantity.In men, it
was shown that men with infertility have higher frequencies of U.urealyticum detection in the
semen than fertile men (Samir, 2018). The prevalence rate was comparatively low in our
study population when compared to other studies may be due to the fact of smaller sample
size of the study.

II.2.2. Prevalence of infection with respect to Mycoplasma hominis

The general prevalence for the infection of M. hominis is shown in figure 28 and the
values that permitted us to draw our graph is represented at the annexe page.

Mycoplasma hominis
3,13

95,31

Prevalence of positives Prevalence of negatives

Figure 29: Prevalence of infection with respect to Mycoplasma hominis

The figure above shows us a prevalence of 3.32% of patients attain by M.hominis. This
prevalence we had was compare to a study carried out in Yaounde (John and al., 2011) who
had a little lesser result obtained of 4% for the prevalence of M.hominis in a group of 65

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patients tested and another study carried out by (Elias and al.,) who had a general prevalence
of 3% for this germ.This arrival may be due to pelvic inflammatory disease in women which
lay place to this germ to install and cause the infection.

By comparing our results with those of (Fernandez and al., 2007), we find a strong
contradiction. Indeed he result underlined that M.hominis has a very high prevalence compare
to U. urealyticum. These germs still have unresolved doubts for science since they are
commensal germs of the genital tract, the presence of a possible pathogenic power still remain
an unsolved puzzle.

II.6-Prevalence of germ with respect to sex

The repartition of infection with respect to germ is represented in figure 29

Prevalence
45,00 40,43
40,00 36,17
35,00
Percentage

30,00
23,53
25,00
20,00
15,00 11,76
10,00 5,88 4,26
5,00
-
Uu Mh Co-infected
Infection

Male Female

Figure 30: Prevalence of germ with respect to sex

II.7. Prevalence with respect to antimicrobial susceptibility

II.7.1. Prevalence of antibiotics with respect to Ureaplasma urealyticum

The prevalence of antibiotics with U. urealyticum is shown in figure 30 and the values
that permitted us to elaborate this graph is at the annex page.

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90,00 85,19 85,19 85,19 85,19 81,48

80,00 74,07 70,37 74,07
70,00
Prevalence 60,00 51,85
50,00
37,04
40,00
30,00 25,93
20,00 14,8118,52
11,11
11,11
7,41 14,81 7,41 18,52 11,11
7,41 7,41 7,41
10,00 - - - 7,41
-

Antibiotics

Sensitive Intermediate Resistant

Figure 31: Prevalence of antibiotics with respect to Mycoplasma hominis

U.urealyticum is more sensitive to Pristinamycin, Doxycyclin and Josammycin with
percentages of 87.18%, 84.38% and 78.13% respectivily. It shows a higher resistance to
Ciprofloxacin and Tetracycline with percentages of 90.63% and 53.13% respectively,
meanwhile we noted a higher percentage of intermediate on Ofloxacin with a percentage of
46.88%. The profile of resistance we had is confirmed by another study who took place in
China by (Qing-Yong et al., 2013). Doxycycline can be consider as drug of choice for
treating genital mycoplasmain our setting. The mechanism resistance is probably the
occurrence of a target alteration located in the DNA gyrase and topoisomerase intravenous
subunits reported (Sneha and al., 2021) in his study. The high resistance of U. urealyticum to
Ciprofloxacin can be explain by the fact of high antimicrobial usage of this antibiotic.

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II.6.2. Prevalence of antibiotics with respect to Mycoplasma hominis

The prevalence of antibiotics with respect M.hominis is shown in figure 31 and the
values that permitted us to draw our graph is represented at the annexe page.
100,00
87,50 90,63
90,00 84,38
78,13
80,00
Prevalence (%)

70,00
60,00 46,88 53,13 53,13
46,88 46,8843,75
50,00 43,75 40,63
40,00 34,38 37,50
30,00 18,75
9,38 12,50 15,63
20,00 12,50 9,38 9,38
6,25 … 3,13 6,25
10,00 - -
-

Antibiotics

Sensitive Intermediate Resistant

Figure 32: Prevalence of antibiotics with respect to Ureaplasma urealyticum

The diagram above show us that Mycoplasma hominis is more sensitive to
Pristinamycin, Josamycin and Doxycycline with percentages of 85.19%, 70.37% and 74.07%
respecctively. On the other side it show us that there is a higher resistance for Ciprofloxacin,
Azithromycin and Erythromycin with an equal percentage of 85.19%. Meanwhile a higher
percentage were noted on Ofloxacin showing it to be intermediate at 37.04%. The
susceptibility of M. hominis to doxycycline, pristinamycin and josamycin were same almost
for the study of (Mehmet and al, 2010) in Turkey. Mycoplasmas are normally susceptible to
antibiotics that inhibit protein synthesis like macrolide that is the case for josamycin, but are
resitant to antibiotics that act on bacterial cell wall such as like fluoroquinolones that is the
case for ciprofloxacin.

RECOMMANDATIONS
 The laboratory should develop a better method of safe guarding data of patients for
easy exploitation of results
 The population of Garoua and its environment especially the youths should be well
sensitized about their sexual lives.

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II.8.Type of Product used

Figure 33 represent the type of products patients often used for their intimate toilette

90,00 83,33
77,78
80,00 72,73
70,00
60,00
Prevalence

50,00
40,00
27,27
30,00 22,22
20,00 16,67
10,00
-
Simple water Toilette soap household soap
Type of soap

Prevalence of positives Prevalence of negatives

Figure 33 : Type of product used for intimate toilette

People using household soap are found to be more infected contrarily to those using simple
water or toilette soap. This may be due to the fact that household soap have a high pH which
is not adequate to the pH of the genital which most be acidic.
II.9. Clinical Information

Figure 34 represent why people often carry out Mycoplasma exam

90,00
80,00 76,47
70,00
70,00
Prevalence (%)

60,00
50,00 50,00
50,00
40,00
30,00
30,00 23,53
20,00
10,00
-
Pre-marital test Controle test Sterility test
Clinical information
Positives Negatives

Figure 34 : Clinical information

People to be tested have been seen to do the exam mostly for sterility which shows that
urogenital mycoplasma infection is a serious diseases which causes problem like sterility.

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II.10.Prevalence of Protected Sex

Figure 35 represent the prevalence of people usually using sexually protective method

70,00 64,29
61,11
60,00
50,00
Prevalence

38,89
40,00 35,71
30,00
20,00
10,00
0,00
Prevalence of positive Prevalence of negative
Tested

Protected sex Unprotected sex

Figure 35 : Prevalence of Protected sexual intercourse

It is seen that those who usually uses sexually protective method during sexual intercourse are
least infected contrarily to those who are not using them. This is justify by the fact that
urogenital mycoplasma are transmissible infections. This result was same for a study carried
out by (Fadima,2022).

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PART FOUR: CONCLUSION AND PERSPECTIVES

At the end of our work, which was for us to determine the prevalence of the infecion of
mycoplasma infections (Mycoplasma hominis and Ureaplasma urealyticum) and to dermine
the antimicrobial susceptibilty of each antibiotic isolated for patients atending CPC/AG and
tested positives, a cross-sectional and retrospectie study lead us to know:

In our retrospective study, out of 604 patients the prevalence of M.hominis were 1.56%,
3.32%, and 3.89%, for U.urealyticum were 38.20%, 36.02%, and 48.41%, for co-infection
were 17.97%, 18.01 and 18.02% for the respective last three years. The infection had been
seen to affect mostly female with prevalence of 98.68, 94.53% and 95.92%. The highest age
group most affected was range between 26-35(51.32%, 50.39%, and 43.15%). Also the
antimicrobial susceptibility was more sensitive to Doxycycline and resistant to
Ciprofloxamin.

In our cross-sectional study, out of 64 patients studied for both men for and women,
general prevalence of infection to one or the two germs was 70.31%. U. urealyticum infection
was present in 29.69% and M. hominis infection was present in 3.13% of the patients. Out of
this co-infection was noted in 37.50% patients. The ages of the patients ranged fom 15-25 and
greater than 55years. Most of the patients in which urogenital mycoplasmas isolated belonged
to the reproductive age group 26-35years with a prevalence of 53.33%. Majority of patients
60.00% were single. 80.85% of tested patients had been found to be females. U.urealyticum
showed high sensitivity rates for Pristinamycin (87.18%) and Doxycycline (84.38%)
meanwhile it resistance was lighter for Ciprofloxacin (90.63). Doxycycline (85.19%) and
Pristinamycin (70.07%) showed a good efficacy against M.hominis meanwhile Erythromycine
and clarithromycin were resistant to M.hominis.

PERSPETIVE

The following should be done to ameliorate on this present study

 The prevalence of the infection should be carried out in the whole north region in
order to determine the prevalence of this infection at the regional level.

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PART FIVE: REFERENCES AND BIBLIOGRAPHY

 Ahouga R. Voufo (2020). ScienceDirect Study on the gender prevalence and

sensitivity of urogenital mycoplasmas to antibiotics in Yaoundé Cameroon. Vol 8.
20pages.
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 PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF MYCOPLASMA INFECTIONS IN
PATIENTS ATTENDING CPC/AG

PART SIX: ANNEXES

▪ QUESTIONNAIRE
NAME OF THE PATIENT (NOM DE LA PATIENTE)/ BAR CODE (CODE BAR)
…………………………………………………………………………………………………
AGE OF THE PATIENT/ AGE DE LA PATIENTE
…………………………………………………………………………………………………
OBJECT OF THE EXAM/ OBJET DE L’EXAMEN
…………………………………………………………………………………………………
MARITAL STATUS/ STATUT MATRIMONIALE
…………………………………………………………………………………………………
DATE OF LAST PERIOD/ DATE DERNIER REGLE
…………………………………………………………………………………………………
ARE YOU USUALLY HAVING WHITE DISCHARGE? / AVEZ-VOUS DES PERTES
BLANCHES?
…………………………………………………………………………………………………
IF YES, UNDER WHICH QUANTITY, ASPECT AND SCENTED? / SI OUI? SOUS QUEL
ASPECT, QUANTITE ET SI ODORANTE ?
…………………………………………………………………………………………………
ARE YOU USING ANY SOAP OR PRODUCT DURING YOUR PERSONAL HYGIENE?
/ UTILISEZ VOUS UN SAVON OU PRODUIT POUR VOTRE TOILETTE INTIME?
…………………………………………………………………………………………………
IF YES, WHICH TYPE OF SOAP OR PRODUCT? / SI OUI QUEL TYPE DE SAVON OU
PRODUIT?
…………………………………………………………………………………………………
ARE YOU USUALLY HAVING PROTECTED OR UNPROTECTED SEXUAL
INTERCOURSE? / AVEZ-VOUS DES RAPPORTS SEXUEL PROTEGER OU NON
PROTEGER
…………………………………………………………………………………………………

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 PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF MYCOPLASMA INFECTIONS IN
PATIENTS ATTENDING CPC/AG

Table 1A : General prevalence of mycoplasma infection

N° Tested N° Positive N° Negative % Positives % Negatives

Infection 64 45 19 70.31 29.69
Co-infection 64 24 40 37.50 62.50
UU 64 19 46 29.69 71.88
MH 64 3 61 4.69 95.31

Table 2A: Prevalence with respect to age

Age range N° Tested Positive Prevalence (%)

15-25 15 11 24.44
26-35 31 24 53.33
36-45 11 10 22.22
46-55 4 0 0
>55 3 0 0
Total 64 45 45

Table 3A: Prevalence with respect to sex

Sex Male Female Prevalence (%)

N° Tested 17 47 41.18
N° Positive 7 38 80.85

Table 4A: Prevalence with respect to marital status

Married Singled Total

N° Tested 38 26 64
N° Positives 27 18 45
Table 5A: Prevalence of antibiotics with respect to U.urealyticum

Antibiotics Ureaplasma urealyticum

S I R
DOT 27/32(64.29%) 2/32(4.76%) 3/32(9.38%)
PRI 28/32(87.50%) 0/32(0%) 4/32(12.50%)
JOS 25/32(78.13%) 4/32(12.50%) 3/32(9.38%)
OFL 14/32(43.75%) 15/32(46.88%) 3/32(9.38%)
CIP 0/32(0%) 3/32(9.38%) 29/32(90.63%)
AZI 6/32(18.75%) 11/32(34.38%) 15/32(46.88%)
ERY 12/32(37.50%) 5/32(15.63%) 15/32(46.88%)
TET 14/32(43.75%) 1/32(3.13%) 17/32(53.13%)
CLA 13/32(40.63%) 2/32(6.25%) 17/32(53.13%)

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 PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY OF MYCOPLASMA INFECTIONS IN
PATIENTS ATTENDING CPC/AG

Table 6A: Prevalence with respect to M. hominis

Antibiotics Mycoplasma hominis

S I R
DOT 20/27(74.07%) 0/27(0%) 7/27(25.93%)
PRI 23/27(85.19%) 0/27(0%) 4/27(14.81%)
JOS 19/27(70.37%) 5/27(18.52%) 3/27(11.11%)
PFL 3/27(11.11%) 10/27(37.04%) 14/27(51.85%)
CIP 2/27(7.41%) 2/27(7.41%) 23/27(85.19%)
AZI 0/27(0%) 4/27(14.81%) 23/27(85.19%)
ERY 2/27(7.41%) 2/27(7.41%) 23/27(85.19%)
TET 5/27(18.52%) 2/27(7.41%) 20/27(74.07%)
CLA 3/27(11.11%) 2/27(7.41%) 22/27(81.48%)

Figure 1A: Mycoplasma IST 2 KIT notice

Figure 2A: strips before and after 48hours for positive tests

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